Positive Behaviour Support Policy

1. Purpose

The Learning for Life Autism Centre Inc (Learning for Life) recognises that children and vulnerable people have the right to be in a safe environment at all times and be treated with dignity and respect. The purpose of this Policy is to outline the positive behaviour management approach that Learning for Life takes when working with Clients.

Through this Policy Learning for Life contributes to the elimination of the use of Restrictive Practices for persons with a disability and ensures safeguards are in place for occasions where it is necessary to use Restrictive Practices to protect the welfare of Clients and the safety of third parties.

2. Policy Statement

1. Learning for Life supports a “Person-centred Approach” to the delivery of therapy services such that therapy may include inputs from Clients, families, friends and carers to make informed decisions about a Client’s health and wellbeing. Learning for Life also recognises and understands the central role of families in children’s lives and in turn supports a family-centred approach being included in the delivery of therapy services to children. Any reference in this Policy to a Person-centred Approach therefore also includes family-centred approach given Learning for Life’s services are provided to children.

2. Learning for Life understands that therapy services may be provided that assist with Behaviours of Concern exhibited by Clients. Learning for Life is committed to ensuring that Behaviours of Concern exhibited by Clients under Learning for Life’s programs and supervision are dealt with promptly and appropriately, having due regard for the rights of the Client, the rights of any other persons affected by the behaviour and Learning for Life’s duty of care

3. Learning for Life is committed to upholding the dignity and safeguarding the rights of the Client and the right to receive services in a manner which results in the least restriction of their rights and opportunities.

4. Learning for Life shall engage employees and contractors have who the right skills and training to meet the standards prescribed by this Policy.

3. Scope

This Policy applies to all staff of Learning for Life and will be implemented with all Clients of Learning for Life.

4. Definitions

Authorised Program Officer means each Learning for Life staff member who is an NDIS registered behaviour support practitioner and is authorised to develop and implement Behaviour Support Plans with respect to Learning for Life Clients.

Behaviours of Concern may be defined as behaviour of such an intensity, frequency or duration as to threaten the quality of life and/or the physical safety of the individual or others and likely to lead to responses that are restrictive, aversive or result in exclusion. Behaviours of Concern include:

• self-injury and self-mutilation which leads to physical trauma and/or disfigurement requiring medical attention including biting, hitting, pinching, scratching themselves, pulling hair;
• violent or dangerous behaviour which has the potential to cause physical injury or emotional trauma to others including biting, hitting, kicking, pinching, scratching, swearing, screaming, throwing objects;
• persistent refusal to follow necessary treatment procedures for medical conditions e.g. as epilepsy, diabetes or other conditions that, if not treated, will further endanger the person’s health;
• persistent refusal to participate in agreed activities such as recreation, social events and with respect to children, attendance at school;
• extreme manipulative behaviour including mischievous accusations against others, inappropriately engaging emergency support services or persistently overusing medical and other professional services;
• offensive behaviour including extracting, eating or smearing faeces or other body products, engaging in sexual activities in public places, or generally behaving in a manner likely to elicit negative community reactions.

Behaviour Management Plan means a training plan developed under the NDIS specialist behavioural intervention support framework which supports parents, carers and other relevant workers in implementing behaviour management strategies required to support a Client.

Behaviour Support Plan means a comprehensive and specialised support plan developed under the NDIS specialist behavioural intervention support framework to address significantly harmful or persistent behaviours of concern.

Behaviour Support Practitioner means an NDIS registered behaviour support practitioner authorised to develop Behaviour Support Plans with respect to Learning for Life Clients. 

Client for the purpose of this policy, means a child who is enrolled in a Learning for Life program. Where Client is referred to in the context of obtaining consents, consultation, decision making or providing information, it also extends to the Client’s parents/guardians.

Dignity of Risk is the idea that self-determination and the right to take reasonable risks are essential for dignity and self-esteem, thus should not be impeded by excessively cautious caregivers concerned about their duty of care.

Informed Consent means permission an individual gives to sharing information, either implied or explicit, after they have demonstrated that they understand the purpose of the request and the likely outcomes of that consent.

