Brad Wyner, Behavior Support Specialist
[email protected]
Jessica Thorne, Program Director
[email protected]
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We support a lot of people with challenging
behavior.
Our goal is to prevent those challenging
behaviors from happening, by helping people
feel safe, connected, and in control.
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We never want to reach a point where we are
just talking about a “behavior,” and losing
sight of the person in question.
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Most have severe to profound IDD
Most communicate through body
language and do not speak
Tend to have high behavior support
needs
More ICF than waiver
“Person Centered Planning emphasizes the
needs and choices of the individual when
planning services.”
-DODD website
“In person centered planning, groups of people
focus on an individual and that person's vision
of what they would like to do in the future”
- PACER Center
“For people being supported by services, it is
not person centered planning that matters as
much as the pervasive presence of person
centered thinking.”
- Helen Sanderson
The individual is the head of their own team.
No matter their level of intellect.
Even if they can’t communicate with words.
Every else is there to help the individual meet
their goals, feel safe, and happily live their life
the way they want to live it.
Really.
If the individual isn’t able to directly
communicate their desires, it is the team’s job
to figure out the individual’s desires.
A person-centered team focuses on . . .
What does the individual want?
What does the individual need?
What someone needs is not necessarily . . .
 What would be best
 What would be safest
 What they would want if they understood
 What their family wants
 What the experts want
 What the doctor says
 What the guardian wants
It’s what the person needs.
If a person needs something,
but doesn’t want it . . .
begin the team process for a
restrictive measure.
Here are some red flags . . .
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Focused on forms
Focused on procedures
Rule/Regulation/Policy-focused
Agency-focused (“what we do here is . . .”)
Staff-focused
Guardian-focused
“What’s best for them”
(With a big disclaimer – all of those things could
actually be person-centered! For example, we try
to create person-centered forms to drive personcentered thinking)
Maladaptive behavior are a person’s
attempt to:
 Communicate
 Manage stress
 Get needs met
 Solve a problem
And it’s the best they could do in that moment.
Behavior we see
Thoughts &
feelings
Strategies
to Figure Out What is
Most Important to a Person
When They Can’t Tell You
With Words
(aka this is what goes in your assessment)
1) Ask their staff. Pay attention to what is
observed consistently between people.
(if you hear the same idea from multiple DSP’s,
it’s probably true)
2) Use professionals to filter information from
staff through specific knowledge about
diagnoses (for example, what we know about
people with autism, what we know about
people with psychotic disorders).
Use that as a filter, but not as a “source” of
information
3) Describe the staff that this
person seems to like best. What
traits do they have in common?
4) Be mindful of the person’s life
story
Questions to ask staff & other people who
know the individual well:
 What do you think they want?
 What makes them happy?
 What makes them smile?
 When are they least likely to be upset?
 What do they try to avoid?
 What gets their attention more than other
things?
 Are there times that have had more or less
frequent problem behaviors? The better
times – what do they have in common?
When interviewing staff about behavior, ask
questions that are as generic as possible.
“What’s that about?”
or
“What’s up with Jess hitting?”
rather than
“What do you think she wants when she hits?”
If everyone else disappeared,
what would the person do with
their day?
Imagine this person didn’t have a
disability.
What would they be like? Where do
you think they would choose to
live?
What would be their hobbies?
Profession?
Who would they surround
themselves with?
Adding a trauma-aware layer:
How you can help the person feel . . .
 more powerful?
 more comfortable in their own skin?
 safe in their own home?
 more included?
 stronger connections to the people they see
day to day?
Now. . .
Let’s interweave all of that
stuff into a plan
Some highlights . . .
WHAT WE LIKE AND ADMIRE ABOUT YOU
To get to know the person and what others
appreciate about their gifts, ask the team to
think about what attracts others to this person.
What do people like and admire about this person? How would
we introduce this person to someone they do not know? What
compliments does he/she receive? What is he/she good at? What
do people thank this person for?
MY HOPES & DREAMS
What is your best future? What are your long
term hopes and dreams?
What will you be doing, with whom and where? What do you hope
to achieve? Don’t be afraid to dream big!
GOOD DAY/BAD DAY
What makes me happy/safe? What makes a great day
and what supports need to be in place to assist me in
having a successful day. Additionally, what makes a
bad/frustrating day? This will help the team be aware
of things that are stressful and/or aggravating and can
be minimized/avoided.
GOOD DAY
 What makes me happy
 What needs to be in place for me to be successful
BAD DAY
 What makes a bad/frustrating day
MY ROUTINES AND RITUALS
Routines and rituals ease us through our days,
comfort us when we need it and help us mark
special occasions.
Some areas to consider are daily rituals (must haves),
special events, how to transition to new activities,
weekday/weekend routines, holiday traditions, etc.
ACTIONS THAT MAY NOT BE
UNDERSTOOD BY OTHERS
(when I do this, it means this, you
should do this)
When I Do This
It Means This
You Should Do This
Other headings include:
 My gifts & talents
 Important to/Important for
 How I communicate
 Important relationships
 Who helps me make decisions
 My supervision needs
 My money & possessions
 Important procedures to keep me safe
 My environment
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My home & future plan
My plan for success (skill development)
My path to employment
My transportation
My health
Strengths, needs, priorities and corresponding
skill development goals and/or service
supports
My schedule
Meeting minutes
RISK SUMMARY: I May Be At Risk of
(Medical, Behavioral, etc.)
Include diet texture needs, important steps for
positive communication, intense medical needs,
positive and proactive procedures supporting
behavioral needs, etc. (include IAF categories)
What it is?
What I need from you to keep me safe?
If applicable, include: endangering behaviors, aggressive behaviors, stereotypic
behavior, threatening behavior, self injurious behavior, destructive behavior, disruptive
behaviors, withdrawn behavior, suicidal behavior. See Ohio ICF/IDD assessment.
Side note: don’t just use a risk
summary in place of a “behavior
plan.”
Use it as part of a person-centered
plan to capture what doesn’t fit
into other categories
ICF DISCHARGE PLAN
“Described services/supports available in ICF vs
waiver on date ______”
Services & Supports necessary for the person to
move to a more integrated setting; who will
address
Strategies to address barriers
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If the person has no interest in moving (for
example, if elderly), paint a picture that
shows they are making an informed choice to
stay in the ICF
Show baby steps in moving toward a more
integrated home each year
Don’t use the same language in each plan
Avoid the feeling that ICF is the default, just
because that’s where they’re at. Show an
informed choice.
COMMUNITY EMPLOYMENT
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Show where the person is on the path to
employment
Show progress addressing barriers
Incorporate individual’s unique Strengths,
Abilities, Preferences, Resources, and Desired
Outcomes
The details of how staff enact elements of a
plan day to day don’t need to go into the plan –
that is super important, but can be separate.
When you are centered on the
person . . .
You can still be mindful of staff
strengths.
“I did then what I knew how to do.
Now that I know better, I do
better.”
― Maya Angelou