@article{ref1,
title="Positive behaviour support for adults with acquired brain injury and challenging behaviour: a randomised controlled trial",
journal="Annals of physical and rehabilitation medicine",
year="2021",
author="Ponsford, Jennie L. and Hicks, Amelia J. and Gould, Kate R. and Downing, Marina G. and Hopwood, Malcolm and Feeney, Tim J.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Challenging behaviours are common and disabling consequences of acquired brain injury (ABI), causing stress for close-others and disrupting community integration. Positive Behaviour Support (PBS) interventions have support from case studies as a means of reducing these behaviours, but controlled trials are lacking. <br><br>OBJECTIVES: This study aimed to evaluate, with a randomised waitlist-controlled trial, the efficacy of a 12-month PBS intervention, termed PBS+PLUS, in reducing challenging behaviours after ABI. <br><br>METHODS: Participants included 49 individuals with ABI (PBS+PLUS Intervention and Waitlist Treatment-as-usual groups) and their close-others. The design was a randomised waitlist-controlled trial with 12-month follow-up. PBS+PLUS involved setting collaborative goals toward a more meaningful life with the individual with ABI and addressing barriers to achieving these, including challenging behaviours, through skill-building, restructuring environments and executive strategies. The primary outcome measure was the Overt Behaviour Scale (OBS). The Challenging Behaviour Self-Efficacy Scale (CBSES) was a secondary outcome, assessing close-others' self-efficacy in addressing challenging behaviour. Measures were completed at baseline and every 4 months. Data analyses involved mixed-effects and negative binomial regressions examining change over time by group. <br><br>RESULTS: The PBS+PLUS Intervention group included 24 participants and the Waitlist group 25 participants. On the OBS, the Intervention group showed a significant reduction in challenging behaviour over the 12-month intervention. However, the Waitlist group showed similar improvement on the OBS over the 12-month waitlist period. The Waitlist group was not denied an intervention from other providers during this period. Gains continued for 8 months post-intervention. The PBS+PLUS intervention resulted in significantly greater gains in close-others' confidence in addressing challenging behaviours on the CBSES, relative to those in the Waitlist group, who showed no such gains. <br><br>CONCLUSIONS: Although we cannot say this intervention is more effective than any other, the study did show that PBS+PLUS can result in significant and sustained reductions in challenging behaviour in individuals with severe ABI and increased confidence of close-others in addressing these difficult behaviours. AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY: #ACTRN12616001704482.<p /> <p>Language: en</p>",
language="en",
issn="1877-0657",
doi="10.1016/j.rehab.2021.101604",
url="http://dx.doi.org/10.1016/j.rehab.2021.101604"
}