Successful Outcomes of Positive Behaviour Support in Children — with St Jude’s PBS Practitioner Luke Hazelwood
Successful Outcomes of Positive Behaviour Support in Children — with St Jude’s PBS Practitioner Luke Hazelwood
Positive Behaviour Support (PBS) is a contemporary practice of supporting clients — both children and adults — overcome challenging behaviours linked to disability or trauma, and function at a more positive capacity in their everyday lives.
What forms of disability or diagnoses are typical of children exhibiting challenging behaviour and may benefit from Positive Behaviour Support?
Autism Spectrum Disorder (ASD)
Global Developmental Delay
Attention Deficit Disorder (ADHD)
Fetal Alchohol Spectrum Disorders (FASD)
In this article, we chat to St Jude’s PBS practitioner Luke Hazelwood, who specialises in working with children in particular. Luke sheds light on how PBS can be applied in guiding children’s behaviour in positive ways.
When we asked Luke about a standout client success story, he didn’t hesitate in mentioning Oskar. Luke has been working with Oskar and his family for four years, and in that time Luke has seen Oskar improve in leaps and bounds in many ways. Let’s delve into Oskar’s journey.
Oskar is a ten-year-old boy who lives with Autism and Type 1 diabetes. Oskar required support and guidance with most everyday tasks, as he has difficulty maintaining an appropriate level of behaviour throughout the day. Oskar’s behaviour would fluctuate daily, due to complex reasons related to environmental and sensory factors, thermoregulation and his sugar levels.
Oskar’s family engaged a specialist support worker, a speech therapist and a St Jude’s Positive Behaviour Support practitioner to implement a comprehensive plan to enable Oskar to live out day to day where his challenging behaviours are monitored, and he feels safe, secure, and empowered to tackle his every tasks.
When Oskar and his family first met with the St Jude’s team, it was outlined what goals he would like to achieve by engaging with a Positive Behaviour Support practitioner.
Therapy Goal #1
Oskar wished to improve his understanding of safety, whilst feeling supported to access the community.
Therapy Goal #2
Oskar would like to attend more community events with supports and school holiday programs.
These goals were outlined in Oskar’s NDIS plan. Both of them had review dates and intervention strategies attached to them to provide Oskar with the highest possible chance of success in achieving his goals.
Strategies used to support Oskar
The strategies used to support Oskar were a combined effort of informal and formal supports, consisting of support professionals and Oskar’s family. All strategies have been strategically designed using hidden-learning techniques and positive reinforcement to help Oskar build both his self-esteem, maintain consistency in his routine and become more independent.
Therapy Goal #1 – Better understanding of safety
Due to increased excitement and elevation, Oskar can often have a lack of environmental awareness, especially in public settings. This can potentially result in him finding himself in dangerous scenarios — i.e. going to cross a road without looking both ways for oncoming traffic. This manifests in other ways, such as Oskar transitioning from one activity to another without much forethought, and failing to let people know he is moving to another location.
To address this, it was assessed which Oskar’s triggers were for these types of responses. Identifying triggers early on is key for effective regulation and support.
Therapy Goal #2 – Attend more community events
To work towards achieving this goal, Oskar was given access to the community whilst being supported via positive reinforcement. Oskar responded positively to reward-based systems and scenario cards which helped strengthen Oskar’s understanding of appropriate and safe behaviour.
Due to Oskar’s complex behavioural requirements, he was unable to attend mainstream school holiday programs with other children. Our PBS practitioner designed a personalised school holiday program for Oskar, taking into account his interests and the type of activities he enjoyed. The two-week schedule allows Oskar to choose where he goes and what he does. It also allows for 6 hours of support per day for Oskar.
Positive outcomes for Oskar
Oskar has achieved many wins on his journey to becoming more independent and has been able to attend events and be in environments that were previously inaccessible to him.
Outcome 1 – The Royal Show
Oskar attended the 2021 Perth Royal Show with his mum Tara. Previously, Oskar would find this type of busy environment challenging. However, with effective planning, regulation techniques and the right support system, Oskar was able to successfully attend and enjoy the Royal Show.
