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Journal of Intellectual Disabilities
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What's this?

An evaluation of positive behavioural support for people with very severe challenging behaviours in community-based settings

Brian McClean

Brothers of Charity, Roscommon, Ireland

Ian M. Grey

Royal College of Surgeons in Ireland, Medical University of Bahrain

Margaret McCracken

Brothers of Charity, Roscommon, Ireland

This study employs a multiple baseline across individual design to describe positive behaviour support for five people in community settings. The individuals represent all people with intellectual disability residing in one county with long-standing challenging behaviour resulting in serious physical injury. Five types of outcome are presented: rates of behaviour, rates of medication, psychiatric symptomatology, quality of life and revenue costs. The systems of support required to maintain outcomes and develop real lifestyles include behaviour support planning, mental health review, on-call intensive support and emergency respite care. Behaviours reduced to near-zero levels following implementation of positive behaviour support and improvements were sustained over 24 months. The use of psychotropic medications reduced by 66 percent over the same period. Quality of Life Questionnaire scores improved significantly for three of the five participants. The results are discussed in the context of a framework for supporting people with severe challenging behaviours in the community.

Key Words: challenging behaviour • cost effectiveness • service delivery • specialist team • evidence-based practice • residential services

Journal of Intellectual Disabilities, Vol. 11, No. 3, 281-301 (2007)
DOI: 10.1177/1744629507080791
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