Positive Behavioral Interventions and Supports Can Help Adults with Special Needs

By Margaret Walsh, M.A., BCBA
 
For many years, Positive Behavioral Intervention and Supports (PBIS) have been used in school districts across the country to help improve students’ learning and behavior. Here in Massachusetts, PBIS practices are now also benefitting adults with intellectual disabilities (ID) served by the Department of Developmental Services (DDS).
 
What, exactly, is PBIS?
 
According to DDS, it is a “systematic, person-centered approach to understanding the reasons for behavior and applying evidence-based practices for prevention, proactive intervention, and teaching and responding to behavior, with the goal of achieving meaningful social outcomes, increasing learning and enhancing the quality of life across the lifespan.”
 
For more than three years, the state has been working with agencies, families, clinicians, self-advocates, and educational consultants to help make this initiative a reality.
 
PBIS focuses on four integrated elements to help improve the overall outcomes of all individuals receiving services:
 

• Evidence-based practices that have scientific support and have been proven to work with individuals with ID

 

• Systems that are developed to help identify what support is needed and to help guide teams in selecting interventions

 

• Data that is carefully recorded to help inform decision making and progress

 

• Meaningful and measurable outcomes that are developed by the team

 
The PBIS model employs three tiers of support to prevent problem behavior. The first tier – universal interventions – is used for all individuals. The focus at this level is to prevent new cases of problem behavior from occurring. This is done by developing a common statement of purpose and clearly defined behavioral expectations. Universal supports encourage expected behavior and discourage problem behavior.
 
The second tier’s supports – targeted interventions – are for individuals who are not responding to tier one supports. Individuals needing this kind of support are at risk for developing chronic problem behavior, but do not need intensive support. At this level, the goal is to reduce current cases of problem behavior.
 
Tier three – intensive supports – focuses on decreasing the complications and intensity of high-risk problem behavior.
 
In our work with adults with ID, the main goals of the tiered approach are to ensure that these individuals have access to services that quickly address their needs, prevent problems from occurring, and enable them to be more involved in their community.
 
When PBIS is being implemented correctly, it is a team approach. Everyone should participate in decision making, including parents or caregivers, the individuals involved, clinicians, staff, and management. This may be a big culture shift for some, but it is more effective and efficient because everyone in the room has a chance to provide key information to help inform decision making. For example, a team member may think a more intense behavior intervention may be needed, but another might suggest a simple environmental change that would be more effective and less restrictive. When all stakeholders are at the table, it is more likely that the decisions made are the ones that will work best for everyone involved.
 
PBIS provides a logical and efficient framework to help deliver effective services to adults with ID that can help reduce problem behavior and improve their quality of life. To learn more about PBIS, visit www.mayinstitute.org/pbis or www.PBIS.org.
 
Margaret Walsh, M.A., BCBA, is the Clinical Director for the Western Massachusetts division of the May Center for Adult Services. She can be contacted in West Springfield at 413-734-0300 (ext. 262) or at mwalsh@mayinstitute.org.
 
About May Institute
May Institute is a nonprofit organization that is a national leader in the field of applied behavior analysis and evidence-based interventions, serving autistic individuals and individuals with other developmental disabilities, brain injury, neurobehavioral disorders, and other special needs. Founded nearly 70 years ago, we provide a wide range of exceptional educational and rehabilitative services across the lifespan. The May Center for Adult Services in West Springfield provides day and residential services to adults with developmental disabilities living in western Massachusetts. For more information, call 800.778.7601 or visit www.mayinstitute.org.