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Behavioral Supports
POLICY STATEMENT
A full and active life supported by caring relationships should minimize the occurrence of problem behaviors1 in people with intellectual and/or developmental disabilities2. When problem behaviors occur, people with intellectual and/or developmental disabilities should have access to positive behavioral supports that focus on improved quality of life as well as reductions in the behaviors.
ISSUE
Our constituents often lack the positive supports and caring relationships necessary to develop full and active lives. As a result, many haven't yet learned appropriate responses to many life situations.
Further, many of these constituents have been frequently subjected to aversive3 procedures and deprivations4 that may cause physical and/or psychological harm and inhibit appropriate alternative skills and behaviors. These are dehumanizing, result in a loss of dignity, and inhibit full participation in and acceptance by society.
As more of our constituents move into or remain in the community, many have not been able to access positive behavioral supports in natural settings including the family home. Training and support for families and care givers are woefully lacking and need to be significantly increased.
POSITION
A full and active life supported by caring relationships should minimize the occurrence of problem behaviors in people with intellectual and/or developmental disabilities. When problem behaviors occur, our constituency should have access to positive behavioral supports that focus on improved quality of life as well as reductions in the behaviors.
Behavioral supports should be individually designed and positive, emphasize learning, offer choice and social integration, be culturally appropriate, and allow for modifying or replacing the environment.
Aversive procedures are not consistent with positive, proactive approaches or best practices and must be “avoided.”
Preliminary Considerations before applying a positive behavioral intervention:
- Perspectives from the individual, his or her family, their social/cultural background, and the circumstances in which the behavior occurred.
- Contributing factors such as physical or medical conditions, social and environmental influences.
- The completeness and accuracy of information from other agencies.
- The nature, extent, and frequency of the perceived problem behavior and what the person is trying to communicate through this behavior.
Considerations for acceptability of a positive behavioral invention:
- Potential secondary effects and risks associated with the intervention.
- Legal, social, and ethical implications.
- Ease and practicality of implementation.
- Consistency with values of the individual’s culture.
Consideration for designing positive behavioral supports:
- Designed in a person-centered process involving the individual. Determined within the broader context of providing quality medical, psychological, educational, and habilitative services.
- Approached systematically, based upon a formal functional analysis5, a thorough assessment of each individual’s unique abilities and contributions, an understanding of how previous interventions worked, the least restrictive strategy and described in a written plan.
- Grounded in evidence-based procedures adequately documented in the clinical and educational research literature that will (a) prevent problem behaviors, (b) teach new skills that may replace problem behaviors, (c) involve consequence strategies for preventing the on-going reward of problem behavior, (d) create individually appropriate positive consequence for pro-social behavior, (e) ensure safety (when appropriate), and (f) monitor systemically both the extent to which the support is administered and the extent to which the support is effective.
Considerations for implementing positive behavioral supports:
- Applied with informed consent6 in a humane and caring manner respecting individual dignity.
- Implemented in positive, socially supportive, and culturally appropriate environments, including the home.
- Carried out by individuals (staff, family members and others) who have been trained and are qualified to effectively apply positive, non-aversive approaches. Positive interventions for behavioral change should include adaptations to the environment and reinforcers that our constituents and their families identify as "extraordinarily" positive. Interventions must not withhold essential food and drink, cause physical and/or psychological pain, use drugs as restraints, or produce humiliation or discomfort.
- Monitored continuously and systematically to ensure that support is implemented as proposed, and that the support is consistent with individual needs, positive in its methods, successful in achieving established goals, and changed in a timely fashion if success is not evident or occurring at an appropriate rate.
Adopted: Board of Directors, The Arc of the United States
August 4, 2008
Board of Directors, AAIDD
August 18, 2008
Congress of Delegates, The Arc of the United States
November 8, 2008