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Positive behaviour support for children and young people

Affinity Trust delivers a Positive Behaviour Support service for children and young people with learning disabilities, and mental health needs and autistic children and young people in Bradford, Wakefield, Gloucestershire, Greater Manchester, and Lancashire.

We offer intensive PBS support with each practitioner allocated to 1 or 2 young people for a period of time between between 6 and 24 months.

The PBS service aims to support young people aged 25 and under with highly complex needs to avoid admission into specialist residential placements and hospital settings and improve their quality of life. We also enable parents, carers and other professionals to implement the PBS strategies effectively.

This model can be adapted in size, structure, length of time worked with a child and intensity to meet the commissioning authorities’ local requirements.

Model of support

The staff team is managed by a service lead (clinician). Service Leads are qualified to at least a Diploma level 5 in PBS and have higher level qualifications in subjects relevant to the provision PBS as well as extensive experience in supporting Autistic people and people with learning disabilities and complex, challenging behaviours via a PBS model.

The Service Lead line manages a team of PBS practitioners who have significant experience of working directly with disabled children and young people with challenging behaviour and working with families.

The young people we work with are all under 25 years old, have a learning disability or Autism and present behaviour that is of significant frequency, intensity and duration to place them at high risk of going into residential care or hospital settings.

Key elements of the model include:

  • Evidence-based, assessment-led support with a person-centred ethos.
  • We fully involve the child or young person, their family and the professionals working with them in developing PBS strategies through understanding what has worked/not worked previously, potential triggers/functions, and the broad social and physical context in which behaviours occur.
  • Full functional analysis is undertaken by our Service Lead to inform person-centred strategies, supported by active data-sharing.
  • A highly detailed, person-centred PBS plan is developed that focuses on getting to know the young person, what they enjoy and are good at, and how their diagnoses affect them. This is written in the first-person which promotes better uptake of information.

Achieving goals

During planning, we agree person-centred outcomes focusing on improving quality of life and inclusion and developing the skills of young person, parents and professionals.

  • Use of proactive and preventative strategies, alongside a focus on reducing the use of restraint (chemical, physical, environmental)
  • Regard to the importance of proportionate, safe and effective reactive strategies to ensure the safety of the young person.
  • Strong multi-disciplinary practice. Co-production and sign-off of PBS plans and quarterly PBS reviews. Involvement in all reviews, planning meetings, EHCP reviews and other multi-disciplinary meetings relating to the young person.
  • Allocation of a named PBS Practitioner per child for up to 2 years, who works across all settings (school, family home, short break services etc.), to ensure PBS is embedded consistently. The PBS Practitioner works at the times most required by the child and family and this may include early mornings, evenings, and weekends.

On completion of the intensive delivery period and with the full agreement of parents and all involved professionals we will withdraw after implementing a planned transition. Alternatively, the young person can move into monitoring and maintenance. This includes monthly meetings with the Service lead or PBS Practitioner, 6 monthly PBS reviews and intensive responses to crisis situations or escalations in behaviours.

Aims and outcomes

The aims and outcomes of the service are to:

  • Improve the life experiences and wellbeing of each child or young person and their family by reducing rates of entry to residential care.
  • Reduce the frequency, intensity and duration of behaviours that challenge displayed by the child or young person.
  • Support the child’s or young person’s development of independence and life, social and communication skills.
  • Support regular attendance at school or college and an ongoing place in the education system.
  • Develop parents’ skills and confidence in looking after their child.

Outcomes

We have had great success with 90% of referrals being able to remain at home and school. Benefits for the families we have worked with included:

  • Significant increases in self-regulating capacity for the young person.
  • Significant increases in quality of life for the young person - reduced behaviours, less social isolation, less stress for parents and improved relationships.
  • Greater participation in classroom, social and community activities.
  • Significant increases in skills and confidence for each young person and for parents.
  • Strong testimonials from parents that evidence the changes the service has effected

Broader PBS advice, support and training

As part of the contract with the commissioning authority, we can provide PBS levels 1 and 2 training for parents and professionals. To date we have provided training for approximately 350 professionals and 100 parents.