ArticlePDF Available

Positive behavioural support in Australia: A state of the nation report 2023

Authors:
  • Australian Centre of Restraint Reduction
  • Centre for Positive Behaviour Support

Abstract

Australia has seen an expansion in the use of positive behavioural support (PBS) in recent years. PBS in Australia was originally conceived in disability and school-based settings. Two areas of recent PBS expansion include the aged care and psychosocial disability, often through legislated approaches, which may not be well referenced in the current evidence base of PBS in terms of application or efficacy. The emerging use of PBS approaches across Australia is additionally complicated by the socio-political environment of being a federated country. States will often take differing approaches to each other, whilst at the same time being guided by national federal policy and legislation, which presents its own challenges at a service delivery level. This paper will focus on the current state of PBS in Australian disability and school contexts using a socio-political perspective. We use this perspective to describe the origin of PBS in Australia within the deinstitutionalisation and civil rights movement (Dunlap et al., 2009) and the ongoing political reforms that shape PBS policies and practices, which in turn shape research (Sailor and Paul, 2004). Following the Positive behavioural support in the UK: A state of the nation report (Gore et al., 2022), we describe the context, definitions, delivery, barriers, facilitators and future of PBS in Australian disability and school sectors. We start with describing the history and influence of applied behaviour analysis (ABA) on PBS in Australia, before discussing PBS application to disability and school contexts. We conclude with recommendations for a national approach to PBS in Australia.
Positive behavioural support in Australia: A state of the nation report 2023
6 © Bild, International Journal of Positive Behavioural Support Autumn 2023, 13, 2, 6 –12
Association (ABMA) was established in 1974, attracting
both academics and non-academics (Birnbrauer, 1994).
By 1995, cognitive therapies had become more popular
than radical behaviourism and the ABMA had become
the Australian Association for Cognitive and Behaviour
Therapy (Jones et al., 2018). ABA, as the Association was
then known, did not have a formal presence in Australia
until 2018 (Hayward et al., 2018).
Influence of ABA on PBS in Australia
It is critical that we reflect upon the origins of PBS in
Australia so that we can appreciate the ongoing influences
on the barriers and facilitators to its application. Like other
western countries, Australia had its ‘behaviour modification’
and ‘behaviour therapy’ periods. In Australia, these began
in the 1950s, influenced by attitudes and values of pre-
and post-World War II academic psychology (Winkler and
Krasner, 1987). The Australian Behaviour Modification
Correspondence: Sharon Paley, Australian Center for Restraint Reduction and Elimination.
Email: Sharonpaley@reducingrestraint.org
Positive behavioural support in Australia:
A state of the nation report 2023
Brent A. Hayward1, Sharon Paley2, Lorna Hepburn3, Matthew Spicer4, Sam McGowan5,
Alinka Fisher6, Sophie Staughton7, Fiona J. Davis8 and Mark Wakefield9
1 School of Social and Political Sciences, Faculty of Arts, University of Melbourne,
and Department of Education, Victoria, Australia
2 Australian Center for Restraint Reduction and Elimination, Australia
3 Queensland Department of Education, Australia
4 The Centre for Positive Behaviour Support, Australia
5 Behaviour Support & Training, Australia
6 Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Australia
7 Veritable Pty Ltd, Australia
8 Disability Counsel, Australia
9 Independent co-author, Australia
Introduction
Australia has seen an expansion in the use of positive behavioural support (PBS) in recent years. PBS in Australia
was originally conceived in disability and school-based settings. Two areas of recent PBS expansion include the aged
care and psychosocial disability, often through legislated approaches, which may not be well referenced in the current
evidence base of PBS in terms of application or efficacy. The emerging use of PBS approaches across Australia is
additionally complicated by the socio-political environment of being a federated country. States will often take differing
approaches to each other, whilst at the same time being guided by national federal policy and legislation, which presents
its own challenges at a service delivery level.
This paper will focus on the current state of PBS in Australian disability and school contexts using a socio-political
perspective. We use this perspective to describe the origin of PBS in Australia within the deinstitutionalisation and
civil rights movement (Dunlap et al., 2009) and the ongoing political reforms that shape PBS policies and practices,
which in turn shape research (Sailor and Paul, 2004). Following the Positive behavioural support in the UK: A state of
the nation report (Gore et al., 2022), we describe the context, definitions, delivery, barriers, facilitators and future of
PBS in Australian disability and school sectors. We start with describing the history and influence of applied behaviour
analysis (ABA) on PBS in Australia, before discussing PBS application to disability and school contexts. We conclude
with recommendations for a national approach to PBS in Australia.
Positive behavioural support in Australia: A state of the nation report 2023
© Bild, International Journal of Positive Behavioural Support Autumn 2023, 13, 2, 6 –12 7
PBS in disability services
PBS only existed as policy in state and territory government
disability services agencies (Hayward et al., 2019) and
their non-government providers (Hayward et al., 2023) up
until the establishment of the National Disability Insurance
Scheme (NDIS; ndis.gov.au). The NDIS defines disability
as an impairment or significant change in at least one body
function, body structure or how one thinks and learns
(NDIS, 2022). Changes to the funding of disability support
from the states and territories to the federal government
influenced the promotion of PBS by additionally shifting
the responsibilities for regulations and safeguards to
the federal government (Hayward et al., 2023), as the
NDIS Quality and Safeguarding Framework (Department
of Social Services, 2016) specifically promotes PBS for
reducing restrictive practices.
