Evaluation of the delivery of a Positive Behaviour Support Service to regional and remote children on the autism spectrum and their local support team via video-conferencing technology

Positive Behaviour support includes the following sequential process across the treatment program 1) functional assessment of behaviour (behaviour assessment interview and observation sessions conducted in-vivo, live via video link, or via presentation of video recording), 2) behaviour support planning (development of behaviour support plans), 3) implementation, and 4) monitoring. These are outlined in detail below in accordance with a Proficient or Above Behaviour Support Practitioner under the NDIS Quality and Safeguards Commission Positive Behaviour Support Capability Framework 2019. Functional Assessment • Establish a developmental history • Analyse any current or previous interventions including reactive strategies • Consider physical or mental health problems, including the effect of medications and sleep • Analyse other considerations such as a history of trauma, sensory processing, social and interpersonal history • Analyse the relationship between the person and their environment • Identify enablers and barriers to quality of life, including understanding the protective value of friendships and family, and their contribution to safety • Identify barriers to intervention • Lead an interdisciplinary assessment of complex behaviour • Construct a model of understanding that explains the functions of behaviours • Refer on when the requirements fall outside of the scope of behaviour support Behaviour Support Planning • Include strategies that remove conditions likely to promote behaviours of concern including: o Environmental modifications o Active engagement through structured and meaningful daily activities • Include strategies for replacement behaviours • Include preventative strategies such as relaxation, distraction and diversion • Include reactive strategies when behaviours are not preventable • Minimise or eliminate the use of restrictive practices • Develop a behaviour support plan according to the literacy and communication needs of the target audience • Develop a behaviour support plan that is compatible with the ability and resources of the implementers • Develop a behaviour support plan that is supported by data that measures how accurately it is implemented • Clearly articulate responsibilities and timeframes Implementation • Provide education and training to an interdisciplinary team • Address barriers to implementation • Identify the resilience, capacity and sustainability of implementers and make appropriate adjustments to a behaviour support plan to take these into consideration • Provide implementers with information on ethical reactive strategies • Provide implementers with information on risks and consequences of non-compliance with implementation • Train implementers in escalation mechanism and emergency response plans • Identify appropriate methods of feedback for those implementing a behaviour support plan • Facilitate team building to enable successful implementation of a behaviour support plan • Adjust a behaviour support plan as required • Identify incident debriefing supports available to implementers • Provide training on facilitating critical incident debriefing to appropriate members of the implementing team if required Monitoring • Support staff to collect ongoing data to evaluate the effectiveness of a behaviour support plan • Provide information on how consistently staff are implementing a behaviour support plan that may be affecting evaluative data • Support the person and other key people to contribute to a behaviour support plan’s evaluation and review meetings • Use the person’s outcomes as performance indicators • Ensure mechanisms are in place to collect and report on incident report data The intervention is delivered in collaboration with the family and local support team. Structured interviews are conducted to gather information to inform the behaviour support plan. All team members are actively involved in the for face to face and via video for online). Family and local support team are trained in the delivery of the behaviour support strategies through modelling (online and face to face), and question and answer. The support program will be administered in 2 hour weekly sessions for the first four weeks and then in 1 hour fortnightly sessions for the following 24 weeks. The intervention will be administered by NDIS registered behaviour support practitioners (BSP). The BSP’s are a registered speech pathologist, occupational therapist, psychologist, or social worker and have additional training and experience in administering behaviour support program. Implementation data will be collected at regular intervals by the Behaviour Support Practitioner via the Implementation checklist. The Implementation checklist is part of the Behaviour Support Intervention Program and outlines strategies that are to be implemented by participant families and local support team members as informed by the Behaviour Support protocol. Behaviour Support Practitioners record the progress on the Implementation checklist in their case notes. Adherence to/attendance in treatment sessions will be monitored through the participant case notes. Participants will be assigned to the intervention or control based on distance. Participants who reside more than 50km from any Aspect Behaviour Support Practitioner will be assigned to the intervention group.