This book supports students undertaking the level three Health & Social Care unit HSC 3045, and is part of a series produced by the British Institute of Learning Disabilities (BILD) intended for people working directly with individuals with an intellectual disability. The book is structured in a straightforward manner, providing an introduction to positive behaviour support (PBS), describing proactive and reactive approaches, before offering a series of chapters dealing with responding to incidents, supporting people following an incident, and revising strategies. It ends with a brief overview of legislation and frameworks, codes of practice and policies. A useful glossary is provided.
Any book aiming to be brief (132 pages) and accessible in offering advice on supporting positive behaviour is laudable, particularly given the complexity of the issues. There are good examples, easy-read tables and activities that lend themselves to group as well as individual study, and each chapter signposts students to other sources of information – usually companion books produced by BILD. There are examples of useful practices, and the embedded emphasis on person-focused thinking and action is strong. The author's experience as a learning disability nurse and as a trainer becomes apparent early on, with clear graphics and summaries.
I noticed a tendency to refer the reader to earlier chapters, which breaks the flow of reading, and the bullet points and lists of key themes may become oppressive. There are some fundamental conceptual issues that any second edition should consider revising, including an apparent confounding in the language used of positive approaches (Lovett, 1996) and PBS (Sailor et al., 2009); if the former, then perhaps a more explicit drawing out of the importance of rapport (Carr et al., 1994) and interaction and lifestyle opportunities would be useful; if the latter, then offering simple methods to establish the likely function of a behaviour might be welcome. The language used is, of course, intended to support learning for direct workers but, even so, having a source for cited “facts” would be of help – where is the research that shows of all communication, 55 per cent constitutes visual methods (face, body), 37 per cent sound (pitch, fluency)? Such quibbles distract from the vitally important message the author is endeavouring to convey; clarity of concepts count, especially for those learning about providing effective support: a positive incentive is probably not the same as a reinforcing event, and the definition of positive reinforcement is wrong. A positive reinforcer is functionally defined by its effect on a specific behaviour. So the cited example of praise as a positive reinforcer doesn’t hold. For some people praise will increase a given behaviour, for others, not.
This then suggests the book is focused on practical general options for those seeking to adopt positive approaches, rather than the more technically precise PBS: for most people, positive equates with something good. There's a lot of sound mileage in such advice, in trying to deliver the space and interactions individuals prefer. And so, as a starting point on the journey to help people better support those whose behaviour challenges the system, this is a useful introduction.
