Positive Behavior Support is celebrating its’ 25th anniversary this year as a concept. Writing with Rob Horner were Glen Dunlap, Robert Koegel, Edward Carr, Wayne Sailor, Jacki Anderson, Richard Albin, and Robert O’Neil. Prior to this article, terminology was shifting away from behavior management and behavior modification and towards phrases such as “non-aversive behavior management.” The problem with the term “non-aversive” was primarily because it focused on the negative, and not the positive.
Building on the work of people such as Judith Favell, Gary LaVigna, Ann Donellan, Wade Hitzing and many, many others, these authors started working on defining the presence of positive aspects of behavior change, rather than on eliminating the negative. In their article, the authors wrote:
“Behavioral interventions should maintain and support the personal dignity of the individual. Procedures that typical members of a community find excessive should be viewed with extreme caution. Because the purpose of behavioral interventions is to assist people to become full participants in society, the procedures used to achieve this goal should be within the standards set by society. Requiring interventions to be socially valid recognizes that it is not just the type of intervention that is important, but also the manner in which that intervention is implemented. By its nature, behavioral technology requires continuous, on-site technical and ethical judgement. Even mildly intrusive or reinforcement based interventions can be used in an inhumane, undignified manner that is disrespectful and stigmatizing to the individual with challenging behaviors.” (Horner et al, 1990)
In the 1980’s, Wade Hitzing consulted on a client for whom I was the program director, and responsible for writing his behavior plan. I had begun teaching operant conditioning (behavior modification) at the college level in 1981, and was really quite good at the use of what was called “mildly intrusive” interventions. Listening to what Wade had to say about a more positive approach to behavior change, I thought to myself “this is not just stupid, it is dangerously stupid” because I thought it would put staff and individuals served at greater risk to back away from the use of controlling techniques to change behavior. I listened to and read the works of Gary LaVigna and Tom Willis from the Institute for Applied Behavior Analysis, and I went to conferences where I presented on why this new approach was a fad and destined to fail.
Well, I was wrong! I was responsible for services to a man whose behavior was very challenging for himself and for others, resulting in physical harm to others and to himself, and who was on the receiving end of a very controlling behavior program which I had written. He had to have a pacemaker put in, and the cardiologist said that we could not restraint this man or put him in positions of elevated stress for six weeks. “Six weeks!” I cried – I can’t go six days without a major issue. But, having no choice, I re-arranged his environment, re-wrote his plan, adjusted the staffing, and went six weeks without the need for restraint.
I thought, can we go for 12 weeks? And we did. He was never restrained again. Scales fell from my eyes, a bright light came down from the skies, all the old movie clichés in an instant were in front of me, and I realized I had spent almost 20 years getting really good at doing restraint, when I should have been getting really good at not doing restraint!
The genius of Positive Behavior Interventions and Supports, as we now call it, is that it focuses on the presence of the positive, on how we can add to the quality of life of the individuals we serve. The focus is on how we can change antecedal conditions, how we can change environments, how we can support people, and not just their behaviors. I will be eternally grateful to all the people who write about PBIS, and am glad to be doing my part with The Mandt System® to improve the quality of life for people affected by behavioral challenges.
Quality of Life is not measured in things, it boils down to these five things based on research and explained more fully in a book chapter Simon Kemp and I wrote that is in “A Human Rights Perspective on Reducing the Use of Restrictive Practices in Intellectual Disability and Autism” published by BILD, the British Institute of Learning Disabilities. Quality of Life is about relationships, predictability in one’s life, being a member of a community where you not only participate and receive from others, but you participate and give to others. Quality of Life is about health and being pain free, and it is about hope, believing that things will change for the better.
There are hundreds of thousands of people that use The Mandt System® in their work with people affected by disabilities around the world. I have stories from Australia, Canada, Hong Kong and the United States about how well this positive stuff works. It is a joy to read these emails and listen to these stories as I travel and listen to people in the teaching I do.
So Happy Birthday, Positive Behavior Interventions and Supports!
Bob Bowen SVP Product Development