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Paving the Way

Early intervention for children with learning disabilities whose behaviours challenge

Local Crisis response



The Ealing Intensive Therapeutic Short Break Service (ITSBS) is for young people with learning disabilities who are at risk of being placed in residential care. This is usually due to their challenging behaviour.

How does it work?

The ITSBS aim to keep children in their family homes and communities, long term. They provide intensive support and follow up focused around the child aiming to reduce challenging behaviours and provide a break for the parents/young person. After a successful pilot, the ITSBS became a permanent service.

The Ealing Service shows that a crisis does not have to result in an unplanned admission to hospital or a move to a 52-week school. Crises can be well-managed locally in what look very cost-effective ways using a positive behavioural support approach.

Professor Martin Knapp, LSE

What has it achieved?

  • Children are more likely to stay in the community when receiving this type of intervention.
  • Individual interventions are monitored and overall the service has shown significant improvement.
  • Families are better able to cope, improving quality for the young person and family.
  • It costs £109,337 a year to give 7 young people intensive support and follow up. This costs less than a year of residential care for just 1 person.

Because of the help I received from the Clinical Psychologists, my son is still at home and not in residential care.


What are the tips to help develop and sustain a service of this type?

  • Evaluate and develop the service each year.
  • Show the savings made by investing in other solutions to residential care.
  • Use approaches that are proven to work.
  • Link up with other services around the country to share ideas.

What are the challenges?

  • Finding the right short breaks service; staff must have the right training and the service must be flexible.
  • Working with Social Care staff who specialise in challenging behaviour.
  • Helping people see that there are alternatives to 52 week schools.

As a result of the work our child is now sleeping at night, she is calmer, happier, and levels of self-injurious behaviour have reduced a lot. The whole family feel happier and less stressed now – it has had a positive effect on all of us.


For more information about this service please see the following evaluations: