Lack of Specialist Clinicians Failing Australians with an Intellectual Disability

There is a huge gap in learning and expertise for Australians working with people with an intellectual disability that needs to be bridged, writes Simon Wardale, manager of Endeavour Foundation’s Specialist Behaviour Service.

Bluntly speaking, complex and challenging behaviours are not very well understood, even within the disability sector, and that situation is borne out by the training – or lack thereof – available for Australian practitioners.

Positive behaviour support means enabling and empowering people with an intellectual disability to learn positive and effective ways of meeting their needs, so they no longer need to employ challenging behaviours. It’s recognised both in Australia and internationally as the most effective clinical intervention. But positive behaviour support is a derivative of applied behaviour analysis – a discipline that, conversely, is not taught in any Australian academic institution.

Training in the US, UK and New Zealand delivers a degree of clinical expertise that is beyond anything available here. It’s crucial that we take our lead from these international models because, quite simply, they are delivering significantly better outcomes for people with an intellectual disability.

Currently we try to up skill generalist clinicians to work in this incredibly challenging area, while our counterparts overseas view it as a Masters degree specialty. That’s a huge gap in learning and expertise that we have to bridge.

We need an increased focus on the technical aspects of positive behaviour support – being person centred is critical, but insufficient. Good quality behaviour support plans are a critical requirement for positive outcomes. Support workers need to have readable, achievable behaviour support plans that are based on sound, well-evidenced strategies.

In effect, people with serious or long-standing challenging behaviour need more than niceties, they need skilled clinicians who can translate proven behaviour change strategies into frontline disability services.

Because having effective behaviour support, that really works, is a fundamental human right. This is even more critical for people whose rights or freedom of movement have previously been limited as a response to their challenging behaviours.

Our commitment – first and foremost – needs to be on improving the quality of life for the person. Challenging behaviour must be recognised as just a symptom and, as with any clinical intervention, our focus has to be on targeting the cause.

About the author: Simon Wardale is the manager of Endeavour Foundation’s Specialist Behaviour Service. He has worked with people with an intellectual disability and challenging behaviour for more than 20 years. His most recent roles have been at the legal / practice interface, leading positive behaviour support practice in jurisdictions that have adopted regulatory regimes regarding the use of restrictive practices. He has held senior positions with the Office of the Senior Practitioner (Victoria) the Centre of Excellence for Behaviour Support (Queensland) and as director of Forensic Disability (Queensland). His publications have focused on training and development in positive behaviour support.

Wardale recently presented a paper on the issue at the world congress of the International Association for the Scientific Study of Intellectual and Developmental Disabilities.