Language, definitions & acronyms

Active support (sometimes referred to as ‘person-centred active support’ or ‘PCAS’) is a systematic approach to the design, delivery and monitoring of services for people with intellectual disability. 

It is characterised by providing systematic supports that help to engage people in a range of ordinary everyday activities that are meaningful for the person and which enhance their health, wellbeing and quality of life. 

Active support can include activities at home and in the community. 

It typically involves enhanced social and communication opportunities, together with systematic skill development to increase people’s independence. 

In the context of behaviour support, these skills are sometimes referred to as 'functionally equivalent replacement behaviours'. 

Behaviour Support Practitioners are people registered to work with people with disability who display behaviour(s) of concern to reduce those behaviours safely and improve the person’s quality of life.

They:

• assess behaviour
• develop behaviour support plans
• train carers and staff
• monitor progress toward the person’s goals.

An NDIS Behaviour Support Practitioner is someone registered with the NDIS Commission to: 

• undertake behaviour support assessments (including functional behavioural assessments); and
• develop behaviour support plans that may also include the use of restrictive practices.

Behaviour Support Practitioners work with:

• the person with disability
• APOs
• the Independent Person
• family members
• health professionals
• allied health professionals
• others, as necessary.  

A key part of their role is working to reduce and/or eliminate use of regulated restrictive practices.

Behaviour(s) of concern have been defined as:

• ‘Any behaviour that is a barrier to a person participating in and contributing to their community (including both active and passive behaviours) that undermines, directly or indirectly, a person’s rights, dignity or quality of life, and poses a risk to the health and safety of a person and those with whom they live and work’ (McVilly, 2002).
• ‘Behaviour of such intensity, frequency and duration that the physical safety of the person or others is placed or is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of or result in the person being denied access to ordinary community facilities’ (Emerson & Einfeld, 2011, p. 1).

These two definitions serve to focus attention on different but complementary issues that should be taken into account when assessing, monitoring and evaluating a behaviour support plan.

Common types of behaviours of concern include:

• self-injurious behaviours (eg: hitting, head butting, biting),
• physically aggressive behaviour (eg: hitting others, spitting, kicking),
• verbally aggressive behaviour (eg: shouting angrily or screaming at others, threats directed at others or self),
• sexualised behaviour (eg: public masturbation, crossing professional boundaries with support staff); and/or
• damaging property in a way that jeopardises the safety of the person or people around them (eg: throwing objects at people).

The National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 define chemical restraint as:

‘The use of medication or chemical substance for the primary purpose of influencing a person’s behaviour. It does not include the use of medication prescribed by a medical practitioner for the treatment of, or to enable treatment of, a diagnosed mental disorder, a physical illness or a physical condition.' 

A Circle of Support is a group of people who love and support a person with disability.  

They are not paid parts of a person’s support network, but are instead family, friends and other people who have long-term connections with the person. 

They care about the person with disability and have their best interests at heart.

Read more about Circles of Support. 

This is a legislative review conducted by the Department of Families Fairness and Housing. 

It ensures providers have met their legislative requirements for authorising the use of restrictive practices as part of a behaviour support plan.

While ‘disability’ is defined in several ways in Australia, APOs will need to understand several definitions:

The Disability Act 2006 defines disability as:

1. ‘a sensory, physical or neurological impairment or acquired brain injury or any combination thereof, which—
      i. is, or is likely to be, permanent; and
      ii. causes a substantially reduced capacity in at least one of the areas of self-care, self-management, mobility or communication; and
      iii. requires significant ongoing or long-term episodic support; and
      iv. is not related to ageing; or
2. an intellectual disability; or
3. a developmental delay.’

The NDIS defines disability as:

• ‘…a physical, intellectual, cognitive, neurological, visual, hearing or psychosocial impairment that:
      i. is (or is likely to be) permanent;
      ii. substantially reduces [a person’s] ‘functional capacity’ in one or more of the following areas: mobility, communication, social interaction, self-management, learning and self-care;
      iii. restricts [a person’s] ability to participate in work/study, engage with peers and/or interact with their wider community (i.e. has a clear social and/or economic impact);
      iv. requires lifelong NDIS support.’ 

The United Nations Convention on the Rights of Persons with Disabilities defines disability as resulting from:

• ‘the interaction between persons with impairments and attitudinal and environmental barriers that hinder their full and effective participation in society on an equal basis with others.’ 

With respect to behaviour support planning, the UN definition focuses on addressing environments of concern to the person with disability, rather trying to 'fix the person'. It is important to consider that staff and other people can be part of 'the environment'.

A service provider that does not receive NDIS funding is a non-NDIS funded provider of services to people with disabilities. 

Their funding will typically come from state government sources or other entities, such as the Transport Accident Commission or a private insurance company.

The Disability Act 2006 defines disability service providers as ‘a person or body registered to provide disability services under the Social Services Regulation Act 2021.’ 

Find out more from the Victorian Social Services Regulator that oversees disability services.

The National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 define environmental restraints as restricting a person from freely accessing all parts of their environment. 

Find out more about environmental restraints by watching the Department of Family, Fairness and Housing’s video.

