Research Article Contribution of occupational therapists in positive behaviour support Micah Perez, 1 Glenys Carlson, 2 Jenny Ziviani 3 and Monica Cuskelly 4 1 School of Medicine, Royal Brisbane and Women’s Hospital, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, 2 Disability Practice Improvement, Department of Communities, 3 Children’s Allied Health Research, Queensland Health and The University of Queensland, and 4 Graduate School of Education, The University of Queensland, Brisbane, Queensland, Australia Aim: Positive behaviour support employs specific strate- gies which aim to both reduce the incidence of behaviours of concern and enhance the quality of life of people with intellectual disabilities. This study aims to identify activi- ties and experiences of occupational therapists working in behaviour support contexts to understand how they see their contributions in this area. Methods: Semi-structured interviews were undertaken with 10 occupational therapists who have provided behav- iour support for people with intellectual disabilities. Audio recordings were transcribed verbatim and thematically analysed. Results: Three major themes emerged from the interview data: contextualising and understanding behaviour; occu- pational therapy – why and how?; and ‘challenges, strengths and expanding horizons’. Conclusions: Participants saw themselves as providing an occupational perspective in the delivery of behaviour support, to individuals with behaviour support needs. They highlighted that this was achieved utilising their skills and knowledge about positive behaviour support strategies. Their approaches were seen as drawing on: their understanding of neurological function and how it relates to a person’s occupational engagement; combining occupa- tionally focussed approaches with behavioural analysis methodology to guide practice; and advocating for person- centred interventions. These observations form the basis for exploring ways in which occupational therapists can advance their contributions in positive behaviour support settings. KEY WORDS behaviour modification, environment design, intellectual disability, quality of life. Introduction Positive behaviour support emerged in the mid-1980s as a response to potentially damaging behavioural approaches to the management of individuals with chal- lenging behaviours (Meyer & Evans, 1989; Will, 1999). The intent was to produce more meaningful, sustainable and long-term outcomes for individuals in community contexts (Horner et al., 1990). This approach was based on applied behavioural analysis, and retained its emphasis on functional assessment (Dunlap, Carr, Horner, Zarcone & Schwartz, 2008). Positive behaviour support has since grown into a systematic approach that involves the redesign of environments to enhance quality of life and promote more functional behaviours for at-risk populations such as (yet not restricted to) children and adults with intellectual disabilities (Carr et al., 2002; Dunlap et al.). Individuals with intellectual disabilities can at times behave in ways that cause harm to themselves or others, or that result in damage to property. For the purposes of this study, these behav- iours will be referred to as ‘behaviours of concern’. Positive behaviour support is a collaborative, team- based approach which: (i) draws upon social, behavio- ural, educational and biomedical science principles; (ii) combines evidence-based practices with formal strate- gies; (iii) considers the impact of environmental contexts on functional abilities and behaviour; and (iv) addresses the unique and often complex needs of individuals with intellectual disabilities (Carr et al., 2002; Hieneman & Dunlap, 1999). This approach aims to enhance quality Micah Perez MOccThySt, BSc (BiomedSci); PhD Scholar. Glenys Carlson PhD, BOccThy; Principal Program Officer. Jenny Ziviani PhD, MEd, BA, BAppSci (OT); Professor Children’s Allied Health Research. Monica Cuskelly PhD, MAppPsych, GradDipEd, MEdSt, BA (Hons); Associate Professor. Correspondence: Jenny Ziviani, Children’s Allied Health Research, Queensland Health and The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Qld 4072, Australia. Email: j.ziviani@uq.edu.au Accepted for publication 9 May 2012. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia Australian Occupational Therapy Journal (2012) 59, 428–436 doi: 10.1111/j.1440-1630.2012.01036.x