Behaviour Support Plan -Comprehensive

EXP0034.0001.0033

o NDIS Quality and Safeguards Commission

Behaviour Support Plan - Comprehensive

Participant name: [~~~~~~~~~~_~:'~:'~~~~~~~~~~J

Plan details

Behaviour support practitioner:

Specialist behaviour support provider: _

Start date: 30/03/2020 End date: 30/30/2021

Practitioner 10: _

Review date:

30/03/2021

State/Territory: QLO Is a short-term approval in place? No {SA and QLD only}

Important information

This form is approved by the NOIS Quality and Safeguards Commissioner for the purposes of section 23 of

the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018. This

form seeks to collect information - including personal information - for the purpose of administering and

enforcing the National Disability Insurance Scheme Act 2013 and the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018. Please refer to the Privacy Collection Statement

and the NOIS Quality and Safeguards Commission's Privacy Policy at

https://www.ndiscommission.gov.au/privacy. The NOIS Commission makes no representations about, and

accepts no liability for, the accuracy of information in this document.

Person details

NOIS participant #:

First name:

r·_·-·-·-AS-K-·_·_·_·l L_._._._._._._._._._._._._._!

Gender:

Male

Preferred method of contact:

Phone - Mother

How does the person communicate?

Title:

Mr

Middle name:

Oate of birth:

Is the person of Aboriginal or Torres Strait Islander origin?

Last name:

Country of birth:

Australia

Email address:

Ooes the person receive informal decision-making support from fa m i Iy /frien ds/ advocate?

NDIS Quality and Safeguards Commission - Comprehensive behaviour support plan template v2.0 June 2019 1

EXP0034.0001.0034

Non-verbal Torres Strait Islander iiIiiiiIihrOUgh Mother,

No N/A No

No

Family Home 4 years

Disability details

Intellectual disability

Autism spectrum

Participant's current address

I 28/10/2016

Key contacts

Ms.

Mother 6/10/2017

-Dr. - -Medical Professional Paediatrician 8/08/2018

NDIS Quality and Safeguards Commission - Comprehensive behaviour support plan 2

EXP0034.0001.0035

Dr. - -Medical Professional General Practitioner 30/11/2017

-Mr.

House staff Lifestyle Manager 30/11/2017

Ms. - -Allied Health Professional Speech Pathologist 30/11/2017

Ms.

Allied Health Professional Speech Pathologist 30/11/2019

Ms. - -Allied Health Professional occupational Therapist 30/11/2017


EXP0034.0001.0036

Ms.

Case Manager NDIS Support Coordinator 30/11/2017

Ms. Joanna Mullen

Other Advocate 30/11/2017

Ms. - -Other Teacher 27/08/2018

Ms. - -Medical Professional Chronic Care Coordinator 27/08/2018

NB: Consultation and collaboration with the majority of the above identified 'key contacts' has been ongoing since initial consultation in 2017.


EXP0034"0001"0037

Implementing providers

Provider name: ABN (or registration 10) Outlet name:

-Authorised reporting officer name:

Provider name:

Assessments

Assessor:

About the person

Strengths, life dreams and aspirations

ABN (or registration 10) Outlet name:

Assessment type:

Functional Behaviour Assessment

OT Functional Assessment

Adaptive Behaviour Assessment System, third edition (ABAS 3) - Parent Form

Report date:

3/02/2020

30/03/2020

3/04/2020

ear-old male of Torres Strait Islander descent" He resides at in a Department of Housing home, with his mother

9-yea brother_and 9-year old niece s been caring for!-"-AiiK"l all his life, and formal supports have been limited and inconsistent ov~rihis"time"_is transitioning into another home in April 2020, andi"-A-SK-l will be supported to reside independently in his current home thath"as-b"e~n modified for his needs"

l:~:~~~~Jand his family relocated November 2016

after. On (ceased due to funding issues), successfully accessing e ucation with 1:1 supportfAs-i(-"1displayed challenging behaviours at a high frequency, but these were"h-an"dled with stri nt risk and behaviour mana placer"j~"BK"-!commenced the Mardi"-i6iS-"L/ntil st 2018"


EXP0034.0001.0038

behaviours of harm and behaviours of concernr·-ABK-·! displayed at school.

[~~~~BJcurrently engages in 1:1 support shifts an-orne and in the community to develop his adaptive daily living skills (ADLs) and engage in activities contributing to a high quality of life (QoL).

r·-AB-K"-l has received limited consistent intervention throughout his deveropmental years, and much of his capacity to learn and build new skills was unknown initially. On initial referralr·-AS-K-·!displayed frequent and severe

L_._._._._._._._! r'-'-'-'-'-'-'-'-'-:

challenging behaviours. These extremity of these impactedL._~~_~_._i access to disability services and exacerbated carer fatigue experienced by his mother _ Over time, with the support of NDIS and the health system, the

challenging behaviou{~~~BJdisplays has decreased in frequency, duration and intensity, and he has entered a 'skill development' stage.

:-'-'-'-'-'-'-'-'-'-"1

!._._t.\~_~_._.jstrengths include this capacity to build skills. He is also described as a very good natured, kind young man with a great sense of humour.

Likes/dislikes likes:

[~A"f.i.'!~J is called_ by his family. He enjoys bouncing, throwing and catching balls, shooting hoops, going on drives, jumping on the trampoline, swimming, listening to music, dancing, water play, bean bags and being read to.

r·_·-AEiK·_·-!support team have also started encouragingr·-AS·K·l to help with L._._._._._._._._._. L._._._._._._._.

household tasks such as vacuuming, carrying his laundry basket to the washing line and blowing leavesJ·-A-SK·_·!shows that he likes his support team by carrying their photos ar~u-na-an·d repeating their names, or pointing to their photos for his mother to state their names. r-AS-K-·ican enjoy social connections in small groups (i.e. with his family; 1:1 with'·h-fs-si:j"fi'port worker), and can also

indicate that he would like alone timeC~~i5Jcan demonstrate fixed interests consistent with his ASD diagnosis, for example, repetitively choosing the same preferred activities (i.e. music and ball).

Dislikes:

Consistent with his ASD and ID diagnosesFAS-j(-·-idoes not like change or unpredictability in his routine. He additio~·a·ny-arsn!kes noisy environments and

small children in close proximity to him, also likely to be related to the sensory

needs of his ASD symptoms.r.·~.A.~~K.Jpresents with a specific phobia to dogs, and has been known to run from support staff if dogs are off their leash in his direct environment.

Communication - outline !~}~~~~K~J currently communicates primarily through non-verbal means (e.g. facial the way the person best expression or maladaptive behaviours such as spitting or throwing objects). He communicates (e.g. will occasionally use speech, with some use of gesture (e.g. pointing). expressive and receptive L~:A~K] first language is a creole language, with Aboriginal English (AE) his communication abilities, whether alternative

second language and Standard Australian English (SAE) his third language.

communication systems i-·_·ABi{"-·-ihas two visual supports in his communication environments: a portable 1._._._._._._._._)

are currently in place) "First Then" board and a "Who's coming today" board, which is placed in i·_·_·-A-liK-·-·-·!bedroomr-A-SK·-·!also has several activity-specific communication 1._._._._._._._._._._. 1._._._._._._._ ....

boards.


EXP0034.0001.0039

Receptive language

Receptive language skills refer to the ability to understand and interpret spoken and written words and sentences.

C~~I()an understand spoken language and is able to follow simple and familiar one-step instructions.

It was reported that r·-A-SK-lhas difficulty following multi-step instructions (e.g. wash your hands, th~·n-b·r·ush your teeth") and answering verbal questions containing two choices (e.g. "would you like a banana or an orange?").r·-AS-K-·-i does not have any literacy skills. i._._._._._._._._!

L~j~~~KJcomprehension is reduced when distracted (e.g. someone else is talking nearby), in large or busy crowds, and when he is frustrated, confused, upset or in painL~)\~~KJ comprehension is enhanced with the use of visual aids, including gesture (e.g. pointing), Key Word Sign (KWS), real objects (e.g. a cup), modelling and pictures.

Expressive language

Expressive language skills refer to the ability to convey meaning using modes such as speaking, writing, gestures and facial expression.

[)~~EiK.Jprimarily uses non-verbal language to communicate, including facial expression, gestures (e.g. flicking his hand to indicate "get out") and

maladaptive behaviours such as throwing objects or spittingC~~RJ is increasingly using speech (primarily creole or AE) to communicate with familiar communication partners. When using speech,i-·_·-ji:iij{·-·!mean length of

L._._._._._._._._._} r._._._._._._._."

utterance is 1-2 words. He previous employed echolalia (i.e.! ABK !will typically copy what others say, not produce speech spontan~o-usiYr:nore typically, however spontaneous use of verbal language has been increasingly observed.

Since receiving NDIS supportF-·ABi{"-·-ihas developed substantially his 1._._._._._._._._)

communication skills, including verbal communication. This has been supported by his direct support workers and through speech and language intervention.

l~~~A~~T(J is now able refer to his familiar support workers by name.

Speech intelligibility

l~~~A~~T(Jdemonstrates reduced speech intelligibility (clarity of speech), however, his communication partners report no difficulty understanding his speech (although this is likely due tor.~·.~·.A·~K~·.~·j typical use of echolalia and speaking in context).

Communication environment

L~.~$.j{~.J has several visual supports: a "First Then" board, a "Who's coming today" board and some activity-specific communication boards. These boards

are primarily utilised and modelled bY[~~~~A.E~KJcommunication partners.


Social and emotional wellbeing - outline the person's current social connections and supports, emotional state (e.g. any active mental health symptoms)

EXP0034.0001.0040

"First Then" board

This board is portable and typically held and carried bY[~~~~A~!.(~}ommunication partners. There is a folder of pictures relating to all activities L~~~I.(Jundertakes and places he visits, which are used in conjunction with this board.

