A multi-agency approach to managing challenging behaviour
Our district special school has pioneered a behaviour support programme where health, education and social services have come together to work in partnership with families who are managing behaviours that challenge at home. The programme has been running for seven years and continues to thrive.
Meeting the needs of pupils with profound, severe and complex needs is always a high priority for any school, though families often report a lack of behaviour-related services for children with these needs. Back in 2004, the school identified the opportunity to extend and develop its partnerships with local agencies in order to support families. Following discussions with managers working at a strategic level, the behaviour support programme was set up in 2004.
The importance of working with parents in a multi-agency way has long been recognised, but the idea has gained much topicality recently with the announcements that the Government is to replace statements of SEN with combined education, care and health plans and provide parents with greater influence over support for their child.
While existing legislation recognises that multi-agency working is an effective way of supporting children and families with additional needs and securing real improvements in their lives, this has often been hard to achieve in reality. Lacey (2004) says that “joint practice has proved difficult and may even be non-existent. Meeting the needs of children requires flexible working on the part of statutory agencies who need to communicate and agree policies and protocols that ensure a ‘seamless’ service, for ultimately working together leads to a better quality of provision.”
Our behaviour support programme was primarily aimed at enabling families to manage challenging behaviour at home. It was hoped that this would prevent or reduce the ongoing problems which can create long-term disabling outcomes for children, and can be expensive for families and agencies.
The programme offers families support from a broadly based team of professionals who work with them to provide a time-limited and focused intervention. The team includes a speech and language therapist, social worker and school nurse, as well as specialist teachers and senior teaching assistants. The professionals are all able to offer skills, experience and relevant expertise.
Key workers are allocated to families based on the needs of the child and the family, as well as on the experience and particular skills of the key worker. The children identified for the initial programme were all of primary school age, though the programme is now available and suitable for all ages from two to 19 years.
At the start of the programme, families are invited to a meeting to find out more about what is involved. If families express an interest in participating in the programme, they are invited to complete a referral form. This helps families to identify individual behaviours that are of concern to them at home. Over the years, children on the programme have exhibited behaviours ranging from scratching, hair pulling and biting to disturbed sleep patterns and/or self-injurious behaviours. As a result of these behaviours, families have experienced injuries, emotional issues, isolation, depression and sleep deprivation.
Key workers work collaboratively with families over a ten week period. There is an expectation, which is shared at the pre-programme meeting, that families will fully engage and commit to the programme. During this time, key workers meet with the family regularly to help them identify the behaviour they would like to address, to assess the function of this behaviour and to identify strategies to support families to manage the behaviour at home. Interventions are tailor-made to specifically meet the needs of each family.
Interventions used on the programme have included:
- introducing visual support in the home environment and help to use these systems effectively
- supporting families to implement alternative and augmentative communication systems in the home
- helping families to establish routines.
Working with parents
Support and contact with families has included home visits and joint meetings in school, as well as telephone and email contact. The key worker observes the child in school and works alongside the teacher. Throughout the process, key workers hold regular multi-agency team meetings to share expertise and discuss individual outcomes. At the end of the programme, families and key workers meet together to review, evaluate and celebrate its effectiveness. This meeting is structured to enable families to reflect and share the success and the impact of the changes in the child’s behaviour as a result of the support and intervention.
The programme has evolved over the years, based on the feedback and evaluations of families and key workers. Every year, families have consistently reported improvements in the identified behaviour. Families have also commented that they have gained a better understanding of their child’s needs, felt more confident in addressing the behaviours and achieved overall improvements in family life, specifically for siblings.
Families rated the home visits as the most useful intervention, followed by telephone contact. The key workers also reported improvements in the child’s behaviour. However, the greatest improvement was noted to be in the families’ increased confidence in managing their child’s behaviour. Key workers valued the opportunity of working in a multi-disciplinary way, and the opportunity to discuss matters with colleagues from other disciplines and agencies, enabling them to extend their knowledge and skills.
In addition to the benefits for families, the programme has also provided excellent continuing professional development for key workers. Despite time and cost considerations, as well as occasionally inconsistent support from other agencies, the programme has continued to develop and forty-four families have now been through it.
This is a successful example of multi-agency working at a local level that has an impact and makes a difference to children and families. As well as the delivery of this programme for its own students, and developing an outreach and consultancy service, the school is keen to extend the behaviour support programme beyond its own locality. It has already hosted two conferences to share the programme with colleagues from local schools, health and social services. Collaboration across different agencies can be difficult to achieve, but as this programme shows, it is possible and can provide unique benefits for the families and children involved.
Liz Skilton is Speech and Language Therapist and Sam Perryman Assistant Headteacher at Milestone Academy, Kent: