First Steps Toward Positive Behavior Support in the Netherlands:A Pilot Study Exploring the Effectiveness of a Training for Staff

Despite the effectiveness of positive behavior support (PBS) in reducing challenging behaviors, the availability of PBS for individuals with intellectual disabilities is limited in many countries including the Netherlands. Training care staff supporting individuals with intellectual disabilities in PBS may be a way to improve the provision of PBS. We aimed to explore the preliminary effectiveness of a PBS training for staff in reducing challenging behaviors of individuals with intellectual disabilities. Using a one group, double pretest-posttest design, 24 staff members involved in the care of 11 adult individuals with intellectual disabilities and challenging behaviors participated. We assessed changes in challenging behaviors and quality of life of the individuals, in staff self-efficacy in dealing with challenging behaviors, and in the use of restraints, using staff rated questionnaires, structured interviews, and medical files. At posttest, we found significant reductions in challenging behaviors, improved quality of life, and increased staff self-efficacy, but no changes in the use of restraints. In contrast, no significant changes on any of the measures appeared between the two pretests. These findings suggest that a staff training in PBS may be effective for reducing challenging behaviors in individuals with intellectual disabilities

Exploring the association of staff characteristics with staff perceptions of quality of life of individuals with intellectual disabilities and challenging behaviours

Background This study aimed to examine the associations between individual staff and staff team characteristics and quality of life of individuals with intellectual disabilities and challenging behaviours. Method With multilevel analyses, we examined educational level, experience, attitudes and behaviours of 240 staff members, in relation to their perception of quality of life of 152 individuals with intellectual disabilities and challenging behaviours they cared for. Results Two individual staff characteristics were related to better quality of life: higher educational and self-reflection levels. Of the team characteristics, higher educational level, higher self-efficacy and more friendly behaviour were associated with better quality of life. Unexpectedly, higher staff-individual ratio was related to lower quality of life. Conclusions Both individual staff and staff team characteristics are associated with quality of life, indicating the need to take staff team characteristics into account when examining quality of life

The relation between child feeding problems as measured by parental report and mealtime behavior observation: A pilot study

Because feeding problems have clear negative consequences for both child and caretakers, early diagnosis and intervention are important. Parent-report questionnaires can contribute to early identification, because they are efficient and typically offer a 'holistic' perspective of the child's eating in different contexts. In this pilot study, we aim to explore the concurrent validity of a short screening instrument (the SEP, which is the Dutch MCH-FS) in one of its target populations (a group of premature children) by comparing the total score with the observed behavior of the child and caretaker during a regular home meal. 28 toddlers (aged 9-18 months) and their caretakers participated in the study. Video-observations of the meals were coded for categories of eating behavior and parent-child interaction.The results show that the total SEP-score correlates with food refusal, feeding efficiency, and self-feeding, but not with negative affect and parental instructions. This confirms that the SEP has a certain degree of concurrent validity in the sense that its total score is associated with specific 'benchmark' feeding behaviors: food refusal, feeding efficiency and autonomy. Future studies with larger samples are needed to generalize the findings from this pilot to a broader context.Fil: Van Dijk, Marijn. University of Groningen; Países BajosFil: Bruinsma, Eke. University of Groningen; Países BajosFil: Hauser, Maria Paulina. Universidad Nacional de San Luis. Facultad de Psicologia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Effects of positive behaviour support delivered by direct staff on challenging behaviours and quality of life of adults with intellectual disabilities:A multicentre cluster-controlled trial

Background: Effects of staff provided positive behaviour support (PBS) for individuals with intellectual disabilities are unclear. Method: Using a multicentre non-randomised cluster controlled design, 26 teams of residential group homes, including 245 staff members of 167 individuals with intellectual disabilities, were allocated to a PBS or control group. Conducting multilevel analyses (n = 123) we examined individuals' changes in irritability, other challenging behaviours and quality of life. Results: Compared to controls, irritability did not significantly decrease more in the intervention group, but lethargic behaviours did. Personal development and self-determination significantly increased. Irritability of individuals in the PBS group with higher levels of irritability or lower levels of intellectual disability significantly reduced more compared to controls. Conclusions: PBS was effective in reducing irritability of individuals with severe levels of irritability or intellectual disabilities. Moreover, PBS decreased lethargic behaviours and improved several domains of quality of life.</p

Staff ability to carry out behavioural strategies for individuals with intellectual disabilities and challenging behaviours

Purpose - The purpose of this paper is to give an overview of studies that focused on variables likely to affect staff ability to carry out behavioural strategies for challenging behaviours in individuals with intellectual disabilities. Design/methodology/approach - Literature review: studies that were published in a peer reviewed journal, between 1999 and 2016, were selected for this review. Findings - In total, 29 articles were selected. Several factors likely affect staff ability to appropriately carry out behavioural interventions were identified: staff assumptions, distressing emotions elicited by challenging behaviours, reciprocal reinforcement systems, service characteristics and cultural systems. Originality/value - These findings raise the question what staff need in order to be able to change their naturally occurring behaviours in response to challenging behaviours and to carry out behavioural interventions. Future research may identify barriers and facilitators underlying the provision of effective interventions, taking into account the possible role of staff beliefs, their emotions, service characteristics and cultural systems