Understanding the reasons behind difficult behaviour

I am currently in the middle of marking the assignments of my Dip Ed and B Ed students. The assignment is about researching different types of disabilities and describing how these disabilities effect the social/behavioural, communication, cognitive, sensory, physical and literacy/numeracy development of children.

As I was reading through these assignments I came across a really good summary of the key functions of behaviour displayed by children with Autism. I spoke to Nicole, who agreed that I could share her summary with you....

By Nicole Ribera

There are four primary functions of behaviour, as identified by Helfin & Alamio (2007):

1. To get something (attention/access)

Behaviours occur so the individual can obtain something that is desired. Sometimes it is attention and sometimes is access to an object, food or activity.

2. To avoid (escape) something

Behaviour occurs to allow the individual to escape something that is undesirable. Individuals may want to avoid work that is perceived as too hard, too boring or uninteresting.

Behaviours can also communicate information about the interaction between an individual and their environment. Individuals may communicate through their behaviour that others are too close to them or that they want to be around (or want to avoid) particular people.

Students may become aggressive toward their peers so that they can be sent to the office and avoid an unwanted activity. Students may engage in behaviours so they can escape being the centre of attention or having peers close to them.

3. Sensory-based responses

Behaviour occurs to get pleasurable feedback. Individuals may participate in an activity, movement or behaviour because of the sensory stimulation or feeling that it gives them. An example may be a child may rock, flap or suck their thumb for the sensory pleasure that is received from the action. These behaviours help to reduce anxiety, stress and pressure sometimes felt by individuals.

4. Pain attenuation

Behaviour may occur so that a pain does not hurt as much. For individuals with ASD, their behaviour may indicates pain or discomfort. An individual with a toothache, for example, may hit their jaw. Or if a student has a headache, they may hit their head on the desk.


Reference:
Helfin, L.J & Fiorino Alaimo, D. (2007). Students with Autism Spectrum Disorders: Effective Instructional Practices. Pearson Education: New Jersey USA

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No such thing as evil

“There is no such thing as evil. Youth behaviour that challenges the common expectations and values of society is not the result of inherent wickedness, but is a multifaceted problem emerging from a complex network of factors.” (Leaman 2005 p1)

I don’t think there is anything I want to add to that… I just thought it was a great, thought-provoking statement. It draws attention to what is not always in the forefront of our minds when we are dealing with the most difficult behaviour: that behaviour is very complex and there are many factors both seen and unseen that influence that behaviour.

But, like Leaman, I also want to make that point that this is not excusing behaviour. Rather, it is an attempt to understand it so we can effectively change it.

Leaman also talks about three hidden contributors to aggressive or other disruptive or difficult behaviours.

Low self-esteem

There are many reasons for low self-esteem, but one that children with differing abilities may face more frequently than others is failure. Failure in the classroom. Failure in social relationships. Failure in achieving their potential in other areas.

A child who experiences what they see as failure can be at risk of spiralling into disempowerment and/or depression. For some children this can be seen in bullying behaviour as the child tries to empower themselves. For others it can be seen in both passive and active defiance, or refusals to complete tasks.

For example, it is recognised that children diagnosed with Oppositional Defiance Disorder often have low self-esteem (Better health Channel, 2007). Their refusals to obey rules, swearing, blaming or needling others can be linked to (though they are not exclusively a product of) low self-esteem and the need for power and control. Refusals to obey rules and swearing or bullying others swing the balance of power back in their favour. Blaming others for their mistakes or errors, or simply refusing to attempt tasks, can be a protection mechanism to avoid being seen as weak or having failed in a task. By doing these things they are controlling their environment through intimidation or defiance.

Egocentricity

Acting impulsively or acting without first considering the effect of their actions on others can also be a contributor to aggressive behaviour. For more on this see the previous posts on executive function and the development of empathy.

Internalised anger

Children with Down Syndrome can also be seen as stubborn or defiant. However, the issue is more that, due to their intellectual disability/developmental delay, it is more likely that they do not understand what is required of them (Feeley & Jones, 2006). The difficulty is that they may find it very hard to put into words as their developmental delay and physical difficulties can influence their ability to communicate complex, abstract concepts like emotions. This may be exacerbated by low self-esteem from experiences of “failure”, and thus increase the risk of the child acting aggressively or defiantly in order to express their feelings or protect themselves from embarrassment.

