Behaviour
Challenging & complex behaviours: the ABC approach
Despite its
simplicity, the ABC model for understanding challenging behaviour
and developing suitable responses.
It can be very stressful dealing with behaviour issues, but the
ABC model is a handy way to understand what is happening, and
respond instead of just reacting. It involves looking at the:
- Antecedents (what happened before the
behaviour?)
- Behaviour (what is the actual behaviour?)
- Consequences (what happens afterward?)
This is an effective technique for taking the emotions away from
challenging behaviours, analyzing these behaviours, then creating
effective responses. When creating a behaviour support plan, it
will be important to work out which strategies you will use. These
strategies are not to be used occasionally, but will need to be
applied consistently by everyone who encounters the targeted
behaviours. While they may be difficult at first, your chosen
techniques will eventually become second nature.
Antecedents
What occurs before the behaviour (and may
have triggered it)?
The antecedents are simply all the relevant things that happened
before the behaviour occurred. They can also be considered as
triggers for the behaviour, such as:
- things that other people did or said
- emotional state (e.g. depressed, tired, anxious etc.)
- the environment (e.g. hot, noisy, cramped, smell, bright
lights).
Managing these antecedents, or triggers, is a proactive way to
avoid behaviours occurring in the first place. Here are some useful
strategies:
- Build and maintain good rapport
- Avoid or minimize known triggers
- Sometimes a distraction or redirection away from the trigger
may be all that is necessary
- Involve the brain-injured person in discussing triggers
- Work together on possible coping strategies in dealing with
triggers
- Suggest and encourage these strategies when a trigger
occurs.
Graduated exposure to the
antecedent
This is useful when antecedents can't or shouldn't be avoided.
With time and patience, it can be a powerful technique. For
example, Kirsten starts screaming in supermarkets due to sensory
overstimulation. Her mother says they will just stand outside the
supermarket for 30 seconds then go home. The next time, they go in
for 30 seconds then go home. This is gradually lengthened until
Kirsten has adapted to this difficult environment.
Preparing for the antecedent
An inability to cope with chaos, unpredictability and lack of
routine is common after a brain injury. For example, if Chris finds
the activity and noise of a supermarket unpleasant, it can help to
talk about expected reactions and ways to cope before the
event.
Behaviour
What happens during the
behaviour (what does it look like?)
Before you respond to an actual behaviour, the key is to
understand the purpose of the behaviour and what it may be
expressing about unmet needs. Although emotions can be running
high, there are still strategies that can prove useful during the
behaviour itself:
- Stay calm and speak in an even tone
- Give simple directions and prompts about coping mechanisms
- Use non-threatening hand gestures
- Manage your personal safety and remember the strategies agreed
on for dangerous incidents
- Recognize when it's time for disengagement/exit strategies for
crisis situations.
- Ignoring the behaviour
In some cases, behaviour occurs to get attention, so the best
strategy may be to ignore it. As with many of these techniques,
tactical ignoring is best linked with positive reinforcement. For
example, a child is ignored during a tantrum, but is rewarded with
praise, a treat or favourite activity once the tantrum is over.
Consequences
What are the immediate & delayed reactions from
everyone involved? The consequences, or our responses to a
challenging behaviour, are very important. For example, a pleasant
consequence can simply reward the behaviour, while a negative
consequence may discourage it.
Pleasant consequence: "When I yell everyone
gives me what I want".
Negative consequence: "When I yell
everyone ignores me completely").
When we use the ABC technique to analyze behaviour, we tend to
stop reacting emotionally in ways that often make the situation
worse. A consistent response from everyone to
challenging behaviour can have a very strong effect over
time.