On 27th March, the NDIS released a new guideline on Behaviour Support, to make it clearer about what supports they can, and cannot fund. While many of us in the industry are well-versed in NDIS terminology and how Behaviour Support works, it’s very important to understand and know the exact wording that the NDIS uses. In this article, we’ll delve into the new 18-page guideline and highlight all the key updates and aspects.
Any wording that is in italics is official NDIS wording. Any wording that is not, is our own words.
To read the full document yourself, you can access the NDIS website here, otherwise, read our adapted summary below:
NDIS: Every behaviour has a purpose and is a way of communicating a message. You might use certain behaviours, for example, to communicate what you want, a need that’s not being met or something you want changed in your environment. Sometimes, these behaviours can cause harm to you or others and impact your quality of life. They may be called behaviours of concern.
If you need behaviour support because of your disability, we may fund behaviour support for you. The aim of behaviour support is to understand the reasons for your behaviour and implement positive strategies. These strategies will help you, and the people who support you, understand your needs and find better ways to support you.
Insight: Keep in mind that terminology does change from time to time, and between providers and individuals. Here, the NDIS uses the term Behaviours of Concern. At Insight PBS, we use the term Challenging Behaviours.
What do we mean by Behaviour Support?
NDIS: Behaviour support is a therapeutic support that can be included in your plan as an NDIS support. Behaviour support includes strategies and supports to look at the reasons why you may have behaviours of concern. It’s a support for you to meet your individual needs and will help those that support you to meet your needs. Behaviour support should use evidence-based practice and be in line with the legislation and policy frameworks for behaviour support.
It aims to:
- increase your quality of life
- understand the reasons for your behaviour
- find ways to meet your needs
- reduce and manage behaviours of concern over time.
This is done by creating individual behaviour support strategies. Some strategies are positive behaviour support strategies. These aim to:
- develop your skills. For example, what you can do to show you are hungry or upset
- make changes to your environment, like having soft lighting and regular routines,
- provide your support team with guidance about the best ways to support you.
What Behaviour Support does the NDIS fund?
NDIS: Behaviour support that is an NDIS support must be provided by professionals with specialist skills in behaviour support. Behaviour support can only be provided by registered NDIS providers.
Supports the NDIS can fund include:
- behaviour support assessments (Functional Behaviour Assessment)
- behaviour support plans that aim to reduce and manage behaviours of concern
- training and monitoring staff who are using a behaviour support plan
- positive behaviour support training for a family member, friend or carer
- interim behaviour support plans.
Insight: There are providers out there that may not be NDIS registered. If you’re receiving supports, make sure to check that each provider is NDIS registered.
Behaviour Supports that are NOT NDIS supports
NDIS: There are some key aspects that the NDIS deos NOT fund. These include:
- supports that include restrictive practices that are not allowed in your state or territory
- seclusion rooms.
- behaviour support given by:
- providers that are not registered with the NDIS Quality and Safeguards Commission
- behaviour support practitioners that aren’t approved by the Commission.
Insight: Each behaviour support practitioner needs to receive a letter of suitability from the NDIS, prior to them starting work. You can read more about this in our previous post: How to become a Behaviour Support Practitioner.
What is the Behavioural Assessment?
NDIS: When we talk about a behaviour assessment, we mean a functional behaviour assessment (FBA). This is completed by your NDIS behaviour support practitioner to look at:
- your needs that are not being met
- the reasons for your behaviours
- ways to manage behaviours of concern.
To do this, your behaviour support practitioner will look at your behaviour. They’ll talk with you, your family, carers and support workers. They’ll also look at any assessments you’ve had before. This will help them understand your behaviour support needs. It will also show them what behaviour support you’ve had in the past and if it worked for you.
By doing this, your behaviour support practitioner is getting information to find out more about your behaviour support needs, including:
- antecedents for behaviour. This means what happens before the behaviour of concern and what may be causing it
- the behaviour itself. Identifying what the behaviour looks like such as identifying how often the behaviour happens, how long it happens for and the risk to you and others
- the consequences of the behaviour. This means what happens after the behaviour. For example, you may get to spend time by yourself or with someone you like or get something you wanted.
A functional behaviour assessment will also find out where, when and how these behaviours may or may not happen and how they affect your life. The assessment must also consider your culture, religious beliefs, and individual circumstances when working with you.
Insight: It’s important to note here that an FBA is the main assessment that most Behaviour Support Practitioners complete. Also note that the above language highlights a key aspect of the practitioner role, they observe behaviour, and use that to build a Behaviour Support Plan. They do not provide immediate crisis intervention. To learn more about what a Practitioner can and cannot do, read our article here.