It is important, in this case, to recognise that children with Down Syndrome have been shown to be at increased risk of depression and other anxiety disorders (Pollack, 2009). So responding to the needs of the child rather than focusing on the behaviour is important.


Leaman has some great suggestions of strategies to deal with difficult and aggressive behaviour. If you can get your hands on this book, whether you are a teacher or a parent dealing with challenging behaviour, I am sure you will find it very helpful.


References:

Better Health Channel/Victorian Government. (2007). Oppositional Defiance Disorder. Retrieved 26th August 2009 from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Oppositional_defiant_disorder

Feeley, K. and Jones, E. (2006). Strategies to Address Challenging Behaviour in Young Children with Down Syndrome. Retrieved 26th August 2009 from http://www.down-syndrome.org/case-studies/2008/

Leaman, L. (2005) Managing Very Challenging Behaviour. London: Continuum

Pollack, S.D. (2009) Waisman Center. Retrieved 26th August 2009 from http://www.waisman.wisc.edu/faculty/pollak.html

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Helping siblings and peers deal with aggressive behaviour

Please read the post on Roger’s Chain of Action first or this probably won’t make much sense….

Teaching siblings and peers about the reason for aggression

One of the things we need to do is help to promote some understanding of why one child may be more aggressive than another. This can be done in many different ways, but we need to make sure that we do it in a way that doesn’t label or stigmatise the child who is being aggressive.

For example, I just posted a u-tube video about my book, Dave is Brave. One of the things I highlight is that the book can be use to promote understanding of why children may be behaving a certain way.

In the book Golly is seen to be behaving like a “bully”, knocking children over, taking their toys and so on. As we follow the story we learn that one of the reasons he may have been doing this is that he wanted to play but was unable to articulate this. The questions to be used by teachers and parents at the back of the book highlight this and could be used to help promote empathy in children if they have a child with language and/or social/behavioural difficulties in the classroom.

General discussions about anger, fear, frustration, or playing games like charades where children are trying to get their intentions across without words can also be used to promote understanding of reasons behind aggressive behaviour.

But that is just the beginning. We also need to teach children ways they can protect themselves from aggression in their siblings or peers without increasing the chances of them being hurt. This is where Roger’s chain of reaction may come in useful.

Step one: Tactical ignoring

It is possible to teach children to ignore aggressive behaviour that is not threatening or aimed at themselves. For example, if a child with autism is having a melt-down because something is out of place or their routine is disrupted, their behaviour may be what we traditionally see as a tantrum rather than aggression aimed at other children.

In this case you could have a rule or agreement within your classroom or home that this behaviour will be ignored. You may need to discuss with peers and siblings that if someone is angry or frustrated, and they are banging things or screaming or even throwing things in a way is not threatening to them:
- That they should just keep working or playing.
- That their peer/sibling is not angry at them, just finding it difficult to cope.
- That mum/dad/carer/teacher will deal with the situation.

Step two: Simple direction, rule re-statement, or question and feedback.

If the aggression is a result of difficulties with social activities such as sharing toys and so on, you could teach siblings or peers to use prompting phrases like:
- “Use your words/picture cards/point”
- “Tell me what you want”
- “Do we need to get mum/dad/Ms X?”

These could be accompanied by a gesture such as the one used by Dave in Dave is Brave. And make sure you help the children recognise that they should speak calmly and confidently in these situations.

Step three: Repeat step two or take child aside and give them a clear choice.

If it doesn’t work the first time, teach siblings/peers to try at least three times before calling in the teacher – but only if the child is not significantly hurting them.

Step 4: Isolation, time-out, exit from the room.

As discussed in the previous post, you should have a crisis management plan for when behaviour is putting others at risk of being significantly hurt. At this point, peers/siblings could be taught one of two actions.

1. If they are not being closely supervised by an adult, to remove themselves from the vicinity of the child and seek adult help.
2. If they are being closely supervised by an adult, to calmly follow an agreed crisis procedure. This should be practiced just as a fire drill might be practiced.

Many schools have “lock down” procedures in place. For example, I heard of one school whose children promptly and calmly protected themselves with their chairs and filed out of the classroom in response to a teacher’s signal. Then they were re-located to a different room which was then locked so that the child (who was being supervised by a teachers aide) could not cause harm. The children then continued learning whilst procedures were put in place to help the child who was distressed and displaying aggressive behaviour – which may include calling in the police in extreme cases.


Reference for Roger’s chain of action:
Brady, L. & Scully, A. (2005). Engagement: Inclusive Classroom Management. Sydney: Pearson Education.