"Who's coming today" board

This board is placed on the wall inL~.·A§K·~.J room and has several photographs of his communication partners in a folder to be used with it.

Activity-specific communication boards

i-·-pjiK·_·! has several activity-specific communication boards including at the '·-pa·rk~-·r·eading a book, playing a game, and a choice board listing basic emotions

(e.g. happy, sad).

l:~~$!.(:l's communication difficulties and support needs

i~~~A~~T(Jhas difficulty understanding complex or long sentences, difficulty following multi-step instructions and difficulty making choices.[~~~AIi.KJdoes not have any literacy skills-L~A~KJ requires aid from his communication partners to support all communication interactions.

[~J.:\~R.~.~.]communication strengths

i :~~~R] is reportedly able to understand his three languages when accompanied with visual supports such as gesture, KWS, demonstration/modelling, real objects and/or pictures.L~A~KJ is able to inconsistently use gesture (e.g. pointing) when he wants something (e.g. his ball) and utilises facial expression accurately to convey his mood.!-·-pj~iK·-i demonstrates the ability use pictures to convey some wants and needs ~h·en-·p-~ovided with a high level of support from

communication partners (e.g. will take his SW photos to his mother to query whether staff members are attending his home that day).

Social

r~.·~t\~KJenjoys social interaction with people he is familiar and comfortable with (i.e. family and support workers), and also enjoys his own space at other times. He enjoys being outside, both in his own backyard and in his community (i.e. pools, beach, river, park), but again, can prefer to stay in his home, listening to books and music, resting or sleepingfA-SK-1 has experienced peers engage in teasing behaviours towards him duri~·g-h·is"t"rme in.(i.e. children throwing

rocks at him, calling him derogatory names) and can show suspicion and dislike towards children and adolescents when groups of children are in his environment. Historical medical documentation indicates that[~)\!3..K~J progressively self-isolated during his early adolescent years in the Torres Strait.

r~.·~~~X~."Jcan show aversive regard to younger children, displaying physical aggression if they enter his personal space. Long-term social goals fori-·-·AS-K·_·-i

L._._._._._._._._)

includes the introduction and trial of small social activities involving preferred


Relevant history

relevant developmental history, previous interventions, adverse life events

EXP0034.000 1.0041

activities such as music and danc disability impacts his social skills and ability to regulate his emotions in a pro-social fashion.

[~~~~A~KJsocial skills deficits are consistent with his ASD and ID diagnoses.

ic health medical records indicate tha was born in by vaginal delivery (suction only used) at 40 weeks

gestation. Testing of chord blood identified thati~~~A~~T(jwas born with congenital STI. Exhaustive research around the consequences of untreated maternal UTI is not available, however it is noted that consequences can include: stillbirth/perinatal death; premature delivery; long-term neurological sequelae for half of the survivors (complications involving the central nervous system (CNS) that include cognitive, sensory, and motor deficits), bone deformities and deafness. These consequences potentially exacerbated

chromosomal issues. The diagnosis of "Down Syndrome with global ~,-".c.:~,~;-c-'-m"ental delay" is later identified in the paediatric summaries o()S§I(~!

aged 6 - 9 years, however there is no record viewed by the author to indicate that genetic testing for Down Syndrome has been completed. Collateral from the SDAOT notes that a genetic disorder is likely, however there was some uncertainty around Down Syndrome.

During his first few months{)S§I{}eveloped a dry cough, which eventually progressed into pneumonia with significant respiratory problems causing

~ation. There are ~?_t~_s_,~,~thin the medical records ofL~~~~){~J mother __ highlighting that! ABK !was "different" to her other children early on in his life, and medical not~s'ou'tiTning observations of!-'-,AjiK'-: presenting " ... small for 5 months and rather floppy", however no ;f'uriFie-r-!assessment

~ evident in the medical records d his family relocated to __ in the Torres Strait from he nt most of his

childhood, before relocating with his family to hortly after this:-'-,AjiK'-!and his family relocated again to nd then in Novemb~-~-20i6'to _

Developmental delays became evident as:-'-A-EiK'-! got older. From the age of 5

years until aged 8 years,CA~KJwas revi~w-e(Tat'least annually by Dr. s seen in clinic with his Mum via a 'Paediatric outreach

visit summary' on (as outreach from the

Summaries of these reviews (dated: 22.03.07; 27.09.07; 08.05.08; 18.09.08; 07.08.09; 15.10.10) identify behaviour problems of "spitting" and "running away" and requiring constant supervision during this age range. Dexamphetamine (7.5mg - 5mg mane and 2.5mg lunch) was tria lied 22/03/2007 to treat "hyperactivity" but ceased due to reports that this increased aggressive behaviour. The summaries further note thatl-'-ABK-'-lwas

1-._._._._._._._)

engaging with a speech and language pathologist from during 2007, and an OT and educational assessment completed in January 2008 identified a diagnosis of Intellectual Disability (these assessment reports were not available to the author)r'-'A'S-i('-'-'] paediatric reviews indicated developmental delays (not toilet

trained ~g~-d'9'y~-~rs; not feeding himself; limited speech), but that_ was able to managei'-'-A-SK'-'-lchallenging behaviours, which presented

predominantly as se'rf-TiiTurlo-us behaviour (i.e. head banging) whenl-'-ABt(']was

"frustrated and angrY"-L.~~~,R.JNas attending_school 5 days-,'pe/ week over the rs of these reviews, however It was noted th s


Current health status

Sensory processing and emotion regulation -provide an outline of any

EXP0034.0001.0042

copying other student's behaviours of spitting at this time, and had also engaged in sexualised behaviours in a public area. It is noted that over the years of paediatric reviewr~~~~KJ was also identified to have an ongoing 'heart murmur' and potential sight impairment (of which no assessment records were

able to be viewed by author). Secondary toC~:~~~K:~:Jmedical and behavioural concerns, reviews outline potential social issues, such as overcrowding, alleged domestic violence and alcohol use.

In 2014i·-A-BK·-·!was assessed by the Child and Adolescent Mental Health Team due to ~·n-fnc·re·ase in aggressive, anxious and self-isolating behaviours.i-·-·ABK·_·1 commenced O.Smg - lmg Risperidone nocte._ notes that Risp~rid-on·e-·· was ceased after trial due to ineffectiveness. Paediatric review this year also indicated increasingly aggressive behaviours, described as " .. very difficult explosive and violent outbursts most days. The triggers are unpredictable but often include change and people's interactions with him. He generally seems an anxious young man ... He has sensory seeking behaviours, hoarding and repetitive behaviours and a preference for isolation".

On attended for 3 terms (ceased due to funding issues), successfully accessing education with 1:1 support. i·-ABK-·1displayed challenging behaviours at a high frequency, but these were 'Ea·ncrfed with stringent risk and behaviour management strategies in place. i-·-A-EiK·--:Commenced m March

i·i6iffu~til August 2018. This was ceased by the school due to the behaviours of

harm and behaviours of concernL7~:-~~Jdisplayed at school.

i·_·-AEiK·-·-!mother reports thati-·-A-BK·-lexperienced aversive interactions with his 1-._._._._._._._._._. L_._._._._._._ ....

peers in the Torres Strait. She states that there were incidents in which peers wantedi·-A-BK·_·! off their basketball court and would throw stones at him and

tease hi'm·._notes tha(~$.~{:lcan be apprehensive towards peers as a result.

L.~."A~K.~.1 biological father has passed away.

L~~$.K:l is observed to be in good health mainly, although medical check-ups have been difficult to achieve on a consistent basis. He indicates pain in his groin region and his head at times, and underwent dental procedures in August 2019 to treat potential gingivitis and extraction of teeth due to decay. During the August 2020 medical procedure,C~~13..KJwas put under general anaesthetic and along with his dental procedure, was meant to get several other medical procedures done, including having bloods for health and genetic testing and having the bony growth on his knee examined. The results of these procedures were unfortunately not available to the author at the time ofi-·-ABK·_·S PBSP

I_._._.-.-.-.-.-.~

review.

A Comprehensive Health Assessment Package (CHAP) has been recommended by the author to i·_·_·A·S-K·_·_·! previous treating GP on several occasions, however,

1._._._._._._._._._.

at time of PBSP review this had not yet been actioned.

Consistent with his ASD diagnosisFABK-·! displays specific sensory sensitives. i-·-ABK·-·!presents to be averse to I~U(rrwlth the exception of enjoying loud '·m·uslcnmd crowded confined environments. He shows repetitive fixed


relevant sensory processing information and the person's emotion

regulation skills

Does the person receive informed decision

making support?

Family and informal support systems - what

family and informal

support systems are involved with the

person?

Community activities

what community activities does the person

currently participate in?

Activities of Daily Living

indicate the level of independence/prompting

EXP0034.0001.0043

behaviours, such as playing with his ball and listening to musicr-AliK"·-: does L._._._._._._._!

show enjoyment in sensory activities such as having his hand rubbed gently, jumping on the trampoline, water play, sitting on bean bags and dancing. Specific assessment of!-·_·A·S-i(·_·_·! sensory processing by an OT is recommended

to gain further clarification·-Of!==~~KJ needs.

!.~7~!3.:~Jhas a history of emotion dysregulation. It has been observed that if

[~~A~RJfeels sad, scared, confused, frustrated or angry, he can engage in challenging behaviours (i.e. physical harm to others and property damage). If given spacer·-ABK-·lwill self-regulate in time.:-·-ABK-·_·iwill often show remorse

L._._._._._._._.. I_._._._._._._._}

and apologise to support staff after a behavioural escalation through hugging or

high fiving them or gently rubbing their arm.L~A-~~Jhas capacity to develop his emotions, starting with assessing whether he is able to comprehend the

difference in basic emotions of happy, sad, scared and angry.

