Sensory-based Positive Behaviour Support has been central to Nathan’s* journey since he moved into one of our supported living services in July 2024. He presents with PICA behaviours, which carry significant health risks due to the ingestion of inedible items. Early review highlighted that recorded behavioural data did not fully capture the complexity of his needs or the daily challenges faced by staff, creating gaps in accuracy, regulatory assurance, and long-term funding stability.

 

Strengthening Data and Staff Practice

The PBS team implemented a structured improvement plan that included targeted training on incident reporting and ABC form completion; real-time reviews of submissions on RADAR; feedback to address inaccuracies; and coaching to help staff identify triggers, functions, and early warning signs.

As recording improved, reported incidents increased, not because Nathan’s behaviour escalated, but because documentation became more accurate and reflective of his actual presentation.

 

Functional Analysis and Sensory Needs

With reliable data in place, a functional analysis identified that many of Nathan’s behaviours were sensory-seeking. These included oral sensory feedback linked to his PICA profile, along with proprioceptive, tactile, and movement-based input.

Staff observations aligned with this analysis: Nathan spent extended periods withdrawn under a weighted blanket, disengaging from activities, with incidents most likely when sensory needs were unmet. This highlighted the need for proactive, sensory-based environmental adaptations.

 

Sensory-Based Environmental Adaptations

Working collaboratively with the service team, PBS practitioners introduced a taste-safe sensory activity planner to reduce ingestion risks while meeting sensory needs safely. Nathan’s lounge was transformed into a dedicated sensory space, including:

• Ball pit and sensory tent
• Tactile mats and a light projector
• Waterplay equipment and sensory instruments
• Weighted and textured blankets

 

Although Nathan had previously rejected similar equipment, graded exposure and PBS modelling led to meaningful engagement. Staff reported spontaneous laughter, playful routines, affectionate interactions and improved shared attention. Nathan began following simple instructions more consistently and demonstrated increased communication attempts and longer periods of focused activity.

 

Communication Development Through SALT

Following the staff’s request, the SALT team assessed Nathan and embedded communication strategies within his PBS plan. They observed increased use of gestures, facial expressions, vocalisations and turn-taking, alongside effective use of objects of reference and reciprocal play.

Guidance included supporting expressive and receptive communication, allowing processing time, using Makaton and gesture-based requests, managing tactile behaviours, and implementing visual supports and predictable routines. These strategies significantly strengthened Nathan’s ability to express his wants and needs safely and effectively.

 

Restrictive Practice Reduction

At baseline, Nathan had 14 PROACTSCIPrUK restrictive components in place. Over the past year, 4 of the 14 restrictive components were not used and have now been removed, a 28.6% reduction in restrictive interventions.

This reduction reflects improved sensory provision, proactive routines, strengthened communication strategies and trauma-informed, person-led PBS practice, fully aligned with Restraint Reduction Network (RRN) and BILDACT standards.

 

Quality of Life Improvements

Following the combined PBS and SALT intervention, Nathan is now significantly more engaged in meaningful activity, spending far less time withdrawn and instead seeking appropriate sensory input. He communicates more through gestures, vocalisations and playful routines, engages positively with staff, and demonstrates improved emotional regulation with fewer high-risk PICA behaviours.

Staff report increased confidence, stronger relationships and higher-quality documentation that accurately reflects his needs. Nathan is now thriving within a structured, sensory-responsive and predictable environment.

 

Measuring Progress Through Our Outcomes Pathway

Nathan’s progress is also reflected through our Outcomes Pathway tool, which enables us to evidence meaningful change across key areas of life. His journey demonstrates measurable impact in:

• Physical Health: Reduced high-risk PICA behaviours, safer sensory alternatives and improved health monitoring
• Communication & Expression: Increased use of gestures, vocalisations, shared attention and structured communication strategies
• Mental Health & Emotional Wellbeing: Improved emotional regulation, reduced escalation and greater feelings of safety within a predictable environment
• Independence & Daily Living: Increased engagement in purposeful activity and reduced time withdrawn
• Relationships & Social Interaction: More frequent positive interactions, playful routines and affectionate engagement with staff

 

*Name and Photo changed for privacy.