Safety in schools NSW DET document:
http://www.schools.nsw.edu.au/media/downloads/schoolsweb/adminsupport/safetysecurity/htbass.pdf

Crisis management flow-chart from the Spastic Centre
http://www.thespasticcentre.org.au/services/about_tsc/policies/s10-05.pdf

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The dreaded power-struggle

“Mark, can you sit down and do your work please?”

“No.”

“Mark, sit down please.”

“I don’t want to.”

“Sit down.”

“Why?”

“Because….because you need to do your work.”

“I don’t want to.”…

Half an hour later.

“MARK THOMAS ANTHONY PETERSON! Put your BOTTOM on your SEAT or… or…”

“What are you goin’ #$%#$% do?” You quickly duck out of the way of a flying chair. “I said I don’t want to do it!!”

Angry, you confront him and say “Don’t you throw things at me!”

“I will @#$%@ do what I @%%# well like!!!”

…..

Have you ever been caught in an un-winnable argument like this? I have come close with a few children aged between 8-11 who were diagnosed with oppositional defiance disorder, ADHD or bi-polar disorder.

But I usually remembered just in time the important techniques that ensure the child, myself and other children around did not get hurt. Here is one of the techniques that helped me diffuse the situation.

Roger’s Chain of Action

Let’s re-tell this scenario following Roger’s “chain of action” (cited in Brady and Scully, 2005).

It’s homework time at home, or deskwork time at school.

You point to your schedule which is hung on the wall. “Okay, everyone/Mark. Its nearly time to work at your desks/do your homework. You will need your pencil case, your Maths book and your ruler (you write this on the board/on a sticky note and put it on his desk). I’ll set the timer for five minutes so you can get ready.”

Mark is clearly not moving. He looks in your direction to see what you will do.

Step one: Tactical ignoring

You decide to see what will happen if you ignore. The minutes tick away. Mark starts to do things like flicking spit-balls at his sister or throwing small projectiles such as his rubber at his peers.

Ignoring is obviously not working.

Step two: Simple direction, rule re-statement, or question and feedback.

As you are wandering around helping others, you stop close to Mark, ensuring you have his attention without getting “in his face”.

“What are you meant to be doing, Mark?”

“I dunno.”

“You can check the schedule if you don’t remember.”

“I’m not dumb.”

“I know that.” said with a genuine, warm smile. “So what are you meant to be doing?”

Mark reluctantly tells you.

“That’s great! You should have just enough time. There’s still one minute on the timer.”

He starts getting ready, albeit mumbling, “I hate maths!” But you have walked away and ignore this. You know he is capable of the work you have set, and he knows you are willing to support him where necessary, so discussion is not necessary and will only prolong the argument. Though you may want to quickly state these facts before you walk away.

Unfortunately, he discovers a tempting projectile in his equipment and starts to set up a catapult using his ruler in order to release some of his frustration. He’s not ready to stop fighting yet.

Its time to act quickly.

Step three: Repeat step two or take child aside and give them a clear choice.

You don’t waste time with reviewing what he is meant to be doing. Someone may lose an eye.

You put your hand on Mark’s catapult and ask him calmly, “Do you want to do this now, or during recess/your favourite TV show?”

“You can’t do that!” He is hanging for a showdown.

Calmly you say, “It’s your choice. You have about 30 seconds left on the clock.” Then you walk away (with the ruler and the projectile).

Conclusion 1: It works (and it usually did for me)

The success of this process relies on you having built a rapport with the child, respecting and caring for their needs. It also requires firmness, confidence and consistency in application. If you fail to follow-through with choices at any time the child will not take you seriously.

So don't "threaten", just state facts about what is going to happen.

Conclusion 2: He opts out and starts throwing larger projectiles.

So…

Step 4: Isolation, time-out, exit from the room.

Have a crisis management plan in place to respond to any escalating aggression.

At home:
You may have a punching ball or “outburst” space where he can have it out safely.

Or, if possible, remove Mark to his room where anything he breaks has consequences for him rather than the family – though it is likely that this could start another argument and you will be unable to get him out of the room.

Another option is to remove yourself and any other children to a different room.

But there must be consequences after the outburst has subsided. That is, you must follow through with the choice you gave him. So Mark will have to do his work later and miss out on his favourite show.