[SJ Yes

D No

D Unknown

:-·-"AiiK"·_·]is from a large family ofTorres Strait Island descent. He is the.of

!!!III1(~~:l~:~~~;~]~~~;~~I~~~sii~~~~i~h his mother and

service with 1:1 shifts.t:~:~:A~:~~:~:Jadult siblings intermittently visit and reside at his home, and supervisei·-·-ABK-·lon occasionfAS-.(jhas limited informal

1._._._._._._._.- 1-._._._._._._._ ..

connections outside his immediate family.

As noted, L~~~~-KJ mother and younger brother will transition out of the current home and[~~~AIi.KJ will be supported to live independently as he enters

adulthoodL~A~RJrequires 24/7 1:1 support and constant supervision.

:-·_·As-K"-·-:engages in daily fixed support shifts through ~isability support

'·se-rvTce~_also provide additional support shifts (i.e. overnight) when requested by:-·_·ABK·_·1 mother. :-·-ABK·-·has a small, consistent and long-term

team of male'su·p-po·rt·~orkers throu-gh·_The duration of[·.~·.~·t\~.K·.~·.~".J support shifts was reduced following his last plan review due to funding.

r·-As-K"-·1has been accessing respite thro the '-pa·s·i:·-i·Years.:-·-ABK-·-·ispent one night on a fortnightly basis. During

."_.L-: .... -: .... -: .... -: .... -: .... -:-..-._}

these staysL._.~_E!I5_._: was the only resident in the respite facility. Respite has currently been ceased due to exhaustion of 'in kind' funding in!-·-·-A-Eij(·-·-lcurrent

plan. As:-·-ABK-·l is transitioning into supported independent li~rng:·-he·-i·s-~o longer i~-n·ee-d·of accessing this respite house. Behavioural forms indicate that

r·-AS-K"-·jshowed some resistance to attending respite (i.e. banging on Perspex

~a·n(rpornting in the direction of his home when travelling in the car to respite;

refusing to exit the car when arrived at respite; grabbing_support staff

when being supported to transition into care of respite staff). As[~~~AIi.KJ did not display excessive enjoyment in attending respite, the cessation of this support is unlikely to impact his quality of life.

The Bristol ADL scale is an informant-rated measure that reviews 20 Adaptive

Daily Living skills (ADLs), both basic and instrumental. Items are rated on a four

point scale (from totally dependent to totally independent, with an additional


EXP0034.0001.0044

required to complete Iin~IiIIIiIiIPtiOn). Loryanna completed the Bristol ADL fo{~~~J~.~t_h_._. activities of daily living OT for the purpose of his PBSP, to provide a picture ofl._._.A~~._._.J

functional needs.

L~~~A~KJ results for the Bristol Activities of Daily Living Scale were as follows:

1. PREPARING FOOD l~~~~~KJdoes not currently have the opportunity to

prepare food.

2. EATING [~~~~B::'Juses a spoon when needed to feed himself.

3. PREPARING DRINK [~~A~R~Jis not given the opportunity to prepare drinks.

4. DRINKING :~~~jf~~Jdrinks independently from a cup.

5. DRESSING r~.·A.~E.J dresses himself with some prompting.

6. HYGIENE ::~:~$K]understands how to use soap and a cloth to wash

himself but requires prompting and physical support to

wash all parts of his body.

Full support to wash hair.

7. TEETH i·_·A·S-K·_·i is given full assistance to brush his teeth. I._._._._._._._}

8. BATH/SHOWER i)~~~}(Jcan turn the shower on, attempts to wash himself

but requires assistance through visual prompts and hand

over hand assistance to wash all his body. He is dependent

for hair washing.

9. TOILET/COMMODE [~J.:\i:!~t<}s generally independent toileting but requires

assistance to wipe after bowel motions. He knows to use

toilet paper but does not check to determine when his

bottom is clean.

10. TRANSFERS i·_·ASK·: is independent with all transfers. L._._._._._._.~

11. MOBILITY i)i~~KJwalks independently over most surfaces.

12. ORIENTATION - L~~~~~~~~~]appears to understand the passing of time during TIME the day. It is believed he does this by the movement of

the sun.

13. ORIENTATION - i-·ABK-·] is oriented within his home. i-·ABK-·]is not L._._._._._._.~ L._._._._._._.~

SPACE orientated when out in the community and requires

constant 1:1 supervision. This lack of orientation is likely

due to limited exposure. It is unknown whetherr-·"A·BK·_·!is L._._._._._._._}

able to develop orientation in the community and the risk

of harm should[~)\f!KJ not be supported 1:1 is currently

too great to assess this.


EXP0034.0001.0045

14. COMMUNICATION L.~~R~]shows understanding to simple instructions and attempts to respond verbally with gestures. He also uses

visuals to communicate his wants and needs.

15. TELEPHONE i·_·-ABK-·1Joes not use a telephone but will put one to his L._._._._._._._.~

ear copying others use of one.

16. HOUSEWORK/ GARDNEING

L~)\~KJattempts to complete some household chores. He requires complete supervision and support.

17. SHOPPING

18. FINANCES

19. GAMES/HOBBIES

20. TRANSPORT

:-·-ABK-·-has recently been exposed to the supermarket. I_._._._._._._._}

Despite an incident of aggressive behaviour in this environment, ongoing skill development in this area is

recommended.

All finances are managed by others for[}~~)(J

!:~:~$K]has fixed and repetitive interests consistent with his ASD diagnosis. These include but are not listening to music, playing with a ball and water play.

:-·-ABK-·lis taken in cars by others. Support workers use a '-c-a-r-iN-i"i"h a security screen separatingU~!li(jfrom the driver for safety.

OT provided further information regardingr-·"A-S-K-·-j functioning in the area life skills: c._._._._._._._._."

MobilitY{~A~~BJ mobilises over a variety of surfaces and is able to complete all

transfers independently. There are no reports of falls.

self-care{~~~~~:J requires prompting and physical assistance with showering

and toileting. He is able to take himself to the toilet and urinates independently

but requires assistance with wiping. He also needs assistance with thoroughly

cleaning and drying all parts of his body. He also needs full physical assistance to

brush his teeth accurately.

L~A"~~KJis aware a comb is used on his hair but is unable to complete the actions

required to remove knots from his hair.

r·-As-K:-·!is able to dress and undress himself with some prompting. . . L._._._._._._._ .•

L~~~I(lwili allow support workers to trim his hair using clippers. He requires

regular positive reinforcement (thumbs up/good as gold) to allow the support

worker to shave his beard.

Meal Preparation and Meal Times:

[~~A~f(Jhas not had the opportunity to prepare drinks and meals. All meals and

drinks are prepared for him.


EXP0034.0001.0046

[~~AI~}(Jeats using a spoon and drinks independently from a cup.

Cognition:

[:~:~~K:Js able to make choices when using visuals and limited choices. He will

request preferred activities and understands the who is coming today board.

L~A~~~Jappears to be oriented to location at home. He appears to have some understanding of time passing during the day as he knows when it is meal time. It is thought he understands the movement of the sun, but:-·-ABK-·l is unable to

I._._._.-.-.-.-.~

confirm this due to his limited communication skills.

Safety in the home:

Risks in the environment:

IfL~A~~l{l becomes escalated he can use objects in his environment as weapons.

In the past, objects used as weapons have included crockery, tables, chairs and

curtain rods.

L~.~$.j{~.Jcan also throw objects at spinning ceiling fans that can cause a safety

risk for himself and others.[~~A~RJ can additionally slam doors continuously and

bang on glass windows and doors, causing them to shatter.

:-·_·-AliK"·-·-:home has been adapted to mitigate possible harm due to certain I-._._._._._._._._._}

objects (i.e. curtain rods removed, bedroom furniture fixed). However,

awareness around reducing objects that can be thrown by [~A~~~] and supervised access to the kitchen area should ideally be maintained. Due to

L~~~A~KJskilis deficit on background of his severe intellectual disability, he does not show capacity of understanding dangers of sharps, such as knives, scissors

and other blades. Skill development in this area is recommended.

Risks to others safety:

:-·-ABK·-·jcan display physical aggression towards any other person in his

'e·nvTron'ment.:-·-AS·K-·-: can grab on to others' clothing, scratch, hit, push, kick and L._._._._._._._) ._._._._._._._._".

punch other people in his environment.j._.~~~_.jcan display a specific dislike to younger children when in his environment and there have been a few incidents in whichr·-A-Bt(·jhas displayed physical aggression towards children causing

harm to t-he·m-r';'_~~KJneeds to be closely supervised in public due to this, and

appropriate reactive strategies need to be employed to manage the behaviours

if they are displayed.

Risks due to skills deficit:

[~~AI~}(Jdoes not show caution around hot or dangerous items (i.e. stove,

scissors, knives) and requires supervision. He is not able to use electrical outlets


Related mainstream service - what other

mainstream services are involved with the person? (e.g. community mental health team, housing)?

Treatment order/legal order (if applicable) -include details of any treatment order or Ie

EXP0034.0001.0047

or sockets safely, or use tools and equipment safeIY[~A~f(Jis not able to care

for his own minor injuries and requires support across these tasks.

Safety in the Community

Risks in the community due to skills deficitr~A~f(Jis not able to independently

avoid people whom might take advantage of him and he requires support to

follow road rules for safety. Close supervision is therefore required to keep

[~~A~f(Jsafe when he is out in his community. When traveling in a vehicle, a

clear shield is required to separate the front and back sections of the vehicle to

maintain the driver's safety. There have been several incidences in which !-·-,A.-Eij(·_·i has attacked the vehicle driver or another passenger. i_._._._._._._.J

Risks to others in the community: There have been past incidents whereL~A-~~J has physically attacked other people in the community (i.e. peers, younger

children, support workers, family) and close supervision and behaviour

management strategies are to be needed in the community to reduce this risk.

