title: An evaluation of an intervention sequence outline in positive behaviour support for people with autism and severe escape-motivated challenging behaviour.
abstract: BACKGROUND
  Positive behaviour support emphasises the impact of contextual variables to enhance participation, choice, and quality of life. This study evaluates a sequence for implementing changes to key contextual variables for 4 individuals. Interventions were maintained and data collection continued over a 3-year period.
  
  
  METHODS
  Functional assessments were conducted with 4 individuals with exceptionally severe challenging behaviours. Interventions were based on the multi-element model of behavioural support (LaVigna & Willis, 2005a). Dependent variables were behavioural ratings of (1) frequency, (2) episodic severity, (3) episodic management difficulty, and measures of (4) mental health status, and (5) quality of life. The intervention sequence was low arousal environment, rapport building, predictability, functionally equivalent skills teaching, and differential reinforcement strategies.
  
  
  RESULTS
  Substantial reductions in target behaviours were observed, along with incremental improvement in mental health scores and quality-of-life scores.
  
  
  CONCLUSIONS
  The study demonstrates the efficacy of positive behaviour support for people with exceptionally severe behaviour in individually designed services.
authors.affiliation: Brothers of Charity Services, Roscommon, Ireland. bmcclean@indigo.ie
authors.forename: Brian
authors.initials: B
authors.lastname: McClean
authors.forename: Ian
authors.initials: I
authors.lastname: Grey
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000523:psychology; D001321:Autistic Disorder / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D003156:Community Mental Health Services / Q000379:methods*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D007494:Ireland; D008297:Male; D009042:Motivation; D011788:Quality of Life; D016728:Self-Injurious Behavior / Q000523:psychology / Q000628:therapy; D012720:Severity of Illness Index; D012944:Social Support; D016896:Treatment Outcome; D055815:Young Adult