At school:
Have a “buddy teacher” who is in a room close-by to whom Mark goes to “cool down”. The buddy teacher will have a desk close to the door where he can sit unobtrusively. It would also be important to have some physical outlet, such as a stress-ball. Though just walking between rooms (always being within sight for duty of care reasons) may be enough for some children.

Alternately, you may have a telephone in your room and an agreement that you can call either the principal, the deputy principal or the head teacher for welfare, who will then come down and either remove Mark or stay with him whilst you move your other students to do their work in the lovely sunshine or the library as the case may be.

But, again, you must follow through with the choice you gave him. So Mark will either work on his Maths with you or another staff member (such as the principal or in the library) during recess.

This should be seen as a natural consequence for his actions, rather than a “punishment”, especially if (as his actions suggest) Mark is struggling with self-esteem or self-efficacy issues.

If you follow these steps you might find that you have avoided a power-struggle and saved yourself and others a lot of time and angst.


Reference:
Brady, L. & Scully, A. (2005). Engagement: Inclusive Classroom Management. Sydney: Pearson Education.

Interesting reading:
http://www.thespasticcentre.org.au/services/about_tsc/policies/s10-05.pdf
http://education.qld.gov.au/health/pdfs/healthsafety/mh-casestudy-behmgt.pdf
http://www.disability.wa.gov.au/dscwr/_assets/main/instructional/documents/doc/crisis_managment.doc
http://www.kidsguardian.nsw.gov.au/example-folder-5/Accreditation/Guidelines/guide_behav_mngt_v1.0.pdf
http://www.dadhc.nsw.gov.au/NR/rdonlyres/22C82E91-4AAA-4FB0-8C7C-C4C6F1DA3AD9/4576/behaviour_support_policy_january_2009.pdf
http://www.family-advocacy.com/help/Risk%20management%20flowchart%20for%20student%20behaviour.pdf
http://www.family-advocacy.com/help/DET%20risk%20management%20plan%20proforma,%20sample%20&%20guidance.pdf

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Violence in the Media and aggression…

Over many years, there has been a debate raging around this issue. I don’t want to enter into that debate here, but I do want to talk about the things we need to consider when we are making decisions about what our children watch or what video games they play.

How might aggressive behaviour develop?

There are a number of theories about the development and occurrence of aggression across different stages of child and youth development. Kirsch (2006) provides a good overview if you want to read more. However, here I just want to quickly summarise these.

Some children may be more wired towards aggression
This has to do with personality characteristics and the outcomes of disorders such as Autism, Attention Deficit Disorders and Developmental Delays. These children aren’t necessarily going to act aggressively, but due to impulsivity, difficulties with problem-solving or other aspects of cognition they are at higher risk of developing aggressive behaviour depending on what they see, hear and experience.

We learn many social skills by observing
What we see and hear has a great influence on how we behave. It influences our sense of what is “normal” and acceptable. So if we are constantly seeing others act aggressively, whether in real life or in the media, we are more likely to accept this behaviour as “normal”. We may even start behaving more aggressively. This has been described as de-sensitisation.

The other effect is that we can develop a different definition of what constitutes aggression or unacceptable behaviour. This may lead to us not responding in the same way to aggressive behaviour in others. So if I am exposed to swearing and the yelling of derogatory comments regularly, I am less likely to feel that I am being treated unfairly or being bullied when someone yells and swears at me. And while it does not necessarily follow that this behaviour does not affect me emotionally, it can mean I don’t defend myself or communicate to the other person that this behaviour is unacceptable.

Our experiences reinforce what we see
What we experience in our lives, and what those who we trust and love do around us, can influence whether we take on what we see. For example, Kirsh discusses research that suggests that the effects of what children see in the media can be increased or decreased through discussions with teachers and parents. For example, what children learn from educational shows or documentaries is increased if teachers or parents explicitly discuss the content of the shows with them. On the flip side, the effects of a scary movie can be reduced by the presence of an adult if that adult makes the child feel safe. And violence in the movie can be put into perspective through discussion of social values and/or the difference between real life and what they have seen.

Aggression may not be evident immediately
In some cases, the influence of violent media can be evident immediately. For example, when I was working in a child care centre there was definitely an increase in children playfully or intentionally hurting each other with “karate” moves during the “Ninja Turtle” craze. For the most part this behaviour could be shaped and changed through discussions and behaviour modification techniques, but for some children it became a significant bar to their relationships with their peers.