What’s a Behaviour Support Plan?
Insight: We’re running a webinar in June on the topic of Understanding Behaviour Support Plans. Register via the button below
NDIS: A behaviour support plan is a plan written by an NDIS behaviour support practitioner. The goal of your behaviour support plan is to improve your quality of life. A behaviour support plan should look at ways to meet your needs and respect your dignity.
There are two types of behaviour support plan:
- comprehensive behaviour support plans
- interim behaviour support plans.
Comprehensive Behaviour Support Plans:
NDIS: A comprehensive behaviour support plan is a detailed plan developed by a behaviour support practitioner. Before your practitioner writes your plan, they will do a behaviour assessment with you.
This assessment helps to make sure your behaviour support plan looks at your needs. Your plan will also provide positive behaviour support strategies for you, your family, carers and support workers.
These positive behaviour strategies help to:
- provide your support team with guidance about the best ways to support you
- support your safety and wellbeing
- build on your strengths. For example, your skills, interests or what you would like to do.
- look at ways to build your capacity and help you connect with your mainstream and community supports so you can pursue your goals
- increase your life skills, like doing day-to-day activities
- make sure your behaviour support plan will meet your needs and goals over time.
Your comprehensive behaviour support plan may also include regulated restrictive practices. These are practices that may be used as a last resort in your state or territory to protect you and others from harm. Your plan will tell you if and when these practices may be used. It will also provide information to your support team on how to reduce or stop using these over time.
If your behaviour support plan includes restrictive practices, your behaviour support plan must be reviewed at least every 12 months. You must provide us with a copy of your new behaviour support plan.
Insight: It’s key to note here that there is no mention of how long it should take for your practitioner to complete the first Comprehensive Behaviour Support Plan (When there are no restrictive practices in place). It’s really the Wild West when it comes to this. The NDIS does supply providers with a service guide, depending on how complex each participant is. If there are more challenging behaviours and restrictive practices in place, then it will take more time to complete a report. Here is an example of one, where we suggest a total of 45 hours to build a comprehensive plan:
Again though, how long will it take to bill 45 hours? Depending how full the caseload is with the practitioner, they might only be able to do 1-hour a week. Unfortunately, this part is not regulated. We’ve met carers who are still waiting for a Comprehensive Behaviour Support Plan to be written, more than a year after the service began.
Make sure you choose a reputable provider who has a positive track record of completed services, and stricter timelines. For reference, Insight PBS has a deadline of 6-months to complete a Comprehensive Behaviour Support Plan.
NDIS: An interim behaviour support plan is a short plan prepared by an NDIS behaviour support practitioner. Like a longer behaviour support plan, it will look at your behaviour support needs. It will also look at ways to prevent behaviour and reduce harm to you and the people around you.
Your interim behaviour support plan may also include regulated restrictive practices and when they may be used. It will also provide information on how to reduce or stop these practices over time.
You will need an interim behaviour support plan if:
- your support workers use a restrictive practice and don’t yet have authorisation from your state or territory.
- your support workers use a restrictive practice that isn’t in line with your behaviour support plan, and the use is likely to continue
- you need restrictive practices in place.
Your NDIS behaviour support practitioner must prepare your interim behaviour support plan within 1 month from the first day they know that a restrictive practice has been used. Your behaviour support practitioner must give your interim behaviour support plan to the NDIS Commission as soon as it is ready.
Your behaviour support practitioner must prepare your comprehensive behaviour support plan within 6 months from the first day they know a restrictive practice has been used. They must also give this behaviour support plan to the NDIS Commission.
What are some examples of Behaviours of Concern?
Insight: We’re running a webinar in May on the topic of Strategies for Managing Behaviours of Concern. Register via the button below!
NDIS: Behaviours of concern are behaviours of such frequency, intensity, or duration that they put you or someone around you at risk of physical or other harm. This means that your behaviours may be a problem for you and for others.
Examples of behaviours of concern include:
- physical aggression, like hitting someone
- verbal aggression, like yelling at someone
- property damage. For example, smashing a plate on the ground
- unwanted or inappropriate sexual behaviour
- inappropriate or unsafe impulsive behaviour
- hurting yourself
- any behaviour that stops you and the people around you from having a better life.
Behaviours of concern may be your way of communicating something. You may:
- feel you are not able to communicate what you want
- feel that you are not being understood
- be telling someone you want something, like food or to go out
- be telling someone that something is not working for you, like too many changes in the people supporting you.
