Understanding Acquired Brain Injury and Behaviour Change: A Guide to Managing Challenging Behaviours
Written by Sue Sloan
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Acquired Brain Injury (ABI) disrupts and impairs functions of the individual’s unique brain and can dramatically change the way the individual thinks, behaves and relates in everyday situations. Behaviour change is referred to as challenging behaviour or behaviour of concern and is known to severely impact the individual’s participation in previous activities and life roles. ‘Understanding acquired brain injury and behaviour change. A guide to managing challenging behaviours’ is a detailed resource that outlines how to create a positive behaviour support plan.
Section 1 explains acquired brain injury and the nature of the injury that disrupts the pathways necessary for behavioural control. Mathew is introduced to the reader, and his detailed case study is used throughout the resource. Section 2 discusses the deleterious impact of cognitive and behavioural change on participation in social roles and everyday activities. Section 3 outlines challenging behaviours commonly seen after acquired brain injury such as verbal aggression, physical aggression, absconding and inappropriate social behaviours. It also describes how such behaviours can trigger a downward spiral of worsening outcomes and escalating challenges. This section also introduces key concepts that underpin and inform the development of a positive behaviour support plan. Section 4 describes the ABC model, which enables us to systematically analyse the behaviour in the context in which it occurs, and so come to understand the function of the challenging behaviour. The way consequences shape and reinforce behaviour is clearly explained and a range of detailed case examples are provided. Section 5 outlines the steps for data collection and documentation of the positive behaviour support plan. The PBSP contains both proactive and reactive strategies to reduce challenging behaviour and also shape the development of pro-social replacement behaviours in the context of supporting participation. Section 6 outlines the Community Approach to Participation which is a model of long term rehabilitation that draws on the principles of neuroplasticity to rebuild skills and pro-social behaviours to facilitate participation. Section 7 provides a summary of the keys to working with people with challenging behaviours after acquired brain injury.