The reaction of crew to a particular situation can be predicted ,but only in theory. Practically, there are a number of variables that result in a behaviour and these are in a constant state of flux.

Threats are defined as “events or errors that occur beyond the influence of the flight crew, increase operational complexity, and which must be managed to maintain the margins of safety”. During typical flight operations, flight crews have to manage various contextual complexities. Such complexities would include, for example, dealing with adverse meteorological conditions, airports surrounded by high mountains, congested airspace, aircraft malfunctions, errors committed by other people outside of the cockpit, such as air traffic controllers, flight attendants or maintenance workers, and so forth. The TEM model considers these complexities as threats because they all have the potential to negatively affect flight operations by reducing margins of safety.

Human factors in aviation needs to take these in view before arriving at a conclusion especially when investigating accidents/incidents. Humans are not considered a threat in the Threat Error Management concept since it considers only external factors which are not under the control of the flight crew. The behaviour of the crew must be considered when identifying threats, other factors like fatigue, crew health etc are also threats that can pose risk to the conduct of the flight.

• Antecedents (what happened before the behaviour?)
• Behaviour (what is the actual behaviour?)
• Consequences (what happens afterward?)

Antecedents

What occurs before the behaviour (and may have triggered it)?
The antecedents are simply all the relevant things that happened before the behaviour occurred. They can also be considered as triggers for the behaviour, such as:

• things that other people did or said
• emotional state (e.g. depressed, tired, anxious etc.)
• the environment (e.g. hot, noisy, cramped, smell, bright lights).

Managing these antecedents, or triggers, is a proactive way to avoid behaviours occurring in the first place. Here are some useful strategies:

• Build and maintain good rapport
• Avoid or minimize known triggers
• Sometimes a distraction or redirection away from the trigger may be all that is necessary
• Involve the brain-injured person in discussing triggers
• Work together on possible coping strategies in dealing with triggers
• Suggest and encourage these strategies when a trigger occurs.

Graduated exposure to the antecedent

This is useful when antecedents can’t or shouldn’t be avoided. With time and patience, it can be a powerful technique. For example, person X starts screaming in supermarkets due to sensory overstimulation. Her mother says they will just stand outside the supermarket for 30 seconds then go home. The next time, they go in for 30 seconds then go home. This is gradually lengthened until person X has adapted to this difficult environment.

Preparing for the antecedent
An inability to cope with chaos, unpredictability and lack of routine is common after a brain injury. For example, if person X finds the activity and noise of a supermarket unpleasant, it can help to talk about expected reactions and ways to cope before the event.

Behaviour

What happens during the behaviour (what does it look like?)

Before you respond to an actual behaviour, the key is to understand the purpose of the behaviour and what it may be expressing about unmet needs. Although emotions can be running high, there are still strategies that can prove useful during the behaviour itself:

• Stay calm and speak in an even tone
• Give simple directions and prompts about coping mechanisms
• Use non-threatening hand gestures
• Manage your personal safety and remember the strategies agreed on for dangerous incidents
• Recognize when it’s time for disengagement/exit strategies for crisis situations.
• Ignoring the behaviour

In some cases, behaviour occurs to get attention, so the best strategy may be to ignore it. As with many of these techniques, tactical ignoring is best linked with positive reinforcement. For example, a child is ignored during a tantrum, but is rewarded with praise, a treat or favourite activity once the tantrum is over.

Consequences

What are the immediate & delayed reactions from everyone involved? The consequences, or our responses to a challenging behaviour, are very important. For example, a pleasant consequence can simply reward the behaviour, while a negative consequence may discourage it.

Pleasant consequence: “When I yell everyone gives me what I want”.

Negative consequence:  “When I yell everyone ignores me completely”).

The ABC of behaviour is critical in understanding of why we do what we do.