DOCSLIB.ORG

181109 Markus Hernes.Pdf (2.006Mb)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
181109 Markus Hernes.Pdf (2.006Mb) “What Are We Doing?” Managing challenging behaviour and reducing the use of compulsion and power through legislative reflections and Positive Behaviour Support Markus Hernes Master’s Thesis Master of Philosophy in Special Needs Education Department of Special Needs Education Faculty of Educational Sciences UNIVERSITY OF OSLO Autumn 2018 !II “I found it challenging, and at the same time quite exhilarating. But also a feeling of, you know, what are we doing? We just can’t continue, we need to know what we are doing.” !III !IV Abstract This thesis is concerned with how and in what ways the technology of Positive Behaviour Support (PBS) might help reduce the use of compulsion and power in schools. In Norway, legislative confusion in schools regarding the use of compulsion and power relating to legislative matters, is not a new or controversial issue. The Education Act §9 A-10 prohibits any use of restrictive methods, but the Penal Code §§ 17 and 18 might be applied in situations of a serious nature. This discrepancy might create a legislative vacuum in which the line between the duty of care, and the use of coercion, might be difficult to navigate or, in the worst case, lead to the unlawful use of compulsion and power in Norwegian schools. The study aims to investigate in what ways current legislation might contribute to the reduction in the use of compulsion and power, in what way PBS might help to clarify the current legislative confusion, and which components of PBS that might lead to the reduction in the use of compulsion and power. The data in this study is based on qualitative research interviews with four teachers working at a special needs department in an upper secondary school in Norway. The site of this study implemented PBS in 2014, specifically as a response to an audit by the county governor revealing unlawful use of compulsion and power, thus adding relevance to the research topic. Main findings: • Stand alone intervention-strategies at the site of study, specifically Active Support and the Low Arousal approach, were effective in reducing the use of compulsion and power. • The technology of PBS seemed to increase the impact of such intervention-strategies, specifically the systemic component. • The proactive component and person-centred approach of PBS, although somewhat abstract in nature, provided staff with some concrete and practical methods that helped reduce the use of compulsion and power, specifically the reflection-form and subsequent discussions. !V “What Are We Doing?” Managing challenging behaviour and reducing the use of compulsion and power through legislative reflections and Positive Behaviour Support !VI ©Markus Hernes 2018 “What Are We Doing?” Markus Hernes http://www.duo.uio.no Print: Reprosentralen, University of Oslo !VII Acknowledgements Firstly, I want to thank two wonderful people for enlightening conversations, inspiring thoughts and for being all-around good guys: Åsne Sandvik (Kapellveien Habiliteringssenter) and Ulf Wangensteen Berge (ViD Vitenskapelige Høgskole). Thank you for sharing all your wisdom and knowledge with me! Secondly, during my preliminary research, I reached out to the following professionals working in the field of research, for a conversation about the use of compulsion and power: Børge Stave (Verge Opplæring AS), Silja Nicoline Angellsen (Kapellveien Habiliteringssenter), Ingunn Midttun (Kapellveien Habiliteringssenter), Kristian Rusten Finvold (Nordvoll Autismesenter), Anne Berit Aarstad (Karlsrud Skole, byomfattende gruppe for autisme), and Christine Spence (prosjektleder, Stavanger Kommune) I thank you all for your time, inspiration and generosity! Thirdly, a big thank you to my supervisors Kolbjørn Varmann (Universitetet i Oslo, UiO) and Ulf Wangensteen Berge (ViD Vitenskapelige Høgskole), and to all my informants. Thank you for your trust and patience. … Lastly, and most importantly, to all the people I have worked with whose challenging behaviour has tested me, caused both doubts and insecurity and brought me sleepless nights, but whom I nevertheless have grown to cherish and love. Thank you!! !VIII Table of Contents 1. Introduction ..........................................................................................................................1 1.1. Background and relevance ........................................................................................2 1.2. The Problem ..............................................................................................................5 1.3. The Solution ..............................................................................................................6 1.4. Research question ......................................................................................................7 1.5. Clarifications and omissions ......................................................................................8 1.6. Abbreviations .............................................................................................................9 1.7. Structure ..................................................................................................................10 2. Theory .................................................................................................................................11 2.1. Challenging behaviour .............................................................................................11 2.2. Compulsion & Power ..............................................................................................12 2.3. Ethics .......................................................................................................................13 2.4. Restrictive practices .................................................................................................16 2.5. Restraint reduction ...................................................................................................17 2.6. Legislations in Norway ............................................................................................19 2.6.1. The Norwegian Penal Code ............................................................................20 2.6.2. The Education Act ..........................................................................................21 2.6.3. The Health Care Services Act and IS-10/2015 ...............................................22 2.6.4. Summary of legislations ..................................................................................25 2.7. Applied Behaviour Analysis (ABA) ........................................................................25 2.8. Active support and Low arousal approach ..............................................................27 2.9. Positive Behaviour Support (PBS) ..........................................................................28 2.9.1. Main components............................................................................................. 