title: An evaluation of positive behavioural support for people with very severe challenging behaviours in community-based settings.
abstract: This study employs a multiple baseline across individual design to describe positive behaviour support for five people in community settings. The individuals represent all people with intellectual disability residing in one county with long-standing challenging behaviour resulting in serious physical injury. Five types of outcome are presented: rates of behaviour, rates of medication, psychiatric symptomatology, quality of life and revenue costs. The systems of support required to maintain outcomes and develop real lifestyles include behaviour support planning, mental health review, on-call intensive support and emergency respite care. Behaviours reduced to near-zero levels following implementation of positive behaviour support and improvements were sustained over 24 months. The use of psychotropic medications reduced by 66 percent over the same period. Quality of Life Questionnaire scores improved significantly for three of the five participants. The results are discussed in the context of a framework for supporting people with severe challenging behaviours in the community.
authors.affiliation: Brothers of Charity, Lanesboro Road, Roscommon, Ireland.
authors.forename: Brian
authors.initials: B
authors.lastname: McClean
authors.forename: Ian M
authors.initials: IM
authors.lastname: Grey
authors.forename: Margaret
authors.initials: M
authors.lastname: McCracken
mesh_terms: D000328:Adult; D000374:Aggression / Q000187:drug effects / Q000523:psychology; D001321:Autistic Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D003156:Community Mental Health Services / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology* / Q000534:rehabilitation* / Q000628:therapy; D007494:Ireland; D008019:Life Style; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D010348:Patient Care Team; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011788:Quality of Life; D012114:Residential Treatment / Q000379:methods; D012144:Respite Care; D016728:Self-Injurious Behavior / Q000523:psychology / Q000628:therapy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D011619:Psychotropic Drugs