BEHAVIOURAL ASSESSMENT SERVICE Referrals are welcome from any setting for Behavioural Assessment and the process would involve the service user and when appropriate the service user's family and/or advocate/care staff. The type of assessment will depend on the challenging behaviour(s) referred and the service user's needs. Functional Analysis and in some cases Humane Analogue Assessment will be the focus of the assessment process. The assessments will be carried out in the service user's own living environment and other settings he/she might be during the day. The time scale of assessment will depend on the service user's presenting challenging behaviour(s) and settings. We recommend a minimum of sixty hours for long standing challenging behaviours. The Pegasus has a policy to – Interpret Behavioural Assessment findings to the service user and when appropriate, to the service user's family and/or advocate/care staff. Interpret Behavioural Assessment findings in terms of actions to be taken, to the persons responsible for carrying out the service user's intervention plan. Treat all Behavioural Assessment Reports as confidential. We would only send reports to other agencies that provide services to the service user and/or the service user's family with initial consent from the referral agency or service user. Abide by the Code of Practice of the British Association of Behavioural and Cognitive Psychotherapy. Use Behavioural Approaches that have proven record to be non-aversive and successful and easy to use. A typical Holistic Behavioural Assessment will include - Description of Services currently being used by service user Background Information Living Arrangements Flow of the Day Day Care Placement Health and Medical Status Previous and Current Treatment Functional Analysis of Presenting Problems which includes - a. Data Collection by care staff and/or family b. Interviewing care staff and/or family c. Direct Observations by the Consultant or Pegasus staff Functional Performance Analysis Motivational Analysis [Reinforcement Inventory] Intervention Plans and Recommendations (Adapted from Gary La Vigna et al).

BEHAVIOURAL CONSULTATION SERVICE The Behavioural Approach adopted by Pegasus is free from the use of any punishing technique. Interventions are aimed to modify or eliminate factors influencing the difficult behaviour(s) and to replace them with behaviours that are adaptive and appropriate. Behavioural Plans to manage difficult behaviours must be directed to enhance the development of the individual according to the principle of normalisation (social role valorisation). Thus the approach for working with people with difficult behaviour(s) is aimed at developing desirable and adaptive behaviours, rather than merely the elimination or suppression of undesirable behaviours. Reliance on punitive measures as the primary means of behavioural management is unacceptable by Pegasus Some examples of Recommended Behavioural Plans - ENVIRONMENTAL MANIPULATION: Changes in the physical, programmatic and interpersonal environment geared towards the service user's needs. POSITIVE PROGRAMMING: A gradual education process for behaviour change involving systematic instruction. Positive Programming teaches new behaviour over time and is based on a Functional Performance Analysis. In providing positive programming, the ethos of Gentle Teaching is emphasised.[Gary La Vigna and Anne Donnellan] General Skills Training - This includes Structured Training Programmes in the areas of Domestic, Vocational and General Community functioning. Activity Sequence Board or Book - This approach assists service users who have problems with spoken communication to choose activity in sequence by means of pictures. This is aimed at enabling the service user to predict the flow of the day. It is also aimed at reducing the likelihood of protest behaviours and behaviours cued by the anxiety associated with the "unknown" or lack of predictability. DIRECT TREATMENT STRATEGIES: These Schedules of Reinforcement Programmes are aimed to reduce the incidence of challenging behaviour(s). Differential Reinforcement of Other Behaviour [DRO] A DRO schedule of reinforcement is recommended as a strategy for reducing aggression and property destruction. The procedure involves positively reinforcing the service user for omitting the target behaviour(s) during specified periods of time. Differential Reinforcement of Other Behaviour-Progressive [DROP] This is a progression from DRO and is aimed to prevent satiation. Differential Reinforcement of Alternate Behaviour [DR-Alt] This procedure involves positively reinforcing the service user for exhibitingalternate desired behaviour therefore omitting the target behaviour(s) duringspecified periods of time. Differential Reinforcement of Low Rates of Behaviour [DRL] A DRL schedule of reinforcement should be initiated in an attempt to reduce the frequency of high rate challenging behaviour. GENTLE TEACHING: It is a way of interacting with people, which uses positive values as the foundation for setting goals to help the person learn and develop. The values of Gentle Teaching include human presence (being with people), participation (doing activities with people), respect (for the service user), equality (between staff and service user), shared value (appreciating things together), shared involvement (doing things together), mutual change (staff and service user change together) and human reward. (social praises, positive comments, handshake etc) [J. McGee et al]. The concept of Gentle Teaching involves - A process that places Human Bonding/Friendship at the centre of Human Growth and Development. A Proactive and Flexible approach instead of Reactive and Rigid approach. A Vehicle for Infusing Trust, Dignity, Reciprocity, Growth and Value sharing into Human Relationships. Adopts a general approach of Interrupt/Ignore, Redirect and Reward Model. Uses Human Rewards which are Brief, Immediate and Repeatable. The Behaviour Change philosophy of Gentle Teaching is based on O'Brien's Accomplishments: Presence Participation Respect/Dignity Choice Competence.