Understand PBS

Behaviour Support for Intellectual Disability

Positive behaviour support (PBS) for people with intellectual disability starts from dignity and the presumption that the person is capable and has something to communicate. Behaviour that worries others is usually meaningful: a way of expressing a need, a feeling, or a response to an environment that doesn't quite fit.

Good behaviour support looks closely at communication, builds on a person's strengths, adjusts the environment to suit them, and (importantly) checks that distress isn't being caused by pain, illness, or a health issue that's gone unnoticed.

Who this is for

People with intellectual disability, their families, and the support workers and coordinators around them who want a respectful, practical explanation of how positive behaviour support can help.

Presuming competence and starting with dignity

Presuming competence means assuming that a person understands more than they may be able to show, has preferences worth listening to, and is communicating something real through their behaviour. It's a stance, not a test. And it shapes how respectfully and effectively support is provided.

When we begin from dignity rather than low expectations, we look for the meaning behind behaviour and the supports that help a person take part in their own life. Positive behaviour support is never about doing things to a person; it's about understanding them and working alongside them and the people who know them best.

Communication and skill-building

For many people with intellectual disability, behaviours of concern are closely tied to communication. When it's hard to be understood, frustration and distress build. Paying attention to how someone communicates, and giving them more accessible, reliable ways to express needs and choices, often reduces the pressure that drives difficult moments.

Skill-building is part of this too. Rather than focusing only on stopping a behaviour, PBS looks at what would help the person meet the same need in a safer, more effective way, taught patiently and at the person's pace.

  • Understanding how the person communicates, including without speech
  • Offering accessible ways to express needs, choices, and discomfort
  • Teaching new skills gently and at the person's own pace
  • Building on strengths, interests, and what already works
  • Giving real, everyday choices wherever possible

Ruling out pain and health issues first

One of the most important things behaviour support does is take physical health seriously. Diagnostic overshadowing is when a person's distress or change in behaviour is put down to their disability, and a treatable cause (pain, infection, dental problems, constipation, reflux, medication side effects, poor sleep) is missed.

A sudden change in behaviour, in particular, deserves a careful look at health before anything else. A good behaviour support process works with families, GPs, and other health professionals to make sure that nobody assumes 'that's just how they are' when the real issue is that the person is unwell or in pain.

Adjusting the environment, not just the person

A great deal of what makes a day hard sits in the environment and routines around a person rather than in the person themselves. Predictable routines, the right level of support, meaningful activity, and surroundings that suit someone's sensory and access needs can prevent a lot of distress before it starts.

Because each person's circumstances are their own, behaviour support comes with no promise of a set result. Its value lies in changing what can be changed, such as routines, support levels, surroundings, and the chances a person has to make their own choices, so that day-to-day life sits more comfortably with who they are, rather than asking them to fit a setting that was never quite right.

Frequently asked questions

What is diagnostic overshadowing and why does it matter?

Diagnostic overshadowing is when a change in someone's behaviour or mood is assumed to be 'just their disability', and an underlying medical cause like pain, infection, or dental trouble is missed. It matters because untreated health issues are a common, fixable reason for distress. Good behaviour support always considers health, especially when behaviour changes suddenly.

Does behaviour support assume the person can't understand?

No. Positive behaviour support works from a presumption of competence, assuming the person understands more than they may be able to show and has preferences worth respecting. The aim is to support and include the person, not to do things to them or talk over them.

How is behaviour support for intellectual disability funded?

Positive behaviour support can be funded where it is reasonable and necessary in relation to a participant's disability, and it is usually found under Improved Relationships in an NDIS plan. A support coordinator or the NDIS can help confirm what's available in a particular plan.

What if the person can't tell us what's wrong?

That's common, and it's exactly why behaviour support pays such close attention to behaviour as communication. We look at patterns, work with the people who know the person well, support more accessible ways to communicate, and make sure health and pain are checked, so that needs which can't be spoken still get noticed and met.

Sources

Last reviewed June 2026.

Looking for respectful, practical behaviour support?

If someone you support has an intellectual disability and you want behaviour support that starts with dignity and takes health seriously, we're happy to talk it through. Plainly and without pressure.

We aim to respond within about one business day.