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Positive behavior support (PBS) involves the changing situations and events that people with problem behaviors experience in order to reduce the likelihood that problem behaviors will occur and increase social, personal, and professional quality in their lives. It is an approach that blends values about the rights of people with and without disabilities with a practical science about how learning and behavior change occur. PBS is a set of research-based strategies used to increase quality of life and decrease problem behavior by teaching new skills and making changes in a person's environment. Positive behavior support combines valued outcomes, behavioral and biomedical science, validated procedures; and systems change to enhance quality of life and reduce problem behaviors such as self-injury, aggression, property destruction, defiance, and disruption. The overriding goal of PBS is to enhance quality of life for individuals and others within social settings in home, school, and community settings.
Research evaluating the effectiveness of positive behavior support began in the field of developmental disabilities with both children and adults living at home and in community settings. These researchers were interested in whether PBS could be an approach that may improve an individual's quality of life and reduce the incidences of problem behavior. Important characteristics of PBS include:
Originally, many positive behavior support interventions were evaluated using single subject designs or case studies. Single subject designs and case studies usually involve a smaller number of individuals being studied as opposed to large numbers participating in a group experimental design. The more examples of individual studies describing successful interventions with a wide range of children and adults, the greater the evidence over time that the results of PBS may be a widely successful approach.
In 1999, Carr and his colleagues published a synthesis of research in positive behavior support. This monograph provided evidence that positive behavior support is an effective approach for reducing challenging behavior and increasing quality of life for individuals with developmental disabilities.
Functional Behavioral Assessment
The cornerstone of PBS is the design and use of functional behavioral assessment to understand what reliably predicts and maintains an individual's problem behavior. Individuals engage in a behavior because it is functional; it helps them acquire some form of reinforcement (e.g., they get something desirable or pleasant, or they avoid something undesirable or unpleasant). A person may engage in problem behavior because circumstances in both the internal and/or external environment (i.e., antecedents, setting events) trigger or â€˜set the stage' for behavior to occur. Functional assessment is a process for identifying the events that trigger and maintain problem behavior. This process involves information gathering through record reviews, interviews, and observations and the development of summary statements that describe the patterns identified. Primary outcomes of the functional assessment process include:
The team that forms around a child or adult in order to create a PBS plan should represent all of the situations and settings that are part of the person's life. Information that is gathered from a functional behavioral assessment helps the team develop and implement behavioral intervention plans that are positive, proactive, educative, and functional. PBS plans include a number of interventions that can be implemented across situations and settings. These interventions include: 1) proactive strategies for changing the environment so triggering events are removed, 2) teaching new skills that replace problem behaviors, 3) eliminating or minimizing natural reinforcement for problem behavior, and 4) maximizing clear reinforcement for appropriate behavior. Many of the interventions used in PBS were first validated in research studies published in the Journal of Applied Behavior Analysis.
A hallmark of PBS planning is its emphasis on improving overall lifestyle quality (relationships, activities, health) as an integrated part of behavior support. PBS focuses not only on reducing behavior problems, but on enhancing a person's overall quality of life. Outcomes include lifestyle improvements such as participation in community life, gaining and maintaining satisfying relationships, expressing personal preferences and making choices, and developing personal competencies. Such improvements in quality of life are facilitated by establishing a positive long-range vision with the individual and his/her family (e.g., through person-centered planning) and establishing natural supports through effective teamwork.
Person-centered Planning and Wraparound
Wraparound and person-centered planning (PCP) are two strategies that can be used to facilitate team-based plans for improving a child or adult's quality of life as defined by the child or adult, his or her family, and other members of the community. Although wraparound and PCP have some similarities, they originated to support different populations of people (individuals with emotional and behavioral disorders and individuals with developmental disabilities).
Wraparound is a team-based planning process that is led by an individual and family. The wraparound process results in a tailored and individualized set of supports services and interventions that result in an increase in positive lifestyle outcomes. In particular, wraparound has been a valuable process for supporting children and adolescents with emotional and behavioral problems. A comprehensive wraparound plan addresses needs defined by the child and parents, and those closest to them (i.e., family, friends, and teachers) with a particular emphasis on building upon a child's strengths. Family members are considered full and active partners in the process Although behavior and academic interventions are often included, wraparound plans are more comprehensive because multiple life domains (i.e. medical, basic needs, safety, cultural, spiritual, etc.) and settings (i.e. home, school, community) are addressed.
Person-centered planning (PCP) strategies were developed to support children and adults with developmental disabilities so that they are actively involved in defining lifestyle preferences and personal goals. The PCP process is also a team-based process that results in ongoing problem-solving meetings with a group of people who are interested in helping the child or adult achieve a lifestyle based upon his or her preferences, needs, and choices. The purpose of a PCP is to build a context in which a student can create a vision for how he or she wants to live, and to brainstorm, strategize, and plan to make that vision a reality (Flannery et al., 2000).
A clear need outlined in Carr's 1999 AAMR monograph synthesizing research in the field was the need for more research on issues related to PBS and issues related to lifestyle enhancement. Few of the studies reported in the AAMR synthesis reported data on quality of life changes or other social validity evaluations to indicate how well the interventions fit the values, resources, and skills of the individuals who would need to implement those interventions on a long term basis. Many studies within the literature were time limited and did not address critical issues related to sustainability. Tensions naturally exist in the research field between the need to establish clear methodological rigor and to demonstrate that PBS can be implemented in natural settings with family members, teachers, and other individuals where it can be difficult to control all of the variables that may contribute to behavior.
This concern led to the establishment of a journal dedicated to positive behavior support. The Journal of Positive Behavior Interventions is the first journal dedicated to positive behavior support research.
Journal of Positive Behavior Interventions
The research field of PBS remains exciting and vibrant. Research is now tackling the issues set forth by the Carr monograph and other critics. One exciting area of research is on systems change in educational settings.
Part of the definition of PBS includes the importance of considering the larger systems in which PBS is being implemented. Examples of systems issues may include the values and mission of a school or organization, the level of administrative support and attention is given to PBS planning, how easily fiscal resources can be allocated to support implementation efforts, and policy and procedures supporting PBS training and technical assistance. These issues are critically important in order to create an effective PBS plan that will be sustainable and contextually appropriate for a child or adult receiving support.
School-wide PBS is implemented systematically so that all students benefit by learning social skills and experiencing positive school settings. School staff work together to ensure everyone responds consistently to the occurrence of problem behavior and use data to identify areas of the school that may need more intensive interventions. Data are also used to identify students in need of more intensive supports based on each child's needs. Researchers are focusing on determining whether implementing large scale implementation of PBS at statewide, district-wide, and school-wide implementation levels are being successful.
Researchers are now focusing on larger systems-level changes for systematically implementing large scale implementation of PBS at statewide, district-wide, and school-wide implementation levels. Researchers are currently evaluating the effectiveness of the school-wide PBS model.
Click here for information summarizing school-wide PBS research
Other organizations can benefit from the school-wide PBS model by adapting the same types of outcomes, systems, and data based decision-making processes to the unique services provided. More research is needed in states, schools, and other organizations to demonstrate how to implement PBS in ways that are sustainable across time and in diverse situations and settings.
Click here for information about implementation research