Escalation Behaviors
These behaviors indicate Brian is escalating to crisis.
During escalation behaviors in the home, staff will do these things and go to this location.
-Model deep breaths; go to the guestroom (or a separate room from Brian) and close the door.
-Refrain from verbal communication.
-Provide visual check-in if hearing an item break or Brian yell 'ouch', etc. If injured, provide first aid or call 911 as needed.
Brian might begin displaying these behaviors, indicating that his crisis is getting worse.
Crying; running towards someone with a raise fist; striking someone (other than staff) with his fist; striking staff multiple times with force; destruction to property whether by throwing several items, pushing over furniture, or striking objects that do not belong to him (vehicle in parking lot). Brian might yell very loud 'No!' or 'Knock it off!'
If Brian goes toward staff with a raised fist or someone else, staff will
These behaviors mean Brian is de-escalating
-Absence of extreme behaviors (no throwing items or destruction of property).
-and no yelling
- - - for at least 10 minutes (all behaviors) - - -
- - - for 20 minutes if crisis occurred in the home - - -
Staff have already tried this without success to help Brian NOT reach crisis.
the Behavior Support Plan (BSP)
In the community, this is what staff will do to assist Brian in exiting a business or building as safely as possible.
-Model deep breaths.
-Gently state, 'it's a tough day. let's go home to feel better'.
-Avoid direct eye contact. Keep Brian in peripheral vision.
This is the doctor the BHS or parent will contact in a crisis, if needed.
Dr. John Williams
If Brian does not get his items to leave the building/business, staff will
-Get Brian's items if he is okay with it (does not yell or show behavior when staff get it).
-Continue to exit the location
-Inform BHS if Brian's items are left at a business/location. BHS will pick-up the items at another time.
If Brian says he is ready to return to his schedule, or wants to continue/go to the next scheduled activity, staff will
-Remind Brian 'everyone has tough days. Let's relax today and try again tomorrow'.
-Suggest preferred or enjoyable activities that Brian can do in the apartment. Ask if he would like to do it together (Sequence, Uno, movie, etc.) or alone.
An increase in frequency of the these behaviors indicates Brian is struggling even more to self-regulate
Statements of "I'm mopey" or "miserable" or "having a difficult day"; being 'stuck' on dates; striking an object or his leg and/or yelling; striking others; statements like "I'm in the middle of something"
This is when staff will contact the BHS, or the back-up BHS or, Brian's mother in the event BHS is off or unavailable.
Before escalation occurs = failure of BSP after several attempts.
In the community and once at the vehicle, staff will
-Mention taking a 10-minute break. Say, '10-minute break. I'll set a timer'
-Set timer on staff phone (if Brian opts to have it on his phone, that is okay).
-Encourage Brian to sit in the vehicle. It's okay to sit outside but must monitor for safety near vehicles/streets.
-Model deep breathing, monitor Brian in peripheral vision.
If Brian does not initiate discussion about what occurred.
-Staff refrain from verbal discussion.
-Engage in preferred or enjoyable activities with Brian, if he wants.
-Team meeting will occur and either BHS, mom, or team will discuss with Brian what to do when he feels that way in the future.
The on-call BHS is available to Brian's staff outside of business hours to do this.
-Be a source of support to Brian's staff.
-Review the BSP/CIP, to assist and provide reminders of what strategy to implement.
-Provide insurance/medical information if staff need it at an emergency room/hospital.
This person will contact Brian's provider and/or employer in the event Brian cannot attend or needs to leave early.
-For work - JD
-For appointments - BHS
This is when staff will transport Brian from the community to his apartment.
-Staff only transport Brian if they feel safe to do so.
-Follow the driving safety plan if behavior occurs in the car.