Roy Deveau

The role of physiological arousal in the management of challenging behaviours in individuals with autistic spectrum disorders

Challenging behaviours restrict opportunities and choices for people with autistic spectrum disorders (ASD) and frequently lead to inappropriate and costly service interventions. Managing challenging behaviours of people with autism is an important area of research. This paper examines some of the evidence for the role of physiological arousal influencing these behaviours. Evidence from the emerging literature about sensory differences is examined. It is proposed that sensory reactivity is associated with hyperarousal; catatonic type behaviours are associated with low levels of reactivity (hypoarousal). A low arousal approach is proposed as a generalised strategy to managing challenging behaviours with ASD. The use of non-contingent reinforcement and antecedent control strategies are recommended for use with challenging behaviours which have a sensory component. Examples are provided to illustrate the approach. The implications of arousal and the use of physical interventions are discussed. It is proposed that arousal is a construct which has significant heuristic value for researchers and practitioners.

Impact of practice leadership management style on staff experience in services for people with intellectual disability and challenging behaviour: A further examination and partial replication.

BACKGROUND AND AIMS Practice leadership (PL) style of frontline management has been shown to be associated with better experiences for staff working with people who may exhibit challenging behaviours (Deveau & McGill, 2014). This study aimed to examine additional staff experience factors with a different, larger sample and to partially replicate the findings of (Deveau & McGill, 2014). METHODS This study was a survey of staff self-reported data collected as part of a larger study. Information was collected on PL and staff experiences of: stress, turnover, job satisfaction and positive work experiences. RESULTS AND CONCLUSIONS The results broadly supported Deveau and McGill (2014) and demonstrated an association between PL and greater job satisfaction and positive experiences for staff. Results on staff turnover were inconsistent. The positive impact of PL on staff experience was further supported by this study. Suggestions are made for further research. IMPLICATIONS These findings suggest further research is needed to examine the potential of interventions in frontline management/leadership practice to improve staff experience of working in challenging environments.

Reducing challenging behaviour of adults with intellectual disabilities in supported accommodation: A cluster randomized controlled trial of setting-wide positive behaviour support

BACKGROUND Improving the quality of social care through the implementation of setting-wide positive behaviour support (SWPBS) may reduce and prevent challenging behaviour. METHOD Twenty-four supported accommodation settings were randomized to experimental or control conditions. Settings in both groups had access to individualized PBS either via the organisations Behaviour Support Team or from external professionals. Additionally, within the experimental group, social care practice was reviewed and improvement programmes set going. Progress was supported through coaching managers and staff to enhance their performance and draw more effectively on existing resources, and through monthly monitoring over 8-11 months. Quality of support, quality of life and challenging behaviour were measured at baseline and after intervention with challenging behaviour being additionally measured at long-term follow-up 12-18 months later. RESULTS Following intervention there were significant changes to social care practice and quality of support in the experimental group. Ratings of challenging behaviour declined significantly more in the experimental group and the difference between groups was maintained at follow-up. There was no significant difference between the groups in measurement of quality of life. Staff, family members and professionals evaluated the intervention and its outcomes positively. CONCLUSIONS Some challenging behaviour in social care settings may be prevented by SWPBS that improves the quality of support provided to individuals.

Commentary on “Can active support improve job satisfaction?”

Purpose – The purpose of this paper is to provide a commentary on Rhodes and Toogood’s article on the possible relationship between Active Support training and staff job satisfaction. Design/methodology/approach – Rhodes and Toogood unusually and importantly include outcomes for both frontline staff and service users following an Active Support intervention. This commentary builds upon this approach by drawing on ideas recently raised by Deveau and McGill (2015). Findings – A number of important themes are identified including the mutuality of direct support staff (DSS) and service user experience, the significance of considering both the formal and informal aspects of organisational culture and the value of employing a complexity theory perspective. Originality/value – Effective public services require an understanding of the factors influencing the behaviour of public service staff. In intellectual disability services, positive outcomes can only be obtained through a broader appreciation of the drivers ...

Characteristics of the most expensive residential placements for adults with learning disabilities in South East England: a follow-up survey

Purpose – The purpose of this paper is to investigate the characteristics of the highest cost residential placements provided for adults with learning disabilities in the South East of England, comparing findings with a previous survey. Design/methodology/approach – Lead commissioners for NHS and Local Authority teams in the South-East of England were asked to provide information on the five highest cost placements that they currently commissioned. Findings – The average placement cost was £200,000 per annum with a range from £81,000 to £430,000 per annum. Individual characteristics of people placed were broadly similar to those identified in previous studies. Originality/value – Significant resources are used to support relatively few individuals. These individuals’ needs and characteristics suggest areas for research and practice development.