Reducing restrictive practices in the NDIS using PBS is
via funding for behaviour support for people who display
challenging behaviour. While this behaviour support is
termed ‘PBS’ by the NDIS, it is reflective only of individual
behaviour assessment and behaviour support plan (BSP)
development and not a comprehensive implementation
of PBS (Hayward et al., 2019), unlike that implemented
in schools (see later discussion). The Australian disability
PBS literature is described by Hayward (2022a) as
disparate. He goes on to describe a ‘surge of publications
from 2012 and the dominance of PBS with BSPs, PBS
as an intervention for behaviours of concern, and PBS
delivered through training’ (Hayward, 2022a, p.6). These
observations coincide with the passing of NDIS legislation
in 2013 (Hayward et al., 2023), supporting Sailor and Paul’s
(2004) argument that political reforms (i.e., the NDIS) shape
PBS policies and practices, which in turn shape research.
Although the NDIS is the predominant funder of ‘PBS’ in
Australia, ‘PBS’ services are also delivered by different
jurisdictional funding arrangements for people with different
health and social care needs, thereby leading to variation in
definition, standards and practices for PBS.
PBS delivery in a disability context
BSPs in the NDIS must be written by a behaviour support
practitioner who is NDIS registered. There are no minimum
qualifications or skills be to a registered practitioner, nor
must the skills be demonstrated (Bould et al., 2022;
Hayward, 2023a). This resulting self-assessment and
endorsement for behaviour support practitioner registration
has been criticised (Hayward, 2022b) and permits persons
with a broad range of qualifications and/or experiences to
register as practitioners, leading to variability and quality in
what is called and delivered as PBS.
Intellectual and developmental disability (Winkler and
Krasner, 1987) and behaviour in schools (Dadds, 1988)
featured little in Australian academic behaviour therapy
until the mid-1990s when behaviour intervention in
Australia became influenced by the work of LaVigna
and associates from the Institute of Applied Behaviour
Analysis in the USA (Hudson et al., 1995a; Radler and
Hudson, 1996; Beamish and Bryer, 2019).
Towards PBS in Australia
Radler (see Radler and Hudson, 1996) is seen as
integral to the introduction of LaVigna and associates’
multi-element behaviour support approach to PBS in
Australia through demonstrating behavioural (Hudson
et al., 1995a) and cost-benefit (Hudson et al., 1995b)
outcomes in government community disability services,
but strikingly, it did not influence Australian departments
of education (Beamish and Bryer, 2019). This is a critical
distinction in the history of PBS in Australian disability
services and schools. Radler’s influence seems to be
opportunistic; he was an employee of the government
disability agency responsible for behaviour assessment
and intervention which allowed him to apply LaVigna and
associates’ approach at scale. The community-based
(and non-aversive) behaviour supports led by Radler
commenced in 1990 (see Hudson et al., 1995a); a time
of hastening deinstitutionalisation of intellectual disability
services in the Australian state of Victoria (see Wiesel
and Bigby, 2015), perhaps providing an auspicious
opportunity for this new approach to behaviour support.
The approach of LaVigna and associates continued to
influence some disability services up until at least 2009
(Crates and Spicer, 2012).
The first published paper in Australia which specified
PBS as we know it today in a disability context was Keen
and Knox’s (2004) review and case study of PBS and
family-centred support systems. In the school context,
Beamish attended a workshop conducted by Radler in
1991 and then a seminar by LaVigna and colleagues in
1993, influencing her research and teaching in special
education using ABA and PBS (Beamish and Bryer,
2019). Beamish went on to publish the first Australian
PBS study in a school setting (Beamish et al., 2001).
As yet there is no single agreed interpretation or definition
of PBS that can be applied across Australia. Whitefield et
al. (2022) and Hayward (2022a) provide comprehensive
summaries of the Australian school and disability PBS
research, respectively. In this brief article we focus on key
matters identified by the authors of the present paper.
Positive behavioural support in Australia: A state of the nation report 2023
8 © Bild, International Journal of Positive Behavioural Support Autumn 2023, 13, 2, 6 –12
There are 5,863 registered behaviour support practitioners
in Australia (NDIS Quality and Safeguards Commission,
2023); however, a recent survey of practitioners revealed
a mode of only one year of experience in the field.
Furthermore, 40% of surveyed practitioners were not
from professions within a national regulatory system (i.e.,
the Australian Health Practitioner Regulation Agency;
Kelly et al., 2023). This has led to clinicians expressing
concern that their less experienced peers are providing
specialist behaviour support (Bould et al., 2022). Other
studies have identified poor PBS knowledge and skill
(Carmichael et al., 2020; 2021), amongst other issues
related to resourcing, collaboration with stakeholders and
poor implementation of interventions (Leif et al., 2023).
Future priorities and developments
The development of a unified practice in PBS and minimum
independently verified standards for practitioners would
strengthen the workforce. A self-regulatory approach, like
that which exists for behaviour analysts (https://auaba.
com.au/) has merit, and Behaviour Support Practitioners
Australia (bspaustralia.org.au) has been established as a
first step in this direction.
PBS in schools
In Australia, a majority of students attend schools operated by
state and territory governments, with around 35% attending
independent, religious or private schools (Australian Bureau
of Statistics, 2023). Primary schools provide the first six years
of education to students aged between 5 and 12 years, with
secondary schools typically delivering another six years of
education to students up to the age of 17 or 18 years. There
are also many separate schools for students with disabilities
and a range of alternative education programmes for
students requiring specialised support. Each state, territory
and non-government educational jurisdiction develops their
own policies and procedures for student behaviour. PBS has
been taken up to varying degrees across all school sectors
and jurisdictions. Since the early 2000s, several government
departments have invested in professional development
and structural support for schools wanting to adopt PBS as
a school-wide approach to behaviour support.