However, it is the more long term effects that we can’t predict and are less likely to be able to manage. For example, the American Psychological Association (2003) reports on a 15 year study of 329 people which showed that children who watch a lot of violent media early in life are at greater risk of becoming physical in domestic arguments, or having been convicted of crimes.

There is also the concern that children who have a tendency towards aggression may enjoy watching it, which in turn could lead to a warped view of what is acceptable and what is not.

Triggers for aggression
So if a child comes to think of aggression as being part of life and an acceptable way of dealing with problems, they are more likely to have a physical response to social problems such as arguments, debates, insults, frustration and anger. It is the latter emotions that bring about aggressive behaviour.

What we need to consider for children of differing abilities

Taking things literally
We need to be especially thoughtful about what our children watch if they tend to take things literally. For example, children with intellectual disabilities may find it very difficult to understand that there can be a dual set of values – one for “real” relationships, and one for the shows they watch. They may take statements or modelled behaviour in the media literally. So watching on thing, then hearing another from their parents or teachers, can be a very confusing experience.

Children who have Autism and Aspergers may also struggle with this as they also tend to have a very literal, black and white view on the world.

Difficulties with self-management
Children who have difficulty thinking about consequences or the effects of their actions on themselves or their peers before they act can also be at greater risk of being influenced by repeated exposure to aggression in the media. For example, children with ADHD often act impulsively in response to their feelings due to the difficulty with executive function (see previous post). So they need extra support to get into the habit of controlling their behaviour. Repeated viewing of uncontrolled or inappropriate behaviour could mean that this behaviour becomes habitually seen as acceptable.

Ongoing frustrations and feelings of failure
Children with a wide range of difficulties, including physical and sensory disabilities such as cerebral palsy and vision or hearing impairments, experience many frustrations and challenges throughout the day. They may find themselves tired or unable to effectively communicate what they know, want or need to others. The way they respond to these feelings is not only shaped by their natural, impulsive response. It is shaped by what methods they have learnt to deal with this situation. So, again, if they are seeing inappropriate models in the media, it may influence their behaviour.


Conclusion

So while the media can’t necessarily be blamed for aggressive behaviour, it can be a contributing factor. And for children with differing abilities, we need to make sure that all our hard work teaching positive social skills isn’t being weakened by repeated exposure to media that communicates contradictory values and inappropriate approaches to problem-solving.

So when you are deciding on media use in your family or classroom, consider the content in the context of the values and skills you want your children to learn. Also consider how much/how often they view movies, videos, TV shows and play computer games. And, finally, consider whether they do it unsupervised and how much you talk to them about the content they have seen. Because, in the end, the values and social skills you model and communicate to your child will be a significant factor in helping them process the information in a balanced way.


References:
Kirsh, S.J. (2006). Children, Adolescents, and Media Violence: A Critical Look at the Research. London: Sage Publications.

American Psychological Association. (2003). Childhood Exposure to Media Violence Predicts Young Adult Aggressive Behaviour, According to a New 15-Year Study: Children Who Identify with Aggressive TV Characters and Perceive the Violence to be Realistic are Most at Risk for Later Aggression. Retrieved 16h August from: http://www.apa.org/releases/media_violence.html

American Psychological Association. (2004). Psychologists Help Protect Children from Harmful Effects: Decades of psychological research confirms that media violence can increase aggression. Retrieved 16h August from: http://www.psychologymatters.org/mediaviolence.html

Want to read more:
http://spil.medieraadet.dk/upload/04a_melb.pdf This is the best article. I recommend reading this.
http://ultimateparenting.com/pdf/violence_in_the_media.pdf
http://www.commonsensemedia.org/impact-media-violence-tips
http://www.media-awareness.ca/english/issues/violence/effects_media_violence.cfm
http://www.youngmedia.org.au/mediachildren/index.htm
http://www.psychologymatters.org/videogames.html
http://www.psychology.iastate.edu/faculty/caa/abstracts/2005-2009/07BA.pdf

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The Therapeutic Teacher.... or Parent

Image from Dave is Brave. Copyright A.Gray and D.East.

Since bringing up the issue of dealing with aggressive behaviour I have heard a range of comments from parents, teachers and teachers in training.

Some of the concerns for beginning teachers revolved around the fear of whether they could deal with difficult behaviour in the classroom. Both parents and teachers have asked the question, “How can I make sure I support the child displaying the aggressive behaviour whilst still protecting the other children around them?” Other concerns revolve around the issue of the stress and potential harm to themselves.


