The efficacy of positive behavioural support with the most challenging behaviour: The evidence and its implications

Abstract

Background Positive behaviour support (PBS) is behaviour analysis applied in support of people with challenging behaviour. Questions have been raised as to PBS effectiveness, costs, and accessibility.

Method Outcome studies meeting specified criteria for PBS were selected for review. All told, 12 outcome studies encompassing 423 cases were included.

Results This review showed that PBS was effective with both severe and high-rate behaviour problems, was cost-effective, used a methodology that was easily trained and widely disseminated, and worked in institutional settings in which the most difficult problems are thought to be, as well as in the community.

Conclusions The major implication of this review is that practitioners may be obligated to use PBS when faced with the need to develop a plan of support given the ethical principle of using the least restrictive method consistent with the right to effective treatment.

Keywords:

• positive behaviour support (PBS)
• efficacy
• challenging behaviour

Acknowledgement

We would like to thank John Q. Marshall for facilitating the 20-year follow-up described in this review and for his contribution to the dissemination of positive behaviour supports as the Director of Training for the Institute for Applied Behavior Analysis.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.