Government departments of education in the three
most populated Australian states of New South Wales
(NSW), Victoria and Queensland began training schools
to implement school-wide positive behavioural support
(SWPBS) using materials provided by the federally-funded
There are national practice standards and quality
indicators for practitioners (NDIS Quality and Safeguards
Commission, 2021) that are largely consistent with the 12
key components of PBS identified by Gore et al. (2022).
However, the function of PBS in the NDIS is to regulate
restrictive practices through BSPs (Australian Government,
2018). While behaviour support practitioners operate to
a national definition of restrictive practices, the legislative
framework for restrictive practice authorisation remains
with the state and territory governments (Hayward et
al., 2022). At this state government level, there is no
matching policy framework nor clear definition for PBS
(Hayward et al., 2019).
Barriers and facilitators
Due in part to the increased demand for behaviour
support services in the NDIS (National Disability Services,
2022), PBS practice is experiencing ‘scope creep’ into
mental health and psychosocial disability, with some
governments specifically promoting this. For example,
the Australian Capital Territory Government (2020, p.6)
incorrectly says that ‘Positive behaviour support (PBS)
is an evidence-based framework to support people of
all ages in all settings.’ Here, PBS services risk being
delivered as a one-size-fits-all approach across a diverse
range of client presentations beyond developmental
disability where evidence for PBS is best established.
Gore et al. (2022) reflected that some aspects of PBS
(i.e., a focus on life quality) could be readily generalised
to other populations but that more focused supports will
likely require modification to meet the needs of the given
population. Using the examples of dementia and serious
mental health issues, the authors also suggest, however,
that extending PBS to these populations ‘may turn out
to be extending the defining qualities of the approach
rather than the approach itself’ (Gore et al., 2022, p.9).
Work has begun to describe the application of PBS in
dementia (Fisher et al., 2022), but significantly more is
required before extending PBS even further, as the
Australian federal government has suggested, into aged
and veterans care (Hayward, 2023a).
This ‘scope creep’ is similar to Rotholz et al.’s (2013)
‘definition creep’, a phenomenon where government
agencies are using the term ‘PBS’ in a manner that does
not reflect the actual implementation of PBS. ‘Scope
creep’ was also identified by Hayward et al. (2017) in an
Australian PBS disability policy.
Positive behavioural support in Australia: A state of the nation report 2023
© Bild, International Journal of Positive Behavioural Support Autumn 2023, 13, 2, 6 –12 9
adoption in place from education authorities. Similarly,
there is no common process across jurisdictions for
monitoring of SWPBS implementation fidelity. Fidelity, or
implementation integrity, is the degree to which SWPBS
is implemented as intended (Fox et al., 2021). Fidelity
of implementation in Queensland schools is variable
(Hepburn, 2019), whilst a study of 15 government and
independent schools in Victoria found that over 70% were
implementing with fidelity (Fox et al., 2021) and fidelity
showing a relationship to student and staff outcomes in
Victoria (Department of Education, 2022). A majority of
government schools implementing SWPBS in NSW self-
reported implementing Tier 1 features at a high degree
of fidelity (Centre for Education Statistics and Evaluation,
2021), but to date there have been no large-scale studies
of SWPBS implementation or outcomes conducted in
Australia.
Barriers and facilitators
A consistent nationwide approach to implementation of
SWPBS in schools has been hampered by the fragmented
nature of education delivery in Australia (Beamish and
Bryer, 2019). Although funding to both government and
non-government schools is provided federally, education
authorities in each state and territory operate independently
and set their own education policies and priorities.
Such fragmentation has meant that each jurisdiction
has developed their own professional development
and resourcing model for SWPBS, potentially creating
inefficiencies and limiting strategic use. Additionally,
there is no system for implementation data collection or
outcomes across jurisdictions (Poed and Whitefield, 2020),
making it difficult to gauge effectiveness or gain traction
for scaling up implementation efforts. Finally, although the
importance of ongoing coaching for successful SWPBS
implementation is well documented (e.g., McIntosh et al.,
2013), no Australian data is available to enable comparison
of the different coaching models adopted by different
jurisdictions (Poed and Whitefield, 2020).
Recent Australian research has identified some of the
facilitators to achievement of SWPBS implementation
fidelity. Fox and colleagues (2021) surveyed over 200
teachers working in independent and government
schools implementing SWPBS with fidelity in Victoria.
Overall, the duration of SWPBS implementation was
found to predict implementation fidelity most strongly.
This result may be cause for cautious optimism, given
that Australian implementation began in the early 2000s,
with many schools sustaining implementation over
several years.
US national Center on Positive Behavioral Interventions
and Supports (PBIS; Poed and Whitefield, 2020). The
impetus for the introduction of SWPBS by government
departments was largely a desire to adopt a more proactive
approach to behaviour support (Poed and Whitefield,
2020), with schools keen to see a reduction in time spent
managing challenging behaviours.
PBS delivery
It is estimated that approximately 30% of Australian
schools across government, Catholic and independent
sectors have been trained to implement SWPBS.
Adoption is highest in the eastern states, with
approximately half of schools in Queensland and NSW
reporting they are currently implementing the SWPBS
framework (Poed and Whitefield, 2020). The Department
of Education (2022) in Victoria has committed to
providing SWPBS implementation support to 50% of
their schools. Implementation largely follows the PBIS
Implementation Blueprint (Office of Special Education
Programs, 2015), with only minor language adaptations,
apart from the relabelling of SWPBS to positive behaviour
for learning in NSW and, later, Queensland (Beamish
and Bryer, 2019; Poed and Whitefield, 2020). In general,
schools install systems which support implementation
of SWPBS essential features, such as explicitly teaching
and reinforcing school-appropriate behaviours and
responding instructionally to unproductive behaviours.
