How Do We Know If Positive Behaviour Support Is Working
One of the most important questions a person, family or support team can ask is, "How do we know if this is actually working?"
If a behaviour support plan has been in place for several months and behaviours of concern are still occurring, it is understandable to wonder whether progress has been made. At the same time, people may begin Positive Behaviour Support with the expectation that having a practitioner and a plan will make the behaviour stop completely.
Families deserve a clearer answer than either of those assumptions. A written plan is not evidence, by itself, that support is effective. The ongoing presence of a behaviour also does not tell us everything that may have changed. We need to look at the pattern over time, the person's experience, the way their needs are being met and whether the environments and people around them are responding differently.
Positive Behaviour Support should lead to change. Over time, we would expect behaviours of concern to become less frequent, less intense, shorter, less harmful or less disruptive to the person's life as the reasons for the behaviour are better understood and addressed. Complete elimination may be possible for some behaviours, but it cannot be the only acceptable measure of progress in every situation.
A useful review therefore asks more than, "Is the behaviour still happening?" It asks what is changing for the person, what is changing around them, and what needs to change next.
Positive Behaviour Support Should Lead to Measurable Change
Current Australian NDIS guidance describes Positive Behaviour Support as an approach that improves quality of life while reducing the likelihood and impact of behaviours of concern. It also expects teams to monitor how a plan is being implemented, whether agreed goals are progressing and what outcomes are being achieved. Read the NDIS Commission policy.
This gives us two responsibilities. We need to measure whether the behaviour itself is changing, and we need to understand whether the person's life and the support system around them are improving.
For the identified behaviours of concern, a review may look at changes in:
frequency, including how often the behaviour occurs within a meaningful period or opportunity
intensity, including the level of distress, force, injury, disruption or support required
duration, including how long the incident and recovery period last
risk and impact for the person and others
the situations, settings or times in which the behaviour is more or less likely
how early the person's cues are noticed and responded to
how often the person can access another effective way to have the same need understood and met
the use of restrictive practices, including whether active reduction and fade-out are occurring
One difficult day does not establish a trend, and an incident count without context can be misleading. Health changes, sleep, pain, medication, transitions, staffing, demands and exposure to difficult environments can all affect what the data means. If a child has increased school participation from one morning to four days each week, for example, the same number of incidents now occurs across much more time at school. The raw total has not changed, but the rate and the child's access to education may have improved. The team still needs to understand each incident, while interpreting the information fairly.
Lower Behaviour Does Not Automatically Mean Better Support
A reduction in visible behaviour is only a positive outcome when we understand how that reduction was achieved and what it means for the person.
If incidents reduce because the person is no longer included in community activities, is afraid to say no, has learned to mask distress, is shutting down, is heavily sedated or has lost access to choice, the numbers may look better while their quality of life has become worse. We need to ask whether the person is genuinely safer and better supported, or whether their distress has simply become less visible.
The reverse also needs careful interpretation. A person may begin expressing refusal more clearly when they have access to AAC, feel safer with supporters or learn that their communication will be taken seriously. More visible self-advocacy is not automatically a deterioration. The team needs to distinguish communication that should be respected from behaviour that continues to create distress, injury or risk.
Progress Can Appear Before a Behaviour Stops
Behaviour change is often accompanied by smaller shifts that show the support is beginning to reach the person earlier. These shifts should not replace the goal of reducing distress and risk, but they can help us understand the pathway towards it.
Meaningful early changes may include:
the person noticing or communicating early body signals, discomfort, fatigue, pain, fear or overload
the person using an accessible signal, gesture, AAC message, movement, object, word or action to ask for a break, help, space, more time or an end to an activity
supporters recognising subtle cues before distress reaches crisis point
requests and refusals being noticed, believed and acted on
the person accepting co-regulation or returning to a preferred regulation strategy more readily
recovery becoming quicker, gentler or less exhausting
the person returning to a chosen activity, relationship or routine after distress
greater access to preferred people, activities, places, communication and genuine choice
An alternative communication tool is only an outcome if it works in real life. It needs to be available in the moment, understandable to the person, accepted across environments and honoured by the people receiving the message. Teaching someone to request a break does not help if adults continue the demand after the request is made.
A Practical Example
Consider a hypothetical young person who hits others during overwhelming transitions. At baseline, this occurs most days, incidents often last for 45 minutes and the young person needs a long period away from activity to recover. After several months, the behaviour still happens once or twice each week. Its intensity has reduced, injuries are less likely, the young person sometimes uses an AAC message for "stop" or "break", supporters respond to earlier cues and recovery usually takes 15 to 20 minutes. They are also able to return to a chosen activity more often.
The behaviour has not disappeared, but the change is real and measurable. The plan should continue to build on what is helping, while the team investigates the situations in which distress still escalates. Progress is not a reason to stop being curious.
The Environment and Support System Should Change Too
The person should not carry the whole burden of change. If Positive Behaviour Support is working, the environments and people around them should be learning and adapting as well.
We might expect to see:
sensory, communication, task and environmental barriers identified and reduced
routines becoming more predictable without becoming rigid or controlling
demands adjusted in ways that preserve participation and autonomy
support offered proactively rather than only after a crisis begins
families, educators, support workers and therapists sharing a clearer understanding of what the behaviour may be communicating
more consistent responses across home, school, work and community settings
clearer responsibilities, communication and follow-through across the team
strategies that are realistic for the person's actual life, culture, resources and support arrangements
A plan can contain thoughtful strategies and still produce limited change if the strategies are inaccessible, impractical or applied inconsistently. This is why review needs to distinguish between the quality of the plan and the quality of its implementation. If the strategy is poorly matched to the person's needs, the plan must change.
