Introduction/Rationale: The home modification process can be particularly challenging for children and adults with behaviors of concern. Following Foundations' 2021 report on challenging behaviour, feedback from individuals with lived experience, practitioners, and professionals highlighted the need for specialised guidance to improve the modification process for this population.
Objectives: To develop evidence-informed best practice guidance that complements existing home modification guidance while specifically addressing the needs of individuals with behaviors of concern, enhancing the experience of the modification process for service users and practitioners.
Methods/Approach: The guidance was developed through collaboration with Dr. Steve Carnaby, an expert in Behaviors of Concern. A day-long stakeholder workshop brought together diverse perspectives including occupational therapists from NHS, Social Care, Education, and Independent sectors, technical officers, third-sector representatives for people with lived experinece of behaviours of concern, and researchers. The workshop findings were synthesised with existing evidence and guidelines to create comprehensive, person-centered guidance.
Results/Practice Implications: The resulting best practice approach provides structured guidance across key areas: assessment processes, funding considerations, design principles, and implementation strategies. The guidance emphasises understanding behaviour purpose, environmental influences, and person-centred modification design. It includes practical tools for practitioners and promotes collaborative working between stakeholders.
Conclusion/Contribution to Occupational Therapy: This guidance enhances occupational therapy practice by providing a structured, evidence-informed approach to home modifications for individuals with behaviors of concern. It reinforces occupational therapy's role in understanding the relationship between behaviour, environment, and occupation, while promoting person-centered practice in complex home modification cases.