Bi-Psycho-Social Approach
When should we use a Bio-Psych-Social Approach?
All the time
Why is it important to use positive behaviour strategies when supporting SA?
What would SA be observed doing in level 1 of the escalation continuum ?
rocking, restless, pacing, crying, SIB level 1, undress/strip
Who should be recording data on the daily data sheets?
Bonus: name all data sheets
Everyone!
Daily, BM, Sleep, PRN effectiveness, video monitoring, ETO, ½ door
Why is it important to incorporate choice?
Bonus: Name three ways to incorporate choice
To address functions: escape and access to tangible items
To provide a sense of control and autonomy
Bonus: between activities, between foods, between tasks, order of activity,
When you are trying to engage SA in an activity with you, how can you offer choice in this moment?
Use PECS, show concrete choices, offer choice between 2 preferred activities
When SA is in level 1, name 2 of the things we should do?
•Remain calm
• Provide a safe space between Sam and staff
• Address pain management. (E.g., ask him if he would like a Tylenol, offer a cold cloth for his head)
• Ask how you can help him with concrete visuals or picture symbols from the PECS
binder for choice
• Introduction of preferred activity
• Model appropriate and alternative actions
to inappropriate behaviours (e.g., deep breaths, squeezing stress ball, etc.)
When providing SA a first/then visual prompt and he follows through, how would you chart that on the data sheet?
First/then accepted
When should you provide SA verbal praise during his day?
Bonus: Give an example
when he is doing positive behaviours
If you would like SA to brush his teeth before going outside, how could you communicate this to him?
first/then with PECS
If SA is in level 2 on the escalation continuum (aggression to others level 2 and banging), after how many minutes of unsuccessful redirection should staff utilize the ½ door?
Bonus: what happens if during ½ door protocol he is leaving the building or at risk of harming himself?
10 minutes
Bonus: pursue at safe distance, intervene to ensure safety (stop ½ door protocol)
When do we record on video monitoring sheets?
Anytime we watch the camera’s during an escalation while in ½ door and SA leaves line of vision (goes around the corner) or when ETO is happening (staff in kitchen with entire door closed) – while escalated
Why is it important to focus on SA's strengths?
helps with skill growth and development
Why is it important to present SA’s day to him in a visual first/then format?
Sets expectations, begins to develop a routine or structure in his day which provides consistency and predictability and gives SA a sense of safety – knows what to expect
When can staff re-engage with SA during ½ protocol?
Bonus: when does ½ protocol turn to ETO?
After 5 minutes of no level 2 or 3 behaviours
Level 3 behaviours, targeting top of ½ door
What is the comment section for on the daily data collection sheet?
Any notable occurrences, antecedents, any positive behaviours, anytime further clarification is needed
Why is it important to build rapport with Sam?
He needs to feel safe and comfortable with his staff
What forms of communication should staff accept?
Bonus: Name one time you would model the “help” sign for SA?
All of them!!
Bonus: When he is escalating, when you help him with something
True or False: it is recommended to continually talk to SA while he is highly escalated (level 3) using lots of words and placing demands such as "show me what you want?"
Bonus: what do we do when SA is in level 3?
False
Remain calm, utilize ETO
If SA has grabbed staff’s wrists 4 times in a row (redirection was not successful) and as the staff were removing themselves to start ½ door protocol he hit his head multiple times, how would you record the behaviours on his data collection sheet?
Bonus: what other data sheets would you fill out in this scenario if he escalated to level 3?
1 tally for aggression to others level 2 and 1 tally for SIB level 3
½ door, ETO, video monitoring