McClean Brian, Grey Ian
Brothers of Charity Services, Roscommon, Ireland.
J Intellect Dev Disabil. 2012 Sep;37(3):221-31. doi: 10.3109/13668250.2012.704981.
Positive behaviour support (PBS) emphasises multi-component interventions by natural intervention agents to help people overcome challenging behaviours. This paper investigates which components are most effective and which factors might mediate effectiveness.
Sixty-one staff working with individuals with intellectual disability and challenging behaviours completed longitudinal competency-based training in PBS. Each staff participant conducted a functional assessment and developed and implemented a PBS plan for one prioritised individual. A total of 1,272 interventions were available for analysis. Measures of challenging behaviour were taken at baseline, after 6 months, and at an average of 26 months follow-up.
There was a significant reduction in the frequency, management difficulty, and episodic severity of challenging behaviour over the duration of the study. Escape was identified by staff as the most common function, accounting for 77% of challenging behaviours. The most commonly implemented components of intervention were setting event changes and quality-of-life-based interventions.
Only treatment acceptability was found to be related to decreases in behavioural frequency. No single intervention component was found to have a greater association with reductions in challenging behaviour.
积极行为支持（PBS）强调由自然干预人员实施多成分干预措施，以帮助人们克服具有挑战性的行为。本文调查了哪些成分最有效，以及哪些因素可能介导有效性。
61名与智障及具有挑战性的行为患者打交道的工作人员完成了基于能力的PBS纵向培训。每位工作人员为一名优先级个体进行了功能评估，并制定和实施了一份PBS计划。共有1272项干预措施可供分析。在基线、6个月后以及平均26个月的随访时对具有挑战性的行为进行了测量。
在研究期间，具有挑战性的行为的频率、管理难度和发作严重程度均显著降低。工作人员将逃避确定为最常见的功能，占具有挑战性的行为的77%。最常实施的干预成分是设置事件改变和基于生活质量的干预措施。
仅发现治疗可接受性与行为频率的降低有关。未发现单一干预成分与具有挑战性的行为减少有更强的关联。