Consideration of the community environmentL.A~K.l is being supported to, the

time of the day and year (i.e. school holidays, after school) and any other

potential setting events (i.e. factors that make challenging behaviours more

likely to occur) need to be considered prior to community access.

i·_·-A-liK-·-·!resides in a Department of Housing (QLD) home. i·_·A·BK-·_·! home 1._._._._._._._._. 1._._._._._._._._.":

environment has undergone OT assessment through the Housing services and adaptations have been made to supportr·_·AS·j(·_·-i needs.

i._._._._._._._._._!

The Specialist Disability Assessment and Outreach Team (SDSAOT) were involved withi·-AB-.(1from the age of 10 years, with regular reviews conducted whilst in Torr~s·Strait:' Wheni-·-ABK-·l and his family relocated to_in 2016, and i·_·A·S-i(·_·] was in rec~Tpt-orNDIS supports, SDSAOT provided a hand over ofi-·_·ABK"·"·Thistorical information to the plan author and closed!-·-·-ABK·_·_·1

I_._._._._._._._._} i_._._._._._._._._._.i

file with their service.

. . . . . mother_as had intermittent involvement with _

for additional support in caring forl~~~)\"j~K~J

ura esca ations a encing significant carer's fatigue. Involvement was closed when

appropriate disability support and medical services were put in place.

i-·-ABK·-·!has been case managed by Joanna Mullens at Independent Advocacy '·",forfh"·Queensland (IANQ) since 2017.

Not applicable.


EXP0034.0001.0048

conditions currently in place

Behaviours of concern

Frequency, duration and intensity ofi-·_·A·liK"-·_·! behaviours of concern have been analysed based on ABC

forms completed by his disability supp~-~t-;~·~~·ice_and his respite service

Physical aggression - others

• Slapping others - swiping arm in close vicinity to others and making contact

• Grabbing others by their clothing - reaching arm(s) out and making contact with

clothing, this can include maintaining a hold and/or releasing immediately

• Scratching - digging his fingernails into another person and can include pulling his

hand across another person's skin or clothing whilst digging them in.

• Spitting - projecting saliva from his mouth into his external environment (excluding

while talking or yelling).

• Throwing objects at others - picking an item up with his hands (i.e. furniture, food) and throwing it at another person, wall, ceiling, floor.

Freguency:

Month 00 00 00 (j) 00 rl 00 00 00 00 (j) (j) 00 rl rl rl a rl rl rl rl rl rl rl

a a rl a a a a a a a a N a N N N N N N N N N N ... >- N tlO c.. ...... > u ..c ...

c.. ro c ""S ::J u 0 OJ c ro

« ~ ::J « OJ 0 Z 0 ro OJ ~ --, --, Vl --, u...

Frequency 3 3 4 2 2 0 5 6 5 3 3 1

Month (j) (j)

(j) (j) (j) a (j) rl rl (j) (j) a rl a a (j) rl rl rl rl rl N N a N N rl a a a a a a a N a N N N N N N N ... >- OJ N tlO c.. ...... > u ..c c.. ro c

""S ::J u 0 OJ c « ~ ::J « OJ

0 Z 0 ro OJ --, --, Vl --, u...

Frequency 2 6 2 1 3 1 0 6 13 6 2

It is hypothesised that the significant increase in frequency evident in December 2019 is due to large numbers of people staying and visiting:·-·AS·j(·_·l family home over the Christmas

; , period. Staff report that several shifts withC~~13..KJo\ier-·this time were spent withr·-·A·BK·-l preferring to remain in his bedroom. ,_._._._._._._._.,

Duration (average in minutes):

Month 00 00 00 00 00 00 00 (j) (j)

rl 00 (j) rl rl 00 rl rl rl rl rl rl rl a rl a a rl a a a a a a a

N a N a N N N N N N N N N ... >- N tlO c.. ...... > u ..c ... c.. ro c

""S ::J OJ u 0 OJ C OJ

ro « ~ ::J « Vl 0 Z 0 ro u... ~ --, --, --,

Average 35 71 46 25 55 0 65 86 6 2 20 5

Our.


EXP0034.0001.0049

Month (j)

(j) (j) (j) (j) (j) (j) a rl (j) a rl a rl (j) rl rl rl rl rl N N a N a rl a a a a a a a N N a N N N N N N N .... >- N tlO c.. ...... > u ..c c.. ro c

""S ::J OJ u 0 OJ C OJ « ~ ::J « Vl 0 Z 0 ro u... --, --, --,

Average 5 46.5 30 20 10 10 0 15 19 15 5

Our.

The duration of[~~~JS_~f(J challenging behaviour presents to be decreasing over time.

Intensity (average):

Month 00 00 00 00 00 00 00 (j) (j)

rl 00 (j) rl rl 00 rl rl rl rl rl rl rl a rl a a rl a a a a a a a a

N N N a N N N N N N N N .... >- N tlO c.. ...... > u ..c ....

ro c c ro c.. ~ ::J ""S ::J OJ u 0 OJ OJ ~ « « 0 z 0 ro --, --, Vl --, u...

Average 1.7 1.2 2 2.5 2 0 2 2 2.5 1 2 3

intense.

Month (j)

(j) (j) (j) (j) (j) (j) a rl (j) a rl a rl (j) rl rl rl rl rl N N a N a rl a a a a a a a N N a N N N N N N N .... >- N tlO c.. ...... > u ..c c.. ro c

""S ::J OJ u 0 OJ C OJ « ~ ::J « Vl 0 Z 0 ro u... --, --, --,

Average 2 2.7 3 2 2 2 0 2.5 2.7 3 3

intense.

Physical Aggression - Intensity Scale::

1 attempts at physical/no contact

2 contact no injury

3 bruising or redness

4 first aid required

5 medical attention/QPS or QAS assistance required

Severe Intellectual Disability; Autism Spectrum Disorder, level 3; Communication deficits;

being physically unwell or in pain; being tired; too much noise/many people in his environment; meal time; change (i.e. unable to follow usual route into home; new support

worker; new environment)

Another person is his personal space, particularly small children

Being asked to perform a non-preferred activity

Not gaining access to a preferred item or activity

Quiet, low stimulus and well-known environment in whichL~A-~~Jhas full access to preferred activities and his support staff. Also having access to his communication aids.


EXP0034.0001.0050

Unfamiliar, noisy environment with new people and new routines. Small children present. Request for non-preferred activity to be completed.

Escape non-preferred activity - whenCA~KJdoes not want to perform the activity requested (including engaging in social situations and ending a preferred activity)

Access tangible - when[~~~FsJwants to access a certain object or activity, he can display physically aggressive behaviours towards others or abscond.

Escape non-preferred activitY:L~A-~~Jstating "no" when he does not wish to engage in the activity requested.

Access tangible: i-·-AS·i<·-igesturing towards desired item or activity, or using communication L._._._._._._._}

aids such as visual symbols from communication book to indicate what he would like access to.

Goalf.~~13..KJis able to communicate to his communication partner that he does not want to do a certain activity, or that he would like a certain item or activity, without engaging in physical aggression towards others.

Achievement of this goal will be observable and measurable through the reduction of physical aggression towards others. Support worker case notes will also outline instances in which

L~~~¥f~(Jhas indicated a preferred activity or item and been supported to access this.

Property damage/destruction

• Picking up furniture and tipping or throwing, throwing objects, hitting windows, walls or parts of a vehicle with parts of his body, holding object and moving in swinging motion (can make contact with another person or something else in environment).

Freguency:

Month 00 00 00 00 00 00 00 (j) (j)

rl 00 00 rl rl rl rl (j)

rl rl rl a rl rl rl a a rl a a a a a a a a N a N N N N N N N N N N ... >- N tlO c.. ...... > u ..c ...

c.. ro c - ::J u 0 OJ c ro ~ ::J ::J OJ ro OJ

~ « --, --, « Vl 0 Z 0 --, u...

Frequency 0 2 2 0 0 3 4 4 0 0 1 1

Month (j)

(j) (j) (j) (j) (j) (j) a rl (j) a rl a rl (j) rl rl rl rl rl N N a N a rl a a a a a a a N N a N N N N N N N ... >- N tlO c.. ...... > u ..c c.. ro c

""S ::J u 0 OJ c « ~ ::J « OJ

0 Z 0 ro OJ --, --, Vl --, u...

Frequency 0 0 1 1 1 0 0 2 2 0 0

Duration (average in minutes):


EXP0034.0001.0051

Month 00 00 00 00 00 00 00 (j) (j)


N a N a N N N N N N N N N .... >- N tlO c.. ...... > u ..c .... c.. ro c - ::J OJ u 0 OJ C

OJ ro

« ~ ::J ::J « 0 z 0 ro ~ --, --, Vl --, u...

Average 0 71 46 0 0 35 65 86 0 0 2 5

Our.

Month (j) (j) (j) (j) (j) (j) a (j) rl rl (j) a

rl a a (j) rl rl rl rl rl N N a N N rl a a a a a a a N a N N N N N N N .... >- OJ N tlO c.. ...... > u ..c c.. ro c - ::J u 0 OJ C

~ ::J ::J OJ ro OJ « --, --, « Vl 0 Z 0 --, u...

Average 0 0 30 5 5 0 0 5 7 0 0

Our.

The duration of[~~~JS_~f(J challenging behaviour presents to be decreasing over time.

Intensity (average):

Month 00 00 00 00 00 00 00 (j) (j)


N a N a N N N N N N N N N .... >- N tlO c.. ...... > u ..c .... c.. ro c - ::J OJ u 0 OJ C

OJ ro

« ~ ::J ::J « 0 z 0 ro ~ --, --, Vl --, u...