Each jurisdiction supports school implementation differently,
depending on funding models and deployment of staff
with relevant PBS knowledge and skills. For example, in
the government sector, professional development and
coaching are provided by regional advisers in Queensland
(Hepburn, 2022) and area-based coaches in Victoria
(Department of Education, 2022). Implementation support
varies according to diocese in the Catholic education
system. Advisers and coaches are generally experienced
and registered school professionals, commonly teachers,
with knowledge of PBS and SWPBS essential features,
but no special qualifications are required.
Policies and guiding documents at both the federal and
state/territory levels, such as the Australian Student
Wellbeing Framework (Education Services Australia,
2020), promote a continuum of supports based on
identified student needs and encourage a positive
approach to behaviour support, with a focus on
positive relationships. Nevertheless, take-up of SWPBS
is left up to individual schools, with no mandates for
Positive behavioural support in Australia: A state of the nation report 2023
10 © Bild, International Journal of Positive Behavioural Support Autumn 2023, 13, 2, 6 –12
relationships between governments and universities are vital
for PBS to evolve (Hayward, 2023b), and they should begin
to evaluate outcomes for recipients of PBS supports and
make these evaluations accessible to interested persons.
Importantly, there is no collaboration across sectors
for PBS in Australia. Hayward (2022a) recommended
establishment of an inclusive national framework and
lead agency for PBS. This seems sensible with the large
investment in PBS by individual jurisdictions and sectors
in the last two decades, and with no indication that PBS
in Australian disability services and schools will align in any
way in the foreseeable future.
References
Australian Bureau of Statistics (2023) Schools: Key statistics.
Available at: abs.gov.au/statistics/people/education/
schools/2022 (accessed 26 February 2023).
Australian Capital Territory Government (2020)
Positive behaviour support plan guideline. Available
at: communityservices.act.gov.au/__data/assets/
pdf_file/0006/1460058/Positive-Behaviour-Support-
Plan-Guidelines.pdf
Australian Government (2018) National Disability Insurance
Scheme (Restrictive Practices and Behaviour Support) Rules
2018. Available at legislation.gov.au/Series/F2018L00632
(accessed 26 February 2023).
Barker, K, Poed, S and Whitefield, P (eds.) (2022) School-
wide positive behaviour support: The Australian handbook.
Abingdon: Routledge.
Beamish, W and Bryer, F (2019) ‘Behavioural support in
Australia’, In F Bryer and W Beamish (eds.) Behavioural
support for students with special educational needs.
Advancing inclusive and special education in the
Asia-Pacific. Singapore: Springer, pp.69–88.
Beamish, W, Bryer, F and Wilson, L (2001) ‘Positive
behavioural support: An example of practice in the early years’,
Special Education Perspectives, 9(1), 14–29.
Birnbrauer, J S (1994) ‘The first 20 years of the Australian
Behaviour Modification Association’, Behaviour Change,
11(2), 65–81.
Bould, E, Sloan, S and Callaway, L (2022) ‘Behaviour support
for people with acquired brain injury within the National
Disability Insurance Scheme: An Australian survey of the
provider market’, Brain Impairment, 2022, 1–15.
Carmichael, J J, Gould, K R, Hicks, A J, Feeney, T J and
Ponsford, J L (2020) ‘Understanding Australian community
ABI therapists’ preferences for training in and implementing
behaviour interventions: A focus on positive behaviour support’,
Brain Impairment, 21(2), 191–207.
Future priorities and developments
There is a strong need for robust research into the
implementation and outcomes of SWPBS in Australian
schools (Poed and Whitefield, 2020; Fox et al., 2021).
However, the publication in recent years of several
Australian academic articles (e.g., Fox et al., 2021; Poed
and Whitefield, 2020) and the publication of an Australian
SWPBS handbook (Barker et al., 2022) is a hopeful sign
that appetite is growing among Australian researchers to
collaborate on research projects which will help advance
the effective use of PBS in schools.
PBS in other services
The length of this paper has not permitted us to include
early childhood (pre-compulsory) education contexts,
but it is important to acknowledge the work of the late
Janene Swalwell and collaborators (e.g., Swalwell and
McLean, 2021) in the application of the pyramid model in
Australia. There is an emerging field of Australian research
on the application of PBS in brain injury (e.g., Carmichael
et al., 2020; 2021; Fisher et al., 2021; Gould et al., 2021)
which is beginning to evaluate outcomes for people with
brain injury receiving PBS supports. This is an important
development in the Australian PBS research which, as
we have discussed in this paper, has largely ignored
outcomes for recipients of PBS supports, including in
schools, to date.
Conclusion and future considerations
While PBS in Australian disability services and schools
shared an origin in ABA up until the early 2000s, their
similarities ended there, and they diverged to become
distinct. PBS in disability services is now a national policy
of individual behaviour assessment and BSP development
undertaken by practitioners with no minimum qualification
or skill and operating in the context of restrictive practice
regulation. PBS in schools is entirely a state or territory
initiative, encouraged by a desire to respond to behaviour
more proactively using established models from the
USA and a professionalised school workforce with no
reference to restrictive practices, but with closer attention
to practice fidelity.