Interim Behaviour Support Plan means a Behaviour Support Plan that is developed for the temporary use of Restrictive Practices, with the intention to minimise these practices, while a comprehensive Behaviour Support Plan is being prepared.

NDIS Commission means the NDIS Quality & Safeguards Commission.

Regulated Restrictive Practices in relation to Learning for Life Clients involve the practices listed below, except where the practice is an age-appropriate child safety or injury prevention measure implemented in line with community standards and its recommendation or use would be relevant to any child of that age and not just because the Client has a disability or behaviour of concern:

• seclusion: sole confinement of a person in a room or physical space (at any hour of the day or night) where voluntary exit is prevented or not facilitated, or it is implied that voluntary exit is not permitted;
• chemical restraint: the use of medication or chemical substance for the primary purpose of influencing a person’s behaviour. Chemical restraint does not include the use of medication as prescribed by a medical practitioner for the treatment of, or to enable treatment of, a diagnosed mental disorder, physical illness or physical condition;
• mechanical restraint: the use of a device to prevent, restrict or subdue a person’s movement for the primary purpose of influencing a person’s behaviour. Mechanical restraint does not include the use of a device for therapeutic or non-behavioural purposes;
• physical restraint: the use or action of physical force to prevent, restrict or subdue movement of a person’s body, or part of their body, for the primary purpose of influencing their behaviour. Physical restraint does not include the use of a hand-on technique in a reflexive way to guide or redirect a person away from potential harm or injury, consistent with what could reasonably be considered the exercise of care towards a person;
• environmental restraint: restriction of a person’s free access to all parts of their environment, including items or activities.

Determining whether a practice or intervention is a Regulated Restrictive Practice for the purpose of a Client needs to be made on a case by case basis, taking into account the context in which the practice is used and the age of the Client.

Restrictive Practice means any practice or intervention that has the effect of restricting the rights or freedom of movement of a Client.

The Victorian Senior Practitioner has the power to issue prohibitions and directions under the Victorian Disability Act 2006 and is responsible for, among other things:

• ensuring that the rights of people who are subject to Regulated Restrictive Practices in Victoria are protected and appropriate standards are complied with; and
• the authorisation of chemical and environmental restraint and the approval for the use of seclusion, mechanical and physical restraint in Victoria.

5. Communication

1. This Policy shall be communicated to existing Clients on its commencement and to new Clients on the commencement of their service.

2. This Policy shall be communicated to all staff of Learning for Life on its commencement and to new staff members on the commencement of their employment in compliance with Recruitment and Induction Policy and Training and Registrations Policy.

3. Learning for Life shall provide information and training to all clinical staff about this Policy and its application.

4. Client feedback about the practices of Learning for Life can be communicated according to the Client Complaints, Feedback and Grievances Policy.

5. This Policy shall be read in conjunction with: 

• Child Safe & Vulnerable Persons Policy; 

• Code of Conduct; 

• Client Complaints, Feedback and Grievances Policy; 

• Client Confidentiality and Privacy Policy; 

• Duty of Care and Incident Management Policy; 

• Individual Programs Policy; 

• Infectious Diseases Policy; 

• Occupational Health & Safety Policy; 

• Performance Management and Disciplinary Policy; 

• Recruitment and Induction Policy; 

• Risk Management Policy; 

• Training and Registrations Policy; and 

• L4L Restrictive Practices Flow Chart. 

6. Human Rights

1. The Universal Declaration of Human Rights sets out a number of articles that are fundamental human rights to be universally protected. Learning for Life acknowledges these human rights and the interrelationship between these rights and the delivery of therapeutic services to Clients. Learning for Life shall ensure Clients’ rights are upheld whilst delivering positive behaviour support in line with the NDIS (Restrictive Practices and Behaviour Support) Rules 2018.

• Age Discrimination Act (Cth) 2004; 

• Australian Human Rights Commission Act (Cth) 1986; 

• Disability Discrimination Act (Cth) 1992; 

• Equal Opportunity Act (Vic) 2010; 

• Racial Discrimination Act (Cth) 1975; 

• Sex Discrimination Act (Cth) 1984. 