Average 0 1 1 0 0 1 1 1.5 0 0 5 1

intense.

Month (j)

(j) (j) (j) (j) (j) (j) a rl (j) a rl a rl (j) rl rl rl rl rl N N a N a rl a a a a a a a N N a N N N N N N N .... >- N tlO c.. ...... > u ..c c.. ro c - ::J u 0 OJ C

~ ::J ::J OJ ro OJ « --, --, « Vl 0 Z 0 --, u...

Average 0 0 1 1 1 0 0 1 1 0 0

intense.

Property damage/destruction - Intensity Scale::

1 No damage

2 Damage - replacement/repair cost up to the value

of$20

3 Damage - replacement/repair cost between $21 -

$50

4 Damage - replacement/repair cost between $51 -

$100

5 Damage - replacement/repair cost over $100

Severe Intellectual Disability; Autism Spectrum Disorder, level 3; Communication deficits; being

physically unwell or in pain; being tired; too much noise/many people in his environment; meal


EXP0034.0001.0052

time; change (i.e. unable to follow usual route into home; new support worker; new environment)

Another person is his personal space, particularly small children

Being asked to perform a non-preferred activity

Not gaining access to a preferred item or activity

Quiet, low stimulus and well-known environment in which[~~~~BJhas full access to preferred activities and his support staff. Also having access to his communication aids.

Unfamiliar, noisy environment with new people and new routines. Environments with children.

Escape non-preferred activity - wheni·-A-SK·-·!does not want to perform the activity requested (including engaging in social situation~-·an-d·e-nding a preferred activity)

Access tangible - when:·-ABK-·1wants to access a certain object or activity, he can display L._._._._._._._!

physically aggressive behaviours towards others or abscond.

Escape non-preferred activity:i-·-ABK-·-istating "no" when he does not wish to engage in the 1-._._._._._._._)

activity requested.

Access tangiblef.~$.}(]gesturing towards desired item or activity, or using communication aids such as visual symbols from communication book to indicate what he would like access to.

Goal:!-·-A-EiK"·-Hs able to communicate to his communication partner that he does not want to do L.._._._._._._._!

a certain activity, or that he would like a certain item or activity, without engaging in property damaging behaviours.

Achievement of this goal will be observable and measurable through the reduction in property.

Support worker case notes will also outline instances in whichCAIiKJ has indicated a preferred activity or item and been supported to access this.

Harm to self - physical

• Any behaviour tha(A~~~J engages in that can bring harm to his

body, including banging head forcefully with another part of his body

(i.e. hand), banging his head against another surface, scratching his

arm using a sharp object (e.g. broken piece of plastic), biting and

hitting himself. This behaviour includes any attempt, despite whether

contact is made or not.

Frequency:

6 incidents from April 2018 - February 2020

Duration (average):

30 seconds


EXP0034.0001.0053

2

Poor health; time - between 1600 -1700; certain medications (i.e. when trialling Vyvanse)

Most often in relation to pain, however 1 incident of SIB occurred in context of displaying other topographical behaviour (i.e. property damage and physical aggression towards others) triggered by want to escape an activity (return to his bedroom from the family room).

WhenC~~13..KJis not on stimulant medication Vyvanse, he is receiving regular check ups and has undergone his health assessment and dental treatment under general anaesthetic (completed August 2019). He is hydrated and not hungry.

i-·_·AS-K"-·lhas untreated medical condition causing painfAS-K-·1has not had 1._._._._._._._._.1 I_._._._._._._._}

access to pain killer medication contingent on indicating he has headache.

He has grazes in his groin area from self-stimulation.

Sensory - bangs head when experiencing pain (i.e. headache, tooth ache, self-inflicted grazes on body such as groin area from self-stimulation). Could also be experiencing neck pain as result of rapid head-throwing movement when dancing.

Indicating pain through the use of a visual aids, gestures and/or key word sign.

GoaIC~~BJwili be able to communicate that he is experiencing pain in certain areas of his body using a visual aid or pointing to areas of his body and using key word sign to sign 'pain'.

Harm to self - wandering

r·_·ABK-·-!leaving his environment without supervision of his support person. This L._._._._._._._._ r·_·_·_·_·_·_·_".

can include both when his support person is and is not aware ofi ABK i leaving. For example,L~~$.RJan run from his support person in the corr\mu-nity and has also left his home without the knowledge of his support person.

Frequency:

April 2018 - February 2020 3 incidents of wandering form home unsupervised.

Duration:

One incident lasted over 1 hour

Other incidents approximately 30 minutes asL~A~~~Jhas been located on neighbour's veranda.

NB: This information was obtained verbally fromC~·.~·~}{~Jmother as it was not collected in Behaviour Recording Sheets. This will now be recorded ongoing.

L~:~~~f(]tront gate has also been tied shut with elastic since his 'wandering' incidents. It is likely that this has reduced the frequency of this behaviour. There


EXP0034.0001.0054

was also a period of time when i-·-ABK-·ldid not have free access to his front yard 1._._._._._._._ .•

and therefore front gate, again reducing his ability to engage in this behaviour and likely decreasing the frequency.

N/A

Bored/limited access to meaningful activities and/or social attention.

Lack of supervision.

Observation bYL~A-~~Jof unlocked gate and unsupervised environment

Preferred stimuli outside home (i.e. cat, windchimes)

CA~~B~Jsupervised.

i·-ABK-·1unsupervisedr-ABK-·-i has not engaged in preferred activities or social 1_._._._._._._._.1 1-._._._._._._._)

interactions during his day (i.e. understimulated).

Access tangible - activity/item

L~A-~~]ndicates that he would like to access his community by showing his support worker visual symbols depicting walk or car, or an environment in the community (such as beach or park) or by physically going to the front gate. Support workers support and superviser·-AS-K-·1on his requests to access his community due to his inability to curren-tly-acce'ss this independently.

GOALi·-A-BK·_·) is able to communicate to his support staff that he would like to

leave hom·e~·-~nd support staff supervisei·-ABK·-"j1:1 accessing his community. L._._._._._._._ . .i

Achievement of this goal will be observable and measurable through the reduction on wandering behaviour, and support worker notes outlining

community access, both scheduled and initiated be[~~~~i~J

Formulation and hypothesis

The reason for a behaviour occurring can be described in terms of the function it serves or the reason

challenging behaviour to self or others is maintained. When we look atl."~.·2:\~·~.·Jchalienging behaviour, the

following functional assessment is hypothesised:


EXP0034.0001.0055

Setting Event Antecedent Behaviour Consequences

• Diagnoses of • Being asked to • Physical aggression • [~~~~j{Jcan Intellectual perform a non- towards others: Slapping, obtain his

Disability and preferred grabbing others by their desired

Autism activity such as clothing, Scratching, outcome, such

Spectrum shower, washing Spitting, throwing objects as having

Disorder and himself, cleaning at others others leave his

related plate, leaving direct

communication preferred • Property environment,

and social skills environment damage/destruction: accessing a

deficits. 1\ • Not gaining

~ Tipping and throwing items tangible item or

" • Feeling tired, I access to a I in his environment; activity he

unwell or in pain II preferred item ~ banging on walls, screens I '"

wants, escaping

• Bored/lack of or activity windows a non-preferred

meaningful • Small child in activity

activity close proximity Self-Injurious Behaviour: • i·_·_·-ABK-·_·-l t(C~~F{~j

• Any behaviour thati-·-·ABK·_·-i

•

L_._._._._._._._._._)

environment engages in that can'·b-dn·g-·-·_·' being noisy and harm to his body over populated

He has new • Absconding/wandering: support workers leaving his environment

without supervision of his

support person.

Summary statement:

Whenr·-ABK-·! engages in challenging behaviour, he is trying to express: I._._._._._._._ . .i

"I don't want to do that" (i.e. escaping non-preferred activity)

Wher{~~~F{)s requested to perform a non-preferred activity (i.e. go for a shower/wash himself in the

shower; have his music turned off; be guided to leave a room; wash plate; engage with support workers

when wanting alone time; have a meal that is not the temperature or food type he would like), he can show

early warning signs such as low pitched growling, looking at others from the corner of his eye, pointing and

pacing. Often, no early warning signs are reported to be observed however.[~~~.f:!.K~j behaviour may escalate into physical aggression towards others, property damage and occasionally self-injurious

behaviour (although this is extremely rare). Physical aggression and property damage can be chained, with i-·-A-EiK"·-! damaging property initially if not able to access another person (e.g. banging on Perspex and

~win·dows when unable to access driver in vehicle}.[:~~~~~:J is more likely to engage in challenging behaviour

if he is feeling tired, unwell or in pain (i.e. constipated; headache; gum or groin pain); there are too many

people and/or social noises in his environment; it isr~.·~.·~~f:!i5~.·~.Jmeal time or; there has been a change in his

routine (i.e. shower at different time of day; different route to destination); and/or new staff are

supporting him.


EXP0034.0001.0056

"I want that" (i.e. access tangible item or activity)

Wheni-·-ABK-·-iwould like access to a preferred tangible item or activity (e.g. drive in car, items in L._._._._._._._)

neighbour's yards such as cat and windchime), he can engage in aggressive behaviours towards his support

staff and has also absconded in the past. These challenging behaviours are more likely ifL~A~~~J is

understimulated or bored or left unsupervised.

"I don't want young children in close proximity to me" (i.e. escape social situation with children)

When:·-AS-K-·lwould like to escape smaller children within a social situation, he will show physical

aggre~sro·n-to~ards them in the form of swiping at them and pushing them out of his way. This is more

likely to occur ifi·-AEiK·-!is in the community and ifthe child is staring at him, moving quickly neari·-·AS-.(l L._._._._._._._. ._._._._._._._._) L._._._._._._._._!

and/or making loud noises.L._~!3..I5_._ihas not shown early warning signs of escalation during these incidents,

and presents to return to baseline quickly following the display of physical aggression.