But it is too simplistic to suggest all that is required is
more research about PBS to influence decision-makers;
PBS researchers must produce policy-relevant research
(Hayward, 2023b). It is vital that PBS leaders in government
agencies and schools, and non-government services and
schools, improve the standard of PBS practices. Effective
Positive behavioural support in Australia: A state of the nation report 2023
© Bild, International Journal of Positive Behavioural Support Autumn 2023, 13, 2, 6 –12 11
Gore, N J, Sapiets, S J, Denne, L D, Hastings, R P, Toogood,
S, MacDonald, A, Baker, P, Allen, D, Apanasionok, M M, Austin,
D, Bowring, D L, Bradshaw, J, Corbett, A, Cooper, V, Deveau,
R, Hughes, J C, Jones, E, Lynch, M, McGill, P, Mullhall, M,
Murphy, M, Noone, S, Shankar, R and Williams, D (2022)
‘Positive behavioural support in the UK: A state of the
nation report’, International Journal of Positive Behavioural
Support, 12(Suppl 1), 4–39.
Gould, K, Ponsford, J L, Hicks, A J, Hopwood, M, Renison,
B and Freeman, T J (2021) ‘Positive behaviour support
for challenging behaviour after acquired brain injury: An
introduction to PBS + PLUS and three case studies’,
Neuropsychological Rehabilitation, 31(1), 57–91.
Hayward, B A (2022a) Positive behaviour support in
Australian disability services: Social network perspectives
on policy and people. Doctoral dissertation, University of
Melbourne. Available at: hdl.handle.net/11343/311268
(accessed 26 February 2023).
Hayward, B A (2022b) ‘Where is applied behaviour
analysis (ABA) in the National Disability Insurance Scheme?
Commentary on “Delivering behaviour support to children and
adolescents with autism via telepractice: A narrative review”
(Johnsson & Bulkeley, 2021)’, Research and Practice in
Intellectual and Developmental Disabilities, 9(2), 182–187.
Hayward, B A (2023a) ‘An argumentation analysis of
testimony about positive behaviour support and chemical
restraint in Australia’s Royal Commission into Violence,
Abuse, Neglect and Exploitation of People with Disability’,
International Journal of Developmental Disabilities,
doi.org/10.1080/20473869.2023.2238153.
Hayward, B A (2023b) ‘Appreciating the responsibilities of
researchers and governments in “evidence-informed policy”:
Commentary on “Helping distressed people with intellectual
disabilities to manage their chaotic emotions” (Clegg &
Lansdall-Welfare, 2022)’, Research and Practice in
Intellectual and Developmental Disabilities, 10(1), 19–25.
Hayward, B, McKay-Brown, L and Poed, S (2019) ‘Positive
behaviour support in Australian disability policy, and its
future with the National Disability Insurance Scheme (NDIS)’,
Research and Practice in Intellectual and Developmental
Disabilities, 6(1), 14–23.
Hayward, B, McKay-Brown, L and Poed, S (2022)
‘Geographical networks in the divergence of Australian
positive behavior support policy’, Journal of Policy and
Practice in Intellectual Disabilities, 19(2), 220–229.
Hayward, B, McKay-Brown, L and Poed, S (2023)
‘Restrictive practices and the “need” for positive behaviour
support (PBS): A critical discourse examination of disability
policy beliefs’, Journal of Intellectual Disabilities,
27(1), 170–189.
Carmichael, J, Hicks, A, Gould, K, Feeney, T, Analytis, P and
Ponsford, J (2021) ‘We struggle and muddle. A qualitative
study exploring community ABI therapists’ experiences of
using, training in and implementing behaviour interventions’,
Brain Impairment, 22, 34–49.
Centre for Education Statistics and Evaluation (2021)
Positive Behaviour for Learning evaluation – final report.
Available at: https://education.nsw.gov.au/about-us/
education-data-and-research/cese/publications/cese-
evaluations/positive-behaviour-for-learning-evaluation
(accessed 26 February 2023).
Crates, N and Spicer, M (2012) ‘Developing behavioural
training services to meet defined standards within an Australian
statewide disability service system and the associated
client outcomes’, Journal of Intellectual and Developmental
Disability, 37(3), 196–208.
Dadds, M R (1988) ‘Behaviour modification in Australia:
A quantitative review of the last decade’, Behaviour Change,
5(4), 147–153.
Department of Education (2022) School-wide positive
behaviour support: Information for schools (2022–2024).
Available at: https://www.education.vic.gov.au/PAL/SWPBS-
information-for-schools.pdf (accessed 26 February 2023).
Department of Social Services (2016) NDIS quality
and safeguarding framework. Available at: dss.gov.au/
disability-and-carers/programs-services/for-people-with-
disability/ndis-quality-and-safeguarding-framework-0
(accessed 26 February 2023).
Dunlap, G, Sailor, W, Horner, R H and Sugai, G (2009)
‘Overview and history of positive behaviour support’, In W Sailor,
G Dunlap, G Sugai and R Horner (eds.) Handbook of positive
behaviour support, New York, NY: Springer, pp.3–16.
Education Services Australia (2020) Australian student
wellbeing framework. Available at: https://studentwellbeinghub.
edu.au/ (accessed 26 February 2023).
Fisher, A, Bellon, M, Lawn, S and Lennon, S (2021)
‘Family perspectives on the acceptability and usefulness
of the FAB Positive Behaviour Support program:
A pilot study’, Brain Injury, 35(5), 609–619.
Fisher, A, Connolly, T, O’Connor, C and Kelly, G (2022)
‘Positive behaviour support for people with dementia’,
International Journal of Geriatric Psychiatry, 37(12), 1–7.
Fox, R A, Sharma, U and Leif, E (2021) ‘The factors
that count: Predicting implementation fidelity of evidence-
based behavioural supports in Australian schools’,
International Journal of Inclusive Education,
doi.org/10.1080/13603116.2021.1979669.
Positive behavioural support in Australia: A state of the nation report 2023
12 © Bild, International Journal of Positive Behavioural Support Autumn 2023, 13, 2, 6 –12
National Disability Services (2022) State of the disability sector
repor t 2022. Available at: nds.org.au/about/state-of-the-
disability-sector-report (accessed 26 February 2023).