29 2.9.2. Multicomponent technology - The Pyramid Model ........................................31 2.9.3. Summary .........................................................................................................33 3. Methodology ......................................................................................................................34 3.1. The qualitative method ............................................................................................34 3.1.1. Phenomenology and hermeneutics ..................................................................35 3.1.2. Semi-structured interview ................................................................................36 !IX 3.2. My preconceptions ..................................................................................................37 3.3. Instrumentation and data collection ........................................................................38 3.3.1. Sampling method .............................................................................................39 3.3.2. Data analysis ...................................................................................................39 3.3.3. Coding of semi-structured interviews ..............................................................40 3.4. Validity and reliability ............................................................................................41 3.5. Ethical considerations ..............................................................................................44 4. Findings ..............................................................................................................................48 4.1. The presentation of findings ....................................................................................48 4.1.1. The use of legislations in reducing restrictive practises .................................49 4.1.2. PBS as an approach for reducing restrictive practises .....................................54 4.1.3. Focal shift ........................................................................................................58 4.1.4. Values and reflective practise ..........................................................................60 4.1.5. Methods for reducing the use of compulsion and power .................................62 4.1.6. The importance of the PBS-plan...................................................................... 67 4.2. Summary of findings ...............................................................................................70 5. Discussion of findings ........................................................................................................71
Load more

Recommended publications
  • Scoil Chormaic a Guide to Training and Adult Services
    SCOIL CHORMAIC A GUIDE TO TRAINING AND ADULT SERVICES 1 Table of Contents Introduction (Part 1)...................................................................................................3 Introduction (Part 2)...................................................................................................4 Occupational Guidance Service, Disability Services.................................................5 Aspect Day Service...................................................................................................6 Kilkenny Initiative for Training and Education (K.I.T.E.)..........................................10 Irish Wheelchair Association (IWA).........................................................................15 National Learning Network (NLN)/ Ancaire Day Outreach Service.........................20 Cluain Training and Enterprise...............................................................................23 Moorehaven Training Centre..................................................................................27 Gateway Training Centre (Brothers of Charity)......................................................28 RehabCare.............................................................................................................30 Camphill Communities of Ireland............................................................................32 Damien House Services.........................................................................................36 Brothers of Charity, Clare Region...........................................................................37
    [Show full text]
  • Bradley, E. Korossy, M
    HELP with Behaviours That Challenge Abstract When individuals with intellectual and developmental dis- abilities engage in behaviours that challenge, their poten- Volume 22, Number 2, 2016 tial for full community participation, integration and qual- ity of life is greatly compromised. Embedded in the acronym HELP (Health, Environment & Supports, Lived Experience, Psychiatric Disorder), this article describes a biopsychosocial Authors multi-perspective understanding of these behaviours. HELP is an approach that can be embraced comfortably by all stakehold- Elspeth Bradley,1 ers (including individuals with intellectual and developmental Marika Korossy2 disabilities and their families), empowers problem solving and has implications for effective intervention. 1 Department of Psychiatry, University of Toronto, Behaviours that challenge (BTC), otherwise known as “chal- Toronto ON lenging behaviours,” (National Collaborating Centre for 2 Surrey Place Centre Mental Health [NCCMH], 2015) are observed in people with (retired), intellectual and developmental disabilities (IDD) (DSM-5; Toronto ON American Psychiatric Association, 2013). Epidemiological studies estimate that BTC are present in 5–15% of the popu- lation with IDD (NCCMH, 2015) and occur more frequently in those with greater severity of disability (Cooper, Smiley, Allan et al., 2009a; Cooper, Smiley, Jackson et al., 2009b). These behaviours may start early, have a relapsing and remitting course and can challenge services and care provid- ers. As a consequence, individuals engaging in these behav- iours are frequently the recipients of intrusive interventions including the over prescription of psychotropic medication, particularly antipsychotic medication, giving rise to ser- ious side effects, increased medical morbidity and mortal- ity (Alexander, Branford, & Devapriam, 2016; Sheehan et al., 2015). BTC lead to reduced quality of life both for individuals Correspondence so engaged, and their care providers as well as frequently preventing full community integration.