Further hypothesis:

In analysis of ABC forms completed bYL~A~K.~.1support staff, there appears to be a few behavioural

incidents in which[~~A~f(Jpresents to be attempting to show humour (i.e. slapping support worker and

laughing and then hugging them; spitting and running into another room repetitively). It is hypothesised

tha(~~~AIjKJdisability and social skills deficit as a result of his ASD and ID impact his ability to engage in

socially appropriate behaviours eliciting humour. It is also possible that these behaviours have been learned

by watching family and peers in his community throughout his childhood, however choosing the socially

appropriate timing and regulating the force at which the behaviours are completed so that they do not hurt another person, are skills impacted byi-·_·-A-EiK·_·-!social skills deficitr-ABK-·-i has substantial capacity to learn

1_._._._._._._._._.__ L._._._._._._._ .•

replacement behaviours for the function of social engagement.

Preventative / environmental strategies (details of how routine regulated restrictive practices are used should be provided here)

Proactive strategies:

Health and wellbeing:

• ~l."~~-\EIKJto continue to access regular medical review.L.~.A~K.~.1 previous GP, _ _ indicated that this should be at least every 3 monthsCA~~~~J is due for a review of his psychotropic medication, and given he is now 18-years old, paediatric care needs to be transitioned to psychiatric. Accessing an ongoing treating psychiatrist for ongoing review of medication and likely chemical restraint is therefore recommended.

• Follow medication compliance consistent with treating doctor's prescriptions and recommendations.

• The completion of a Comprehensive Health Assessment Package (CHAP). GivenL~:~~~f(Jmedical concerns early in life, potential ongoing health concerns such as a heart murmur and bony growth in his knee andC~~AIjKJsetting events of 'pain' and 'illness', this is an urgent recommendation.

• The review and wellbeing planning based on results of the medical assessment completed in August 2019 is vital (report unseen by author). These assessments were organised to gain blood

testing for general health and genetic conditions, as well as assess the condition of[~~~~~RJ teeth,


EXP0034.0001.0057

gums, groin and knee. Information obtained in this report will support the ongoing management of L~)~~$.R~:~:Jphysical health and assist with diagnostic clarity of potential genetic disorder.

• Maintain[~~)\~~KJPRN Paracetamol procedure, as charted by his GP. This is to be administered at indication of pain.

• Sight assessment follow up. Early medical records indicate possible impairment, however it is unclear whether this was assessed further.[~~~~BJunderwent hearing assessment in 2019 and no impairment was identified at this time.

• Keep water visible in[·-·-A-S-K-·-! immediate environment and encouragei·-AB.(·~o sip at this to

decrease likelihood o~(con-stlp~tion and maintain overall health. Staff r~po-,Tfh~t L~~KJ is

compliant with this encouragement.

• Ongoing dental checks - need and frequency of this should be determined based on the results

fromC~:~~~K:~:JAugust 2019 procedure. • Support to implement a visual aid to assist with identification of pain. Input from a SPL or OT is

recommended for this.

• Compliance with medical recommendations to manage constipation

• Follow up on medical assessment of scrotal ulcers and growth reported bvL~)~~.~~:~j mother on left testicle - need for this

Quality of life:

• Maintain access to a vehicle forr·-AsK-ho engage in his preferred activities and maintain a higher quality of life. ,._._._._._._._ .•

• Supporti-·-pjiK·-lto execute as much choice and control over his daily activities as possible. This can L_._._._._._._._. ._._._._._._._._)

be facilitated through the use of a daily schedule board in whichi ABK ! is supported to choose his preferred activities for the day and sequence these in with self-c'are-a"Ct}vities such as mealtimes

and showering. It is likely that the there will need to be a gradual build up to a daily schedule for i·_·_·-ABK-·-·-ientire day as he is currently utilising a basic 'now and then' board, howeveri-·-·ABK-·_·] L._._._._._._._._._.I L._._._._._._._._.~

presents with good cognitive capacity to work towards this goal. Input from a speech and language pathologist around this goal is recommended.

• A specific focus on home and living skill development is recommended also, particularly a{~~~_~i{J enters the independent living stage of his adult life. Intervention has thus far focused on working towards independent showering (using sequenced visuals, modelling and hand over hand by support workers) and participating in household tasks (i.e. vacuuming, hanging clothes on washingline). OT input for visuals and structure around this development is also recommended.

• Sensory processing assessment and recommendations from OT around implementation of sensory diet and AT items relevant to meet i-·_·ABK-·-·]sensory needs.

'-.-.-.-.-.-.-.-.-.~

Environmental:

• Continue use of visual schedules. Consider increasing visuals to a daily schedule and schedule

preferred activities chosen bYL~~$.~{:l contingent on non-preferred activities.

• Maintain as much routine and predictability as possible, including expectations and encouragement fori·-·-·A·S-K·_·_·! ADL skill development. Due toi-·-A-EiK·-!currently still residing in his family home with his'·m·otJier-·and siblings, there presents to b~-·s·ome-!consistencies in areas of independent skill

development. It is anticipated that when!·~.·~.·~~f3~~·~.·~.Jfamily transition out of the current home, and [.·~.·~~~K~.Jenters the supported independent living phase of his adult life, consistency around this skills development will increase and[~~A~f(Jwili gain a clearer understanding of his ADLs.

• Continue utilisation of 'Who's on today?' board. This assists with predictability and also communicating change toi-·-A-sK·-l if there are staff changes and new staff commencing. It is recommended that photo~·ofne-w staff are added to the board prior to their first shift withC~·.~·~}{~J

• Buddy shifts for new staff to continue. r·_·_·_·_·_·_·_·,

• Maintain a quieter environment with limited amount of people, particularly childrenLJ.:\~~_.! has been increasingly accessing and tolerating community spaces in his community where it is louder,


EXP0034.0001.0058

with larger crowds and small children present (i.e. water park, gym, supermarket, It is recommended that participation in these activities are evaluated on every occasion. For example, if

i·-A-SK·_·! is showing signs of agitation or there are known setting events in play, Iimitingr~.·~.·~~f:!i5~.·~.J '·ex-po·siire to crowded and louder community spaces is recommended. It is additionally recommended that at the stage, accessing community spaces withi·-ASK·-·]during the school

holidays, where children typically congregate (i.e. large playground~~·-w-a-ie~park) is avoided. If exposure to these places is unavoidable (i.e. medical centre), strategies are required to ensure the safety of!"-·-ABK-·land others in his community. These strategies include ensuring a safe distance is maintain~(Tb·et\,\;eenr·-A-SK-l and children, engagingi-·-ABK-·l in conversation or an activity

L_._._._._._._.": j_._ ..... _._._._._.,..._ .•

continuously, employing a predictable routine forLJ~!3..I5_._iwhen accessing this environment (i.e. park and sit in the same general areas as able; activities sequences in same order each time; limit change in treating professionals and use information stories and photos to support unavoidable change; schedule a preferred activity contingent on this event to reinforce engagement behaviour).

• Utilise clear Perspex sheet between the driver andi-·-ABK-·lin all vehicles, withi·-A-SK·_·!sitting in the backseat of all cars. .._._._._._._._.. .._._._._._._._.,

• Always supervisei-·-ABK-·l This is particularly important whenr·-AS-K-·1is accessing his yard, as he does not currentIY-·h~-~~·t'he skills to safely access his commu~TtY·Tndependently and there have been instances ofi·-A-SK·-·!absconding. Supervision whenr·-AS-K-·1communicates he would like alone

time should be subife·-a-nd unobtrusive (i.e. inconspicuo~sly·-che·~kingL~~~~I(] is still in his desired environment (typically his bedroom) every 5 - 10 minutes}.

Skill building / teaching strategies

CA~~~K~Jhas shown that he has the capacity to build skills across areas of functioning. Appropriate to

individuals with intellectual disability, the teaching of these skills needs to be consistent, repetitive and

slower pased. Outlined below are many areasL~A~~j~Jshows capacity to build skills. It is recommended that

one skill development area is focused on at a time.

Communication:

• Teaching appropriate use of "no" when not wanting to engage in an activity.

The use of a reinforcement schedule to practicer·-A-SK-l using "no" on a daily basis, appropriate to

not wanting to perform a certain task, rather th~-n·-disp-I~ying challenging behaviour to

communicate this.

• Visual board: progressing daily schedule from the current 'now, then' board to eventually a full

daily schedule. Supportin(~~~}{)o choose his own preferred activities for his day and placing

these contingent on non-preferred, such as showering. SLP input for this skill development is

recommended.

• Pain visual and key word sign: teachingL~A~BJ to use a visual and key word sign for "pain" to communicate with his support people that he is experiencing pain, and where this is located in his

body. • Emotion regulation: Assessing f·-·-AE3"K·-·-~,Jnderstanding of the basic emotions (happy, sad, scared,

angry) and developing his unde\·stan-dTn~ in this area through the use of visual symbols and social

stories. It is anticipated thati-·-ABK-·l has the capacity to develop his emotion regulation over time. I._._._._._._._ . .i

The use of 'lone of Regulation' resources would be appropriate for this skill development.

