title: The efficacy of positive behavioural support with the most challenging behaviour: the evidence and its implications.
abstract: BACKGROUND
  Positive behaviour support (PBS) is behaviour analysis applied in support of people with challenging behaviour. Questions have been raised as to PBS effectiveness, costs, and accessibility.
  
  
  METHODS
  Outcome studies meeting specified criteria for PBS were selected for review. All told, 12 outcome studies encompassing 423 cases were included.
  
  
  RESULTS
  This review showed that PBS was effective with both severe and high-rate behaviour problems, was cost-effective, used a methodology that was easily trained and widely disseminated, and worked in institutional settings in which the most difficult problems are thought to be, as well as in the community.
  
  
  CONCLUSIONS
  The major implication of this review is that practitioners may be obligated to use PBS when faced with the need to develop a plan of support given the ethical principle of using the least restrictive method consistent with the right to effective treatment.
authors: Institute for Applied Behavior Analysis, Los Angeles, CA 90045, USA. glavigna@iaba.com
authors: Gary W
authors: GW
authors: LaVigna
authors: Thomas J
authors: TJ
authors: Willis
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D006297:Health Services Accessibility; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D012720:Severity of Illness Index; D012944:Social Support