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Complex Support Needs


"Behaviours that occur with such intensity, frequency or duration that the physical safety of the person or others is likely to be placed at risk, or the person's quality of life is negatively affected."

Persons with Developmental Disabilities Edmonton Community Board


Individuals who have a developmental disability, as defined in the PDD eligibility criteria stated above, receive supports from a number of stakeholders including:

Natural supports

    • Unpaid family, friends, and acquaintances

Formal caregivers

    • Paid agency staff, home care, public guardian

The type of services available to most individuals with developmental disabilities is adequate to meet their specific needs. However, some individuals also have complex behavioural needs for which typical services are not adequate.

For most individuals with developmental disabilities

  • A combination of natural and formal supports are adequate
  • The normal planning process is adequate
  • Support needs may change gradually over time.

However, for individuals with complex support needs (CSN)

  • Normal delivery systems (in the individuals' area) may not provide the supports needed
  • Normal planning may have been done but is insufficient
  • Support needs may change over time, sometimes quickly

Often, former attempts to meet their medical needs or modify their behaviours have also been unsuccessful

  • Specialized treatment or supports may have been unavailable
  • The individual may not have responded to normal treatment or correction
  • Traditional medical or behavioural management procedures may not have produced sustained medical or behavioural change

Because individuals with complex support needs require a high degree of flexibility and coordination to meet their needs, organizations have worked to develop better ways of supporting these individuals by promoting and implementing diverse support networks, such as natural supports, formal caregivers, CSN services, and effective service delivery systems. These service providers ensure every member of the support network and service delivery system communicate effectively with one another. They have skilled and experienced case managers to coordinate services, supports, and activities. And they plan ahead and prepare for extraordinary demands and security issues.

Caregivers are also looking for a higher degree of training and emotional support and individuals are looking for therapeutic approaches that are different than what is typically provided in the disability services system. In addition, individuals may need environments that can be modified quickly and efficiently because their support needs may change suddenly.

  • Changes need to be quick, efficient, and effective
  • Changes may involve quantity of support
  • Changes may involve type of support
  • Changes may involve persons or professionals involved in providing support
  • Changes may involve added support from the legal system or Office of the Public Guardian

To help service providers implement and be recognized for their work in providing supports to individuals with complex support needs, ACDS has included CSN as a component of the CET Standards.

Benefits of Pursuing CSN

By adapting services and providing staff training to offer CSN, organizations will be able to serve individuals who have both a development disability and complex medical and/or behavioural needs, and they will advance toward having highly trained and skilled staff.

Individuals will be given a chance to overcome personal or social disadvantages (e.g., injuries to themselves or others, risk of hospitalization/institutionalization, loss of or threat of loss of home, loss of or threat of loss of livelihood, involvement in the justice system, rejection by others in the community, alienation of family and friends).

Service providers can be confident that their services are adequate, staff will be safe from personal injuries, they can offer solutions to individuals and/or guardians who disagree with traditional service or treatment options, they can manage increases in the use and/or intensity of restrictive procedures, and they can avoid liability issues.

The CSN Review Process

A CSN Review can be done in conjunction with either a CET Level 1 or a Level 2 site survey and will include additional indicators specific to supporting individuals with complex support needs. The review follows the same process as a CET survey.

To meet this additional level of service achievement, service providers will go through a CSN Review as part of their CET site survey. Successful achievement will be acknowledged on a CET certificate.

ACDS Head Office

160 3015-12 Street NE
Calgary, AB  T2E 7J2
Ph: (403) 250-9495
Fax: (403) 291-9864

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