Lots of things can be triggers for behaviours of concern, including:
- environments, like crowded, noisy places and bright lights
- situations, like meeting someone new or someone you don’t like
- your support workers not meeting your needs. They might not know how to tell that you are hungry, cold or upset, for example
- being sick, tired or in pain
- not having enough control over what happens in your home or during an activity
- feeling scared.
It’s important to know the behaviours are the concern, not you.
Your behaviour might be related to negative experiences that have happened in your life. There may be things or events in your life or your environment that make you feel unsafe or in danger.
It’s important to remember that some behaviours might be more common for certain age groups. If your child has a developmental delay or disability, early intervention supports for early childhood can be used to help develop skills such as communication skills. This may reduce the need for behaviour support.
What is Positive Behaviour Support?
NDIS: Positive behaviour support is about finding ways to help you and those who support you change behaviours that may be a problem for you or others. This includes using strategies and supports that meet your needs, respect your dignity and make sure you have a better quality of life. These strategies will help you and those who support you to manage your behaviours and reduce the use of regulated restrictive practices over time.
Positive behaviour support includes working with you, your family, carers, and providers to look at why you have behaviours of concern. This will help to understand how to meet your needs in other ways. For example, you may use behaviours of concern because you’re in pain. In this situation, helping to manage the pain may reduce your behaviours of concern.
Insight: Read our comprehensive summary of PBS here.
NDIS: Positive behaviour support can include changing things in your environment. It may include:
- training and support for people helping you
- ways for you to build your skills, so you understand what you want to tell people and how to tell them in a different way
- building your capacity and the capacity of your family and carers to be able to support you better. This includes making sure the people who support you at home and in the community are all using the same ways to help you.
Insight: Here is the biggest misunderstanding that we see in our industry. Notice the wording above. A Behaviour Support Practitioner provides training, strategies, and support for everyone else in the care team to manage challenging behaviours. The practitioner does not actually implement the strategies themselves. The role is focused on building capacity of everyone else. As we said above, practitioners do not provide immediate and crisis interventions.
Read more in our summary of The Role of the Behaviour Support Practitioner.
What are Restrictive Practices?
Insight: We’re running a webinar in April on the topic of Restrictive Practices. Register via the button below!
NDIS: A restrictive practice is any practice or intervention which restricts your rights or freedom of movement. There are different types of restrictive practices, like medication, locking doors or cupboards, or wearing a helmet. Sometimes, your carers or support workers may need to use a restrictive practice if your behaviour puts you at risk of harming yourself or others.
A restrictive practice can only be used when everything else has been tried and hasn’t worked. Or if your behaviour support practitioner has looked at other strategies and said they are not the right things to do.
There are laws and regulations that your practitioner and providers must follow before and when restrictive practices are used. Providers that use restrictive practices when supporting you must get authorisation where needed in your state or territory.26 The restrictive practices must be included in your behaviour support plan and follow the authorisation process in your state or territory.
Your NDIS behaviour support practitioner will talk with you, your family, carers and support workers about the restrictive practice before they put it in your behaviour support plan. They’ll also talk about the reasons for the restrictive practice and risks. They’ll tell you about other strategies they looked at, and why these aren’t right for you. They’ll also talk with you about the strategies and supports that may help reduce and stop the need to use regulated restrictive practices. Your behaviour support practitioner will include these strategies in your behaviour support plan.
Your behaviour support practitioner can only put restrictive practices in your behaviour support plan if they’re the least restrictive option in the situation to make sure you and others are safe
Insight: Here is a detailed summary of the different types of Restrictive Practices:
Seclusion
Section 6(a) of the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 defines seclusion as the:
“sole confinement of a person with disability in a room or a physical space at any hour of the day or night where voluntary exit is prevented, or not facilitated, or it is implied that voluntary exit is not permitted”
Should only be used as a last resort for serious behaviours of concern to prevent harm to the person and others when other strategies have not worked. Strictly prohibited in most states for individuals under 18.
Environmental restraints / restricted access
Section 6(e) of the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 defines environmental restraint as follows:
“environmental restraint, which restricts a person’s free access to all parts of their environment, including items or activities”.
Includes practices that are beyond ordinary community standards for the purposes of addressing behaviours of concern that can cause harm to the individual and others (normal practice – locking the door for safety). These practices may be difficult to identify.
same residence or using the same facilities, affecting their rights and freedoms. Strategies to decrease the ripple effects of these individuals may be sharing a key for a locked draw that the central person is unable access the area.