If a useful strategy cannot be implemented consistently, the team needs to address training, resources, clarity or environmental barriers rather than assuming the person has failed.
Family and Supporter Outcomes Matter
Parent and carer capacity, relief, confidence and wellbeing are also legitimate outcomes.
Families may begin PBS feeling as though they are constantly anticipating the next crisis, explaining their family member to others or holding an entire support system together.
Helpful support should reduce some of that uncertainty and load.
Progress for families and supporters may include:
a clearer shared understanding of what is contributing to distress
greater confidence about what to do before, during and after an incident
less blame, conflict or disagreement within the support network
more consistent responses across people and places
fewer crisis-driven decisions and more opportunity for planning
more moments of connection, participation and ordinary family life
support that feels possible to sustain without exhausting the person or their family
Family wellbeing should be measured without transferring service gaps or professional responsibilities back onto families. A plan is not sustainable if it only works when a parent provides constant oversight, trains every new worker, collects complex data and remains available to prevent every crisis. Families should be partners in the process, not the infrastructure holding it together.
Reviewing Progress Through the GROW Lens
The GROW™ Neuroaffirming Framework offers a practical way to broaden the review while keeping the person's daily experience at the centre.
Grounded in Identity
Does the person feel respected, included and safe to be themselves?
Are we reducing shame and masking rather than rewarding quiet compliance?
Are the person's preferences, culture, identity, strengths and rights reflected in the goals?
Does the person have meaningful choice and influence over their support?
Responsive to Needs
Are early signs of sensory overload, fatigue, pain, fear, uncertainty or loss of control recognised sooner?
Are health, sleep, medication, trauma, interoception and emotional wellbeing being considered where relevant?
Are needs being met proactively, before the person must escalate to be understood?
Are behaviours of concern becoming less likely, intense, prolonged or harmful?
Open to Communication Differences
Does the person have access to communication that works during calm, stress and crisis?
Are AAC, gestures, movement, facial expression, silence, behaviour and other communication forms taken seriously?
Are requests for help, a break, more time, space or an end to an activity honoured?
Are communication partners changing how they listen and respond?
Whole Person and Whole System
Are home, school, work, community and service environments becoming more accessible?
Are the people around the person collaborating and responding more consistently?
Is participation increasing in ways the person values, rather than being measured by attendance alone?
Are family and team capacity, wellbeing and sustainability improving?
Are restrictive practices reducing and active fade-out plans being followed?
When Progress Is Not Emerging
Broader outcomes should never be used to explain away an unchanged or worsening pattern of behaviour, distress or risk.
If meaningful progress is not emerging, the next step is not to lower expectations or keep repeating the same plan. It is to review what may have been missed and decide what needs to change.
A review may need to consider:
whether the current understanding of the behaviour and its function still fits the available information
pain, illness, sleep, medication effects, mental health, trauma, sensory experiences or other unmet health needs
whether proactive strategies are directly linked to the person's needs and the reasons for the behaviour
whether communication options are accessible in the moment and consistently honoured
whether environmental changes have actually been made across the settings where support is needed
whether supporters understand the plan, have received practical coaching and can implement it with the time and resources available
whether the data is clear, proportionate and meaningful, including changes in exposure, participation and opportunity
whether new risks, increased restrictive practices or changes in the person's circumstances require an earlier formal review
The review should lead to specific actions. The person and their support network should know what will change, who is responsible, when it will happen and how the team will tell whether the adjustment helped.
Questions to Take to the Next Review
What matters most to the person, and how have they been supported to shape the definition of success?
What has changed in the frequency, intensity, duration, recovery time, risk or impact of the behaviour?
Does the information account for changes in health, demands, environments, participation and opportunities for the behaviour to occur?
What can the person now communicate, recognise, choose or access that was previously less available?
When the person communicates a need, refusal or request for a break, is it understood and honoured?
What has changed in the environment, and is that change consistently available across settings?
How have quality of life, safety, autonomy, relationships and meaningful participation changed?
Are families and supporters clearer, more consistent and better supported, or is the plan adding unsustainable load?
Has the use of restrictive practices reduced, and are active fade-out actions being implemented?
What is not improving yet, what will be adjusted next, who will act and when will progress be reviewed again?
The Measure That Matters
Positive Behaviour Support is working when daily life is becoming safer, more understandable, more accessible and more self-directed, and when behaviours of concern are becoming less likely, less intense, shorter or less harmful over time.
Progress may begin with small shifts, but it still needs to be visible, discussed and measured. The standard is not perfection. It is meaningful improvement, honest review and an active response when improvement is not occurring.
When we review PBS well, we look for evidence that needs are being met sooner, communication has more influence, environments are carrying more of the load, support is sustainable and distress and risk are genuinely reducing.
Save the reflection questions and bring them to your next behaviour support review or team meeting.
If you are unsure what progress should look like for your family member, ask your practitioner to explain the agreed outcomes, the baseline being used, what information is being collected and what would prompt the plan to change.
Learn more about Grow Therapy Services Positive Behaviour Support and the GROW™ Neuroaffirming Framework.
This article provides general information and does not replace individual behaviour support, medical, psychological or safeguarding advice. Sudden changes in behaviour, health or risk require timely assessment and review.
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