Functionally equivalent replacement behaviours (FERBs) are alternative behaviours that serve the same purpose or fulfil the same function for the person with disability as the behaviour of concern (or challenging behaviour). 

They provide people using behaviours of concern with new, more appropriate ways of communicating their needs and achieving their purposes. 

With these changes, people can achieve the same outcomes that their behaviour of concern previously provided or attempted to achieve.  

Understanding the behaviour(s) of concern and their purpose (from the point of view of the person with disability) is essential to include appropriate and effective functionally equivalent replacement behaviours in behaviour support plans.  

Find out more about functionally equivalent replacement behaviours.

When relating to authorising and using a regulated restrictive practice, ‘harm to themselves or others’ is defined as physical harm under the Disability Act 2006. 

Psychological harm is also recognised by the NDIS (opens PDF doc).  

APOs must be conscious that regulated restrictive practices (eg: physical restraint, environmental restraint or seclusion) can impact the person who is subject to the restraint(s), causing adverse psychological impact that may lead to: 

• poorer quality of life
• a breakdown of relationships (eg: with family and support staff),
• trauma, and/or
• post-traumatic stress disorder.

Find out more about practices that present high risk of harm to NDIS participants (opens PDF doc).

The Australian Human Rights Commission states that:

'Human rights recognise the inherent value of each person, regardless of background, where we live, what we look like, what we think or what we believe.

'They are based on principles of dignity, equality and mutual respect, which are shared across cultures, religions and philosophies. They are about being treated fairly, treating others fairly and having the ability to make genuine choices in our daily lives.

'Respect for human rights is the cornerstone of strong communities in which everyone can make a contribution and feel included.'

The United Nations Convention on Rights of Persons with Disabilities details that people with disability have rights equal to all other members of society, including but not limited to the right to:  

• respect for inherent dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons (Article 3);
• equality before the law and to equal protection under the law, without discrimination (Article 5);
• liberty and security of the person (Article 14);
• freedom from torture or cruel, inhuman or degrading treatment or punishment (Article 15);
• freedom from exploitation, violence and abuse (Article 16);
• respect for his or her physical and mental integrity on an equal basis with others (Article 17);
• personal mobility with the greatest possible independence (Article 20);
• freedom of expression and opinion and access to information (Article 21);
• the highest attainable standard of health without discrimination on the basis of disability (Article 25);
• attain and maintain maximum independence, full physical, mental social and vocational ability, and full inclusion and participation in all aspects of life (Article 26); and
• an adequate standard of living for themselves and their families, and to social protection without discrimination on the basis of disability (Article 28). 

Read more about disability discrimination from the Australian Human Rights Commission.

An 'independent person' is someone who has a connection with the person with a disability.  

The APO appoints an independent person to explain the authorised restrictive practice(s) to the person with the behaviour support plan and their right to seek a review of the proposed restrictive practice(s) if they disagree with their use.

An independent person must not be connected to the provider or a paid support of the person with disability. They could be a member of the person’s Circle of Support.

Find out more about the independent person's role and the definition of independent person under Section 140 of the Disability Act 2006.

The National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 define mechanical restraint as:

‘The use of a device to prevent, restrict or subdue a person’s movement for the primary purpose of influencing a person’s behaviour but does not include the use of devices for therapeutic or non-behavioural purposes.'

Purposes may include the use of a device to assist a person with functional activities as part of occupational therapy or to allow for safe transportation. 

The National Disability Insurance Agency (more commonly known as the NDIA) is the Australian Government agency that delivers and manages the NDIS in Australia.

Read more about the NDIA and its implementing role. 

The National Disability Insurance Scheme (more commonly known as the NDIS) is an Australian Government program that provides funding and support for eligible people living with permanent disability in Australia.

It aims to enhance the lives of people with disability by strengthening the skills and support they need to ‘gain more time with family and friends, greater independence, access to new skills, jobs, or volunteering in their community, and an improved quality of life’. 

Read more about the NDIS.

More commonly known as ‘the NDIS Commission’, this independent Commonwealth agency regulates quality and safety of services delivered under the NDIS.

Read more about the NDIS Commission and differences between the NDIS, NDIS Commission and NDIA. 

The National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 define physical restraint as:

‘The sustained or prolonged use or action of physical force to prevent, restrict or subdue movement of a person’s body, or part of their body, for the primary purpose of influencing a person’s behaviour.  

‘Physical restraint is distinct from the use of a hands-on technique in a reflexive way to guide or redirect a person away from potential harm/injury, consistent with what could reasonably be considered the exercise of care towards a person.’ 

Watch an animation about prohibited physical restraint from the Department of Families, Fairness and Housing.

Refer also to the Victorian Senior Practitioner Direction, Physical Restraint Guidelines and Standards (opens PDF doc).

While ‘positive behaviour support’ is sometimes called ‘behaviour support’, not all ‘behaviour support’ is considered 'positive behaviour support'. 

Positive behaviour support builds on the assumption that all behaviour happens for a reason.  

It is both an approach to providing support and a philosophy of support. 

