You’ve tried everything. Redirecting. Ignoring. Rewards. Consequences. Adjusting the environment. Changing routines. Nothing works consistently, and the behaviors are getting worse.
Maybe it’s aggression toward family members or caregivers. Maybe it’s self-injury that’s causing real harm. Maybe it’s property destruction that’s making your home unlivable. Maybe it’s elopement that puts your loved one in danger.
You’re exhausted. You’re stressed. And you’re starting to wonder if you can keep doing this.
This is when families need to know: professional behavioral support services exist. You’re not supposed to figure this out alone. Asking for help isn’t a failure — it’s recognizing that challenging behaviors often require specialized expertise that families don’t have.
In Nebraska, behavioral support services are available through the CDD and FSW waivers. These services provide assessment, intervention, training, and ongoing support to help individuals with IDD reduce challenging behaviors and develop more adaptive ways of communicating needs.
What Are Challenging Behaviors?
Challenging behaviors are actions that interfere with daily functioning, put the individual or others at risk of harm, limit access to community activities, or create significant stress for the individual and their family.
Common challenging behaviors include physical aggression like hitting, kicking, or biting; self-injurious behavior such as head-banging or scratching; property destruction; elopement or wandering; extreme noncompliance; verbal aggression; and disruptive behaviors.
It’s important to understand that these behaviors aren’t happening because your loved one is “bad.” Challenging behaviors in people with IDD are almost always communication — a way of expressing something they can’t communicate another way.
When Do You Need Professional Behavioral Support?
Not every behavior challenge requires professional intervention. But there are situations where professional help becomes necessary.
Consider behavioral support services when: behaviors are escalating in frequency or intensity despite your efforts; someone is getting hurt; behaviors are limiting participation in necessary activities; you’re losing providers; your family is in crisis; or previous approaches haven’t worked.
What Behavioral Support Services Provide
Behavioral support services in Nebraska typically include a Functional Behavioral Assessment (FBA) that identifies what triggers behavior and what function it serves for the individual.
Functional Behavioral Assessment
The first step is understanding why the behaviors are happening. A behavioral consultant observes your loved one, interviews family members, reviews records, and analyzes patterns to identify what’s maintaining the behavior.
Behavior Support Plan Development
Based on the assessment, the behavioral consultant develops a Behavior Support Plan outlining strategies for preventing the behavior, teaching replacement behaviors, responding to the behavior, and keeping everyone safe.
Training for Caregivers and Staff
The behavioral consultant trains everyone involved in your loved one’s care on how to implement the Behavior Support Plan consistently. Consistency across settings and caregivers is critical for behavior change.
Ongoing Support and Plan Adjustments
Behavioral support isn’t one-and-done. The consultant provides ongoing monitoring to see if the plan is working, makes adjustments when strategies aren’t effective, and supports caregivers through implementation.
Crisis Intervention Support
If dangerous behaviors occur, behavioral consultants can provide crisis intervention guidance, help develop safety plans, and support families through acute situations while working toward long-term solutions.
How to Access Behavioral Support Services in Nebraska
Behavioral consultation services are available through both the CDD waiver and the FSW waiver. Talk to your case manager about the behaviors you’re seeing. Request that behavioral consultation services be added to your loved one’s Individual Service Plan.
What to Expect When Working with a Behavioral Consultant
Initial Assessment Phase: The consultant spends significant time observing your loved one, asking detailed questions, reviewing documentation, and gathering information from everyone involved.
Plan Development and Training: Once the assessment is complete, the consultant develops the Behavior Support Plan and schedules training sessions with family members and caregivers.
Implementation and Monitoring: After training, you start implementing the plan. The consultant checks in regularly to see how it’s going, troubleshoot challenges, and make adjustments.
Plan Adjustments
If strategies aren’t working after a reasonable trial period, the consultant modifies the plan based on data and feedback.
Common Behavioral Interventions
While every Behavior Support Plan is individualized, common strategies include environmental modifications, antecedent interventions, replacement behaviors, reinforcement strategies, de-escalation techniques, and crisis management protocols.
What Families Should Do to Support the Process
Be consistent. Everyone needs to implement the plan the same way. Collect data. Track behaviors so you can see whether things are improving. Communicate with the consultant. Be patient. Behavior change takes time. Take care of yourself.
When Behavioral Support Isn’t Enough
Sometimes despite good behavioral support services, behaviors don’t improve sufficiently. Medical evaluation can rule out pain or medication side effects. Psychiatric evaluation can assess whether mental health conditions are present.
The Bottom Line
Challenging behaviors are one of the hardest aspects of caring for someone with IDD. Behavioral support services exist specifically to help families through professional assessment, evidence-based interventions, and ongoing support. Asking for help isn’t admitting defeat — it’s recognizing that some behaviors require specialized expertise that most families don’t have.