Assisted Daily Living Skills (ADLs):

• Focusing on one home and living skill at a time, and providingj"·-AS-K-·] with sequenced visuals

outlining steps to achieve ADL tasks. It is likely that staff will nL

ee·a-f6-supplement this learning with

modelling, verbal prompting and hand-over-hand support. i-·-ABK-·l is currently working on I._._._._._._._ . .i


EXP0034.0001.0059

developing his independent showering skills and it is anticipated that these will continue to

improve as he his supported to live independently and a more consistent routine is able to be maintained. Implementing household tasks intoi·-·"Aiii<·_·lvisual schedule will assist with i-·_·A·BK-·-l

1._._._._._._._._._) ._._._._._._._._._". L_._._._._._._._ ....

developing his skills in these in a predictable and routine manner suitable tol._._~_~.~._.J needs. Reinforcement for the completion of ADL tasks can be in the form of both verbal encouragement

(e.g. "great work_; good as gold gesture) and a preferred activity placed contingent on

achieving the daily living task (i.e. hang the washing out and then listen to music).

Safety skills:

• Development of appropriate use of sharps, such as knives for food preparation when:·-AS-K-·lreside

independently. This can be supported using visual and verbal prompts, information sto-rTes-a·~d modelling by support staff.

• Development of road safety skills through information stories and support workers modelling safe

behaviour when supportingi·-AS-K-·1in the community. whenCAEiKJ displays road safe behaviours 1_._._._._._._._)

(i.e. looking both ways before crossing the road, stopping for cars), he should be reinforced using

positive regard and encouraging gestures.

Reinforcement/motivation

[~~~~B]s motivated and reassured by his support people using positive statements and gestures to

encourage prosocial and pleasurable behaviour. These encouragements include statements such as "good

as gold_, "you're right_ giving thumbs up, good as gold sign (thumbs up placed on flat palm

of other hand), high fives, smiling, using rhythmic, higher pitched tone in speech and winking with a smile.

Repetition of these behaviours on a frequent basis (i.e. 10 - 15 second schedule) is required, particularly when in the rapport-building stage withi-·-A-EiK·-li-·-ASK-·-iwili repeat these words and gestures back to his

I-._._._._._._._! 1-._._._._._._._)

communication partners.

The use of a reinforcement schedule with identified reinforcers is recommended to teach replacement

behaviours (i.e. "no" to show he does not wish to engage in activity requested; key word sign for 'pain' to

communicate experience of pain).

Placing preferred activities contingent on non-preferred activities is also a motivation strategy for[~~~~:§'RJ

Response strategies (details of when PRN restrictive practices should be included here as part of an overall planned response following on from positive behaviour support strategies)

• Observe for early warning signs of behavioural escalation. Fori·-As-.(lthese include low pitched growling, looking at others from the corner of his eye, pointing·a-nd·-pa'cing. Ifi-·-A-EiK·-! is displaying these behaviours, reduce all requests and demands of-A-SK·-·:and maintain ~·T:5-·arm's length of physical space. Attempt to identify the trigger and add·re·s·s·-th-i~ (i.e. provide tangible activity/item if able or explain why ifi-·-ASK-·lis not able to access this at that time). Ifi-·-AS·.("l is unable to access

1._._._._._._._.. 1._._._._._._._ ..

the identified antecedent and staff have explained this to him, suggest another preferred activity i-·_·AS-j{-·-imay wish to participate in (i.e. if a vehicle is not available and i·_·-ABK-·lwould like to go for a L._._._._._._._._) L_._._._._._._ . ..:

drive, suggest a walk in his neighbour instead). It is noted that at times, prior to challenging behavioursi-·-A-EiK·-!does not show any early warning signs.

• Remove othe·r·-pe·ople fromC~~~~KJ environment if he continues to escalate. If in the community, encouragei-·-A-sK·-lto a safe space (i.e. where he is able to be alone; in the car)

• If[~}~"!:!.KJb·eh-avi~urs continue to escalate, display positive affect (i.e. slight smile, calm demeanour) cease demands and limit speech to encouraging statements such as "good as gold


EXP0034.0001.0060

_ and giving thumps up gestures. Maintain 1.5 arm's length of physical space and do not turn away fromi-·-A-liK-·-l Follow any cuesi-·-A-SK·-lcommunicates (i.e. flicking hands, swiping arm,

pointing, spitting-i-o·Tncfj·cate he wants al~n·e-fi"m·e). If leavingl~~~~~AitiK~~}nvironment, check him at 5-minute intervals. These checks need only to consist of sightingi·-ABK-·1If i·-A-SK·-·!presents calm, ask C~~~KJf he would like the staff member to stay. ._._._._._._._._.. '_._._._._._._.J

• Discreetly remove any objects if safe to do so that could cause harm (sharp objects, projectiles)

• Where possible redirecti-·"Aij-K"-·! to a safer area to limit risk of property damage.

• IfCAiiKJ makes contact'"i;Vith-·s·taff, physical restraint may be required as the least restrictive strategy to maintain safetyr-ABK·_·]typically grabs hold of staff member's shirt (or facial hair if long

L._._._._._._._ . .i

enough): o In the first instance, verbally encouragei-·-ABK·_·]to let go himself, using calm rhythmic

voice. The use of stimulus control has b~e-n·sh-o~n to assist with encouragin~~:~~~~~:J to let go. Stimulus control includes anything that breaks the aggressive though patterns and can include, but is not limited to: staff pretending to trip up or walk into a pole, dancing, taking off shirti-·-ABK-·lhas hold of and singing.

o If staff a~e-·u-naEiie to encouragei-·-ABK-·lto let goTAEiK·-i is often responsive to being

guided to his bedroom by staff ~afkinibackward~-;in(ft"hen encouragin~,-~~A-~~J to let go and have some alone time in his bedroom when at the bedroom door.

o If[~)~~~F.J begins to spit at staff (as is typically the first topographical behaviour displayed by [~~~~~~~KJwhen escalated), it is recommended that staff cover the face using their hands or another object in their environment (i.e. towel, clothing) without obstructing their vision completely. Staff need to state "no spittingr~.·~.·A~f("~.J using a deeper tone of voice and back away fromi-·-ABK·_·!if he has not gained hold of them.

o I~-·-A-SK·-l c'o·niiii·ue"s to hold onto staff, physical restraint is recommended in the form of: '-·-·-~-·-·-·-Blocking and grip release

• Twist and turn NB: It is recommended that these techniques are to be used for no more than 30 seconds to 1 minute at anyone time and must be fully documented each time they are used.

o _ respite staff have been trained in MABO techniques to undertake these restraints safety. It is recommended that" staff also undertake this or a similar training.

• If staff need to leaveC~·.~·~R~J immediate environment, staff are able to shut doors if required, however prohibited from locking doors as containment/seclusion are not approved restrictive practices.

• Ifi-·-AS·j{·-iabsconds, foII oW:-·-A-EiK·-i and using a calm, higher pitched and rhythmic voice, encourage [~~~I(Jt~ return to the en~Tro·nm~nt from which he absconded. Ifi-·-AS·j{·-i is attempting to access an object or activity, support him to obtain this if safe. At times thi~-ca·n-fi~i-·-A-EiK·-!watching the

windchime or cat at his neighbour's home. Continue to gently encouragei-·-ABtt"ito return. 1-._._._._._._._)

• L.~~~.R}s at baseline again when he is showing gestures such as 'good as gold' and thumbs up, when he is engaging in activity with staff again, and when he is not displaying any early warning signs such as low pitched growling, pacing, pointing or looking out of the corner of his eyeL7~13..KJ will also frequently apologise for displaying challenging behaviours when back at baseline. He does this by gesturing that he wants a hug from his support person (i.e. walking towards staff with open arms), gesturing 'high five' and/or rubbing his support person's arm. These behaviours are another

indication thatL~~~~~K~J is at baseline.

Monitoring and consideration for potential future restrictive practices

• Environmental restraint: r~.·~.·~~f:!i5~.·~.J mother has utilised what would be considered 'environmental restraint' to maintain !:~:~:~~~~~:~:~:Jsafety throughout his life. This includes locked gates and doors and restricted access to


EXP0034.0001.0061

sharps (knives in kitchen). As these practices have been in place, there is no clear evidence that without these practices,i-·-·-ABK-·_·1 challenging behaviour and skills deficits put him and others at increased harm. These praCtlce·s·-are therefore not approved restrictive practices, as based on behavioural data, they are not deemed as "least restrictive". Asi-·-A-BK·_·!wili receive 1:1 support in his home, the need for locked doors and gate due to his skills d~flat·s·-(re. limited road safety; risk of being taken advantage of or harmed by unknown individuals if in the community unsupervised} is likely to be superfluous. It is recommended however that behavioural data continues to be obtained in regards to any wandering, and use of sharp implements when escalated. Historically

i-·-ABK·_·] has used curtain rails as a weapon when escalated, implying some risk if there is free access Lto·-sTia·r·ps in his home.

• Containment/seclusion: i-·_·-AiiK"·-·-imother has used containment and seclusion as a strategy to keep herself and other L._._._._._._._._._} ._'_'_'_'_'_'_'_'_'-' ._._._._._._._._._.,

members ofi ABK family safe. The door between the front and back sections ofi ABK !home has a lock, a~-d_ has utilised this, as well as the locks on the external houseLd·~-;;~~-·~~-d fences, to keepi·-·-A-liiC·iin a specific area when he has displayed physical aggression and property

I._._._._._._._._}

damaging behaviour. There have been a handful of incidents in which!-·-A-BK·-i has pursued support staff when escalated, spitting at and attempting to grab them. In som~·-Ofihe-~e incidence,

_ has assisted the support worker to enter the front section of the home and locked ! ABK iinto the back section of the home, where he has deescalated and shown he is back at i_._._._._._._._._!

baseline and remorseful by seeking a hug. The majority of incidents however have been managed by either the support worker vacating the room or guidingr·-AS-i(-·jback into his room, shutting the door on some occasions. This is deemed the 'least restricti~E{me·a·~s of managingr·-·-A-SK-·-l challenging behaviour currently, however again, it is recommended that behaviou'r·ann·Clae~ces, withdrawing strategies and any staff pursuits continue to be recorded to monitor the need for RP.