    [Show full text]
  • The Reflective Journey the Reflective Journey: a Practitioner’S Guide to the Low Arousal Approach
    The Reflective Journey The Reflective Journey: A Practitioner’s Guide to the Low Arousal Approach Andrew McDonnell, CEO Studio3, Clinical psychologist, Visiting Professor of Autism Studies at Birmingham City University The Low Arousal Practitioner • The low arousal approach was developed in the late 1980s as an approach to managing crisis situations • There has been a strong emphasis on ‘in the moment’ crisis management – for example, avoid making demands, be aware of non-verbal cues etc • The key is understanding that we often inadvertently trigger situations or make them worse • Low arousal is about being reflective as a practitioner, and looking at ourselves first and the individual second What Makes a Good Low Arousal Practitioner? • What are the main characteristics of a good low arousal practitioner? • What are their values? • How can we recognise a low arousal practitioner? • What are the features of a low arousal practitioner you work with? The Original Definition " Attempts to alter staff behaviour by avoiding confrontational situations and seeking the path of least resistance” (McDonnell, Reeves, Johnson & Lane, 1998: p164) Low arousal is about ‘us’ not ‘them’ • Many of the central principles of the low arousal approach are based on non-violent philosophies, such as Buddhism and Quaker beliefs • There are also strong influences from mindfulness and particularly the role of reflective practice • Before you attempt to change or ‘manage’ another person, you need to reflect on your own behaviour Early Practice In 1985, as a young practitioner I often witnessed extreme restraint methods such as the one shown below: Experiences of Trauma in Care “Andrew worked in a service supporting with people with disabilities.
    [Show full text]
  • Annex 1: Understanding Autism Quiz
    Annexes Annex 1: Understanding autism quiz Annex 1: Understanding autism quiz 1. Autism affects more males than females YES NO MAYBE 2. Autism is caused by the MMR vaccine. YES NO MAYBE 3. Most people on the autism spectrum are of average or YES NO MAYBE above average IQ. 4. Reported prevalence rate of autism in the UK is 1 IN 60 1 IN 100 1 IN 200 approximately. 5. If a family has one autistic child the other children will YES NO MAYBE also be on the autism spectrum. 6. The number of people on the autism spectrum are YES NO MAYBE entering higher education (university) is on the increase. 7. The proportion of autistic people who have at least 20% 50% 70% one co-occurring condition is: 8. Autistic individuals are more likely to come into YES NO MAYBE contact with the law. 9. Autistic individuals all have sensory sensitivities and/or YES NO MAYBE difficulties or differences in sensory processing. 10. The proportion of autistic individuals who show 10% 25% 50% exceptional skills (e.g. in music, drawing, maths) is: 11. Autistic individuals are generally better at understanding the bigger picture (e.g. the wider context, the gist of a YES NO MAYBE message) than understanding details. 12. Difficulties with executive functioning (e.g. planning and organising, processing sequences, inhibiting YES NO MAYBE inappropriate behaviour) are unique to autistic individuals. 13. The number of children and adults reported as on the autism spectrum is pretty much the same the YES NO MAYBE world over. 14. Autistic individuals experience higher levels of stress YES NO MAYBE and anxiety than those without autism.
