Topic One : Violence or behaviour that challenges in children with learning disabilities and autism – how you can help to make a difference Guest speaker: Yvonne Newbold, World Health Innovation Summit Ambassador - Learning Disabilities, Autism and their Families Around 25% of children who are diagnosed with a learning disability or autism will develop violent and challenging behaviour yet there is very little understanding or awareness of this issue. This means that affected families, who are already coping with frightening and dangerous situations every day at home, are often met with disbelief, judgement and blame from the people they turn to for help. Yvonne Newbold talks through some simple strategies that could make all the difference. Topic Two : Positive Behaviour Support – Supporting people with behaviours of concern in their communities Guest speaker: Tom Evans, PBS Development Lead, British Institute of Learning Disabilities This webinar focuses on Positive Behaviour Support and how it can support children and adults who are at risk of being excluded or experiencing restrictive practices because they have behaviours that are considered to be challenging or concerning.

1. www.england.nhs.uk
Topic 1 : Violence or behaviour that
challenges in children with learning
disabilities and autism – how you can
help to make a difference
Yvonne Newbold, World Health Innovation
Summit Ambassador - Learning
Disabilities, Autism, and their Families
Topic 2 : Positive Behaviour Support –
Supporting people with behaviours of
concern in their communities
Tom Evans, PBS Development Lead,
British Institute of Learning Disabilities
29 June 2017
Learning Disabilities:
Share and Learn Webinar
#improvingLD @NHSEnglandSI

2. VCB = VIOLENT & CHALLENGING
BEHAVIOUR
IN CHILDREN & ADULTS WITH A NEURODEVELOPMENTAL CONDITION SUCH AS
AUTISM
ADHD
OR AN INTELLECTUAL DISABILITY
Presented by Yvonne Newbold
yvonne@yvonnenewbold.com

3. CAUSES OF VCB
Severe Anxiety + Distress
= Fear
= Feeling Threatened
= Fight or flight response
VCB is NOT deliberate

4. SOME CAUSES OF EXTREME ANXIETY
Sensory Processing Difficulties
Change
Transitions
Routines
Communication

5. TOBY

6. WHAT PEOPLE SAID
It’s all your
fault
You’ve got
very poor
parenting
skills
It must be
something
you’re
doing
wrong
You
should be
ashamed
of yourself
You must be
doing something
horrible to him
first
Have you
tried just
loving
him?
Why don’t you just
explain to him that
he mustn’t hurt
people?
Some people
just shouldn’t
be allowed to
have kids

7. HOW DID TOBY TURN THINGS AROUND?
Slowly and
Patiently
Watching
and learning
from Toby
Making fun
and Toby’s
happiness
central to
everything
Counting to
give Toby
time to
process
Rigid
routines to
help him
feel safe
Timers
to help
with
change
Visuals to help
with
communication
Lots of hitting
brick walls
and going
backwards
Now Next Later
boards to
reduce surprises
Never giving up
and always
believing in Toby
Giving Toby control over as
many of his own decisions
as he manage
Plus dozens upon dozens
of other strategies
A complete shift
in approach,
with Toby at the
heart of it
With Lots of Love

8. THE SPECIAL
PARENT’S
HANDBOOK

9. IT ALL STARTED ON WOMAN’S HOUR…..

10. HUNDREDS OF SOCIAL MEDIA MESSAGES
AND EMAILS LATER…..

11. THE FIRST EVER
VCB
CONFERENCE

12. AUTISM AND VCB
% of ASD children who
develop VCB
VCB Without VCB
% of Children with LD
who develop VCB
With VCB Without VCB
LEARNING DISABILITY AND
VCB
RESEARCH INTO PREVALENCE OF VIOLENT
CHALLENGING BEHAVIOUR IN CHILDREN WITH
AUTISM AND CHILDREN WITH A LEARNING
DISABILITY

13. 5 WAYS TO DO THINGS BETTER
STARTING TODAY
1. Just be kind and tell parents it’s almost certainly NOT their fault
2. Give parents information about VCB at the time of initial diagnosis
3. Stop the parenting class madness, VCB parents already have advanced
parenting skills and strategies
4. When concerned parents are seeking help for a child with a diagnosed
neurodevelopmental disorder because of violent behaviour, think VCB first.
It’s a far more likely cause that either a child protection or an attachment
issue.
5. Give Hope / Show Kindness / Extend Compassion / Listen with Empathy
/ Believe in Each Family

