Reducing physical aggression and providing support to follow a routine
- Activ8 Mind
- Aug 29
- 5 min read
POSITIVE BEHAVIOUR SUPPORT GUIDE
How did Positive Behaviour Support (PBS) help to improve quality of life for a 10-year-old living with Down Syndrome and Autism and experiencing behaviours of concern?
Mark* is a 10-year-old boy living with Down Syndrome and recently diagnosed with Autism. With low bone density, he requires support with his mobility. He also has low hearing, vision impairment and sleep apnoea that affects his daily life.
When Sam, our Behaviour Support Practitioner, first met Mark, he had been experiencing behaviours of concern. These included physical aggression and a refusal to follow after-school and sleep routines.
In this Positive Behaviour Support Guide, we look at the steps that Sam took to help reduce behaviours of concern and improve quality of life.
*Not the participant's real name - names have been changed to protect participants' privacy.
Pre-Intervention: Conducting a Functional Behaviour Assessment (FBA) and creating an individualised behaviour support plan
Sam’s first step was to complete a Functional Behaviour Assessment (FBA).
She spent time with Mark in his home and school environment. She observed the behaviours of concern and collected information about Mark’s daily routine and his history.
Understanding the reasons behind the behaviour
On completion of the FBA, Sam was able to pinpoint the reasons behind the behaviours of concern.
She noted that –
Mark was not interested in the activities at school; including activities that he could enjoy and find purpose in which could motivate him to engage and participate.
Mark had unmet sensory needs around bedtime, and this was impacting his ability to follow bedtime routines.
Mark was also struggling with putting items on his face, which made it difficult to support his medical and health needs – he did not like wearing glasses, hearing aids or using his CPAP machine.
Formal supports could benefit from psychoeducation and tailored training sessions to help them effectively de-escalate behaviours of concern.
Creating a bespoke behaviour support plan
The information that Sam collected as part of her FBA provided her with a strong foundation on which to build a bespoke behaviour support plan.
Sam included individualised strategies to support the achievement of Mark’s goals and milestones to help measure his progress.
The intervention: how did Sam use positive behaviour support to help reduce behaviours of concern?
To help Mark and his family achieve their goals, Sam -
Trialled new activities with Mark
In their positive behaviour support sessions, Sam trialled different activities, with the goal of helping Mark discover what he enjoyed. Through this, Sam was able to determine what should – and shouldn’t - be included in his daily routine.
She collaborated with Mark’s parents, using the information gathered through activity trialling to build a structured and full routine.
His parents followed Sam’s guidance and created a play area in their house specifically for Mark. This area included his favourite activities.
Created visual supports to help improve predictability
Sam created visual supports that were suitable for Mark’s visual support needs which helped him feel more prepared for his daily routine.
Provided psychoeducation and training for Mark’s parents and immediate family members
Bespoke training sessions provided Mark’s parents, his grandmother (who lived at home with the family), and his twin brother with clear and guided instructions to best support Mark and help reduce instances of physical aggression.
Collaborated with, and provided training for, relevant school staff
Sam shared her findings with relevant staff at Mark’s school. She highlighted the activities that he was interested in and provided them with training on strategies to help reduce instances of physical aggression.
Staff adopted the recommended strategies and added the activities that Mark felt comfortable with into his daily routine.
Collaborated with Mark’s Occupational Therapist
To address Mark’s challenges with mobility and his sleep routine, Sam collaborated with his Occupational Therapist (OT).
Throughout the implementation of the behaviour support plan, Sam collected data for behaviours of concern. This helped her ensure that her strategies were effective and consistent.
Did the positive behaviour strategies help to reduce behaviours of concern?
Sam’s behaviour support strategies significantly reduced instances of physical aggression and helped to build greater acceptance for daily routines. They also reduced caregiver burnout.
In this PBS intervention, we see that -
Using visual supports helped make daily routines easier to follow
Visual supports – used at home and at school - have helped to build awareness, improve predictability, and reduce anxiety surrounding routines and transitions. Mark is now becoming more communicative regarding how he would like his routines to happen, and much more accepting of routines at school, after school, and at bedtime.
Understanding and making time for favourite activities supported the achievement of goals
Understanding which activities brought joy and fulfilment to Mark’s day and allowed caregivers and school staff to create routines that better supported his needs. This allowed him to receive needed sensory input and spend time with his professional supports and family and use energy to ensure he becomes more tired.
His play area at home provides him with a safe space to focus on his favourite activities, either independently or alongside a family member or support. After school, Mark can engage in activities and unwind after a long day at school.
The consistent application of strategies – at home, in school, and in the community – enhanced the overall outcome
Tailored training sessions, and the introduction of visual and mobility supports, have ensured that the recommended strategies can be applied effectively – at home and at school.
The application of the same strategies in all environments provides Mark with the consistency that he needs to flourish.
Caregivers felt more confident and better able to prevent and respond to behaviours of concern
Tailored psychoeducation and coaching sessions, and increased supports and strategies, have increased Mark’s parents’ confidence. They better understand the reasons behind the behaviours of concern. The supports and strategies provided by Sam allow them to effectively address instances of physical aggression.
This knowledge and their growing confidence - coupled with reduced behaviours of concern - have helped them find more ease within their day-to-day and feel assured that their son’s quality of life has improved. As a direct result, caregiver burnout has reduced.
School staff and supports are better able to support Mark
Through Sam’s training and coaching sessions, school staff now feel better equipped to support Mark. They understand the reasons behind the behaviours of concern, and they know when – and how – to apply strategies that help prevent and / or reduce those behaviours.
Can PBS help you better support an individual experiencing behaviours of concern?
Our team of experienced behaviour support practitioners provide support for children (7+), adolescents and adults with Improved Relationships (IR) funding in Adelaide, Ballarat, Melbourne North, Melbourne North West, Melbourne West, Melbourne North East.
If you’re seeking positive behaviour support, but do not yet have IR funding, we also offer Pre-PBS funding assessments. For individuals with Improved Daily Living (IDL) funding who are stuck on long ‘other therapy’ waitlists, our team is on hand with short-term Skills Building Therapy.
To request our support, or to ask our administrative team a question, contact us directly on 1300 575 329 or at info@activ8group.com.au. If you’re ready to get started, fill in the online NDIS referral form. Please note that our administrative team is available from 9am to 5pm (ACST), Monday to Friday (excluding public holidays).
Note: the information within this Positive Behaviour Support Guide is not intended as advice or for use as self-treatment. A top-level overview of the strategies employed has been included, and it’s important to note that the reasons behind an individual’s behaviours of concern (BOC) may vary, even if the BOCs experienced sound similar – or the same – as those mentioned within this Guide. For support, please contact a qualified professional.
This Behaviour Support Guide features insights shared by Sam, our Melbourne-based Behaviour Support Practitioner.
An experienced PBS practitioner, Sam's professional qualifications include a Bachelor of Psychological Science and a Master's of Primary Teaching. Before becoming a PBS practitioner, Sam worked in a specialist primary school, helping children living with Autism to achieve their learning goals.
Visit Sam's team profile to learn more about Sam, her professional qualifications and her clinical experience.
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