Avril Quinn Joanne Lynch Behaviour Support Specialist CNM2 1 A better life: The implementation and effect of Positive Behaviour Support in a Community Residential Service within the Daughters of Charity Dublin Service

My Story- ‘Getting to know me!’ Rose 42 year old lady Downs Syndrome Moderate intellectual disability Borderline Personality disorder Autism Challenging behaviour Avril Quinn Joanne Lynch 2 Ah! The circle of life. How it all comes together in the end! Birth Infancy Childhood Adolescence Early Adulthood Mid-Life Old Age Death

Avril Quinn Joanne Lynch 3 Issues for Rose Lack of engagement in meaningful activities and relationships No clear boundaries Lack of structure and routine Issues in A.D.L.’s (bathing, changing her clothes, getting up for work in the a.m., mealtimes, change in planned activities). Lack of opportunities for choice, community participation and skills development Severe challenging behaviour

Avril Quinn Joanne Lynch 4 Issues for the staff supporting Rose Agency/Unfamiliar staff’s lack of understanding and skills in supporting Rose and her complex needs Lack of staff knowledge, training & skills Lack of staff confidence Splitting of the staff team Inconsistencies in staff approach in delivering incentives for Rose to display appropriate behaviour

Avril Quinn Joanne Lynch 5 Environmental Strategies: Positive Programming Direct Interventions Reactive Strategy: Staff training Protocols A risk benefit analysis Team meetings A visual structured daily planner Rules Contract Tension relief skills Independence skills Ability to predict & make choices Coping skills Relaxation training Tolerance training Antecedent control strategies e.g. non- breakable plates and cups A DRO schedule Weekly preparation in the form of social stories, weekly calendar and visuals for outings Relaxation activities De-escalation protocol Post Incident Protocol

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My Moving Forward Plan Avril Quinn Joanne Lynch 9

“Moving to my new home”: My Moving forward plan” consisted of a visual calendar for the two weeks prior to the move Names of any new staff that will support me in my new house was in the plan A picture of my suitcase was in it to help me start thinking of what I need to pack My new rules contract for my behaviour in my new house Avril Quinn Joanne Lynch 10

“Moving to my new home”: A plan of action for me and for the staff supporting me to move was completed outlining what we were all going to do each day to prepare and move to the new house. This consisted of a series of structured and consistent routines that would be built on daily to reduce my anxiety levels Avril Quinn Joanne Lynch 11

How is my Life Better? How is my Life Better? I make everyday choices I make important decisions about my life People treat me with respect I take part in every day activities I am part of my local community I am safe from bullying & abuse I get help to stay healthy Avril Quinn Joanne Lynch 12

My Future Dreams My Future Dreams I would love to have a job that I enjoy & I’m good at!! Introduce new things to me but not all at the same time Avril Quinn Joanne Lynch 13 Dreams can come true

What does it take to maintain this structure & support? What does it take to maintain this structure & support? Staff training All staff working with Rose will receive a specialised induction that is specific to Rose’s needs and characteristics. This will be ongoing to accommodate staff changes. Organisational/managerial commitment Avril Quinn Joanne Lynch 14

What does it take to maintain this structure & support? What does it take to maintain this structure & support? “Support services are not there to fix or cure people but to support them to live the life they have chosen” Respect how Rose chooses to live Communication Consistency Dedicated and matched team of staff Avril Quinn Joanne Lynch 15

The Future (at present) The Future (at present) I will need to live my life within this supportive structure provided by staff and others. I measure my quality of life by my capacity to obtain security and remove fear. That optimal goal is largely influenced by my ability to accept and trust in the support and structure created by staff and others. Avril Quinn Joanne Lynch 16

Avril Quinn Joanne Lynch 17 “See the Person, See Me, See Me, See My Potential”!! See My Potential”!! The world is my oyster’!