14. PLEASE GET IN TOUCH TO FIND OUT MORE
ABOUT
• VCB workshops and Training
• For Parents and Professionals
• How to join my Mailing List
Email – yvonne@yvonnenewbold.com
For further resources on VCB
please see my website
http://yvonnenewbold.com/
LDT Learning
Disability
Champion 2015
WHIS Ambassador
Learning Disabilities,
Autism & Families
PEN National Awards –
Outstanding Contribution to Patient
Experience 2016
HSJ Top 50 Inspirational Women in
Healthcare 2014
School for Change Agents 2017

15. SUPPORTING SPECIAL NEEDS FAMILIES ON FACEBOOK
Breaking
the Silence
on VCB
A closed FB
Group for
parents
The SEND Parent’s
Handbook
A Public Page sharing
informative posts daily
for the special needs
community and those
who work with our
families

16. VCB MARKS TO WRIST

17. BRUISE CAUSED BY
VCB

18. SMASHED DOOR DUE
TO VCB

19. BITE MARK DUE TO
VCB

20. BROKEN CHAIR DUE
TO VCB

21. WRECKED LIVING
ROOM DUE TO VCB

22. WOUNDS TO NECK
CAUSED BY VCB

23. BRUISED THIGH
CAUSED BY VCB

24. SMASHED DOOR
CAUSED BY VCB

25. INJURED HAND DUE
TO VCB

26. UPTURNED SOFA DUE
TO VCB

27. ANOTHER BITEMARK
CAUSED BY VCB

28. ANOTHER BRUISE
CAUSED BY VCB

29. A Poem by Penny Thatcher
When you've lost the will to carry on
yet you feel too numb to cry, but
above you is the sunshine and clouds
scudding across the sky.
When everything you have given just
doesn't seem enough, and people
keep on blaming you and everything
seems tough.
I try to take a second
and go outside and breathe,
to notice all the tiny things
the birds, the grass, the bees.
At times like these, what do we need
when it all just gets too much? Some
praise or affirmation or a great big
hugging touch.
Tomorrow is another day
I'll rise back up to fight.
Because in my heart is love
and I know that I am right.
1.
2.
3.
4.
5.

30. THANK YOU FOR LISTENING
One last thing –
If a child’s behaviour deteriorates
rapidly, always seriously consider
pain or illness as potential cause.

31. www.england.nhs.uk
Thank you for listening
Any Questions?

32. Positive Behaviour Support:
Supporting people with behaviours of
concern to stay in their communities
Tom Evans, PBS Development Lead, British
Institute of Learning Disabilities (BILD)

33. 33
Centre for the Advancement
of PBS
About CAPBS
Part of BILD
Set up to support the organisational and workforce development of
PBS in the UK
Working with more than 100 organisations across the social care,
education and health sectors in the UK who support children,
young people and adults who have, or may be at risk of
developing, behaviours that are concerning or challenging
Supporting international PBS workforce development

34. 34
Centre for the Advancement
of PBS
This session will briefly cover:
An overview of Positive Behaviour Support
How PBS can support children and adults with behaviour of
concern who are at risk of being excluded or experiencing
restrictive practices
Our work supporting the implementation of PBS so that people
can stay within their own communities near to family and friends
and other support networks.
For more information, or to arrange a chat about anything you have
heard, please contact t.evans@bild.org.uk

35. 35
Centre for the Advancement
of PBS
The overall aim of PBS
is to improve quality
of life

36. Centre for the Advancement
of PBS
36
What is PBS?
A person centred framework for providing long term support
to people
Especially people who have, or may be at risk of developing,
behaviours that challenge
A blend of person centred values and behavioural science
Uses evidence to inform decision making
Based on a set of overarching values:
− inclusion
− choice
− participation
− equality of opportunity

37. Centre for the Advancement
of PBS
37
Aims of PBS
To improve the quality of a person’s life
and that of the people around them
Includes children, young people, adults
and older people
To provide the right support for a person,
their family and friends
To help people lead a meaningful life and
learn new skills
Avoiding unnecessary restrictions
Not simply about getting rid of problematic behaviour.
With the right support at the right time the likelihood
of behaviour that challenges is reduced

38. Centre for the Advancement
of PBS
38
Key principles of PBS
Behaviour that challenges usually happens for a reason
It may be the person’s only way of communicating an unmet need
PBS helps us understand the reason for the behaviour
We can then better meet people’s needs, enhance their quality of life
and reduce the likelihood that the behaviour will happen

39. Centre for the Advancement
of PBS
39
A PBS framework
Considers the person and his or her life
circumstances as a whole
Considers physical and emotional needs,
such as the impact of trauma
Is proactive and preventative
Reduces the likelihood of behaviours
that challenge occurring by creating
physical and social environments that
are supportive and capable of meeting
people’s needs

