Communication Assessment for People who engage in

Behaviours Of Concern (BOC)

Module 1 : Introduction Overview

Hilary Johnson, Nick Hagiliassis, Barbara Solarsh,

Teresa Iacono, Jo Watson, Teena Caithness

Office of the Senior Practitioner, Disability Services, VictoriaOffice of the Senior Practitioner, Disability Services, Victoria

Introduction Overview

• Defines behaviours of concern

• Sets out legal boundaries of when you can limit a person’s Human Rights www.dhs.vic.gov.au/ds/ospwww.legislation.vic.gov.au

Disability Act 2006

• Protects the rights of peoplewith a disability who:

–show behaviours of concern

–are subject to restrictive interventions and compulsory treatment

Victorian Charter of Human Rights and Responsibilities 2006• Is a law with an agreed set

of human rights, freedomsand responsibilities

• Includes laws, policies andservices provided by State, local government and otherbodies

Roles of the OSP

Protects Develops

ProvidesEvaluates &

Monitors

OSP Evaluates & Monitors

• Restrictive Interventions (RI’s)

– Seclusion

– Mechanical restraint

– Chemical restraint

– Social Restraint

• Behaviour Support Plans (BSPs)

• Restrictive Interventions Data System (RIDS)

Overriding Philosophy of the OSP

Human Rights and citizenship

Quality of life and wellbeing

Community Inclusion

Positive lifestyle and behaviour support

Dignity of risk

Building relationships and collaboration with key partners to enable change to occur

Other activities of the OSP• Provide training – sessions

Human Rights, Risk Assessment, Chemical Restraint, Trauma, Attachment & Psychotherapeutic Interventions, Role of an Authorised Program Officer (APO)

• Support on-line training through Disability Professionals Victoria

• Positive Solutions in Practice articleshttp://www.dhs.vic.gov.au/disability/about_the_division/office_of_the_senior_practitioner/positive-solutions-in-practice

• Grants

• Research

Resources quoted by OSP

• The Office of the Senior Practitioner, Disability Services, Department of Human Services provides useful online resources, practice guides, practice advice and templates for practitioners, clinicians and direct support workers.

• http://www.dhs.vic.gov.au/disability/about_the_division/office_of_the_senior_practitioner

• Much of the Positive Behaviour Support training (2 day + 1 day follow-up) and the e-learning module is based on three resources:McVilly (2002); DDSG (2005); Bloomberg, West Johnson & Iacono (2009)

Positive Behaviour Support e-learning (1)

• e-learning course Positive Behaviour Support (1 hour) designed by the OSP for professionals

• Costs $ 55 AUD

• Go to DPV eLearning Centre http://www.learningseat.com/servlet/ShopFrontPage?companyId=dpv

• Click on “Community Services”

• Click on “Positive Behaviour Support for Disability Professionals”

Positive Behaviour Support e-learning (2)

• The purpose of Positive Behaviour Support module is to provide Disability Professionals with some of the important skills and knowledge needed to design a behaviour support plan that works both to increase quality of life and reduce restrictive interventions.

The module includes information about restrictive interventions that must be reported in Victoria to the Senior Practitioner, and the important components of good planning.

Positive Behaviour Support e-learning (3)

This e-learning training includes:

• An understanding of the possible reasons for the behaviours of concern

• How to target interventions to reduce behaviours of concern and increase quality of life.

• Ideas on how to make sure the interventions are implemented in the same way by all staff.

• Ways to check that the interventions are making a difference and how to review and make changes to behaviour support plans as needed.

Challenging Behaviour - known as Behaviours of Concern (BOC)

Culturally abnormal behaviours of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit the use of, or result in the person being denied access to ordinary community facilities

Emerson (2001)

Behaviours of Concern (BOC)

Any behaviour that:

• is a barrier to the person participating in, and contributing to their community

• undermines, directly or indirectly, a person’s rights, dignity or quality of life

• poses a risk to the health and safety of a person and those with whom they live and work

McVilly (2002)

BOC: people with Developmental Disabilities 1991

Aggressive behaviour

• hitting

• biting

• kicking

• head-butting

• spitting

• slapping

• pulling hair

Self Injurious Behaviour (SIB)

• self-biting

• pinching

• scratching

• slapping

• hitting

• hair pulling

Motivational Assessment Scale (MAS) Durand & Crimmins (1992)

Sensory Stimulation• seeking entertainment

• seeking relief from boredom

Social Contact

• seeking social interaction in general

• seeking social interaction with specific people

Access to Tangible Items

• having things that they want

• having things that they need

• getting things they can’t get independently

Avoidance of Demands

• escaping things they don’t understand

• escaping when can’t cope

Behaviours of Concern forms McVilly (2002)

Internalised Behaviours

• being withdrawn or inattentive

• performing repetitive or unusual behaviours

• enacting self-injurious behaviours

Externalised Behaviours

• being disruptive

• being destructive to property

• being hurtful to others

Asocial behaviour• being unco-operative

• enacting behaviours that others find offensive

Building the Foundations for Effective Commn for Victorians with BOC Subject to Restrictive Practices

1. Identify the foundations of effective communication assessment through the development of a resource kit to support assessment and intervention in relation to communication and behaviours of concern,

2. Increase the capacity of speech pathologists to provide practice support to direct disability staff and others involved in the support of people subject to restrictive interventions.

3. Undertake an evaluation of the tool kit in a natural practice setting i.e., a residential support service

Assessment to inform intervention for behaviours of concern in people with acquired

and developmental disabilities

Hilary Johnson – Manager, Communication Resource Centre, Scope

Teresa Iacono - Professor of Rural Allied Health, Latrobe University, Bendigo.

Barbara Solarsh - Project Co-ordinator, Communication Resource Centre, Scope

Nick Hagiliassis – Psychologist - Acting head of research, Scope

Teena Caithness - Project worker, Communication Resource Centre, Scope

Joanne Watson– Researcher – Scope

Office of the Senior Practitioner

Contact Details

(03) 9096 8427

seniorpractitioner@dhs.vic.gov.au

www.dhs.vic.gov.au/ds/osp