Understanding Behaviour Through Movement Needs in PBS: Supporting Regulation, Activity and Safe Access

May 12, 2026

Positive Behaviour Support requires services to understand how movement needs affect behaviour, regulation and daily routines. The Positive Behaviour Support knowledge hub supports providers to connect behaviour, communication, proactive support, rights and reduction of restrictive practice.

In specialist services, understanding behaviour through PBS means asking whether the person needs to walk, pace, rock, stretch, change position, leave a space, use movement to calm, or release energy before distress builds.

This reflects PBS principles and values, because support should help people regulate safely rather than suppress movement that has meaning. Strong services do not automatically treat pacing, leaving or restlessness as disruption.

Concept Explained Clearly

Movement needs are the physical actions a person may use to regulate sensory input, emotion, anxiety, energy, pain or attention. Movement may be calming, organising or communicative. For some people, sitting still for long periods is difficult and may increase distress.

Behaviour linked to movement needs may include pacing, rocking, leaving rooms, standing during meetings, walking away during activities, repeatedly changing seats, running, pushing past others or becoming distressed when asked to stay still. In PBS, these behaviours should be understood by asking what movement is doing for the person.

Why It Matters in Real Services

When movement needs are misunderstood, staff may try to stop the behaviour rather than support it safely. They may ask the person to sit down, stay in one place or stop pacing without recognising that movement may be helping the person cope.

This can increase escalation and reduce access. People may struggle with appointments, meals, transport, group activities or waiting rooms because movement is treated as a problem. Commissioners and CQC will expect providers to evidence that support is person-centred, least restrictive and responsive to sensory and regulation needs.

What Good Looks Like

Strong services demonstrate that movement is understood in context. Staff know when movement is calming, when it indicates anxiety, when it becomes unsafe and what alternatives help. Plans identify safe routes, movement breaks, pacing spaces, activity timing and support responses.

Good PBS practice protects movement where possible and manages risk proportionately. Staff offer planned movement before crisis, build walking into routines, adapt seating expectations and record whether movement support improves participation. This creates a clear line of sight from behaviour to regulation need, from regulation need to action, and from action to outcome.

Operational Example 1: Pacing During Staff Visits

Step 1 – Context reviewed: A person receiving outreach support paced around the flat whenever staff arrived. Some workers asked them to sit down before discussing the plan for the day, which increased shouting and refusal.

Step 2 – Function explored: The provider observed that pacing reduced once the person knew what was happening. Movement appeared to help manage anxiety during the first few minutes of contact.

Step 3 – Support approach: Staff stopped requiring the person to sit at the start of visits. They gave the day’s plan while walking slowly with the person or standing in a familiar place.

Step 4 – Day-to-day delivery detail: A short visual plan was shown after greeting. Staff used low language and allowed movement while confirming the first activity, rather than waiting for stillness before communicating.

Step 5 – How effectiveness was evidenced: Morning refusals reduced, staff visits started more calmly and the person settled into planned routines more quickly. The provider evidenced that movement support reduced anxiety and improved engagement.

Deepening the Understanding: Movement Can Be Regulation, Not Avoidance

Movement is sometimes misread as avoidance. A person who leaves a room may not be refusing the activity; they may be preventing overload. A person who rocks or walks may be organising their body before they can listen or respond.

Strong PBS services ask whether movement helps the person remain involved. The aim is not to force stillness. It is to support safe participation in ways that respect the person’s regulation needs.

The related article on seeing behaviour as communication in PBS reinforces why movement should be understood as possible communication about regulation, anxiety, sensory need or control.

Operational Example 2: Walking Away During Group Activity

Step 1 – Pattern identified: In a day opportunity, a person repeatedly left group craft sessions after ten minutes. Staff believed they were not interested, but the person often returned after walking in the corridor.

Step 2 – Meaning considered: The team recognised that movement breaks helped the person manage attention and sensory demand. Leaving was not a complete refusal of the activity.

Step 3 – Support adjusted: Staff built planned movement breaks into the session. The person had a clear card showing “walk then return” and a safe route agreed with staff.

Step 4 – Practical delivery: Staff did not follow immediately unless risk increased. They kept the activity place available so the person could return without feeling challenged or questioned.

Step 5 – Outcome evidence: The person returned more often, completed more activity steps and showed less distress during groups. The provider evidenced that movement breaks improved participation rather than reducing it.

Systems, Workforce and Consistency

Movement support must be consistent across staff and settings. If one worker allows pacing and another stops it, the person may experience support as unpredictable. Strong services include movement guidance in PBS plans, community access plans, handovers and supervision.

Managers should review whether restrictions on movement are necessary, proportionate and evidenced. Supervision should explore whether staff are asking for stillness because it supports the person or because it makes routines easier for staff.

Operational Example 3: Waiting Room Movement and Appointment Access

Step 1 – Access difficulty: A person became distressed in GP waiting rooms when asked to sit until called. They stood repeatedly, walked towards the exit and sometimes missed appointments.

Step 2 – Environmental need reviewed: The provider identified that sitting still in a busy waiting room increased anxiety. Gentle movement helped the person remain near the appointment without escalating.

Step 3 – Support response: Staff contacted the surgery in advance and agreed that the person could wait outside or walk briefly nearby while staff monitored the appointment queue.

Step 4 – Delivery detail: Staff used a visual appointment sequence and a planned walking loop. The person returned when called, with staff using one calm transition phrase.

Step 5 – Evidence reviewed: Appointment attendance improved, exit-related distress reduced and staff records showed better recovery afterwards. The provider evidenced that movement support improved healthcare access.

Governance and Evidence

Governance should show how movement needs are understood, planned and reviewed. Providers should be able to evidence PBS plan updates, sensory profiles, activity plans, appointment planning, risk assessments, incident analysis, supervision notes and outcome monitoring.

Strong governance connects movement to function and outcome. Records should show what movement occurred, what it appeared to support, what staff did, whether risk changed and whether participation improved. This creates a clear line of sight from behaviour to movement need, from movement need to support action, and from action to outcome.

Commissioner and CQC Expectations

Commissioners expect providers to support people in ways that maintain access, dignity and stability. They need assurance that movement needs are not managed through unnecessary restriction or blanket rules.

CQC will expect care to be person-centred, responsive and least restrictive. Inspectors may review whether staff understand sensory and regulation needs, whether restrictions on movement are justified, and whether plans are followed consistently. Strong services demonstrate that movement support is practical, safe and evidence-led.

Common Pitfalls

Interpreting pacing as disruption without reviewing anxiety or regulation needs.
Requiring stillness before communication can happen.
Stopping movement breaks that help the person remain engaged.
Reducing community access instead of planning safe movement options.
Using blanket rules about sitting during meals, groups or appointments.
Failing to evidence whether movement support improves participation and wellbeing.

Conclusion

Understanding behaviour through movement needs helps PBS teams recognise when walking, pacing, rocking or leaving a space supports regulation. Behaviour may communicate that the person needs movement to manage anxiety, sensory demand, energy or emotional pressure.

Strong providers support safe movement rather than suppressing it without reason. They evidence how movement-informed support improves access, reduces distress and protects dignity. This gives commissioners and CQC confidence that PBS is practical, least restrictive and rooted in real service delivery.