The challenge of dealing with ongoing challenging behaviour

If we are not careful, the challenge of dealing with ongoing aggressive or difficult behaviour can affect our own mental health. Parents and teachers can become anxious, stressed, tired or even “burnt-out”.


The Therapeutic Teacher

Abrams (2005) wrote an article called Becoming a Therapeutic Teacher for Students with Emotional and Behavioural Disorders. While he is talking about teachers, it is possible that the ideas expressed in this article could be helpful for parents as well.

Abrams discusses research and principles of working with children who have aggressive or challenging behaviour with the aim of balancing the need to manage teacher stress whilst providing adequate support for the students. He argues that the two go hand in hand.

If we can set up an environment that helps prevent the escalation of behaviour, then both the students and the teachers are likely to benefit.


Empathy

One of the key characteristics of a therapeutic teacher is the ability to see beyond the behaviour and focus on the whole child. That is, instead of punishing a child for outbursts or tantrums, the teacher first thinks about the triggers, or the emotion behind the outbursts.

This approach helps us recognise the function of the behaviour (as discussed in the last post), and thus helps us to change or reduce the incidences of the behaviour. It helps us be proactive instead of reactive. Which, in the end, takes much less emotional energy and is much more rewarding – for both the adult and the child.

It also helps us listen and respect children more. It helps us see the child as someone with interests, strengths, needs, abilities… not just an “aggressive child”. As Abrams says, “Therapeutic teachers show respect for each student’s dignity, even when the student engages in antisocial behaviour.” p41

Consistency and routine

One of the most important tools in dealing with behaviour which benefits both adult and child is consistency and routine. Again, this is about preventing difficult behaviour as much as dealing with difficult incidents when they occur.

This can be something as simple as designing a few positive rules, rewards and consequences that the students have had a hand in designing. Reinforcing these calmly, consistently, positively and supportively can have a significant influence on the interactions within a classroom or home.

Routines, or a set sequence of activities throughout the day, can also be very helpful. Children with anxiety issues, difficulty adjusting to change or new experiences will benefit from set routines. These can be represented in a written or pictorial routine displayed and with which the child can interact. For example, putting a sticker next to a completed task. Or removing a picture from a sequence of pictures stuck on a surface using Velcro. This helps them feel in control, and makes the environment predictable and safe – and can be a good basis for rewards.


Organisation and confidence

But, importantly, the success of our strategies not only relies on our respect for our students or an understanding of their needs. It also requires organisation, confidence and a willingness to continually learn.

This means that if something doesn’t work, we don’t feel guilty or beat ourselves up. It is about approaching each day as a fresh start, for both ourselves and our children, and learning from past experiences.


Being realistic – yet hopeful

One of the things that does seem contradictory in Abram’s discussion is his assertion that we need to be realistic while remaining hopeful and optimistic. As discussed in a previous post, it is often a difficult thing to find the balance between high expectations and what we can realistically expect. This is especially difficult when it comes to behaviour.

But if we take one step at a time, one moment at a time, we are more likely to be able to celebrate the small steps without being overwhelmed by the difficult times.


Managing stress

I particularly enjoyed Abrams’ recommendations about stress management. Perhaps we should make it a checklist:

Am I realistic about what behaviour I might encounter tomorrow?
Am I approaching tomorrow with a positive attitude?
Have I set priorities and scheduled my time?
Am I eating well?
Am I exercising?
Am I having enough rest?
Do I have a hobby?
Am I flexible and adaptable?
Am I keeping my sense of humour?
Am I giving myself permission to feel tired/angry/sad/other?
Have I debriefed with a friend/colleague/partner/parent?
Have I come up with ways to deal with the cause of my emotion?
Am I recognising and accepting things I can’t change?
Do I realise that I am not superwoman/superman?

I don’t think I could check all the boxes, but it does help a little to know what to aim for…

Reference:

Abrams, B.J. (2005). Becoming a Therapeutic Teacher for Students with Emotional and Behavioural Disorders. Teaching Exceptional Children, 38(2), p40.

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Ask Amanda ... a student who is under three and displaying aggressive behaviour

Amanda, I have a new student who is two and a half. He is extremely impulsive, he cannot have anyone near him that he is not being aggressive to them, to the point where if I am near and pick him up, touch him or in any way try to talk to or remove him from the situation (hitting repeatedly, punching, pushing etc.) he will with one hand try to stop me while continue to strike out at the child. I think he has some form of spectrum disorder, his other behaviors are what appears to the other adults including his parents to make him 'gifted' his speech is very articulate overly complex sentencing (he is 2) but he repeats everything (very clearly) which I think is echolalia (sp?) not cognitive language use.what can I do to help him stop hurting others.

