Introduction on challenging behaviour

Introduction on Challenging Behaviour By the Children’s Therapy Team.

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Aim of the session: • To identify that parents/carers are experts when it comes to their child/ren.

• Enable parents/carers to gain a better understanding of what challenging behaviour is.

• Empower parents/carers to improve their abilities to manage their child/ren’s behaviours, thereby improving their child/ren’s quality of life.

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Content:

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What is Challenging Behaviour.

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What is Learning Theory.

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What are the risk factors of Challenging Behaviour.

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Possible reasons for an individual exhibiting Challenging Behaviour

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What types of Challenging Behaviour are there.

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How can we prevent Challenging Behaviour: Positive Behaviour Approach

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What can we do if Challenging Behaviour occurs.

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Explanation of terms used:

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General suggestions.

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Useful contacts.

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What is Challenging Behaviour: • Definition: Culturally defined behaviours of such intensity, frequency or durations that the individual or others are at risk of serious harm.

• Behaviours that limits access to community activities. …we are caring and compassionate

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What types of Challenging Behaviour are there: • • • • • •

Spiting.

Kicking.

Punching.

Shouting.

Screaming.

Throwing things

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• Smearing.

• Self-injurious behaviours • Sexually inappropriate behaviours.

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What is Learning Theory: • BF Skinner’s theory on learnt behaviour.

• Behaviour is learnt.

• If a behaviour can be learnt, it can be unlearnt.

• Behaviours that make us feel good or get us what we want will be repeated (reinforced).

• Negative or Positive reinforcement will strengthen a behaviour. …we are caring and compassionate

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Psychosocial Factors • Negative Life Events • Traumatic Events • Lack of Communication Skills • Poor Social Networks • Lack of Meaningful Activity • Mood Regulation Problems …we are caring and compassionate

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Behaviour is Communication

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What are the risk factors of challenging behaviour: personal factors, such as: • A severe learning disability • Autism • Communication difficulties.

• Visual/auditory impairment • Physical health problems • Age: teens to twenties.

• Mental Health.

• Sensory processing difficulties.

• Adhd.

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What are the risk factors of challenging behaviour: Continued Environmental factors, such as: • • • • •

Social environments.

Social/emotional environment.

Sensory under/over stimulating environments.

Developmentally inappropriate environments.

Changes to the environment.

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The physiology of the brain when triggered?

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Introduction on Challenging Behaviour Part 2 By the Children’s Therapy Team.

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ABC’s of Behaviour • Setting Events • Antecedent (Trigger) • Behaviour • Consequence

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My ABC charts Antecedents (What happened before the behaviour occurred)

Behaviour (Description of behaviour)

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Consequences (What happened after the behaviour occurred).

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Time Sampling Chart: Baseline.

Bangin g Head:

Mon

Tues

Wed

Thurs

Friday

Sat

Sun

7-12

12-5

4-9

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Positive Behaviour Support

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Proactive Behaviour Strategies • Preventative – Managing the environment, avoiding stressful situations, using diversion/distraction • Developmental – Teaching new skills, behaviours & coping skills

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Reactive Behaviour Strategies • Planned ways of managing when behaviour is happening or starting to happen • Establishing ‘safe situational management’ as a last resort

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Responding to Meltdowns

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Punishment & Meltdowns

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How can we prevent Challenging Behaviour: Looking at the triggers in the environment • • • • • •

Sensory needs.

Anxiety levels Place Crowds Colours Communication System …we are caring and compassionate

• Temperature • Difficult demands • Over and Understimulating places • Lack of choices • Being tired, hungry or thirsty …we deliver quality and value

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How can we prevent Challenging Behaviour: Teaching new skills 

Using Strengths to overcome weaknesses: All-about me.

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Communications skills: PECs, photographs, objects of reference, intensive interaction, positive reinforcement without action.

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Social interaction skills: social skills training, social stories, modelling and shaping behaviours by using videos and tape recorders

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ADL’s Specific difficulties: Social Stories, videos, tape recorders, hand over hand.

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Sequencing difficulties: Breaking the task down and using backward chaining, Visual Timetable, First and Then, feedback and feed forward.

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Transition difficulties: Visual Timetable, First and Then, A count down to when the activity is going to finish.

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Making choices: Using two items so that the individual can make the choice. …we are caring and compassionate

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What can we do if Challenging Behaviour occurs: Plan of action 

Complete ABC charts.

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Identify the unwanted behaviour. (Target behaviour that if absent would improve the child’s quality of life)

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Obtain a baseline for the unwanted behaviour. (How many times the behaviour occurs in a fix time). This will enable you to identify if the unwanted behaviour is reducing over time.

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Identify a behaviour that could replace the unwanted behaviour. (Wanted behaviour).

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Use positive reinforcement (verbal praise etc) every time the wanted behaviour occurs.

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If safe to do so ignore the unwanted behaviour

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What can we do if Challenging Behaviour occurs: Plan of action (continued) 

if unable to ignore the unwanted behaviour then use minimal interaction skills to enable the child to calm down safely.

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Give the child space by using timeout to calm down. This could mean everyone else leaving the room.

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Once the child has calmed down use distraction techniques.

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There is evidence to prove that punishments do not work and especially with children with a Learning Disability.

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Refer into the appropriate professional.

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Key points: • Staying calm. Remember ‘Body language talks’.

• Communicating in a manner that your child can understand.

• Communicate to your child in a positive manner ie telling your child what you want them to do rather than what you don’t want them to do.

• Use terms such as ‘stop’ rather than ‘no’.

• Using visual aids to support your child to understand what is being said to them.

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Key points continued Using objects of reference.

Implementing routines.

Implementing boundaries.

Using distraction to avoid meltdowns.

• Being consistent.

• Looking after yourself.

• Ask for support.

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Useful Resources

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Plan for the next 6 weeks • Use ABC charts for the most concerning behaviour • Try some of the pro-active strategies suggested • Make a plan for reactive strategies when things get difficult • Use some of the recommended books/resources with your child …we are caring and compassionate

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Useful Contacts: • • • • • • • • • • • •

Nice guidelines: https://www.nice.org.uk/guidance Local Support groups.

Magic:01634 570706 ADHD support group:01634 851312 Valiant Swimming Club:01634 721208 Woodlands Youth Club:01634 335474 National Support groups.

Challenging behaviour foundation: http://www.challengingbehaviour.org.uk/ Facebook groups https://appts.beta.nhs.uk/rally-round/ Charities.

Resources: http://www.sparklebox.co.uk/ …we are caring and compassionate

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Reference List: • Nice Guidelines (2015) Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges. Nice.

• Emerson, E. (2001) Challenging Behaviour: Analysis and Intervention in people with severe intellectual disabilities. 2nd Edn. United Kingdom: Cambridge University.

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