Many NDIS participants receive funding in several support categories in their NDIS plans. One such category is the Capacity Building Category. Behaviour Support services are provided in the Capacity Building – Improved Relationships category. Within these categories there are several subcategories:

Capacity Building – Improved Relationships:

> Specialist Behaviour Supports

> Behaviour Management Plan

A participant may receive funding in one or both subcategories.

The Specialist Behaviour Support category is used to gather information and develop an appropriate evidenced based behaviour support plan for the participant.

The Behaviour Management Plan is used to support implementation and monitor the plans effectiveness with all stakeholders involved.

Behaviour Support Services are very different to ongoing allied health therapy services. Funding in this area is not intended for participants to engage in ongoing therapy on a weekly fortnightly or monthly basis - Behaviour Support is a more intensive and specialised support aimed at the completion of a thorough behavioural assessment.

An initial consultation is completed with your clinician to complete all the required paperwork (consents, service agreements, risk assessments, treatment plan) prior to proceeding with the referral.

Our clinician will then meet with the client, family, carers and any other service providers to gather specific information about the behaviours of concern. Additional information will also be gathered regarding aspects of a person’s life – medical history, communication, adaptive behaviour, likes and dislikes, other professionals involved, schooling, etc.

Assessment questionnaires and data collection may also be completed. This is what behaviour support practitioners call a functional analysis. This information gathered will inform a Behaviour Assessment Report which will identify the function of behaviours and outline the relevant recommendations for future intervention.

As a result, a Behaviour Support Plan will be developed which incorporates these recommendations for the family, carers and or implementing providers. The Behaviour Support practitioner will continue to support the family / carers and implementing providers to monitor and review the effectiveness of the plan.

This will be provided in writing and the behaviour support clinician will support family members, carers and other providers to implement and monitor its effectiveness. Therefore, behaviour support services will look very different to therapy services.

Depending on which category your NDIS funding is in will depend on which is the best Healthstyles practitioner to see you. Our psychologists have 4-year university degrees at a minimum and an additional 2-year internship with specialised supervision before becoming fully registered psychologists. Our social workers have four-year degrees and have a range of different areas of specialisation including mental health, disability, drug and alcohol. We have a diverse team and aim with our intake process to match clients with the most suitable clinician based upon the client needs and the practitioner experience. Although they are not psychologists, these specialty skills allow them to focus on their area of expertise; which is behaviour support and positive behaviour support practices. All behaviour support practitioners receive ongoing and regular Supervision by a Senior Specialist Behaviour Support/Principal Psychologist practitioner with over 25 years’ experience providing Behaviour Support services.

Some of our psychologists, are also working towards being registered Behaviour Support Practitioners with the NDIS Q&S Commission.

This means as well as providing specific psychology services billed in the Capacity Building – Improved Daily Living category they may be able to also provide Behaviour Support Services in the Capacity Building – Improved Relationships category.

This is however rare and can be difficult for families to understand their dual role and hence requires the approval of the Principal Psychologist. This allows our psychologists to focus on their area of expertise, which is providing psychological assessment and interventions services, not necessarily behaviour support services.

It is a requirement that all Behaviour Support practitioners and behaviour support service providers be registered and approved by the NDIS Quality and Safeguard Commission. This is to protect the rights of people with a disability and ensure that all behaviour support and service provision is developed and conducted in line with evidenced based best practices.

A restrictive practice means any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability. Under the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 certain restrictive practices are subject to regulation. A restrictive practice is a regulated restrictive practice if it is or involves seclusion, chemical restraint (routine medication, PRN medication), mechanical restraint (harnesses, buckle covers), physical restraint and environmental restraint (locked cupboards/doors/gates).

There are additional reporting requirements, set out by the NDIS Quality and Safeguards Commission for any behaviour support plans that have or require restrictive practices for NDIS participants. Consequently, your behaviour supports funding should be reflective of the additional administrative requirements of the behaviour support practitioner to ensure these needs are met.

Behaviour Support is aimed at helping the support system (carers, services, staff) to identify the function of specific behaviours and to provide a consistent approach to behaviour change in a written Behaviour Support Plan. On the other hand, Therapy is typically provided through regular one on one session with a therapist. Usually, in therapy you don’t receive a behaviour support plan.

All our Behaviour Support Practitioners are supervised and overseen by our Senior Specialist Behaviour Support Practitioners (Robyne Lennon) who has over 25 years’ experience providing Specialist Behaviour Intervention.

A Behaviour Support Plan is a written document developed by our behaviour specialists in consultation with the person, their family and support network. It is essentially a “how to” support guide that provides guidance of how to support a person when they are displaying behaviours of concern and provides clear strategies in skill development to reduce the persons use of problem behaviour in the future.