I am meeting with the parents and right now I will just ask them how he is at home types of questions. I have only had this child for 2 weeks and want to set up a good relationships with them. I have learned to approach with caution when this type of issue arises. Thanks Beth


First I just want to apologise for taking so long to answer this very tricky question. The world has been spinning very fast lately.

But now I have time to sit, think and answer your question.

I can’t suggest a quick fix

This difficulty is not something that can be addressed easily. It will take time and some investment of energy. However, I may be able to suggest some practical things you can do to help improve things over time.

I will also shy away from suggesting a diagnosis etc. That is up to the psychologist, paediatrician or other medical professional.

Step one: Formal Observation

The first thing you may need to do is take a step back and really observe what is happening. It may even be worth getting a third party in, for example another staff member who works in your centre, to watch what is happening.

The purpose of this is to get a better picture of what is going on. It will help unlock some clues to why he may be behaving this way.

Observational tools:
The observations should be written down. This written account should be factual rather than an interpretation of what is happening.

There are many forms of written observations. But you may find a couple of these useful.
Firstly, the simple anecdotal observation (click here or here for more info). That is, the observer watches for a certain time period and records everything that is happening. Not just what the child is doing, but what others around him did and in what setting it occurred.

The second example is an ABC observation.

A= Antecedent: Write down everything that happened before the child began to display the inappropriate behaviour. This includes anything that other children did, what setting they are in, what was said etc.

B= behaviour. Record exactly what the child did.

C= consequences. Record the responses of those around him. That includes the response of the other children, as well as the response of the staff.


What might be the function of his behaviour?

Read this previous post for more information on funcational behaviour assessment. However, the description of the behaviour you have given suggests to me a couple of purposes the child’s behaviour might have. However, these are only guesses as they are not based on full observations as described above.

1. A reaction to proximity
He may have sensory integration issues and subsequently have difficulty sharing space and equipment. He may not be able to endure the proximity of others, and his behaviour is his way of communicating this.

I did read somewhere else that when reprimanded he says he won’t do it again. But if it is due to sensory integration issues, and he has difficulty with social communication, he may not be able to change this behaviour without consistent and explicit support. He will continue to react impulsively in order to protect himself from the intrusion of others.

If this is the reason for his behaviour, removing him from play may seem very unfair to him as he will feel he is being punished for his anxieties or for what other children are doing. And it is unlikely that he will be able to articulate this in any other way than trying to continue lashing out whilst being removed.

What can you do in this instance?
- Set up a safe space that he can retreat to without fear of intrusion. This can be done using a mat, book shelves, cushions or a chair and table. All children should be told that this is a quiet space and only one person can be there at a time. In this space place a couple of the child’s favourite games. But this is only a starting point as you don’t want to always isolate the child from other children.
- Have a routine session every day based on a turn-taking game. This needs to be a quiet, highly structured game where only one child has a turn at a time. Start with just one or two other peers, and sit between them and the child. Let the child pick the children he wants to play with in this session. As the child gets used to this routine you may find that you can start introducing more children and less structured games. But it may take some months before your intervention is not needed.
- Use the child’s echolalic language skills to teach appropriate communication alternatives to his aggression. For example, teach him to say, “Move, please!” using an appropriate hand gesture when children get too close.

This is not a comprehensive list, but it may be a start.

2. A desire for interaction but limited social skills
I have worked with a number of children who have an intense desire to interact with others and play the same games but end up ostracising their peers because they don’t know how to get involved without aggression. There was a boy who wanted to play tips, but kept being isolated by staff because he was running around punching children. It turned out this was his invitation or his request to play tips. When he was taught how to play, and taught specific language to ask others to play, he ended up with a nice little bunch of playmates.

So if this is the case it is again not surprising that the behaviour isn’t changing. He may not be able to identify why it is wrong, or exactly what behaviour you want him to stop. He may also have a sense that is it “not fair” that he is being isolated when other children are playing together - even if he couldn't articulate this.