NDIS Quality and Safeguards Commission (2021) NDIS
practice standards and quality indicators. Available at:
ndiscommission.gov.au/providers/registered-ndis-providers/
provider-obligations-and-requirements/ndis-practice-
standards-1 (accessed 26 February 2023).
NDIS Quality and Safeguards Commission (2023)
Quarterly Performance Report 1 April to 30 June
2023. Available at: ndiscommission.gov.au/resources/
reports-policies-and-frameworks/ndis-commission-activity-
reports#paragraph-id-6958 (accessed 26 February 2023).
Office of Special Education Programs (2015) Positive
behavioral interventions and supports (PBIS) implementation
blueprint: Part 1 – Foundations and supporting information.
Available at: pbis.org (accessed 20 December 2022).
Poed, S and Whitefield, P (2020) ‘Developments in the
implementation of positive behavioral interventions and
supports in Australian schools’, Intervention in School
and Clinic, 56(1), 56–60.
Radler, G and Hudson, A (1996) ‘The Behavior Intervention
Support Team program: Addressing challenging behavior
of people with an intellectual disability in Victoria, Australia’,
Positive Practices. The IABA Newsletter, 1(2), 3–8.
Rotholz, D A, Moseley, C R and Carlson, K B (2013)
‘State policies and practices in behavior supports for
persons with intellectual and developmental disabilities
in the United States: A national survey’, Intellectual
and Developmental Disabilities, 51(6), 433–445.
Sailor, W and Paul, J L (2004) ‘Framing positive behavior
support in the ongoing discourse concerning the politics
of knowledge’, Journal of Positive Behavior Interventions,
6(1), 37–49.
Swalwell, J M and McLean, L A (2021) ‘Promoting children’s
social-emotional learning through early education: Piloting
the Pyramid Model in Victorian preschools’, Australasian
Journal of Special and Inclusive Education, 45, 122–134.
Whitefield, P, Poed, S and Barker, K (2022) ‘School-wide
positive behaviour support within the Australian context’,
In K Baker, S Poed and P Whitefield (eds.) School-wide
positive behaviour support. The Australian handbook.
Abingdon: Routledge, pp.1–23.
Wiesel, I and Bigby, C (2015) ‘Movement on shifting sands:
Deinstitutionalisation and people with intellectual disability
in Australia, 1974–2014’, Urban Policy and Research,
33(2), 178–194.
Winkler, R C and Krasner, L (1987) ‘A social history of
behaviour modification in Australia’, Behaviour Change,
4(3), 11–25.
Hayward, B, Poed, S and McKay-Brown, L (2017)
‘Analysing text in positive behavioural support (PBS) policy:
A pilot study’, International Journal of Positive Behavioural
Support, 7(2), 37–48.
Hayward, B, Poed, S and McKay-Brown, L (2018) ‘Improving
the adoption of PBS and ABA using diffusion of innovations
theory’, Tizard Learning Disability Review, 23(4), 178–186.
Hepburn, L (2019) ‘Behavioural support in an Australian
government sector’, In W Beamish and F Bryer (eds.)
Behavioural support for students with special
educational needs. Singapore: Springer, pp.89–100.
Hepburn, L (2022) ‘Installation of school-wide positive
behaviour support in government schools: Queensland
experiences’, International Journal of Positive
Behavioural Support, 12(1), 13–20.
Hepburn, L and Poed, S (2021) ‘Deviating from the data:
A response to Bleakley and Bleakley’, Interchange,
52(2), 193–201.
Hudson, A, Wilken, P, Jauernig, R and Radler, G (1995a)
‘Regionally based teams for the treatment of challenging
behaviour: A three-year outcome study’, Behaviour
Change, 12(4), 209–215.
Hudson, A, Jauernig, R, Wilken, P and Radler, G (1995b)
‘Behavioural treatment of challenging behaviour:
A cost-benefit analysis of a service delivery model’,
Behaviour Change, 12(4), 216–226.
Jones, B M, Ralph, A and Mazzucchelli, T G (2018)
‘Remembering Jay S. Birnbrauer’, Behaviour Change,
34(4), 279–285.
Keen, D and Knox, M (2004) ‘Approach to challenging
behaviour: A family affair’, Journal of Intellectual and
Developmental Disability, 29(1), 52–64.
Kelly, G, Louise, K, Kremer P and Fisher, A. (2023)
‘Behaviour support provision in Australia: A cross-sectional
survey of practitioners developing behaviour intervention plans’,
Health and Social Care in the Community. Under review.
Leif, E, Fox, R, Subban, P and Sharma, U (2023)
‘“Stakeholders are almost always resistant”: Australian
behaviour support practitioners’ perceptions of barriers and
enablers to reducing restrictive practices’, International
Journal of Developmental Disabilities, 69(1), 66–82.
McIntosh, K, Mercer, S H, Hume, A E, Frank, J L, Turri, M
G and Mathews, S (2013) ‘Factors related to sustained
implementation of schoolwide positive behaviour support’,
Exceptional Children, 79(3), 293–311.
National Disability Insurance Scheme (NDIS) (2022) Do
you meet the disability requirements. Available at https://
ourguidelines.ndis.gov.au/home/becoming-participant/
applying-ndis/do-you-meet-disability-requirements
(accessed 30 September 2023).