As an approach to providing support, positive behaviour support is an evidence-informed (data-driven) process that can be used when a person’s behaviour is considered ‘a behaviour of concern’. 

The goals of positive behaviour support are to:

• improve the person’s quality of life,
• build on the person's strengths, skills and priorities,
• address deficiencies in their physical and social environments,
• keep the person and those around them safe,
• reduce and, wherever possible, eliminate the need for restrictive practice (when a restrictive practice is used).

Positive behaviour support includes strategies to: 

• enhance the person’s environment (including activities, routines and social dimensions) to better reflect their preferences and priorities, and better meet their needs;
• foster communication by and with the person with disability;
• further the person’s development of the skills needed to exercise choice, control and self-determination; and
• improve the person’s health, wellbeing and quality of life.

Behaviour support must be focused on communication, human rights and the legislative governance that informs this practice, both at the Victorian and Commonwealth levels.

Behaviour support should be person-centred, building on the person's preferences and priorities – asking what more might be possible, and exploring opportunities that broaden their horizons.    

Behaviour support should use an evidence-based (data-driven) approach to understanding a person’s behaviour and the reasons behind it. 

Thoroughly assessing the person’s needs, personal preferences and priorities is essential. This is best undertaken by a multi-disciplinary team.

As a philosophy, positive behaviour support can be used to support a person’s development and quality of life more broadly. 

As such, a person doesn’t need to exhibit a behaviour of concern to benefit from positive behaviour support. 

A provider is a person, business or organisation who is registered with the NDIS (National Disability Insurance Scheme) to provide funded supports to participants. Providers have different areas of experience and expertise.

NDIS-registered providers are regulated by the NDIS Quality and Safeguards Commission. 

All providers (registered or unregistered) must adhere to the NDIS Code of Conduct. 

The relationship authorisation manager (RAM) is a software owned by the Australian Government and used by the NDIS to record approved behaviour support plans.

Find out more about the NDIS-based provider portal from the NDIS or on from the Australian Government. 

A restrictive practice is… ‘any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with a disability.’

See more information on the Department’s website and Section 9 of the NDIS Act 2013. 

There are several types of restrictive practices, including: 

• regulated restrictive practices (eg: chemical, physical, environmental or mechanical restraint, or seclusion),
• prohibited restrictive practices, such as prohibited physical restraints and seclusion for children under the age of 18 (opens PDF doc), and
• unauthorised restrictive practices.

Any proposed use of restrictive practice must be submitted for authorisation by the APO. 

Find out more about the role of the APO and restrictive practices. 

Regulated restrictive practices must be used only in specific situations, including when there is a risk of harm to the person with disability or others.

Risk to safety also applies to risks to the safety of the person with disability (opens PDF doc), staff supporting them and others involved.

The National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 define seclusion as: 

‘The sole confinement of a person with disability in a room or physical space at any hour of the day or night where voluntary exit is prevented, implied, or not facilitated, or it is implied that voluntary exit is not permitted.'

Short-term accommodation (sometimes called STA or respite) is a short period of time away from a person’s usual home.  

This may be used for several reasons subject to approval, including:  

• to support a person in gaining more independence,
• providing rest (respite) for the person or their usual carers, and/or
• ensuring care if a person’s usual carers are not available to provide care for a period of time.

Find out more about short-term respite from the NDIS.  

Under the Disability Act (2006), a supervised treatment order means a civil order made in respect of a person with an intellectual disability under section 193. 

‘Supervised treatment' is a form of compulsory treatment under Part 8 of the Act. 

The Department of Families, Fairness and Housing defines a Supervised Treatment Order (downloads Word doc) as:

‘A civil order made by VCAT under section 193 of the Disability Act that enables the detention of a person with an intellectual disability who poses a significant risk of serious harm to others. Detention involves physical locking the person in a premise or constantly supervising or escorting the person to prevent freedom of movement.’

Find out more about working with the justice system and who to contact with questions.

A Support Coordinator is a paid professional engaged by NDIS participants to help them understand and implement their NDIS plan, including navigating the rules and regulations, payments, referrals to providers and understanding eligible services under their funding so they can get the most out of their plan. 

Support Coordinators can work with APOs and Behaviour Support Practitioners to: 

• guide and problem-solve around services, independence and effective supports, and
• budgets and funding available, including flexibility within approved plan line items. 

A person’s support network includes the active network of people around them who know and care for them.

Support networks include both paid and unpaid supports.

People with disability will have different ideas of what their support network looks like, depending on how they see themselves in relation to the people around them. 

Sometimes a person will have a formally organised Circle of Support or a Micro-Board established to oversee, advise on or coordinate their services and service providers.

Support networks are essential in successful behaviour support.

Read more about support networks in behaviour support and working with support networks as an APO.

Any restrictive practices that are not yet authorised by an APO are 'unauthorised restrictive practices'.

This includes both restrictive practices that are not in the person’s behaviour support plan and restrictive practices that have been proposed in a person’s behaviour support plan, but are not yet authorised.

Find out more about unauthorised restrictive practices from the NDIS.

Find out how to report the use of unauthorised restrictive practices.