Positive Behaviour Support

In Australia, the National Disability Insurance Scheme (NDIS) has transformed the way individuals with disabilities receive support. Central to the success of the NDIS is its commitment to tailored, person-centred care for individuals with a wide range of needs. Two of the most essential components of this support structure are Positive Behaviour Support (PBS) and services for individuals with Complex Care Needs. These components are critical for improving quality of life, fostering independence, and ensuring long-term wellbeing for people living with significant physical, emotional, or cognitive challenges.

This blog aims to shed light on these two key support areas within the NDIS framework, outlining their principles, applications, and how they work to improve lives.

1. What is Positive Behaviour Support (PBS) under the NDIS?

Positive Behaviour Support (PBS) is an evidence-based approach that focuses on improving a person’s quality of life by understanding and addressing challenging behaviours. Rather than using restrictive practices or punitive measures, PBS aims to identify the underlying causes of behaviours and offer compassionate, person-centred interventions.

a. Understanding Challenging Behaviour

Challenging behaviours may include aggression, self-harm, property damage, or withdrawal. These actions are often expressions of unmet needs or communication barriers. Individuals with intellectual disabilities, autism, or acquired brain injuries may engage in these behaviours when they experience frustration, sensory overload, or emotional distress.

PBS begins with a Functional Behaviour Assessment (FBA) to determine the triggers, purposes, and patterns behind a person’s behaviour. This step is crucial to ensure that support strategies are effective and empathetic.

b. Developing Individualised Behaviour Support Plans

After assessment, a Behaviour Support Practitioner develops a tailored Behaviour Support Plan (BSP). This plan outlines proactive strategies that help reduce the occurrence of challenging behaviours and promote positive alternatives. Plans may include:

• Environmental adjustments
  
  

• Skill-building activities
  
  

• Consistent routines
  
  

• Communication support
  
  

• Staff training
  
  

A good BSP is holistic and actively involves the participant, their families, carers, and support staff.

c. Reducing Restrictive Practices

PBS aligns with the NDIS Quality and Safeguards Commission’s goal of minimising the use of restrictive practices, such as physical restraints or locked doors. The focus is on consent, dignity, and empowerment. Any use of restrictive practices must be regulated, justified, and regularly reviewed with the intent to phase them out entirely where possible.

Through PBS, individuals gain greater control over their lives, develop new coping mechanisms, and experience improved relationships and participation in community life.

2. Addressing Complex Care Needs in the NDIS

Many NDIS participants present with multiple or severe disabilities requiring comprehensive, integrated, and long-term care. Complex Care Needs refer to a broad category of support that caters to individuals with intensive physical health, mental health, and behavioural support requirements.

a. What Constitutes Complex Care Needs?

Participants with complex care needs may include those:

• Living with multiple disabilities (e.g., cerebral palsy and epilepsy)
  
  

• Requiring 24/7 nursing or medical support
  
  

• Dependent on assistive technologies (ventilators, feeding tubes)
  
  

• Experiencing severe behavioural challenges
  
  

• Living with dual diagnoses (disability and mental health condition)
  
  

These individuals need multidisciplinary support, constant monitoring, and adaptive environments to live safely and with dignity.

b. Integrated and Coordinated Support Systems

Supporting individuals with complex needs demands a coordinated approach involving healthcare professionals, disability support workers, behaviour specialists, mental health experts, and allied health practitioners. The NDIS allows for collaboration across these disciplines to create comprehensive plans, which may include:

• Daily personal care (bathing, dressing, mobility assistance)
  
  

• Medication management
  
  

• Complex wound care or feeding assistance
  
  

• Behavioural and emotional regulation support
  
  

• Communication and cognitive development
  
  

Effective service delivery often requires around-the-clock support, emergency response systems, and continuous training for carers.

c. The Importance of Continuity and Person-Centred Care

Consistency is critical for individuals with complex care needs. Familiar routines, stable staffing, and predictable environments can prevent distress and reduce health risks. Moreover, NDIS support plans are developed in close consultation with participants and their families, ensuring that personal preferences, cultural needs, and life goals are respected.

The goal is not just survival but a meaningful life—filled with choice, community inclusion, and personal development.

3. How PBS and Complex Care Needs Intersect in the NDIS

While PBS and Complex Care Needs are distinct areas within the NDIS, they often intersect—particularly for individuals who display high-intensity behaviours alongside medical or physical care needs. Managing these cases requires a strategic blend of behavioural insight and medical knowledge.

a. Dual Focus on Behaviour and Health

A participant with complex care needs may engage in behaviours that risk their safety, such as pulling out medical devices or resisting necessary procedures. In such cases, PBS strategies can be used alongside nursing care to reduce anxiety, increase cooperation, and ensure compliance with health interventions.

For instance, a participant with intellectual disability and diabetes might struggle with regular insulin injections. Behaviour support strategies might involve visual schedules, rewards, or sensory tools to reduce fear and make the process more tolerable.

b. Supporting Carers and Families

Caring for someone with both behavioural and complex care needs can be emotionally and physically exhausting. The NDIS recognises the importance of carer wellbeing and may offer respite care, training programs, and counselling services. Equipping carers with the right tools and knowledge reduces burnout and enhances the quality of support they provide.

Additionally, behaviour support plans can be extended to include family environments, enabling smoother interactions and reducing household stress.

c. Achieving Long-Term Outcomes

Combining PBS with complex care allows for long-term improvements in health, behaviour, and social outcomes. Participants can transition from restrictive care environments to supported independent living, participate in community events, or engage in learning opportunities. Over time, some may reduce their reliance on intensive supports as their capabilities and confidence grow.

This integrative approach reflects the broader NDIS mission: enabling Australians with disabilities to live ordinary and extraordinary lives—based on their own values, goals, and potential.

Conclusion: A Holistic Path Forward

The integration of Positive Behaviour Support NDIS    and services for Complex Care Needs NDIS participants is reshaping the disability care landscape. These models not only ensure safety and wellbeing but also encourage autonomy, emotional development, and a higher quality of life.

By investing in proactive, individualised, and compassionate approaches, the NDIS continues to pave the way for a more inclusive and supportive society—where everyone, regardless of their challenges, can thrive.

Whether you're a carer, a service provider, or someone navigating the NDIS yourself, understanding these critical supports empowers better choices, more respectful care, and greater life satisfaction.