3. Learning for Life acknowledges the following Articles under the United Nations (2006) Convention on the Rights of Persons with Disabilities which underpin the Positive Behaviour Support Capability Framework:

Article 12: Equal recognition as a person before the law. This article recognises the right to protection from abuse through support to work on legal and financial issues; that rights and choices are respected; and that support is given to make decisions without coercion.

Article 13: The right to justice.

Article 14: The right to liberty and security. This article recognises the importance of protection against the removal of liberty illegally and without reason, and to protections under the law if liberty is taken away.

Article 16: Freedom from exploitation, violence and abuse. This article is the most direct link with the Australian Government’s (2014) commitment to the reduction and elimination of restrictive practices, and is supported by a Zero Tolerance Framework.

Article 19: Living independently and being included in the community. This article covers people making choices about where they live, who they live with, and the supports they seek to be part of the community.

Article 21: Freedom of expression and opinion, and access to information. This article is about the right to say what one thinks through the type of communication that a person chooses.

Article 26: Habilitation and rehabilitation. This article covers actions that make it possible for people with disability to enjoy maximum independence, full abilities, and be involved in all aspects of life.

7. Positive Behaviour Support and Managing Behaviours of Concern

1. The NDIS Positive Behaviour Support Capability Framework (July 2019) outlines the capabilities required of individuals providing behaviour support under the NDIS and has been produced by the NDIS Commission using best practice positive behaviour support as its guidance.

2. Positive behaviour support is the term used to describe the integration of the contemporary ideology of disability service provision with the clinical framework of applied behaviour analysis. Positive behaviour supports are supported by evidence encompassing strategies and methods that aim to increase the person’s quality of life and reduce behaviours of concern (Source note: Carr, et al., 2002; Singer & Wang, 2009).

3. Where the behaviour support needs of a Client are complex, significantly harmful or persistent, a Behaviour Support Plan may be implemented and can be documented as a part of that client’s overall support plan, having regard to the Client being at the centre of every part of positive behaviour support.

4. All activities related to behaviour management shall be supportive and respectful of the Client’s individual needs and goals, as identified through a Behaviour Support Plan, and based on a current and comprehensive behaviour support assessment.

5. When responding to Behaviours of Concern the following principles shall be held in regard: 

• supporting positive behaviour; 

• using least restrictive alternative; 

• promoting freedom of expression; 

• supporting Clients to make their own decisions; 

• Dignity of Risk; 

• eradicating discrimination; 

• using person-centred planning; 

• respecting the role of parents or advocates in safeguarding Clients’ rights; 

• addressing allegations of abuse quickly and appropriately; 

• managing risks that may arise when providing support to Clients. 

• an appropriately timed response is delivered having regard to the threats posed to the Client and others whilst the Behaviour of Concern persists; 

• thorough analysis and documentation of the relevant behaviour is undertaken; 

• an individualised Behaviour Support Plan or Behaviour Management Plan is developed by an authorised person in consultation with the Client and key stakeholders, and having regard to the Client’s decision-making capacity and rights; 

• support and resources from appropriate external professionals are sought as required; 

• any Restrictive Practice authorised and consented to is administered appropriately with the least infringement of the rights of the Client; 

• the Client’s progress is monitored against behavioural goals described and quantified in the Behaviour Support Plan or Behaviour Management Plan; 

• the Client’s Behaviour Support Plan or Behaviour Management Plan is reviewed in consultation with relevant parties who were involved in the construction of the initial plan 

• implementing team members are supported to understand their duty of care towards Clients and consider risk management to remove the risk of harm arising from Behaviours of Concern; 

• the risk of harm to a child or young person is assessed and any breaches are reported to authorities as outlined in the Duty of Care and Incident Management Policy and/or Child Safe & Vulnerable Persons Policy; 

• any employees who are not appropriately trained or equipped to deal with the Behaviour of Concern are removed, having regard to their safety and wellbeing; 

• counselling is made available to employees affected by Behaviours of Concern; and