    [Show full text]
  • An Investigation of Physiological Arousal in Children with Autism And
    An Investigation of Physiological Arousal in Children with Autism and Co-morbid Challenging Behaviour Sinéad Lydon A thesis submitted to Trinity College Dublin, the University of Dublin, in partial fulfillment of the requirements for the Degree of Doctor of Philosophy (PhD) in Psychology 2015 Supervisors: Dr. Olive Healy (Trinity College Dublin) and Professor Brian Hughes (National University of Ireland, Galway). Declaration I declare that this thesis has not been submitted as an exercise for a degree at this or any other university and it is entirely my own work. I agree to deposit this thesis in the University’s open access institutional repository or allow the library to do so on my behalf, subject to Irish Copyright Legislation and Trinity College Library conditions of use and acknowledgement. Sinéad Lydon Table of Contents Page Summary i Funding iv Acknowledgements v Publications and conference proceedings arising from this thesis vi List of tables vii List of figures x List of abbreviations xi Chapter 1 General introduction 1 Challenging behaviour in autism spectrum disorder 2 Physiological activity in autism spectrum disorder 9 Theories linking physiological activity and challenging behaviour 12 Empirical investigations of the relation between physiological activity 19 and challenging behaviour Conclusions and research aims 29 Chapter 2 A systematic review of physiological reactivity to 33 stimuli in autism spectrum disorder Abstract 34 Introduction 35 Method 38 Results 45 Discussion 70 Chapter 3 Salivary cortisol levels and challenging
    [Show full text]
  • Portfolio Including Thesis ADELINE ANN CRAWFORD a Portfolio
    Portfolio including Thesis Volume I of 2 ADELINE ANN CRAWFORD A portfolio submittedin partial fulfilment of the requirements of the University of Hertfordshire for the degreeof Doctor of Clinical Psychology including a Thesis entitled: Brain Injury and the Experience of Caring: Intrapersonal Aspects from a Personal Construct Perspective The programme of study was carried out in the Department of Psychology, University of Hertfordshire August 2006 TEXT BOUND INTO THE SPINE Contents PageNumber Written ExerciseI 2 Written Exercise 2 24 Small Scale Service Related Project 45 LiteratureReview 69 Thesis Title Page 90 Thesis Contents 91 Dedication 95 Abstract 96 Introduction 97 Method 119 Results 133 Discussion 159 References 177 Acknowledgements 196 Appendices 197 Critical Review 232 I Written Exercise 1 Critically evaluate the concept of "dual diagnosis" and argue its degree of relevance to treatment planning. Introduction To critically evaluate the concept of dual diagnosis, that is two comorbid or simultaneously existing psychiatric disorders (Mueser et at., 2001), the unitary concept of diagnosis must be critically analysed. The concept of diagnosis forms the basis of the contemporary medical model (Kroese and Holmes, 2001), although systems of classification have been in existence since classical times (Gross and Mcllveen, 1996). Diagnosis has several explicit purposes including aiding research; summarising information; and guiding treatment (Nurcombe, 2000). To explore the concept of psychiatric diagnosis, the categorical diagnostic framework of the Diagnostic and Statistical Manual (DSM) (American Psychiatric Association, 2000) will be the exemplar analysed. This system of diagnosis is multi-axial, involving assessmenton five axes all of which map on to different kinds of information that ought to enable the assessorto plan treatment (ibid.