40. Centre for the Advancement
of PBS
40
A PBS framework (cont’d)
Aims to teach people new skills to replace behaviours that
challenge
Enhances opportunities for independent, interesting and
meaningful lives
Involves input from different professionals
Is provided in a coordinated and person centred manner
Includes using multiple evidence based approaches that
support health and wellbeing:
− trauma informed care
− autism specific approaches
− active support

41. Centre for the Advancement
of PBS
41
Skilled empathic staff
Practice Leaders
Appropriate behavioural expertise
Organisational recourses, systems and commitment
Critical to the success of PBS

42. Centre for the Advancement
of PBS
42
Delivery of PBS
Understand why behaviour happens: functional
assessment
Produce a PBS plan
Training staff and carers in following the PBS plan
Provide ongoing support for staff and carers
PBS is most effective when individuals are supported by
people who have a good relationship and rapport with them
and who understand PBS

43. Centre for the Advancement
of PBS
43
PBS plans
Co-produced in partnership with the person and
stakeholders
Followed by everyone
Proactive and preventive strategies
Teaching new skills
Strategies to avert crisis and keep people safe
If restrictive interventions are used these
must be the least restrictive and there
must be a plan about how to reduce reliance
on them

44. 44
Centre for the Advancement
of PBS
A tiered approach to prevention

45. Centre for the Advancement
of PBS
45
Range of service structure and types
Assessment of need and existing
expertise at each level
Review of policy and systems
Planned organisational approach
Focus on transference of learning to
workplace
Ongoing peer and expert support from
Community of Practice
Consultancy and support to guide
organisations through the PBS
pathway

46. 46
Centre for the Advancement
of PBS
Outcomes so far
Significant reduction of restrictive practice use
Reduction in injury rates
Staff attitudinal change
Collaborative working
Consistent practices
QOL measures for people being supported and staff now being
monitored

47. 47
Centre for the Advancement
of PBS
Resources for you
PBS animation: www.bild.org.uk/pbsanimation
BILD Workforce Development Framework: http://bit.ly/2rGo25Z
West Midlands Positive Behaviour Support Organisational and
Workforce Development Framework: http://bit.ly/2sXZr0q
Five signs of PBS: http://bit.ly/2sXVXvf
PBS Academy Competence Framework: http://bit.ly/2sESSwZ
PBS Yammer Group: http://bit.ly/2rFVFob

48. 48
Centre for the Advancement
of PBS
Upcoming events
Free awareness sessions about STOMP and PBS in July
http://bit.ly/2sUiBni
NHS England Experts on Tour Conference, Leeds 27 June Email:
denise.rodgers@nhs.net
Restraint Reduction Network conference – date TBC

49. Thank you!
Centre for the Advancement of PBS
Birmingham Research Park, 97 Vincent Drive, Edgbaston, Birmingham, B15 2SQ
0121 415 6970 | capbs@bild.org.uk | www.bild.org.uk/capbs
Sarah Leitch | s.leitch@bild.org.uk

50. www.england.nhs.uk
Thank you for listening
Any Questions?

51. Please join us on the last Thursday of every month 12:30 to 1:30 pm. This months webinar
will take place on 29th June and is focussed on Lived Experience in dealing with violent
Challenging Behaviour and Positive Behaviour Support Register for the webinar If you
would like to be added to the invitation list please email: marisa.graham@nhs.net
Calling all
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children, young people and adults to have a home within their community, be able to
develop and maintain relationships, and get the support they need to live healthy, safe
and rewarding lives – thereby reducing the numbers of people in inpatient settings. - High
impact actions for service improvement and delivery by Transforming Care Partnerships
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How transforming care is making a difference –
a range of case studies available here.

52. www.england.nhs.uk
Future Share & Learn Webinars
27th
July 2017
(45 mins)
Topic One: “The Assuring Transformation Data System” How to Upload
Data and Run Reports
Andy Tookey, Data & Information Lead, NHS England and Judith Ellison, Higher
Information Analyst, NHS Digital Data Collections Team
Topic Two: Children & Young People – topic to be confirmed
Sue North, Social Care & Education Adviser and Acting Lead – Children and
Young People, Learning Disability Programme, NHS England
31st
August 2017 Helping people with a learning disability to give feedback
Ruth Hudson, Insight Specialist, Joe Penrose, Insight and Feedback Officer and
Katie Matthews, Aaron Oxford and Thomas Chalk, Learning Disability Network
Managers, NHS England
28th
Sept 2017
(15 minutes only)
Topic One: Introduction to the evaluation of Building the Right Support
Fraser Battye, NHS Midlands and Lancashire CSU
Topic Two: Children & Young People – topic to be confirmed
Phil Brayshaw, Service Model Lead (Children and Young People), NHS England