... SW-PBIS was implemented in over 27,500 schools in all 50 states during the 2022-2023 school year (Center on PBIS, n.d.). It has also been adopted by many other countries, including Australia (Hayward et al., 2023), Denmark (Jensen, 2021), Finland (Heiskanen et al., 2023), Netherlands (Willemse et al., 2023), Norway (Sørlie & Ogden, 2007), Sweden (Ingemarson et al, 2014), Türkiye (Melekoğlu & Diken, 2022), and United Kingdom (Denne et al., 2023). It is, therefore, possible to use SW-PBIS effectively in a manner that promotes pro-environmental behavior and fights climate change by given implementation frameworks and widespread implementation. ...
Article
The causes of dramatic climate change mostly lie in human behavior. Humans cause climate change, for example, by creating waste. Pro-environmental behavior plays a crucial role in fighting climate change by preventing waste and conserving resources. Therefore, schools should foster pro-environmental behavior to fight climate change more effectively. Schools can foster pro-environmental behavior by organizing activities focused on both saving water, energy and managing waste through recycling and reuse. As such, one of the systems that can be used to increase the quality and efficiency of green school practices is School-Wide Positive Behavioral Interventions and Supports (SW-PBIS). SW-PBIS is a three-tiered approach that matches intervention intensity to student’s needs, aiming to improve all students’ social and educational outcomes through evidence-based preventive behavioral interventions. However, when SW-PBIS implementations are generally considered, the system is mainly used to prevent problem behaviors. While respect, responsibility, and safety are the most common expectations, no expectation is created or included in the system based on sustainability. So, the starting point of the idea is that while problem behaviors can be prevented with SW-PBIS, pro-environmental behaviors to promote a green school can also be taught and supported. Consequently, this article introduces a conceptual framework to integrate pro-environmental behaviors into SW-PBIS for creating green schools. We discuss the importance of SW-PBIS in fostering pro-environmental behavior and how it can help develop responsible students who contribute to green schools to fight climate change. We also discuss implications for future research and practice. This conceptual framework is expected to expand the scope of SW-PBIS and contribute to the implementation of green school initiatives.
... This contradicts a human rights-based approach that establishes foundations of good support as a minimum service expectation [17] and contradicts Australian legislation [18] that seeks to protect and uphold the rights of people with disability. Readers are directed to the work of Fisher et al. [15,17] and Hayward et al. [19,20] for a more detailed overview of PBS service delivery in Australia and as funded by the NDIS for people with disability. ...
Article
Positive behaviour support (PBS) is recommended as a service response to challenging behaviours. In Australia, however, there has been concern regarding PBS policy and implementation. In response, this article proposes a tiered PBS service model for disability and community settings, which is evidence-based and rights-driven. Relevant literature, policy guidelines, and clinical experience are used to inform a positive behaviour support service model for community implementation. The Positive Behaviour Support in Disability and Community Service (PBS-DCS) model articulates systems-wide practices that support effective PBS provision within a human rights approach. The model describes three tiers of behaviour support: Tier I (Foundational), Tier II (Targeted), and Tier III (Specialist), and considers who should deliver which intervention elements and when. The PBS-DCS model provides a framework to support quality PBS practice in community settings. It is proposed that a proof-of-concept model of community-based PBS should be investigated—and that this would help to ensure current practice aligns with the professional expectations of PBS and deliver high quality services to people living with disability.
Article
Full-text available
Introduction Australia's Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (2019-2023) is examining, amongst many issues, how positive behaviour support (PBS) can address challenging behaviour and reduce the use of restrictive practices, particularly chemical restraint. This study explores the basis of the claims made about this during testimony. Materials and methods Applying existing recommendations for the study of royal commissions, this study uses argumentation analysis of testimony. Results Three central claims about PBS were identified: practitioners, behaviour support plans, and chemical restraint. Comparison with Australian research shows preparation of behaviour support practitioners is poor, behaviour support plans do not show a clear benefit to people with disability, and chemical restraint remains a persisting issue with no viable way forward. Discussion 2 The analysis highlights the difference between perceptions of PBS and the current Australian evidence underlying it. The barriers to the promotion of PBS to address restrictive practices in Australian disability services prompts reconsideration of the policy expansion to address restrictive practices in other sectors.
Article
Full-text available
Clegg and Lansdall-Welfare (2022) have suggested that behavioural intervention is a “historical precedence” (p. 3), and that a particular interpretation of trauma-informed care “has made it acceptable to change-resistant policy-makers” (p. 11). In this brief commentary I argue that government policies are influenced by more than just precedence and policymakers. Using programs of Australian research about the use of social science research (https://issr.uq.edu.au/utilisation-social-science-research) and positive behaviour support policy (Hayward, 2022), in the context of Australia’s National Disability Insurance Scheme (NDIS; www.ndis.gov.au), I argue that both researchers and governments share the responsibility for evidence-informed disability policy.
Article
Full-text available
A restrictive practice (RP) is defined as a practice or intervention that has the effect of restricting the rights or freedom of movement of a person, and includes physical, mechanical, and chemical restraint, and seclusion. If misused or overused, RPs may present serious human rights infringements. In Australia, behaviour support practitioners who deliver behaviour support funded by the National Disability Insurance Scheme are responsible for developing positive behaviour support plans that aim to reduce and eliminate the use of RPs. At present, little is known about the barriers that behaviour support practitioners experience when attempting to reduce and eliminate the use of RPs and, conversely, what helps (or enables) them to reduce and eliminate RPs. To learn more, we conducted an online survey consisting of two open-ended questions with 109 Australian behaviour support practitioners to identify barriers and enablers. We found that fear and reluctance on the part of stakeholders were often barriers to reducing the use of RPs. However, we found that having time, funding, and resources for training, supervision, other implementation activities, care team collaboration, and data-based decision-making helped overcome barriers. We provide specific recommendations for addressing identified barriers for individual behaviour support practitioners, service provider organisations, and government and regulatory agencies.
