How Do You Know if a Positive Behaviour Support Plan is Good Quality?
Introduction
It can be a proud moment in your career as a Behaviour Support Practitioner when it finally comes time for you to start reviewing other practitioner's Positive Behaviour Support Plans (PBSPs). Simultaneously, it can be a moment of “Oh no, now I need to know what I'm doing!” And “How can I tell what actually makes a good PBSP?”
There isn't one single measure that tells us whether a PBSP is high quality. In my experience reviewing PBSPs and supervising Behaviour Support Practitioners, I find it useful to consider quality from two perspectives: the quantitative side — using structured quality-assessment tools and checklists — and the qualitative side — using professional judgement to consider whether the plan is person-centered, practical, understandable, and likely to be implemented.
Ultimately, a good PBSP shouldn't just meet the required components. The assessment, formulation, strategies, implementation and monitoring should connect logically, and the finished plan should be usable by the people expected to put it into practice.
The Quantitative Side
Let's have a brief chat here about some of the checklists and evaluation tools that you can help with your quality assessment. I personally think these are helpful when reviewing PBSPs when you're not yet feeling confident in assessing alone or are worried you might miss something important.
I also think this is also a great way of doing some self-reflection. You can use these tools on your own PBSPs to see whether you're hitting the key points that might make it more effective. When I do training with my Supervisees on these tools, especially the BIP-QEII, I often see practitioners have a lightbulb moment as it all starts to make sense. Sections of the PBSP suddenly seem more connected and you understand how it all works together as a complete process. This can also be a useful way to identify areas for your own professional development, particularly if the assessment highlights the same gaps across several PBSPs.
What is the BIP-QEII?
So I’ve mentioned the BIP-QEII now and probably caused some stress if you’ve never heard of this before. Essentially this is the Behaviour Intervention Plan Quality Evaluation Tool II…so you can see why I’ve abbreviated it. The BIP-QE II isn't an NDIS Commission-specific tool. However, I find it useful in the Australian NDIS context because many of the quality indicators it examines — such as clear behavioural definitions, functional relationships, environmental changes, replacement behaviours, teaching, reinforcement, implementation and monitoring — are also relevant when critically reviewing a PBSP.
I think it can be difficult to get a copy of the BIP-QEII as I often find my Supervisees either don’t have it, or, have never actually heard of it! In my experience, you need to know someone who has access to this and who can talk you through and explain it as it’s quite an intimidating document. There’s quite a lot of text and there’s 12 domains it wants us to assess and give a score between 0 and 2.
Very briefly, these domains want to see clear and effective sections targeting:
Problem Behaviour — Assesses whether behaviours of concern are clearly defined in observable and measurable terms, rather than vague labels or inferred internal states.
Predictors of Behaviour — Looks at whether the plan identifies the environmental conditions or triggers associated with the behaviour, such as physical setting, social context, activities, scheduling, independence, participation and choice.
Analysis of What Supports Problem Behaviour — Assesses whether the plan explains why identified environmental conditions may be contributing to or supporting the behaviour, rather than merely listing triggers.
Environmental Changes — Looks at whether preventative environmental changes are logically connected to the preceding assessment and analysis, with the aim of reducing the person's need to use the behaviour.
Predictors Related to Function — Assesses whether the hypothesised function of the behaviour makes sense in relation to the identified predictors — essentially, whether the formulation hangs together logically.
Function Related to Replacement Behaviours — Examines whether the identified functionally equivalent replacement behaviour (FERB) meets the same function as the behaviour of concern.
Teaching Strategies — Assesses whether the plan explains how the replacement behaviour will actually be taught or prompted, with enough detail for implementation.
Reinforcement — Examines whether reinforcement is clearly specified and designed to strengthen the FERB/desired behaviour, including considerations such as contingency, effectiveness, frequency, choice and immediacy.
Reactive Strategies — Assesses whether there are appropriate strategies for safely responding when the behaviour occurs, alongside elements such as prompting the FERB, redirection, and debriefing.
Goals and Objectives — Looks at whether there are measurable goals, particularly a complete goal for the FERB, so progress can actually be monitored.
Team Coordination — Assesses whether everyone responsible for implementation, monitoring and information exchange is identified, with their responsibilities made clear.
Communication — Examines whether there is a structured system for ongoing, two-way communication between relevant stakeholders, including who communicates, what they communicate, how and how often.
