When someone you support hits out, hurts themselves or runs from a safe place, it can be frightening. It can also be tiring and lonely. In NDIS behaviour support, these are called behaviours of concern. The name matters. It points to the behaviour and its impact, not the person.
This guide explains what behaviours of concern are, why they happen and how positive behaviour support (PBS) can help. It is written for parents, carers and support coordinators. At My Behaviour Support we work with children, teenagers, adults and older adults across Sydney, so these ideas apply at any age.
What are behaviours of concern?
Behaviours of concern are actions that put the person, or the people around them, at risk of harm, or that stop the person from living the life they want. Under the NDIS, how often a behaviour happens, how strong it is and how long it lasts all shape the risk. The term describes the behaviour, never the person.
The NDIS behaviour support guideline describes behaviours of concern as “behaviours of such frequency, intensity, or duration that they put you or someone around you at risk of physical or other harm.” It adds that these behaviours can stop a person from doing the things they want to do, or going to the places they want to go.
The NDIS Quality and Safeguards Commission uses plainer words in its participant fact sheet. It says they are actions that might not be safe for the person or for other people.
Three ideas sit under these definitions:
- Impact matters most. A behaviour becomes a concern because of its effect on safety and quality of life.
- Frequency, intensity and duration count. How often it happens, how strong it is and how long it lasts all shape the risk.
- The behaviour is the concern, not the person. The NDIS guideline says this directly.
Is a behaviour of concern the same as challenging behaviour?
You may still hear the older term challenging behaviour. In NDIS behaviour support today, behaviours of concern is the more common term. It keeps the focus on what the behaviour tells us and the risk it creates.
Does every hard moment need a behaviour support plan?
No. Every child has meltdowns. Every adult has bad days. The NDIS notes that some behaviours can seem concerning without needing a behaviour assessment or plan. What matters is whether the behaviour puts someone at risk, or harms relationships, learning, work or daily life.
What are examples of behaviours of concern?
Common examples of behaviours of concern include hurting themselves, hurting others, verbal aggression, damaging property, running from safe places and actions that cut a person off from their community. Every person is different, so these are broad groups rather than a checklist. Common groups include:
- Harm to self. For example, head banging, biting their own hand or picking at skin.
- Harm to others. Hitting, kicking, biting, scratching or pulling hair.
- Verbal aggression. Yelling at, swearing at or threatening people.
- Property damage. Breaking plates, throwing furniture or damaging doors and windows.
- Leaving unsafe. Running from home, school or a shopping centre without a sense of danger from roads or water.
- Unsafe impulsive actions. Grabbing hot items, climbing high places or eating things that are not food.
- Unwanted sexual behaviour. Sexual behaviour at the wrong time, in the wrong place or towards someone who has not agreed.
- Behaviours that limit community access. Actions that mean a person is kept at home, left out of school activities or can no longer go to the shops or the local footy.
The last group is easy to miss. The NDIS includes “any behaviour that stops you and the people around you from having a better life.” A person who withdraws or is no longer taken out may not be hurting anyone. Their world is still getting smaller.
Why do behaviours of concern happen?
Behaviours of concern usually happen because the behaviour meets a need, such as communicating, escaping something hard, getting something, managing sensory overload or coping with pain. Finding that need is the first job of positive behaviour support. Common triggers include noise, changes in routine, pain and unmet communication needs.
The NDIS guideline opens with a simple idea: every behaviour has a purpose and is a way of communicating a message. In PBS, that purpose is called the function of the behaviour. Finding it is the first job.
Common functions and triggers include:
- Communication. The person may have no other way to say “I’m hungry”, “stop” or “I need help”.
- Sensory needs. Noise, bright lights, crowds or certain textures can overwhelm.
- Escape or avoidance. The behaviour may end a task, a demand or a place that feels too hard.
- Access. It may get the person an item, an activity or someone’s attention.
- Pain or health. Toothache, constipation, reflux, poor sleep or medication side effects can show up as behaviour. This is more likely when a person cannot describe their pain.
- Environment and routine. New staff, a move, too little choice or an unpredictable day can all add stress.
- Past experiences. The NDIS notes that behaviour may relate to negative experiences in a person’s life. A trauma-informed approach takes this seriously.
The NDIS gives a clear example. If a person is acting out because of pain, helping to manage the pain may reduce the behaviour. Punishing it would miss the cause.
How does positive behaviour support help with behaviours of concern?
Positive behaviour support helps by working out why a behaviour happens, then changing the environment, teaching new skills and training the people around the person. It aims to improve quality of life first, and it does not use punishment. The work usually follows 6 steps.
PBS is an evidence-based approach. It aims to improve quality of life first. Fewer behaviours of concern often follow from that. The Commission’s fact sheet says PBS does not use punishment or strategies that can hurt the person. Here is how the work usually unfolds.
1. Understand the behaviour
A Functional Behaviour Assessment (FBA) looks at when, where and why a behaviour happens. We gather information through conversations, structured observations and tools such as the QABF and a Quality of Life assessment. Our guide on how a functional behaviour assessment works explains each step. The aim is a clear, testable idea of what the behaviour is doing for the person.