Plan implementation / system supports (This should identify actions for the implementing provider team that support the implementation of this plan. It should include how will the plan be monitored e.g. through incident reports, data collection and who will be responsible for communicating with the practitioner)

• [:~:~t\~K~JPBSP requires at least annual review, update and upload to the NDIS Commission

Portal. It is recommended that a 3-month mini-review be conducted, with collateral gained from

r·_·_·ABi<:-·-·-!direct support team regarding the effectiveness ofr·-·-·Aiii<:-·_·lpBsP. It is noted that more L._._._._._._._._._oJ L._._._._._._._._._._.

frequent reviews are required if there is a significant increase in challenging behaviours.

• L~:~~$.R~:~:ldisability support service will continue to obtain short term approval for the use of

restrictive practices .

• [~~~~A~~KJ disability support service will continue to record all behavioural incidents for ongoing

functional analysis of challenging behaviour, to monitor the effectiveness of PBSP

implementation and to monitor the use of RPs.

• r·_·-As-i(-·-·1disability support service will continue to seek relevant medical information for L_._._._._._._._._._}

L~:~.~~iC]ncluding a COMP form to clarify potential chemical restraint and a CHAP.

• Behavioural practitioner supporting the implementation of[~~~R.~.~.] PBSP to complete

observations regarding implementation of recommendations.


EXP0034.0001.0062

Restrictive practices schedule

Chemical restraint

i·-AS-K"-·l is currently prescribed fixed dose of Risperidone and Guanfacine (Intuniv). This has been prescribed L_._._._._._._._.I

by his Paediatrician Several

attempts, by different stakeholders have been made to have a 'Clarification of the purpose of medication' (CaMP) form completed by i-·_·ABK-·-"!treating medical team at" in order to determine whether this

1._._._._._._._._ . ..:

medication falls under chemical restraint. Unfortunately,i-·_·ABK-·_·] team have not provided this form to

date, and were unwilling to categorise[·-·-A-B-K-·-lmedicati~n·-everi-~erbally during stakeholder meetings. As

medication presents to have been pre~c-rTbe(fto' manag{-·-ABK·_·-·!challenging behaviour, and erring on the

side of caution[~A~K~J medication has been document-ecri·ri-th·E;' current PBSP as 'chemical restraint' and recommended to be considered this until his treating team inform otherwiseJ"-·ABK-·_·] NDIS support

coordinator and advocate are currently in the process of seeking psychiatric s~~~i~~·f~-~[~~IC for a

medication review. It is anticipated that the new treating psychiatrist will complete a CaMP.

Implementing provider business name

Is authorisation required?

Yes

Authorisation start date:

Click or tap to enter a date.

Implementing provider service location

Administration type

Routine

Have authorisation and consent Authorisation and consent been received? received from:

No Choose an item.

Authorisation end date: Status

Click or tap to enter a date. Choose an item.

• Medication information - NOT FOR ADMINISTRATION PURPOSES • Medication should only ever be administered from a current medication chart provided by a

medical doctor. Medication information in this plan should not be relied upon, as the type, dosage or frequency may change during the time that this plan is in place.

• It is not compulsory to include the details of the medications here, however the details must be entered into the NDIS Commission portal when lodging this behaviour support plan.

Drug name: Dosage: Unit of measurement: Conditions / limits of use:

Risperidone (Apo) 0.5 milligrams Prescription needed

Frequency: Route: Side effects:

BD Oral Nil observed or reported for

Prescriber: Prescriber name: Date of last review by doctor

Paediatrician


6/06/2019


Administration type

Routine


EXP0034.0001.0063

Yes No

• Medication information - NOT FOR ADMINISTRATION PURPOSES

• Medication should only ever be administered from a current medication chart provided by a



Guanfacine (Intuniv) 4 milligrams Prescription needed

Evening Oral Nil observed or reported for

[~~~~A~!{J

Paediatrician - 6/06/2019

Routine

Yes No



• It is not compulsory to include the details of the medications here, however the details must be

entered into the NDIS Commission portal when lodging this behaviour support plan.

Risperidone (Apo) 0.5 milligrams Prescription needed


EXP0034.0001.0064

Nil observed or reported for r·-·A-SK-·-! Oral BD

L._._._._._._._._ . ..:

Paediatrician 6/06/2019

Routine

Yes No




Guanfacine (Intuniv) 4 milligrams Prescription needed

Evening Oral Nil observed or reported for

Paediatrician 6/06/2019

Fade out plan (this should outline how the restrictive practice will be gradually reduced based on when the behavioural goals outlined above are achieved)

It is recommended thati-·-.Aj~iK·-laccess psychiatric management for ongoing review of his medication. The

changeL~)s"_~R~~Jwili exp~·rie-nce·-~hen his family transition out of his home in April 2020 may be a difficult

adjustment for him, and it is recommended that no change is made to his current medication regime

around this period. AsL~~~~){~J new home environment becomes increasingly stable, predictable and

familiar to him, and if challenging behaviours remain low in frequency, a reduction in dose of Quetiapine

could be considered under the guidance of a psychiatrist. The potential for this reduction was outlined by

r:~:~~~~~Jpaediatrician in June 2019.


EXP0034.0001.0065

Important medication history:

r.·~.~.~~K.Jwas tria lied on Vyvanse (stimulant medication) in October 2018. An increase in both the frequency

and duration of challenging behaviours was observed at this time, and included a new SIB of head banging

on hard surface or with another part of his body (such as his palm/fist). This occurred around 4pm in the

afternoon and it was hypothesised thati·-AS-.(jwas experiencing headaches as a side effect. This

medication was ceased under the guide'·ofL~~~A~B-~~J Paediatrician and he was commenced on Guanfacine.

Behaviours were observed to reduce in frequency and duration (i.e. from several hours to a few minutes)

following this medication change.

L.~·~~.K.~Jwas initially commenced on 250mg Quetiapine in September 2017 and a reduction in the frequency

and duration of challenging behaviours was observed. His medication was changed from Quetiapine to

Risperidone in February 2018 by his Paediatrician.

Environmental, Mechanical, Physical or Seclusion

• This table is for recording the use of regulated restrictive practices other than chemical restraint

• Copy and paste this table for each regulated restrictive practice being used



Administration type

Routine

Restrictive Practice Type Sub-type (refer to sub-type list in Sub-type if other:

Environmental


Yes

NDIS Commission portal)

Lock boundary fence

Have authorisation and consent been received?

No

Authorisation and consent received Authorisation start date: from:




Authorisation end date:


Administration type

Routine

Restrictive Practice Type Sub-type (refer to sub-type list in Sub-type if other:

Environmental


Yes

NDIS Commission portal)

Locked boundary fence

Have authorisation and consent been received?

No


Physical Other

Yes No

Physical Other

Yes No

EXP0034.0001.0066

PRN

Blocking and grip release

Routine

Blocking, grip release and twist and turn

Fade out plan (this should outline how the restrictive practice will be gradually reduced based on when the behavioural goals outlined above are achieved)

As proactive strategies and skill development continue to be consistently implemented in supports with i-·-pjiK·_·l it is anticipated that there will be a reduction in challenging behaviour, as has been the case since 1._._._._._._._.-


EXP0034.0001.0067

disability supports were commenced at the beginning of 2017. As challenging behaviours reduce in

frequency, the need for PRN physical restraint will consequently decrease.

Declaration

I declare that:

• I am duly authorised by the specialist behaviour support provider (as stated in this form) to submit

this behaviour support plan.

• I understand that this information is being collected by the NOIS Quality and Safeguards

Commission (NOIS Commission) for the purposes of the NDIS (Restrictive Practices and Behaviour

Support) Rules 2018.

• I have read the NOIS Commission's NOIS restrictive practices and behaviour support guidance and

understand the requirements of registered NOIS Providers in relation to notifying the NOIS

Commission of the use of regulated restrictive practices.

• I understand that the NOIS Commission will, if required, use the information to undertake

compliance and enforcement activities consistent with the National Disability Insurance Scheme Act

2013 (the Act) and any Rules established under the Act.

• I acknowledge the NOIS Commission may share the information contained in the behaviour support

plan with relevant Commonwealth, State, and Territory agencies including the Police.

• To the best of my knowledge, the information provided in this behaviour support plan is true,

correct and accurate.

• I acknowledge that the giving of false or misleading information to the Commonwealth is a serious

offence under section 137.1 of the schedule to the Criminal Code Act 1995.

Practitioner signature

Practitioner name

Oate 3/04/2020

Job title Psychologist

Note: Once assessed under the Positive Behaviour Support Capability Framework, if the practitioner is

considered suitable at a 'core' level they must be supervised by a practitioner at the 'proficient' level. If this

plan has been completed by a 'core' level practitioner the supervisor must also complete the box below.

Supervisor signature

Supervisor name

Oate

Job title


EXP0034.0001.0068

Appendix A

Environmental Electronic monitoring devices

Lock - door(s)

Lock - cupboard(s)

Lock - fridge

Lock - gate(s)

Restricted access - activity

Restricted access - area

Restricted access - item/object

Other

Mechanical Bedrails

Belt

Buckle cover or Harness

Cuffs

Protective headgear

Restrictive clothing

Splints

Strap

Tables/Furniture

Wheelchair seat belt

Other

Physical One person restraint

Two person restraint

Three person restraint

One person escort

Two person escort

Three person escort

Standing restraint

Seated restraint

Other

Seclusion Own room

Containment


Exclusionary time out

In car/vehicle

Other room

Outside

Secure care setting

Other

NDIS Quality and Safeguards Commission - Comprehensive behaviour support plan

EXP0034.0001.0069

37

Behaviour Support Plan -Comprehensive

Documents

Transcript of Behaviour Support Plan -Comprehensive