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The Brief Behavioural Assessment Tool (BBAT)

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Ymddygiad Anhydrin Cymuned Ymarfer Challenging Behaviour Community of Practice Impact Effeithio Change Newid Inform Rhoi Gwybod The Brief Behavioural Assessment Tool ... – PowerPoint PPT presentation

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Title: The Brief Behavioural Assessment Tool (BBAT)


1
The Brief Behavioural Assessment Tool (BBAT)
Ymddygiad Anhydrin Cymuned Ymarfer
Challenging Behaviour Community of Practice
Impact
Effeithio
Change
Newid
Inform
Rhoi Gwybod
2
Acknowledgements
  • The BBAT was developed by
  • Dr Mark Smith Consultant Clinical Psychologist
  • Dr Gill Nethell, Clinical Psychologist
  • Professor Dave Allen, Associate Clinical Director
  • With input from
  • Dr Edwin Jones, Service Development Consultant
  • Special Projects Team,
  • Directorate of Learning Disability Services,
  • Abertawe Bro Morgannwg University Health Board

3
Local context- ABM
  • Challenging behaviour care pathway- variation in
    assessments and interventions offered for CB
  • Admissions to Acute Assessment and Treatment
    Units- no standard product on discharge
  • Training needs identified at T2 and T3
  • Our overall agenda- improving competency and
    raising the bar of basic assessment skills

4
Brief functional analysis
  • Comprehensive functional analysis should always
    be the gold standard, but may not always be
    needed or practical
  • Low level CB
  • Isolated behaviour that occurs in a specific
    context
  • When comprehensive assessment already undertaken
    but needs to be reviewed
  • When there is a need to put interim strategies in
    place due to risks
  • Family settings
  • Short admissions to AATU

5
Other brief assessment tools
  • Some brief behavioural assessment tools already
    published, e.g. Functional Analysis Screening
    Tool (Iwata, 1995)
  • But FAST is very brief (2 pages), and doesnt
    include some key questions that we tend to ask
  • So the BBAT was born!

6
What is the BBAT?
  • Informant based assessment tool to use in
    functional analysis
  • Explores key areas that are usually assessed
    using multiple tools such as FAI, MAS, CAI, RI etc

7
BBAT is designed to help you
  • ? Clearly define behaviour(s) of concern
  • ? Identify key triggers- slow and fast
  • ? Identify possible maintaining consequences
  • ? Identify whether the person is able to use
    alternative responses, other than their
    challenging behaviour, so that you can build on
    these
  • ? Identify the persons main preferences, so
    that you can use these to reinforce
    non-challenging behaviour
  • ? Identify the persons basic communication
    skills

8
What it looks like
  • 8 pages
  • Takes approximately 1 hour-1hour 30 mins to
    complete
  • 8 sections
  • Informant/service user relationship
  • Defining and prioritising the behaviours of
    concern (over last 12 months)
  • When is behaviour most likely to occur (slow and
    fast triggers)
  • Early indicators
  • Possible maintaining consequences
  • Coping skills
  • Basic communication skills
  • Likes and preferences
  • Summary tables

9
Limitations
  • Not a replacement for a comprehensive assessment
  • Caution required when used in isolation
  • Advisable to back up findings with some form of
    observational data as a minimum standard

10
ABMU brief assessment process
  • Informant based assessment
  • BBAT
  • Pre-post measures of change
  • ABC
  • PAS-ADD
  • HoNOS
  • Direct observational data
  • Behaviour Monitoring Form (BMF)

11
Reliability and validity
  • Comparing brief v comprehensive functional
    analysis in Specialist Residential Services
  • Initial results suggest 75 overlap in brief
    and comprehensive functional analysis when using
    BBAT

12
Factor analysis
  • Factor analysis of the 20 items on maintaining
    functions
  • Factor analysis of 126 BBATs indicates that at
    least 16 out of the 20 questions load solely onto
    the factors they were intended to with a loading
    greater than 0.4

13
Implementation
  • All ABMU -AATU staff trained in administration of
    BBAT, which is now used as part of all admissions
  • Training planned for Tier 2 services in
    ABMU--BBAT will form part of minimum standard
    within the Care Pathway
  • Trained small group of 3rd sector staff to
    successfully use BBAT
  • Aneurin Bevan UHB training staff as above
  • Betsi Cadwalladr UHB training staff
  • Very positive feedback !!

14
BBAT training
  • Training led by developers of BBAT
  • Training on the whole brief assessment process
  • Competency based approach
  • Learning how to use the tool
  • Opportunity to practice
  • Using the tool in situ
  • Receiving feedback from a mentor
  • Learning how to develop an intervention
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