Thesis
Full-text available
The advent of Australia’s National Disability Insurance Scheme (NDIS) has increased the profile of positive behaviour support (PBS). This increase is not matched with a coherent understanding of what PBS is, nor are methods for its effective promotion to, and adoption by, workforces and systems understood. International scholars interested in PBS have recommended that research turn its attention to systems and focus on the environmental context more than the individual person with disability. These recommendations are taken up in the aim of this research which is to explore who and what is influencing PBS in Australian disability services. This thesis with publication explores how policy and persons influence the understanding and adoption of PBS through the application of methods from network science. Eight studies were undertaken using policy documents from online sources and participants recruited using reputational snowball sampling. Analyses were conducted using network analysis software. The results of the individual studies are presented across four chapters. In Chapter 2, PBS is found to be incoherently defined by state and federal governments. In Chapter 3, political rhetoric is identified in one prominent PBS policy, while non-government policies are underpinned by a set of dominant yet contradictory beliefs. The final study in this chapter finds evidence that PBS policy is influenced by interpersonal relationships. In Chapter 4, a highly clustered network of persons involved in the Australian promotion and use of PBS is identified, revealing two groups of persons important in the effective application of PBS, although these persons do not necessarily have all the required characteristics for these roles. The network shows that communication about PBS is dependent on several factors that are not sufficiently exploited to be effective. The final chapter applies an existing framework for diffusion of innovations to better understand the successful adoption of PBS and presents a new conceptual framework and practice principles for the introduction of PBS into disability services. The results suggest that foundational issues of the definition and scope of PBS in Australian disability services must first be addressed. There is evidence that PBS remains hampered by persons who are poorly networked, risking the communication of inaccurate and non-contemporary information about PBS. This can be addressed with a deliberate approach to the diffusion of PBS using three main strategies: development and implementation of a single, cross-sector national PBS framework, funding for, and establishment of, a lead national agency for PBS, and the provision of technical assistance at the state level. Without such attention, the reputation of PBS is at risk and the NDIS will not deliver meaningful outcomes to people with disability.
Article
Full-text available
Background and objectives People with acquired brain injury (ABI) may experience behaviours of concern that require therapy services, including behaviour support. In Australia, the implementation of a National Disability Insurance Scheme (NDIS) and development of the NDIS Quality and Safeguards Commission, has led to significant changes to behaviour support workforce processes, and the way behaviour support is funded, regulated and delivered to people with ABI who are Scheme participants. The aim of this study was to explore the current and future provider market of professionals providing behaviour supports to Scheme participants who experience ABI. Method An anonymous survey was designed and distributed via social media channels, an email listserv and professional association newsletters to professionals working within the NDIS in Australia. Data were analysed using descriptive statistics and content analysis. Results One hundred and two surveys responses were analysed. A majority of professionals had an average understanding of the NDIS Quality and Safeguard Commission rules and policies on behaviour support. Responses to current and future registration as an NDIS Practitioner indicated the workforce gap could increase by between 17 and 26%. Respondents also raised concerns about the lack of training and experience of allied health professional students and graduates in addressing behaviours of concern. Responses to the open-ended question highlighted additional issues in the provision of behaviour support within the NDIS. Conclusions This research highlighted the need for an NDIS behaviour support workforce strategy and supply-side market intervention to ensure a viable and sustainable workforce for people with ABI who need behaviour support.
Article
There is currently a limited understanding of the characteristics of the workforce of behaviour support practitioners in Australia. A better understanding will help future considerations of training requirements, professional credentialling, and associated professional regulation. A cross-sectional online survey captured demographic and work-related characteristics of those who develop behaviour intervention plans for people with disability in Australia. The sample (n = 423) was primarily female (78%), aged 26-45 years (57%), and held a graduate (39%) or postgraduate (53%) degree. The largest single professional group was psychologists (28%). The most common duration of experience was one year. Approximately half the respondents were allied health practitioners either registered with the Australian Health Practitioner Regulation Agency, or a member of the National Alliance of Self Regulating Health Professionals. The majority of practitioners had registered with the National Disability Insurance Scheme to provide behaviour support services (85%). Both clients and services were concentrated in metropolitan regions, raising concerns regarding equity of access to behaviour support in remote communities, and among Aboriginal and Torres Strait Islanders. Given the vulnerability of many people with disabilities in receipt of behaviour support, ongoing policy and procedure work is needed to ensure professional credentialling and regulation of the workforce.
Article
Key points Legislative changes are directing clinical practice away from using medication as a first‐line approach for behaviour management. Positive behaviour support (PBS) is a non‐pharmacological intervention approach with increasing acceptance in the disability sector. The utility of PBS for people living with dementia is not well understood. Implementing PBS requires specialist skills and, at times, significant resources. In the context of a progressive disease, this raises important considerations about ‘bang for buck’ for funders.
Article
International Journal of Positive Behavioural Support https://www.ingentaconnect.com/contentone/bild/ijpbs/2022/00000012/00000001/art00004 Abstract: In 2005, the Queensland Department of Education introduced the School-Wide Positive Behaviour Support (SWPBS) framework as a proactive school-wide disciplinary approach. SWPBS is known in Queensland schools as Positive Behaviour for Learning (PBL). It is estimated that around half of all government schools have received training for PBL implementation. The department provides initial and ongoing training and technical assistance to schools to achieve fidelity of implementation, with the goal of improving outcomes for students. Training packages and support strategies have been developed and are continuously reviewed in response to emerging data. Contextual factors impacting on PBL implementation fidelity in Queensland government schools are discussed.