    [Show full text]
  • Ambea Year End Report 2019
    Annual Report with Quality & Sustainability Report 2019 We make the world a better place, one person at a time. CONTENTS Contents The year in brief ........................................... 4 CEO comments ............................................ 6 Our competitive environment .....................8 Targets and strategy ............................... 12 How we create value.................................... 15 Financial targets ......................................... 16 Sustainable care .....................................18 Doing it right should be easy .........................20 Our employees make the world a better place .24 Ambea, a socially responsible company ..........28 Our operations .......................................32 Vardaga .....................................................34 Nytida .......................................................36 Stendi ........................................................38 Altiden ...................................................... 40 Klara ......................................................... 41 Statutory Annual Report ......................... 42 Corporate Governance Report .......................43 Risks ........................................................ 48 The share ...................................................50 The population is growing in Scandinavia and the oldest age groups are growing fastest. That is leading to a sharply Financial statements ...............................57 growing need for care services. Read more on page 9. Directors’ report
    [Show full text]
  • A Research Review on Autism DEDUKTIA
    A Research Review on Autism DEDUKTIA AUTHORS Dr Simon Wallace Professor Karen Guldberg Professor Anthony Bailey Publisher: Eteva Joint Authority Karhukuja 1 04600 Mäntsälä www.eteva.fi ISBN 978-952-68118-6-4 Layout: Oy Graaf Ab Published: 2019 Table of Contents EXECUTIVE SUMMARY 5 INTRODUCTION 7 What is autism? .................................................................. 7 Theoretical considerations .................................................. 8 Terminology and models of disability ............................................ 8 Challenges for the autism research field ......................................... 9 Research priorities of autistic people and their families ........................ 11 Prevalence and economic models ............................................... 12 PART 1: DISCOVERY RESEARCH 17 Causes of autism .............................................................. 17 Genetics ........................................................................... 17 Environmental factors ............................................................ 19 Neuroscience ...................................................................... 21 Areas of difference ........................................................... 23 Social and communication ....................................................... 23 Restricted and Repetitive behaviours ........................................... 25 Sensory sensitivities .............................................................. 26 Measures of IQ ....................................................................
    [Show full text]
  • Educational Discourse and the Autistic Student: a Study Using Q-Sort Methodology
    Educational discourse and the autistic student: a study using Q-sort methodology by Damian Elgin Maclean Milton A thesis submitted to the University of Birmingham for the degree of Doctor of Philosophy. Reference Number: ERN 13-0875 Autism Centre for Education and Research School of Education College of Social Sciences University of Birmingham September 2015 University of Birmingham Research Archive e-theses repository This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder. Abstract With some notable exceptions (e.g. Jones et al., 2012), current guidance regarding best practice for the education of children on the autism spectrum often reflects a medical / behavioural model approach that seeks to remediate perceived deficits (Cumine et al., 1998; Hanbury, 2005; Hewitt, 2005; Worth, 2005; Hagland and Webb, 2009). Such advice can be contrasted with that given by autistic writers (Sainsbury, 2000; Lawson, 2010) often situating itself within a social model of disability. This study utilised Q-sort methodology (n = 60), followed by qualitative interviews (n = 6) to investigate the ideology and priorities of differing stakeholders, including autistic adults, parents of autistic children, practitioners and academics working in the field, and those occupying multiple positions, regarding the education of autistic pupils of secondary-school age.
    [Show full text]
  • Evidence-Based Guidelines to Reduce the Need for Restrictive Practices In
    Evidence-based guidelines to reduce the need for restrictive practices in the disability sector APS Working Group Ms Morag Budiselik Ms Michelle Davies Ms Ewa Geba Dr Nick Hagiliassis Professor Alan Hudson Dr Keith McVilly Dr Kim Meyer Ms Madonna Tucker Dr Lynne Webber APS Project Staff Mr Harry Lovelock Dr Rebecca Mathews Ms Claire Forsyth Ms Rachel Gold © The Australian Psychological Society 2011 Contents Abbreviations used in this guide 4 Executive summary 5 1. Purpose 8 2. Background 8 2.1 The clinical need for a practice guide 9 2.2 Barriers to the application of effective intervention 9 2.3 Prevention of challenging behaviour 9 3. Development of this practice guide 10 4. Definitions 10 4.1 Disability 10 4.2 Challenging behaviours 10 4.3 Restraint and seclusion 10 4.4 Functional assessment 11 4.5 Functional analysis 11 4.6 Learning theory 11 4.7 Establishing operation 12 4.8 Positive behaviour support 12 4.9 Person-centered planning 12 5. Guidelines for practice 13 5.1 Ethical, legal and policy considerations 13 5.2 Approaches to working with people who have intellectual disabilities 17 and challenging behaviours 5.3 Assessment of people with disabilities 18 5.4 Psychological interventions for clients presenting with 19 challenging behaviour 5.5 Determining an appropriate physical environment 20 5.6 Implementation of intervention plans 22 5.7 Evaluating and revising interventions 26 5.8 Working with children and adolescents who have disabilities 26 5.9 Working with people who have persistent self-injurious behaviours 28 6. Conclusions and future action 30 7.
    [Show full text]