Objects of Reference for Positive Behaviour Support in Learning Disability Services
Objects of reference can strengthen Positive Behaviour Support in learning disability services when people need concrete ways to understand what is happening, request a break or access calming support. PBS should not rely only on staff interpreting behaviour after distress has escalated. Where objects of reference work for the person, they can support earlier communication and more predictable staff response.
Strong providers include objects of reference within wider communication and accessibility in learning disability support and connect them with learning disability service pathways and support models. This matters because distress often increases when people do not understand routines, transitions, sensory demands or available support.
Concept explained clearly
Objects of reference are physical items used to represent an activity, place, person, routine or support option. In PBS, they may represent quiet time, help, a break, music, outside space, personal care, travel, health checks or a calming routine.
The purpose is not to use objects to manage behaviour. The purpose is to improve communication so the person has clearer ways to understand, anticipate and influence what happens next.
Why it matters in real services
Distress can escalate when people cannot communicate confusion, discomfort, sensory overload, pain or the need to stop. Staff may record incidents without identifying the missed communication that came before them.
Providers should be able to evidence that objects of reference support prevention, emotional regulation and person-led support, not simply that objects are available.
What good looks like
Good PBS use of objects is proactive. Staff introduce objects during calm periods, use them before high-risk routines and respond to acceptance, rejection, holding, seeking or pushing away.
Strong services demonstrate a clear line of sight from object-based communication to staff action, reduced escalation and improved outcomes.
Operational Example 1: Using an object to request a break
Context: A person in supported living became distressed during busy communal evenings. Staff usually responded after the person shouted or left the room suddenly.
Support approach: The provider introduced a small sensory keyring as an object of reference for break time in a quieter room.
Five practical steps:
- Staff reviewed incident records to identify early signs before escalation.
- The team selected an object already linked to the person’s calming routine.
- Workers introduced the object during calm periods and paired it with quiet space.
- Staff offered the object when early signs of overwhelm appeared.
- Managers reviewed incidents, break use and recovery time over several weeks.
Day-to-day delivery detail: When the lounge became noisy, staff placed the keyring near the person and reduced speech. The person began picking it up and moving towards the quieter room before distress escalated.
How effectiveness was evidenced: Evening incidents reduced, and records showed earlier break requests. The PBS plan was updated to include the object as a proactive communication tool.
Deepening PBS through total communication
Objects of reference should sit within total communication beyond spoken language. A person may communicate through objects, movement, facial expression, vocalisation, posture, touch, signs or avoidance.
This means staff should not wait for a single clear behaviour before responding. Object use should help staff recognise the whole pattern of communication earlier.
Operational Example 2: Reducing distress during personal care
Context: A person became distressed during evening personal care, especially when staff moved quickly from the lounge to the bathroom. Incident records showed repeated escalation at the same point in the routine.
Support approach: The provider introduced a familiar towel as an object of reference for the shower routine and included it in the PBS prevention plan.
Five practical steps:
- The PBS lead reviewed where the personal care routine became difficult.
- Staff selected the towel because the person already associated it with showering.
- Workers introduced the towel before leaving the lounge.
- Staff paused when the person rejected the object or moved away.
- The team reviewed distress, completion, pacing and dignity records.
Day-to-day delivery detail: Staff placed the towel beside the person and waited. If the person touched or held it, staff moved slowly towards the bathroom. If the person pushed it away, staff delayed the routine and returned later.
How effectiveness was evidenced: Personal care incidents reduced, and staff recorded clearer evidence of readiness and refusal. The provider evidenced that the object improved pacing and reduced avoidable escalation.
Systems, workforce and consistency
Objects used in PBS must be recorded in the communication profile, PBS plan, handover notes and staff guidance. Staff should know what the object means, when to introduce it and what action follows.
Supervision should check whether staff use objects before escalation or only after distress has started. Handovers should record object use, rejection, changes in response and any emerging links to pain, sensory overload or environmental stress.
Operational Example 3: Supporting recovery after distress
Context: A person took a long time to recover after distress. Staff were unsure whether to offer reassurance, music, food, space or activity, and repeated verbal questions increased agitation.
Support approach: The provider introduced a music speaker and a quiet-room cushion as objects of reference for recovery options, aligned with accessible information standards in learning disability services.
Five practical steps:
- The team reviewed what had helped recovery in previous situations.
- Staff selected two objects linked to known calming options.
- Workers offered one object at a time after distress, with minimal speech.
- The person’s response guided whether staff offered music, space or continued waiting.
- Recovery time and repeat escalation were reviewed monthly.
Day-to-day delivery detail: After one incident, staff placed the cushion within reach and waited. The person pulled it closer and moved towards the quiet room. Staff did not add questions or instructions, allowing the object to guide the recovery response.
How effectiveness was evidenced: Recovery time reduced, and repeat escalation became less frequent. Records showed that object-based recovery support gave staff a clearer, less intrusive response pathway.
Governance and evidence
The audit trail may include PBS plans, communication profiles, object lists, incident records, ABC analysis, staff observations, supervision notes, environmental reviews and outcome summaries.
Data may show fewer incidents, earlier break requests, reduced recovery time, calmer personal care or better use of sensory support. Qualitative evidence should explain what each object means, how staff use it and how the person responds.
Commissioner and CQC expectations
Commissioners expect PBS to be proactive, personalised, rights-based and evidence-led. Objects of reference can help demonstrate that behaviour support is built around communication and prevention rather than reactive control.
CQC expects safe, person-centred care, effective communication, dignity, skilled staff and good governance. Inspectors may look at whether staff understand distress, use known communication methods and review outcomes.
Common pitfalls
- Using objects only after escalation rather than as proactive communication.
- Choosing objects that do not have clear meaning for the person.
- Failing to link objects to agreed staff responses.
- Recording behaviour without analysing missed communication.
- Leaving objects out of PBS reviews and incident analysis.
- Using objects to direct compliance rather than support understanding and choice.
Conclusion
Objects of reference can make PBS more preventative, respectful and communication-led. Strong providers demonstrate that objects are meaningful, consistently used and linked to staff action and outcomes. When object-based communication is embedded into PBS governance, services can evidence earlier support, reduced escalation and stronger person-centred practice.