2. Write a behaviour support plan
The findings shape a Behaviour Support Plan. An interim plan focuses on safety in the short term. A comprehensive plan is based on the completed assessment. Our guide to what a behaviour support plan is covers what goes inside one. It sets out strategies, skills to teach and clear steps for everyone to follow. Plans are written with the person and the people around them.
3. Build a capable environment
A lot of useful change comes from the setting around the person. We use the Capable Environment Framework to look at the whole picture. That includes predictable routines, meaningful activity, good communication and support staff who feel confident and consistent. Small changes, like a visual schedule or a quiet space, can lower stress.
4. Teach new skills
If a behaviour communicates a need, the person needs another way to say it. Skill building can cover communication, emotional regulation, coping with waiting and everyday independence. The new skill needs to work for the person at least as well as the behaviour did.
5. Use proactive and reactive strategies
Proactive strategies lower the chance that a behaviour will happen. They meet needs early and avoid known triggers. Reactive strategies guide people on what to do if the behaviour happens anyway. A good plan leans heavily on the proactive side.
6. Train, review and adjust
A plan only helps if people use it. We provide training and practical coaching for families, carers and support staff. Then we review progress and adjust the plan as needs change.
Where do restrictive practices fit in?
A restrictive practice is any practice that restricts a person’s rights or freedom of movement, and under the NDIS it must always be a last resort. It must sit inside a Behaviour Support Plan, be authorised where required, and come with a goal to reduce it over time.
Sometimes a plan includes a restrictive practice. The NDIS defines this as any practice or intervention that restricts a person’s rights or freedom of movement. Examples include locking away sharp objects or a helmet to prevent head injury.
The NDIS (Restrictive Practices and Behaviour Support) Rules 2018 set out 5 types of regulated restrictive practice: seclusion, chemical restraint, mechanical restraint, physical restraint and environmental restraint. A restrictive practice must be:
- a last resort, used only when other strategies have been tried or ruled out
- the least restrictive option in the situation, used for the shortest time possible
- included in a behaviour support plan and authorised where your state or territory requires it
- reported and reviewed
If a registered provider uses one without a plan in place, it must be reported to the Commission as a reportable incident. Most importantly, the plan should include strategies to reduce and remove the practice. The Commission says PBS aims to lessen and remove the use of restrictive practices. At My Behaviour Support, Reducing Restrictive Practices over time is one of our core goals.
What can you do about behaviours of concern right now?
Right now, you can put safety first, note patterns, keep simple ABC notes, check for pain and keep your responses calm and consistent. These steps help families and support workers while you wait for help. They also give a practitioner useful information later.
Steps you can take today
- Put safety first. Move other people away, remove objects that could hurt, and give the person space where you can. If a life is at risk, call 000.
- Notice patterns. Time of day, place, people present, noise, hunger, tiredness and recent changes all matter.
- Keep simple ABC notes. Write down the Antecedent (what happened just before), the Behaviour (what the person did) and the Consequence (what happened straight after). A few plain lines is enough.
- Check for pain and health issues. A GP visit can help rule out things like ear infections, dental pain or sleep problems.
- Keep responses calm and consistent. Use few words and a quiet voice. Agree on the same approach across the household or team.
- Look after yourself. Supporting someone through these moments is hard work. Rest, debrief and ask for help.
When should you seek NDIS behaviour support?
Consider a referral if:
- behaviours of concern put the person or others at risk of harm
- the behaviour is happening more often, lasting longer or getting stronger
- the person is missing school, work, community activities or time with family
- support workers or services are struggling, or a placement is at risk
- a restrictive practice is in use, or someone is thinking about one
- you have tried strategies at home and they have not helped
Behaviour support can be funded in an NDIS plan. It must come from a provider registered with the Commission. Our rate is $252.99 per hour, in line with NDIS pricing arrangements, and we confirm it at the first consultation. For children, our guide to behaviour support for children with autism covers what parents can expect.
Frequently asked questions
Is a behaviour of concern a diagnosis?
No. It describes a behaviour and its impact, not a condition. These behaviours can occur alongside autism, intellectual disability, ADHD, mental health conditions or trauma. Many people with the same diagnosis never have them. That is why PBS starts with the person, rather than a label.
Can behaviours of concern be stopped completely?
Nobody can promise that. PBS aims to reduce how often behaviours happen, how intense they are and how long they last. The wider aim is a safer, fuller life over time. Progress is often gradual, and every person is different.
Talk to our team
My Behaviour Support is a registered NDIS provider based in Campbelltown, supporting families across Liverpool and greater Sydney. Our founder and Director, Domenic Barca, is a Proficient Behaviour Support Practitioner with a background in psychology and social work. Michelle Boyce, one of our Behaviour Support Practitioners, works in a trauma-informed way with complex needs.
If behaviours of concern are affecting someone you support, you do not have to work it out alone. Make a referral or call us on 0415 930 548, and our team will talk you through the next steps.
