Positive Behavior Supports

Our Mission Statement “The Center of Hope Foundation provides people with disabilities and their families the resources, services and opportunities to be contributing members of their communities, and to achieve the most fulfilling and meaningful lives possible.”

What is PBS? “Person-centered approach to understanding reasons for behavior and applying evidence based practices for prevention, proactive intervention, teaching and responding to behavior with the goal of achieving meaningful social outcomes, increasing learning, and enhancing the quality of life across the lifespan.”

Positive Behavior Supports Provides environments that offer opportunities for healthy, meaningful lives Staff are caring teachers that are skilled and knowledgeable All activities, plans, routines and learning opportunities reflect individual’s preferences, needs and goals Creates physical and social environments that are positive and responsive (The environment plays a key role in the well-being of a person) Strong connection between Administration and Clinical

Wellness Factors Contact with Nature Experienced Creativity Optimism Balanced Nutrition Work Satisfaction Goal Accomplishment Economic Essentials Intellectual Stimulation Coping with Stress Rest and Sleep Spirit Awareness Time and Space Alone Positive Self-Image Physical Ability Fulfilling Relationships  

What is Behavior? How can we tell if someone is behaving? Anything we say, do, think, feel is behavior. Behavior happens all of the time – good, neutral, sometimes we consider behaviors problem behaviors Every behavior serves a purpose Behavior is communication As staff we must listen to people and their actions in different ways- especially for those who don’t use words to communicate

Antecedents Environmental: weather, people, noise, appointments, etc. Behavioral: rocking, hand flapping, yelling, crying, sweating, red face, heaving breathing, or any increase or decrease in an individual’s baseline behavior. Medical: constipation, increase/decrease in food/fluid intake, increase/decrease in urination, UTIs, menstrual cycle menopause, etc. ** Medical antecedents can be more difficult to detect, but if there is an increase in an individual’s behavior, medical should always be ruled out first.

Proactive vs. Reactive Focuses on antecedent management including events, triggers and antecedents Teaches skills (communication, coping, etc.) Provides positive reinforcement Emphasis is on prevention Will display a decrease in maladaptive behaviors overtime Does not teach a better way to communicate Waits until something happens to respond Provides consequences Emphasis is on responding

How to Create a Positive Environment Create environments that are predictable, safe and consistent with the routines and preferences of the person Understand why people do what they do- what motivates people Be flexible as we listen and implement strategies

Listening Active listening is the focal point to PBS Patience is key to understanding. When an individual is verbalizing how he/she is feeling, provide reassurance that you are going to help.

Communication Keep a calm, neutral, and non-threatening voice. No one likes to feel as though they are being scolded or embarrassed in front of others. Be respectful at all times. Remember that you are working with someone who is frustrated and feels as though he/she has no control over the situation. Explain why you are providing a particular response to the individual. When appropriate, let the individual know they have handled a stressful situation appropriately. Communication and Listening are also important for staff in their interactions with each other. Staff must communicate with each other to avoid any problems or inconsistency.

Body Language A warm and inviting smile can put anyone at ease and helps others to feel comfortable approaching you Hold yourself with a tall, open stance with your hands at your side Make eye contact Avoid your phone. We all need to send a text once and while, but if you consistently check your phone no one will want to interfere with your busy self. To look approachable you must be accessible. Nothing makes you look more outgoing and approachable than actively seeking out people and talking to them.

Offering Choices Many decisions are made for the individuals we serve without their input. Therefore it is important for us to offer choices whenever possible. By doing this, you are validating the individual and the control that they have in their life. Prevents power struggles Builds rapport

Attitude It is incredibly important that we do not let our own attitudes effect how we work with the individuals we serve We all have issues that arise in our personal lives, but we need to keep personal and professional lives separate the best we can We should NEVER let our likes and dislikes of an individual effect how we work with someone Don’t take the negative actions of the individuals we serve personally by holding a grudge This should be taken into account as we work with other staff in the agency as well

Redirecting Behavior Ignore undesired behaviors whenever possible if there is not a health/safety risk Staff should remain calm, in control, clearly state the behavioral expectation Use nonverbal gestures to redirect Staff should model acceptable ways to deal with a situation Offer an activity as diversion

Avoiding Power Struggles As staff, we should not get into any power struggles with the individuals we serve. The ONLY exception is when their safety or the safety of others is at risk. By avoiding power struggles we are breaking the cycle of escalation, tension, intensity, etc. The avoidance of power struggles reduces the likelihood of further physical, verbal and other conflict

Positive Praise Provides encouragement and motivation Boosts self-confidence, self-concept and self-esteem Builds rapport and trust Increases resilience **It is important to note that positive praise should be added into our interactions with staff as well.

Things you can do right now: Be sure that people know what you are asking of them and what is expected in a given situation Offer opportunities for choice- especially for those things that are important to someone Tell people when they are doing a good job or doing something right Ask someone to do something else if what they are doing is socially unacceptable Interact with people in a positive, proactive way- assume the best in them Look for opportunities to teach someone more appropriate things to do, where ever you are Create a positive, responsive environment so someone is offered opportunities to be successful

Aspects to Remember Behavior IS communication Relationships ARE important We need to listen to people in new ways We need to be mindful of our own behavior and the consequences of it Think of ways to say Yes, instead of No/Stop Give people meaningful choices Let people know when they are doing something the right way Assume people are able Create a positive, responsive environment which increases the likelihood that someone will be happy Prevention and not reaction Teach people skills and knowledge to improve their lives

Goals To enhance quality of individual’s lives. To enrich the way in which our staff proactively provide support. To increase the efficiency in which we assess behaviors and needs of individuals i.e. increase overall awareness. To improve the well being of our staff.

Data Current Clinical tracking includes: A Critical Incidents File (see the following pages) which includes all day programs, Employment Supports, Extended Day, the Supervised Apartments and Transportation The number of time outs and restraints per program The Leadership Team will determine other specific data points that will be used to track the agency’s progress of PBS

Trainings that have been completed: Proactive Training in QRDH and SDH End of Life Care Training at West Street Data Tracking Training in COHDH Restraint, Antecedents and Time Outs Training in QRDH Introduction to PBS Training during Orientation

PBS SYSTEMS Leadership Teams Intensive Targeted Universal