Outcome 2 – Capacity building with baking
Oskar was able to learn a new skill by learning how to bake scones on the school holidays. Oskar followed instructions well and was happy, focused and engaged during the activity.
Outcome 3 – Attending the AFL Grand Final
Being able to attend the AFL Grand Final was a huge achievement for Oskar – as it was an event with 90,000 people in the crowd. A specialised safety plan was designed to support Oskar with managing his behaviours and sensory regulation was achieved using noise cancelling headphones. Through a plan devised 6-months in advance, support staff training and development and capacity-building supports, Oskar was able to successfully attend the AFL Grand Final – something he had always wanted to do.
Outcome 4 – Visiting Willie Creek Pearls
Oskar and his family went on a supported day out to Willie Creek Pearls at Hillary’s Boat Harbour, where the activity involved potentially extracting a pearl from an oyster. This day was planned and discussed with Oskar in advance – as there was no guarantee you would find a pearl. To avoid an escalated behavioural response if this were the case, this scenario was discussed with Oskar prior, so he had a better understanding of his expectations of the trip. As it happened, Oskar did manage to find a pearl in his oyster, leading to a very happy and positive outcome.
Other notable achievements for Oskar
The above are only a snapshot of all the achievements that Oskar has achieved over the years from the support of a St Jude’s PBS Practitioner, professional supports and his family. His attendance of numerous activities and community events allows him to feel less isolated, and a valuable part of the community, as he should.
Notably, Oskar has now managed to attend mainstream schooling, whilst previously he required an individual education plan. This allows Oskar to feel a greater sense of normalcy and inclusion — where he can engage with peers of his age. His grades have also improved, and his general mood and happiness levels are much higher.
His confidence and self-esteem are growing, and he no longer feels self-conscious about having to carry his insulin bag around.
What’s ahead for Oskar?
Oskar will continue his education in the mainstream school system. He still works with St Jude’s and his support workers to stay on track with his goals, which evolve and change as he gets older. Our PBS practitioner works closely with Oskar’s family by developing his home routine and providing strategies for challenging behaviours exhibited outside of formal support hours. A comprehensive Behaviour Support Plan was developed closely with Oskar’s parents which they can use as a resource to support him. Reviews are conducted regularly and wins (in which there have been many!) are always celebrated.
Ultimately, Positive Behaviour Support isn’t required for a lifetime — as it is aimed to build the capacity in the child where they can effectively regulate themselves. Although the time-frames may differ for each — from months to years, it isn’t a permanent support.
The importance of Positive Behaviour Support
Positive Behaviour Support is a relatively contemporary practice as it combines traditional psychological strategies such as Cognitive Behavioural Therapy (CBT) and Applied Behaviour Analysis (ABA) but combines this will practical strategies catered to that individual. It, therefore, is a more holistic approach than more clinical methods and involves the family every step of the way.
Our PBS Practitioner Luke sums up Positive Behaviour Support as;
“Providing flexible support to people based on their current needs, taking into account the holistic picture. The ultimate aim is to build the capacity for the individual to become more independent by working with formal and informal support systems”
Dispelling assumptions about challenging behaviours
It is important to bring awareness about ‘challenging behaviours’ in children and where they stem from. Rather than a child simply misbehaving, these behaviours stem from an unmet need — this unmet need could be trauma related, disability related or environmental. Referring to the Iceberg Theory where the behaviour is simply the tip of the iceberg, our PBS practitioners are trained to look deeper into a child’s history and diagnosis to learn about the context behind the behaviour. Once these deeper needs are addressed, it is likely that a child will respond in a positive way.
Contemporary Positive Behaviour Support techniques
The most crucial thing about PBS is that there is no set framework of techniques that can be applied to every child. Its strength and success rate lies in the fact it is a individualised approach which takes into account various factors including;
The child’s disability
The child’s environment
The child’s history/upbringing
The child’s relationship with their family
The child’s nature and personality
The child’s learning style
Positive Behaviour Support strategies are always adapted per individual child, so it will provide them with the best opportunity to achieve their goals and build independence. PBS often uses ‘hidden learning’ based activities, and ones which are rewards based, “creating situations where the child can’t lose”. When a child successfully completes an activity or task, they are rewarded, which builds their self esteem and provides them with the validation they need. The child can often have control about what the reward is, whether that be more free time at home, or choosing a school holiday activity they would like to attend.