I’m lucky enough to have received a copy early on in my career as a BSP and I’ve taken it with me through the years as I’ve trained others in how to use this tool too. I would say it’s not perfect as it’s not tailored against the Australian PBSP templates and is more specifically designed to be used with school children, but overall I feel like it does do a good job of showing how the pieces of analysis should connect with your strategies and the considerations needed to support the effectiveness of said strategies, e.g. setting achievable and specific goals, outlining mutual communication between the BSP and the implementers, etc.
It’s also worthwhile noting that the BIP-QEII is designed for evaluating a Comprehensive PBSP but I think that leaves a quality assessment gap for Interim PBSPs so I’ve adjusted the scoring to measure specifically against the components of an Interim PBSP. If you’d like to see what I’ve adjusted, you can look at my Positive Behaviour Support Plan Quality Assessment available for free to download.
Alongside the BIP-QEII, the NDIS checklists for Behaviour Support Plans are also a great tool for reflection as I find they complement the BIP-QEII by asking questions about sections and considerations not included above. It's important to remember that these tools aren't assessing exactly the same thing. I use the BIP-QE II primarily to examine how well the behavioural analysis, strategies and implementation components connect together. The NDIS Commission checklists provide another lens, including NDIS-specific expectations around person-centered practice, consultation, restrictive practices, implementation, authorisation and lodgement. Used together, I find they give me a more rounded picture of PBSP quality.
What kinds of things do the NDIS Checklists want included?
The Interim Checklist provided by the NDIS Commission has 37 specific questions targetting:
being completed within 1 month since becoming engaged,
a registered BSP working for an organisation registered to provide PBS services wrote it (these are two separate registrations - 1 for you as the BSP, 1 for your organisation),
it’s person-centered and shows strong core values aligned with the PBS approach,
consultation with the participant and supporters,
restrictive practice information,
keeping the PBSP brief and usable,
incorporating proactive and reactive strategies,
mentions of how implementation will work, and
authorisation and lodgement.
So essentially, the Interim is what do we know right now, what are the immediate risks, and what can we responsibly put in place while we learn more? You can see this is a different tool to the BIP-QEII which makes it valuable to our quality assessment.
The checklist itself is obviously going to be more applicable for your Interim PBSP with a restrictive practice included, but in my opinion I still think this is a useful check for any PBSP you prepare without these as well. A note for reflection, this document states the Interim PBSP must be developed within one month of engagement where the participant is subject to a regulated restrictive practice. Where appropriate, I adhere to that regardless of whether there’s a restriction or not as I want all of my participants to be able to receive quick intervention support with some initial strategies for reducing triggers and increasing safety. This isn’t a NDIS Commission requirement, but a practice I’ve followed to provide consistent and quality services across my participants.
Moving on, the Comprehensive Checklist goes a step further on the necessary components you need to add and consider for a good practice Comprehensive PBSP as it now adds a section dedicated to the functional analysis you’ve conducted. This 48 question document has some key differences to the Interim version, which are:
being completed within 6 months since becoming engaged,
a stronger focus on quality of life for the participant,
an expectation that the PBSP is more tailored and holistic,
centered around your functional behaviour assessment, showing more depth of understanding of the risks and why they happen,
there’s now a skills-building component/s,
setting clear goals for the PBSP itself to achieve, and
that a review of this must occur every 12 months or sooner if needed.
So you can see the difference between the Comprehensive PBSP goes a lot further than just being a more detailed or longer document, the quality of your analysis and subsequent strategies should be much deeper and individualised. Essentially, now that we understand the participant much better, why is this happening, and what needs to change in their environments…what skills should we build, what should others do differently, and how will we know whether our formulation and strategies are actually working?
The Qualitative Side
This is where professional judgement becomes particularly important. A PBSP can technically contain all of the expected components and still not necessarily be a high-quality or useful plan. When I'm reviewing a PBSP, I'm also thinking about whether the plan makes sense as a whole, whether the strategies are realistic for the people expected to implement them, whether the participant and their circumstances are genuinely represented, and whether someone could actually pick up the plan and use it. This is also where reflective practice becomes particularly important — we need to be able to notice our own assumptions and question whether there might be another way of understanding what we're reading.
These considerations can be harder to score because there isn't always one objectively correct answer. Instead, I try to consider them in the context of the participant, their supporters, their environment and the purpose of the PBSP.
