This document discusses an organization's transition from using restrictive interventions like supine restraint to using MAPA (Management of Actual and Potential Aggression) techniques to manage challenging behaviors. Key reasons for the change included high restraint use, lack of staff confidence, and a culture where restraint was the norm. MAPA was chosen for its suitability across disabilities, comprehensive training, and focus on individual needs. A behavior support committee oversaw the transition and trained all staff. Case studies show MAPA techniques successfully reduced restraints for students like Luke and led to a more positive culture. Ongoing monitoring ensures continuous improvement.

1. Moving to MAPA

2. What prompted thechange?
• High level of restrictive interventions
• Use of supine restraint
• All staff trained to the highest level
• Culture of the norm in regard of
restraint
• Lack of staff confidence in m anaging
challenging behaviour
• Lack of advice regarding specific
challenges 2

3. Why MAPA
• Suitability to m eet needs across ASD
spectrum
• Com prehensive workbook for staff
• Prioritising student’s individual needs
• Used with adults and children
• Quality Assurance Measures
• BILD Accreditation
3

4. Behaviour Support Committee
• Review of Behaviour Policy
• Oversight of Trends across the schools
• Driver of change from previous system
to MAPA
• Review of all docum entation
• Developm ent of Behaviour Leads in
schools
• Dedicated full tim e Trainers to advise
schools 4

5. 5
MAPA Foundation
• MAPA foundation level has been designed to
enhance understanding and m anagem ent of
disruptive, aggressive and/or violent behavior.
• This approach aim s to ensure that everyone
involved in crisis situations which include
disruptive, challenging or violent behavior can
m aintain the care, welfare, safety and security
of all involved.

6. First Impressionsareimportant
• All Managers to attend Foundation
training – giving them the ability to
feed back positive inform ation on the
change.
• Plan in place to train the Care and
Education Team – Teachers and
Assistant Team Managers
• Countdown to MAPA – Staff
• Move to a restraint free environm ent
• Change of culture 6

7. MAPA Skills– Morein your tool box
• The MAPA program m e aim s to ensure that
the necessary foundation skills will reduce
the likelihood of risky or dangerous behavior
occurring in the first place.
• As well as to m anage such behavior when it
does occur, using a range of MAPA physical
interventions that aim to m inim ize risk
without dam aging the professional and
supportive relationships between
individuals.
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8. Map out plan for school
• SMT m eeting to discuss initial thoughts
having com pleted the foundation training
• Meeting with full MDT and behaviour
support team looking at individual students
and which MAPA skills we ‘think’ will work.
• Risk assessm ent of environm ent – seating
internal / external
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9. CPI assessment of ‘individual’ needs
• CPI consultancy was accessed to m eet
exceptional individual needs.
• CPI assessm ent concluded that additional
training was required at Level 3, adding a 3rd
person, and Level 4, em ergency floor hold.
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10. Documentation
• Change all docum entation to support the
MAPA approach –
Individual Behavioral Risk Assessm ent
Behaviour Support Plan
Student Guidelines
Incident Form
Physical Intervention Log
1 0

11. Staff Needs
• Managing staff expectations of support and
how it is provided – Care Get Together Days
• Detailing agreed approach for student
-IBRA/BSP m aintaining an individualised
approach
1 1

12. CaseStudy - Luke
• Luke displays self-injurious behaviour including
headbutting and biting his hand, and physically
harm ful behaviour towards others including hitting,
headbutting and biting.
• Som etim es it is necessary for staff to physically
intervene to support Luke to ensure he does not
seriously harm him self or others
• Luke uses the soft play room as an area to calm ,
often pacing and taking tim e away
• If Luke’s challenging behaviour escalates staff would
physically support Luke to calm , including a three
person supine intervention with up to three m ore
staff supporting
1 2

13. Luke
• This intervention ensured rapid safe control
of the situation however Luke was not
always able to calm whilst supported in a
three person supine intervention and would
require tim e away to continue the de-
escalation period
• Luke would headbutt the floor whilst
supported in this intervention
1 3

14. Luke
• During Decem ber 201 3 Luke had 47 incidents and
30 required a three person supine intervention, plus
additional staff support
• Luke began putting him self into the supine position,
and when staff disengaged his behaviour would
escalate
• MAPA was introduced during January 201 4, and a
transition period started
• Initially Luke was unsure of the intervention,
therefore he still required a three person supine
support, however each m onth this frequency
reduced – transition was gradual.
1 4

15. Luke
• Luke began to understand the new MAPA
intervention and adapted his behaviour
• Staff developed a consistent approach using MAPA
interventions that best suited him to successfully
calm . The m edium standing/transition hold is less
restrictive and intrusive
• Since March 201 4 Luke has not been supported
with a three person supine, and m edium MAPA
continues to be successful for his needs
1 5

16. Graph 1
1 6

17. Graph 2
1 7

18. ContinuousImprovement
• Monitoring of individual students
incidents
• Quality Assurance standards for
training
• Centre Accreditation
• MAPA trained Behaviour Leads in all
schools
• Monitoring of schools incidents and
support to achieve a restraint free 1 8