Behavior Support Plans for Adults with Intellectual Disabilities

By Margaret Walsh, M.A., BCBA

If you have a family member with an intellectual disability who engages in undesirable behaviors such as avoiding showering, shouting, or constantly rocking, he (or she) may benefit from a behavior support plan.

Behavior analysts (or other well-trained mental health professionals) who provide treatments based on applied behavior analysis will tell you that a carefully created behavior support plan is the cornerstone of effective and evidence-based treatment for adults with intellectual disabilities.

Before the behavior analyst develops this plan, she (or he) will conduct a functional assessment to determine the reason(s) why the person behaves in an undesirable way. Oftentimes, an individual will engage in a problematic behavior because it allows him to escape tasks or events he finds aversive. He may also be seeking attention, or the behavior may be comforting to him. Once the function of the behavior (in other words, the reason for it) has been determined, the behavior analyst will write up a plan based on that information.

A well-thought-out behavior support plan will help the individual learn to replace his problematic behaviors with more adaptive behaviors. This will help him increase his independence. The plan will also help family members and caregivers learn how to react to him in a respectful manner and help him change his behaviors.

There are generally three major components to a behavior support plan: antecedent strategies that focus on preventing the behavior before it occurs; teaching strategies that teach the person alternative behaviors; and consequence procedures that make the behavior less likely to occur in the future. If possible, the individual should work with the behavior analyst to provide input into his own plan.

A behavior support plan should be simple enough to be understood and implemented by the people who support the individual. That individual, or a legal guardian, will need to consent to the plan as it is written before it can be implemented. The people who consent must work closely with the behavior analyst to ensure they understand it. When an individual or guardian gives consent to a plan, it indicates that they approve of all the procedures written in the plan. If the individual or guardian does not agree with or understand any part of the behavior support plan, they should not give consent until the person who wrote the plan provides satisfactory answers to their questions and concerns. It is important to note that once given, consent can be withdrawn at any time.

After the plan has been implemented, data should be collected on the problem behaviors and the adaptive behaviors that are being taught. Data is the only way to make objective and informed decisions about the effectiveness of the plan. This data should always be available to the individual, the guardian, and other members of the person’s support team. It is important for the behavior analyst to describe and display the data to all members of the person’s treatment team. Data can also be helpful to doctors or psychiatrists because it can concretely demonstrate if a medical issue is impacting the person’s behavior.
                                                                                                             
A behavior support plan should be reviewed frequently by the all members of the treatment team to ensure it is working well. If the plan has been carefully crafted and effectively administered, it can result in a significant improvement in a person’s quality of life.

Margaret Walsh, M.A., BCBA, is the Director of Clinical Services for the May Center for Adult Services in Western Massachusetts. She can be contacted in West Springfield 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. For more information, call 800.778.7601 or visit www.mayinstitute.org.