Discussion and Key Takeaways from January

Date: 01/13/2023

Time: 1:00PM – 2:30PM


Amanda Tresback

Angela Procopio-Rahily

Anthony Giuliano


Brenda Cibien

Brian Jadro

Dan Shafer

Doug Hughes

Douglas Watts

Cyndy Miller

Erin Weinman

Jennifer Fuglestad

Janet George

Grayspn Fleischner

James Green

Jim Kiely

Justin Sallaway

Kelly McKeon

Michelle Kissinger

Trisha O’Connell

Pamela Raymond

Jeffrey Raischel

Sarah Weddle

Jennifer Sargent

Serah Muiruri

Sherri Shafman

Toni Cassella

Tracey LaRowe

Weronika Powers

Joseph Weru

Mike Menard-Weibel

Greg Hager

Lauren Giordano

Meghan Miele

General Announcements:

  • During the week of January 17th, DDS will release guidance on the PBS Behavior Safety Plan (BSP) along with a fillable BSP PDF form to facilitate and standardize this process
  • Open Sky Community Services will be hosting upcoming trainings on PBS

Universal Supports and Movement Between Tiers:

  • Individuals have non-static, changing behavioral needs, and therefore providers need to ensure they implement an identification and referral system to adequately adjust and/or increase supports accordingly and within a timely manner. It is of great importance that providers:
    • Consistently analyze the cause of the behavior and determine whether the behavior is short-lived due to specific life events, poses safety risks, or is chronic and worsening
    • Include the individual as much as possible throughout the process of developing the support plan
      • Some providers refer to this as “Nothing about us without us”
  • Proactive and preventive Universal Supports entails individual profiling, which is based on analysis of data sets reflective of individual needs, antecedents, and engagement. By doing so, providers will learn about and keep record of an individual’s general preferences with respect to relationships, communication, assistive technology, as well as their history of challenging behavior and related critical incidents, if any, support circles, and levels of happiness.
    • Some providers have a Universal Support form that has questions directed to the house manager and direct support staff, as well as outlines specific tasks and responsibilities assigned to staff for accountability purposes.
  • Universal Supports should foster highly supportive environments for individuals where stress is minimized, and skill teaching opportunities are maximized (e.g., mindfulness and choice making). When an incident occurs, providers should address the following questions:
    • Who is the challenging behavior a problem for?
    • What did we fail to consider or recognize?
    • What can be done differently?
  • It was noted that the Universal Supports team should also help identify procedural drift and ensure treatment integrity prior to an individual receiving higher tiers of supports.

Beyond Universal Supports

  • When an uptick in undesired behavior has been observed and the need for increased, individualized targeted supports, e.g., implementation of a token, structured scheduled, and/or a check-in or check-out systems, are deemed necessary, the structuring, adjustments, and scaling down of targeted supports should be based on consistent and accurate feedback loops.
  • Feedback Loops: Most providers rely heavily on regular and comprehensive data analyses of newly acquired replacement skills, restrictive practices, assistive equipment, among others. Also, depending on the severity of the behavior, providers will hold clinical and non-clinical meetings, including everyone involved in the individual’s support needs to some degree (e.g., house managers, quality unit staff, provider administration, direct support staff with seniority, and even job developers) on a weekly (more severe) or monthly basis (least severe). During these meetings, data is often analyzed to assess progress and/or setback, and courses of actions are discussed and formalized.
  • Discontinuation of targeted supports occurs when skills, such as replacement behaviors, have been successfully acquired, observed, and assessed over a determined period. Some providers recommend a 3-month heightened monitoring period.
  • Providers would like guidance on how to differentiate support needs without having to conduct a full FBA. If a provider determines the function of the behavior due to a staffing and/or training issue, then no referral is made, and the agency works on filling those capacity-related voids/deficiencies.

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