McClean Brian, Grey Ian
Brothers of Charity Services, Roscommon, Ireland.
J Intellect Dev Disabil. 2012 Sep;37(3):209-20. doi: 10.3109/13668250.2012.704982.
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.
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.
Substantial reductions in target behaviours were observed, along with incremental improvement in mental health scores and quality-of-life scores.
The study demonstrates the efficacy of positive behaviour support for people with exceptionally severe behaviour in individually designed services.
积极行为支持强调情境变量对提高参与度、选择权和生活质量的影响。本研究评估了为4名个体实施关键情境变量变化的一个序列。干预措施持续进行，数据收集持续了3年。
对4名有极其严重挑战性行为的个体进行了功能评估。干预措施基于行为支持的多要素模型（拉维尼亚和威利斯，2005a）。因变量包括：（1）频率的行为评分、（2）发作严重程度、（3）发作管理难度，以及（4）心理健康状况和（5）生活质量的测量指标。干预序列为低唤醒环境、建立融洽关系、可预测性、功能等效技能教学和差别强化策略。
观察到目标行为大幅减少，同时心理健康得分和生活质量得分逐步提高。
该研究证明了积极行为支持在为有极其严重行为的个体量身设计的服务中的有效性。