Mechanical restraint
Section 6(c) of the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 defines mechanical restraint as:
“the use of a device to prevent, restrict, or subdue a person’s movement for the primary purpose of influencing a person’s behaviour but does not include the use of devices for therapeutic or nonbehavioural purpose”.
Physical restraint
Section 6(d) of the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 defines physical restraint as:
“the use or action of physical force to prevent, restrict or subdue movement of a person’s body, or part of their body, for the primary purpose of influencing their behaviour. Physical restraint does not include the use of a hands-on technique in a reflexive way to guide or redirect a person away from potential harm/injury, consistent with what could reasonably be considered the exercise of care towards a person”.
Should only be used for serious behaviours of concern to prevent significant harm to the person or others when other strategies have not worked. Usually used for behaviours such as self-harm, aggression and other behaviours that have a high risk of harm to the person or others.
Chemical restraint
Section 6(b) of the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 defines chemical restraint as:
‘the use of medication or chemical substance for the primary purpose of influencing a person’s behaviour. It does not include the use of medication prescribed by a medical practitioner for the treatment of, or to enable treatment of, a diagnosed mental disorder, a physical illness or a physical condition’
Regulated restrictive practices
Of the types of restrictive practices, only regulated restrictive practices are allowed and then only with strict controls in place. Regulated restrictive practices include:
- seclusion
- chemical restraint
- mechanical restraint
- physical restraint
- environmental restraint
Any form of restrictive practice other than regulated restrictive practices are considered prohibited practices.
Prohibited practices
Prohibited practices include but are not limited to:
- any form of corporal punishment (for example, smacking or hitting)
- any punishment intended to humiliate or frighten a person
- any punishment that involves immobilising a person with chemical or physical restraint including supine and prone restraint holds
- force-feeding or depriving a person of food
- use of medication to control or restrain a person without a behaviour support plan, proper medical authorisation or legal consent
- use of punishing techniques, such as putting a person in a hot or cold bath, putting spice in their food, or squirting liquid on their face or body
- overcorrection, where the punishment is out of proportion to the behaviour (for example, making a person clean an entire room because they tipped their meal on the floor)
- confinement or containment of a child or young person (anyone under 18 years of age) such as forcing them to remain in a locked room or other place that they can’t leave
- punishment that involves threats to withhold family contact or change any part of a person’s individual lifestyle plan
- denying access to basic needs or supports
- unethical practices, such as rewarding a person with cigarettes or alcohol
- any other act or failure to act that is an offence under federal, state or territory laws.
Who can provide behaviour support?
NDIS: You can only use funding in your NDIS plan for behaviour support from a specialist behaviour support provider.
The laws for the NDIS state providers have to do certain things. If they don’t do these things, they are breaking the rules the NDIS Commission has set for providers.
Your behaviour support provider must:
- meet the requirements of the NDIS
- be registered for behaviour support assessments, including functional behaviour assessments, and writing behaviour support plans
- use an NDIS behaviour support practitioner to do your behaviour assessment and write your behaviour support plan
Sometimes, a behaviour support practitioner is a sole provider. This means they are the specialist behaviour support provider and the practitioner.
Providers who get funding from the NDIS must make sure anyone working for them to provide behaviour support has a clearance and is suitable to provide this support.
Does the NDIS fund training for people to provide your supports?
NDIS: Yes. Your NDIS behaviour support practitioner can recommend and provide training for support workers who are using a behaviour support plan. This includes training in the safe use of restrictive practices.
What happens once you have Behaviour Support in your plan?
NDIS: Once you have behaviour support funding in your plan, you can use your funding to get the NDIS supports you need, in line with your plan. If you need help to use your funding, talk to your my NDIS contact, support coordinator or recovery coach. They will work with you to put in place your behaviour support plan. This includes supporting you to find supports and providers and coordinating your supports in line with your behaviour support plan.
Read the full NDIS resource here
NDIS Code of Conduct
NDIS Practice Standards
National Framework for Reducing and Eliminating the Use of Restrictive Practices in the Disability Service Sector.
NDIS Act 2013
Read the full PBS Capability Framework
Read the NDIS steps to become a PBS practitioner
Read more of our blog articles here
Want to work with us? Check out our careers page.
Refer to Insight Positive Behaviour Support here.
Follow us on Youtube, Facebook, Instagram, LinkedIn, Twitter (X) and TikTok!
Want to discuss or have any questions about Positive Behaviour Support ? Feel free to contact us or request a callback.