Our practitioners are a part of a team of behaviour specialists working collaboratively with other professionals including (but not limited to) school teachers, paediatricians, case managers and other allied health professionals.

Our Behaviour Support Plans are based on years of research, feedback and consultation with carers, support workers and families. We have taken ‘what works’ and ensured all the elements of best practice in behaviour support. Combined with our person-centred approach, we achieve results.

• Behaviour Assessment

All behaviour has a ‘function’ or a reason. Our specialists will assess the reasons and develop the intervention needed to address the function.

• Behaviour Support Plans

Our specialists write step-by-step, easy to follow plans that guide families and professionals in how to implement positive behaviour support.

Positive Behaviour Support (PBS) is not just about managing the problem behaviour, it’s about learning to communicate, developing skills needed to be independent and/or to learn self-control or manage emotions. Positive Behaviour Support aims to reduce Behaviours of Concern by helping the person develop skills they need, so they no longer rely on using problem behaviours into the future.

All our Behaviour Support Practitioners have a tertiary qualification and are registered practitioners with the NDIS Quality and Safeguards Commission. We offer flexible services and can provide behaviour support at your home, across preschools, schools or other community settings, or at group homes and residential facilities.

Our Behavioural therapists work alongside speech and language pathologists, occupational therapists, and schoolteachers to deliver evidence-based behaviour therapy.

The field of non linear applied behavioural analysis is widely recognised internationally. Once we get to know the child and his or her strengths and skills, we will design an individualized therapy program. Our team have skills in using a combination of teaching strategies and Non-Linear Applied Behaviour Analysis (IABA) and Cognitive Behaviour Therapy (CBT).

Non-Linear Applied Behaviour Analysis (IABA) is the application of learning principles, to improve social behaviours. Our therapy interventions are designed to increase positive behaviours, teach new skills and generalise behaviour to new environments including:

• social skills, communication, reading and academics

• adaptive living skills, (including gross and fine motor skills, eating and food preparation, toileting, dressing, personal self-care, domestic skills, time and punctuality, money and value, home and community skills, work skills, etc.)

Cognitive behaviour therapy (CBT) is an effective treatment approach for a range of mental and emotional health issues. It is a combination of two therapies: "Cognitive therapy" and "Behaviour Therapy". Combining these strategies are likely to bring about positive and immediate changes in the person’s quality of life. CBT is used to treat a range of behaviour problems including:

• anxiety, low self-esteem

• uncontrollable anger

• emotional or behavioural problems in children or teenagers

• social skills and relationship problems

• motivation problems and reduced resilience and coping

Our practitioners are trained in adapting Cognitive behaviour Therapy to meet the needs of the participant, based upon their age, cognitive functioning etc.

40 years of research has demonstrated the effectiveness of both IABA and CBT with:

• children and adults with mental illness, developmental disabilities and learning disorders

• a range of different carers (parents, teachers and staff)

• settings (schools, homes, institutions, group homes, and hospitals), and

• behaviours (language; social, academic, leisure and functional life skills; aggression, self-injury, oppositional and stereotyped behaviours)

These methods are proven effective in at least these ways:

• increasing positive behaviours (e.g., reinforcement increases appropriate social behaviour)

• teaching new skills (e.g., systematic instruction and reinforcement procedures teach functional life skills, communication skills, or social skills)

• keeping learnt behaviours going (e.g., maintaining and generalising social skills, teaching self-control and self-monitoring).

• transferring a learnt behaviour from one situation or response to another

• to limit the occurrence of inappropriate behaviours (e.g., modifying the learning environment); and reducing inappropriate behaviours (e.g., self-injury or stereotypy and echolalia).

Measuring outcomes in therapy and behaviour support and therapy is important. What matters the most when setting a goal for therapy is defining the problem well enough, so improvements are measurable. For example, ‘aggression’ defined in a measurable way becomes “hits, kicks, bites, pinches or pulls hair”.

Improvement can be seen by measurement of the behaviour problem first, before any treatment occurs, and then again after treatment has occurred. A pre- and post- comparison will develop a reliable understanding of what has worked in the therapy and or behaviour therapy. Your therapist or behaviour support practitioner will help you to develop a list of goals you wish to achieve from behaviour therapy and can provide evidence of ongoing need and progress in therapy and behaviour therapy to the National Disability Insurance Scheme (NDIS) at the time of your plan review.

If you have any questions regarding any of the above, please do not hesitate to contact Robyne or anyone at the Healthstyles Service for ongoing assistance.