What can you do in this instance?
It will be about teaching specific social and language skills. Your observations will be able to tell you which skills are most relevant, but here are some ideas.
Language (teach a gesture or makaton sign language to go with this):
- Can I play?
- Can I have a turn?
- That’s mine. You can have it later.
- Can you move, please.
Social skills:
- looking at facial expressions and identifying when others are sad.
- Turn taking
- Sharing space and equipment

How could you teach these?

Social stories:
My book, Dave is Brave, is like a social story. It demonstrates a sequence of events that occur in consequence of aggressive behaviour, with pictures to illustrate facial expressions and emotions of others. It also has key phrases like, “Can I play?” demonstrated as an alternative to aggressive behaviour. (Sorry if this sounds like advertising, but I wrote the book for children with these sorts of issues so you may find it useful)

You could use this, or you could work with the student to design your own short picture sequence. You could do this by taking photos (with parent permission) of a short role play. Two photo sequences could be:
1) photo of him watching others playing
2) photo of him role playing pushing another person
3) photo of another person being sad
4) photo of him sitting by himself, not able to play with others
Second sequence
1) photo of him watching others playing
2) photo of him asking, “Can I play?” with a smile and appropriate gesture
3) photo of another person smiling back
4) photo of him sitting with others, playing together.

You could also look into using PECS such as Boardmaker and those seen on the do2learn website. This will help make language more meaningful for him if he learns well through visuals.


Responding to aggressive incidents

While he is learning these new skills, you will still need to have a way of managing or responding to aggressive incidents.

If you think that his behaviour might be due to sensory integration issues, or a difficulty with the physical proximity of others, you might want to do the following:
- Manoeuvre yourself in between him and the child he is lashing out at.
- Firmly but calmly and gently say, “Stop” with a stop hand sign
- If he doesn’t stop after 2 or 3 requests, point to his quiet space and ask him to take his toy to that space, re-assuring him that he can come back to this play space when he is ready to be settled (choose a word he can understand and use that same word all the time, you may even have a picture of the quiet space and being “settled” to help him understand what you are saying)

As much as possible, avoid physical contact. Try and shepherd him to the quiet space rather than physically move him if possible. You may also find that taking his toy to the quiet space will mean he comes with you.

If you think his behaviour is due to poor social and language skills, follow the same process. But instead of just saying, “Stop” get him to repeat a key phrase such as, “That’s mine.” with appropriate gestures so other children can understand him.


Conclusion:

The bottom line is that anything you do will take time and energy. You and anyone else working with the child will need to be consistent, repeating exactly the same process and exactly the same words every time an aggressive incident occurs. Remaining calm will be very important.

And if one thing doesn’t work after you have given it a good go (eg one month), do another observation and analyse whether you might need to think about the behaviour having a different purpose behind it.

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Children with Aspergers and Empathy

Just thought I would pop up a link here about the current discussion and discoveries about children with Aspergers and empathy: http://www.thestar.com/printArticle/633688

It was forwarded to me by a friend and parent/advocate for children with Aspergers. Basically it is about the theory that children with Asperegers do not, as may have been thought previously, have an inability to empathise with others. Instead, it may be that they are so sensitive to the emotions of others that they may not be able to cope with the feeling and thus "shut down".

This could mean that the child withdraws, or avoids eye contact or physical contact, or uses other avoidance behaviour.

So this is an important thing to keep in mind when working with children who have Aspergers.

http://www.youtube.com/watch?v=IrNlqgfSq0U if you want to hear it from someone else.

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Why so quiet?

In the first week of every month you may have noticed that my blog goes a bit quiet. That is because I am busy putting together and distributing the Learn to be Buddies newsletter.

This newsletters gives you updates on the products related to the first book in the series, Dave is Brave. This is a picture book that sounds like a social story, and has realistic pictures designed to help children learn about facial expressions, emotions, language, bullying behaviour and defending themselves from bullying.

The Learn to be Buddies newsletter updates you on ways you can be in the running to win copies of the book and related products. This month we are running what I am calling a "Not-Just-Colouring-In Competition."

Also, if you subscribe to the newsletter at http://www.learn2bebuddies.com.au/ your newsletter will come with an easy-to-print pdf article on the last month's blog topic.

If you want a copy of the August newsletter, send a request to amandag@learn2bebuddies.com.au

If you want to receive the monthly Learn to be Buddies newsletter, and be in the running to win a copy of the book read aloud on DVD, subscribe to the newsletter by clicking here, or sending an email with the topic "I want to subscribe" to amandag@learn2bebuddies.com.au

And I promise I will be back blogging early next week...

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