1. Positive Behavior Supports

2. 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.”

3. 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.”

4. 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

5. 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

6. 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

7. 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.

8. 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

9. 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

10. 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.

11. 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.

12. 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.

13. 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

14. 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

15. 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

16. 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

17. 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.

18. 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

19. 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

20. 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.

21. 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

22. 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

23. PBS
SYSTEMS
Leadership Teams
Intensive
Targeted
Universal