J first came to Affinity Trust in January 2018, when he was seven. Referred to us by Bradford Council, J was one of the first children in the city to be supported by our Positive Behaviour Support (PBS) service.
The service outcomes are to keep allocated children out of residential care, maintain education provisions, improve quality of life, and reduce behaviour that challenges.
At the time he was referred to us, J was presenting with high levels of distress at home, including property damage and frequent attacks on his mother.
Our Service Lead carried out a functional assessment of J’s behaviour and a quality of life assessment.
Over a period of direct observation, our team noticed that J struggled with unpredictable environments, over-stimulation, inconsistent boundaries, changes of routine without warning, and poor interaction with some of his support network.
We discussed this with J’s mother and his multi-disciplinary team. All agreed with the information presented and we started to develop J’s Positive Behaviour Support plan.
This plan was shared with and agreed by the multi-disciplinary team. They praised the effort and expertise involved, with one person saying: “It’s amazing to see this much work go into one child’s plan.”
Our team continued working intensively at J’s home and school, and with J’s grandparents and other stakeholders, supporting them in implementing the PBS plan, modelling strategies, and providing guidance. We also designed short environment-specific plans.
Our strategies for J included
providing more predictability in his daily routines, including consistent use of photos and ‘now and next’ boards
improving interactions between J, his parents, his extended family and school staff, to avoid triggers
avoiding over-stimulation by limiting the amount of toys put out at once
ensuring that J understood community visits, their purpose, and where they were going
developing healthy sleep patterns using pictorial prompts.
In the five months since we started implementing J’s plan, there have been significant changes in his presentation:
He is now sleeping well, usually in his own bed.
His diet is more varied – he chooses fruit rather than repeatedly asking for sweets and ice lollies – and his appetite at school has improved.
He is going to the shops with his mother with few incidents in the car or the community.
He is starting to manage his own emotional state and calm himself down when he begins to display early signs of distress. This has included self-regulating at the start of the new school term, which had previously been a major trigger.
At our review meeting in September, J’s mother reported that J had caused no injuries and shown no aggressive behaviour over the past couple of months. She said, “J is like a different child now.”
Our Positive Behaviour Support service in Bradford is commissioned using a Social Impact Bond. Affinity Trust receives payment only if children remain out of expensive residential care placements. Our social investor is Social and Sustainable Capital.
The outcome payments for this service are funded by the Big Lottery Fund, Bradford Council, and NHS Clinical Commissioning Groups for Bradford City, Bradford District, and Airedale, Wharfedale and Craven.
We’re running a briefing for professionals about this service in Bradford on Friday 15 February 2019.