What Are Behaviours of Concern? Understanding the Language Behind PBS Referrals
The phrase behaviours of concern is one you will encounter across NDIS documents, provider websites, plan reviews and clinical conversations without ever being clearly defined. For families, Support Coordinators and NDIS participants themselves, that lack of clarity matters. The language shapes how a person is understood, what services are recommended, and whether the response is compassionate or reductive.
This blog explains what behaviours of concern actually means in the NDIS and Positive Behaviour Support context, why the phrase replaced older language, and how understanding it changes the way participants and families engage with PBS referrals.
What Are Behaviours of Concern?
Behaviours of concern are actions by a person that cause harm, distress or significant disruption to themselves or others, or that place them at meaningful risk. The phrase is used in the NDIS to describe behaviours that warrant clinical support, particularly Positive Behaviour Support, without labelling the person as the problem.
Common examples include self-injury, aggression toward others, property damage, absconding from safe environments, prolonged distress that a person cannot self-regulate, and behaviours that lead to restrictive practices being used. The list is not exhaustive. What qualifies as a behaviour of concern depends on the person, their environment, the frequency of the behaviour and the impact it has.
Why the Language Changed
Behaviours of concern replaced older terminology such as challenging behaviour and problem behaviour. The change was deliberate, as using the term 'challenging' depicts the difficulty as the fault of the person. Behaviours of concern places the difficulty in the behaviour itself, which is separable from who the person is. Changing the way we speak about people with behaviours of concern can help in the way we view and assist them.
The shift matters because it opens up a different clinical conversation. If a person is challenging, the intervention targets the person. If a behaviour is of concern, the intervention explores what the behaviour is communicating, what environmental factors are driving it, and how those factors can change.
This is the foundation of Positive Behaviour Support. Behaviour is understood as communication and as a response to environment, not as a personality trait or moral failing.
Who Experiences Behaviours of Concern?
Behaviours of concern can occur in any person, but they are more common where communication is limited, sensory needs are unmet, trauma is unresolved, or medical or mental health issues are affecting the person's regulation. NDIS participants who receive Positive Behaviour Support often include:
- Adults and children with intellectual disability.
- Children and adults with autism, particularly where communication needs or sensory regulation needs are significant.
- People living with acquired brain injury.
- Participants with complex mental health presentations alongside disability.
- Participants with dementia-related conditions.
Behaviour is rarely random. There is almost always a reason, and identifying that reason is the first job of the clinical team.
Behaviours of Concern and Restrictive Practices
The reason behaviours of concern get formal clinical attention in the NDIS is that they often lead to restrictive practices being used, whether physical restraint, environmental restraint, chemical restraint through medication, seclusion or mechanical restraint. Restrictive practices are regulated by the NDIS Quality and Safeguards Commission, and any use requires clinical evidence justifying it and a plan to reduce or eliminate its use over time.
A Functional Behaviour Assessment is the clinical work that produces that evidence, and a Behaviour Support Plan sets out the strategies to reduce both the behaviours of concern and the restrictive practices used in response. This is why behaviours of concern is the entry point to the broader PBS process.
What to Do If You Are Concerned About a Participant's Behaviour
If a participant is experiencing behaviours that are causing harm, distress or risk, the right next step is a Positive Behaviour Support referral. That referral does not label the person. It initiates a clinical process focused on understanding the behaviour, supporting the person, and reducing the need for any restrictive responses.
At Allied Health 2U, our PBS team works alongside families, Support Coordinators and support workers to understand what behaviours of concern are communicating and design responses that respect the person while keeping everyone safe.
Want to talk through a Positive Behaviour Support referral? Get in touch with Allied Health 2U on 1300 24 2428.
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