ABC-Plus (Antecedent, Behaviour, Consequence)

The ABC Plus is a more structured, richer version of the ABC form. It can additionally capture positive behaviours, sleep, and observation duration. It also contains more behaviour options with severity-descriptions. This aligns different people on what "moderate" means, for example. Finally, negative submissions calculate a weighted-severity meaning that ABC Plus observations are directly comparable to other Melo behavioural assessments.

Here’s how ➡️How Melo equates severity levels between assessment types

1. Setting up

  1. Open a new ABC-Plus form by opening the side navigation bar and clicking “ABC+”

  2. Choose a patient

  3. Start & end times of the observed behaviour

2. Observation type

Positive

Safe, manageable behaviours conducive to good quality of life or recovery.

Negative

Disruptive or dangerous behaviours which make quality care difficult.

Sleeping

Dozing, or resting peacefully.

2a. Positive behaviour 💖

  1. Choose any behaviours

  2. Choose any Scenario & context that help build the picture of the scenario

  3. Choose any Locations where the patient was observed

  4. Choose any People present

2b. Negative behaviour ⚠️

  1. Choose a behaviour type*

  2. Choose a severity* based on the example descriptions (this aligns severity between people from different experiences and backgrounds to help match up observation severities) How Melo equates severity levels between assessment types

    * Note: you can choose multiple behaviour-severities inside one ABC Plus assessment, each with their own freetext description.

  3. Choose any Scenario & context that help build the picture of the scenario

  4. Choose any Triggers (events happening on the lead-up to the behaviour that might have triggered it)

  5. Choose any De-escalation techniques (events that seemed to put a stop to the behaviour)

  6. Choose any Restraint techniques used (normally used as a last resort)

    1. Choosing any restraint technique here will expand and ask for additional detail on rationale / type of restraint etc.

  7. Choose any Personal factors (anything you think the patient might’ve been feeling or trying to communicate through the behaviour)

  8. Choose any Locations (any areas this behaviour occurred in)

  9. Choose any Environmental factors (anything going on around them that might’ve contributed to the behaviour)

  10. Choose any People present (anyone nearby that might’ve witnessed the behaviour)

2c. Sleep 💤

  1. No additional details requried with a sleep observation.

3. Finishing up

  1. Click “Submit“

4. Analysing the data

Behaviour over time graph

Severity line - The 6 behaviour types and their severities are scores in the table below. Each submission takes the highest value chosen (when multiple are selected) produceing a severity at between 1 and 16. Each point on this line is the mean average from that time-slot on the graph; it adds all submission severities together and divides by the number of submissions (aka “frequency”). How Melo equates severity levels between assessment types

Behaviour type

Severity scores

Challanging but unaggressive

1, 2, 2, 3

Verbally aggressive

1, 2, 3, 4

Physically aggressive towards objects

2, 4, 6, 8

Physically aggressive towards self

3, 6, 9, 12

Physically aggressive towards others

4, 8, 12, 16

Sexualised behaviour

2, 6, 8, 12

  • Frequency line shows how many ABC Plus’s were recorded in each chunk of time (granularity)

  • Use of restraint line shows how many ABC Plus’s included at least one answer selected to the restraint question in the form

  • Granularity dropdown sets how many datapoints show in the chart

  • Key events button allows you to annotate timestamps on the graph. This can be useful to highlight how changes in care affect the behavioural lines.

Triggers

This chart shows the most commonly selected answers to this question of all the ABC Plus’s submitted (respecting any filters set).

Behaviours

This chart shows the most commonly selected answers to this question of all the ABC Plus’s submitted (respecting any filters set). Answers from Negative ABC Plus’s are shown in the left/above barchart, and the green right/below barchart is for Positive submissions.

De-escalation techniques

This chart shows the most commonly selected answers to this question of all the ABC Plus’s submitted (respecting any filters set).

Personal factors

This chart shows the most commonly selected answers to this question of all the ABC Plus’s submitted (respecting any filters set).

Restraint techniques

This chart shows the most commonly selected answers to this question of all the ABC Plus’s submitted (respecting any filters set).

Environmental factors

This chart shows the most commonly selected answers to this question of all the ABC Plus’s submitted (respecting any filters set).

Locations

This chart shows the most commonly selected answers to this question of all the ABC Plus’s submitted (respecting any filters set).

Severity spread

This chart shows the what proportion of submissions are what severity (respecting any filters set). ABC Plus submissions use a scale of 1-16 for severity. This is simplified into Melo’s equated severity scale across assessment types. How Melo equates severity levels between assessment types

Time of week

This heatmap shows the most common time of day across the 7 day week for negative behaviours, respecting any filters set; this can helps plan staffing. Sleep and positive ABC Plus observations are not counted in this chart.

Next steps