Our PBS practitioner Luke also developed his own tool — an Environmental Pattern Scale which is provided to the parents or carer of that child as a way of measuring what time of day the child’s behavior escalates. Being able to pinpoint patterns in the child’s behaviour allows for a better plan to be put in place to avoid the child’s behaviour escalating in the first place.
Indications that a PBS Plan is working
Overall success of a PBS plan is measured by various things including;
TGO’s (Therapy Goals & Outcomes)
Reduced crisis points on the Environmental Pattern Scale
Better school attendance/and or transition into mainstream schooling
Happiness and general mood improvements
Reduced anxiety levels
Better school grades
Better family and social relationships
Making a difference
The incredible aspect of Positive Behaviour Support is there are no barriers. It can be approached in so many innovative ways depending on the particular child and their unique needs. A good PBS practitioner will have that innate passion for what they do, and will truly believe in what they are doing. Luke believes that;
“You only need one positive individual in your life to make a difference”
About Luke – St Jude’s PBS Practitioner
Originally hailing from the UK, Luke studied at The University of Greenwich in London. He has worked for many years as a primary school teacher, in the area of special education. Luke is transparent about his own childhood struggles, stemming from his mother falling ill when he was 3, and subsequently passing away when he was only 13. Through his own lived experience with childhood trauma, Luke has the innate need to want to help other children, which ultimately lead to him working with children as a PBS practitioner at St Jude’s. These days, Luke works with 50 children and their families, helping them navigate daily struggles through innovative personalised support plans.
Want to find out more about Positive Behaviour Support at St Jude’s?
If you would like to know more about the fantastic Positive Behaviour Support NDIS services at St Jude’s or want to know more about how our wonderful PBS Practioners can support your child, get in touch with our friendly team today.
We are a passionate team of specialists dedicated to helping children live more fulfilled, independent and happy lives. You can learn about our range of NDIS disability support services on our website.
If you have had a great experience with our St Jude’s Positive Behaviour Support team, please do not hesitate to let us know! You can also have a read of some of our previous testimonials below:
“Luke Hazelwood has been a driving force behind our family and has always gone above and beyond to provide the most professional and compassionate care. I have recommended St Jude’s to many seeking therapies for their children, and do so with nothing but confidence in their ability to provide expert support”
“We have [had] experience with Luke Hazelwood and Simona Pintaudi both of whom have been fantastic. We have seen a major change in our daughter and are very happy to recommend this team to everyone”
“Would absolutely recommend these wonderful therapists to anyone! We were at a point of complete despair, our 8 year old was completely lost and miserable at school, teachers didn’t know how to help him and we as parents were wondering how he would ever get an education. Fast forward to today and our little man is loving school, enjoying the work and is at the beginning stages of trusting people and heading towards full time school. I believe we never could have got here without St Jude’s help and unique approach. Special thanks and gratitude to Luke and Sim”
“Luke has worked with Matthew over the last few years. It has been a very positive experience. Supporting this young man though dark days, his high school, learning about himself, gaining confidence. He now has strategies and the courage to apply for university”
“Thanks to St Jude’s and the ongoing work with Luke Hazelwood, my son at the age of 29, is finally learning how to drive, and is looking forward to eventually being able to have the life skills to live independently, and connecting with community, while still continuing with the supports he needs”
“Luke Hazelwood the specialist behavioural therapist is absolutely amazing! Without his constant help and support given to my son – my son would NOT be in the place he is now Luke’s on going encouragement for my family has and continues to strengthen our family unit. I would hate to think of where we would be without his support. If only we could clone Luke. Luke has helped throughout the home, school and accessing the community. We look forward to all the ongoing gains for my son to make and to be the ‘happy’ family we should be”
Disclaimer: Consent was provided by the client and his family for permission to publish the contents and images in this blog.