Tanya Breen

The following ‘tips’ from consultant clinical psychologist Tanya Breen for getting the most from behaviour support services are written for use by Needs Assessment and Service Coordination agencies working with people with autism.

• Take steps to identify and/or eliminate physical or medical causes of problem behaviour, by arranging for assessment by medical, dental and other relevant health professionals.
• Achieve support for the referral from the autistic person, their family/whanau and key support person, before initiating a referral. This includes explaining that intervention strategies often involve making changes in routines, environments, and the behaviour of families and support people.
• Be descriptive and detailed in the referral, so that the services have a clear idea of what the issues are at the point of referral. This is important because it allows the services to identify which team members might be most appropriate to take on the referral.
• Provide names and contact details of all key people, including family, school, and health and educational professionals.
• Be realistic in your expectations. Even the best service is unlikely to be successful in situations where people are wrongly placed, being abused, or when families and support people are unwilling or unable to make changes themselves.
• Prepare for behaviour support by encouraging people to:
  • Record developmental milestones (e.g. birth details, information on when the person crawled, walked, said 1st words, said sentences, any diagnoses)
  • Record key events in the person’s life across time (e.g. illnesses, residential moves, starting or moving schools, bereavements or losses, etc.)
  • Write descriptions of the problem behaviours that they want help with, in enough detail that anyone reading the description would be able to picture it happening, and/or video the problem behaviour when it occurs.
  • Note down strategies that were used to try to manage the behaviour, and the effectiveness (or not) of the strategies.
  • Record how often the problem behaviours occur (e.g. mark occurrences on the calendar)
  • Gather historical reports and letters from the pre-school, school, GP, other doctors, psychologists, and other allied health or educational staff.
• Encourage and accept feedback on suitability of residential or vocational placements, support needed, training, and other relevant system factors.
• Expect thorough assessment, involving interviews with the client and key significant others, data collection, behavioural observation, and review of relevant historical information.
• Request copies of assessment reports, interventions, and progress reports.
• Question the rationale and supporting data for interventions, and be particularly inquisitive if interventions do not appear to be making positive progress.

This article first appeared in Altogether Autism Journal Summer 2011 and updated May 2018.