The general factors that I pay attention to that haven’t been covered earlier in this article are:
Inclusion of all necessary components for compliance, including proactive and reactive strategies, implementation details, BSP Declaration, etc
Inclusion of restrictive practice protocol, practices to be ceased, or how a housemate’s restrictive practice will be navigated, etc
PBSP length - whether it’s become so long it’s difficult to navigate through
Density of the text - if I don’t want to read it because it looks like big blocks of text, I assume no one else is going to want to read it either
Inclusion of graphics, diagrams, photos, etc - we all need a bit of colour sometimes to break things up and another format helps the brain process
Whether potential barriers I’ve noticed while reading have been addressed or considered - e.g. Mum will be the key implementer but she’s very burnt out so strategies have been staged across the year for introduction
Whether the audience has been considered - e.g. if implementers have English as a second language we might want to reduce jargon (which I also just think is best practice)
How I would feel if I was the participant or the family member reading this - Before I finalise my feedback, I try to read the PBSP through the eyes of the participant and their family. We can become very accustomed to clinical language as practitioners, but we're often documenting some of the most sensitive parts of someone's life. Something can be technically accurate and still be unnecessarily confronting, deficit-focused, or difficult for the person or their family to recognise themselves within.
Quality assurance should develop the practitioner, not just improve the document.
I usually write my comments as a tip for the BSP to consider. We’re not trying to put them down or make them feel bad for writing something incorrectly, that just leads to a dejected BSP who might start to doubt themselves. We want our comments to be empowering - to show what ‘could be’, how things could be improved, what they’re already doing well, etc. We must at least balance out our positive versus improvement comments, and I personally think this is very important.
I usually frame my comments as things for the BSP to consider rather than simply identifying what they've done “wrong”. The aim isn't to leave someone feeling like they've failed; it's to help them see what could be strengthened, why it matters, and what they're already doing well.
I’ve had an experience with a previous Supervisor, years ago now, where it seemed like there was an endless amount of things needing to be changed and very little positive things pointed out. To be completely candid, I was holding back tears during this meeting as I just felt like I’d done a horrible job with it and it hit a nerve as I always want to do my best. This experience has always stayed with me since then and, as a Supervisor, I make sure I’m being sensitive to how the BSP is going to feel when they look through what I’ve said. I don’t want other people to experience that too.
Over time, this has led me to use eight questions when I'm reviewing another practitioner's PBSP:
What are you doing well? What demonstrates your existing or developing capability?
Where your reasoning is strong: What did you notice, connect or question particularly well?
Where I would challenge your thinking: Where might your formulation, assumptions or conclusions need more scrutiny?
What information might you still be missing?
What could make this more person-centered?
What could make this more practical/implementable?
What would I take to supervision? What am I uncertain about, and where would another practitioner's perspective help me test my reasoning?
Your next development priority.
These are also outlined in my Positive Behaviour Support Plan Quality Assessment if you’d like to see a tool already made to help with PBSP Quality Assurance. These questions help me take things back to the bigger picture of the PBSP, including how we can use this evaluation to improve the BSP’s practice too. It’s a win/win!
Conclusion: My General Rule of Thumb for PBSP Quality
After all of those tools, checklists and considerations, my general rule of thumb is actually quite simple: when I finish reading a PBSP, do I understand what we're asking people to do and why we're asking them to do it?
If the assessment, formulation and strategies tell a coherent story, the recommendations make sense for this particular participant, and the people implementing the plan can understand what they're supposed to do, that's a very good sign.
If I finish reading and still feel muddled about why a strategy was chosen, what someone is supposed to do, or how a recommendation relates to the behaviour we're trying to understand, that's usually a sign that something needs further thought.
None of this means you need to spend two or three hours completing every quality-assessment tool for every PBSP. I don't. Which tools I use depends on the plan, the practitioner, the circumstances and what I'm trying to assess.
Could Supervision help with PBSP quality assurance?
Learning to quality assure a PBSP is about more than learning what to look for. It's also about developing confidence in your own professional judgement — knowing when something doesn't quite make sense, being able to explain why, and working out what could make it stronger.
These are exactly the kinds of discussions I have with practitioners in supervision. We can review sections of PBSPs together, explore the reasoning behind your formulation and strategies, or talk through how to provide useful and supportive feedback when you're beginning to review the work of others.
If you're looking for a space to develop those skills, you can learn more about my PBS supervision or book a free 20-minute chat to see whether it might be a good fit.
