Managing Challenging Behaviours

traffic light

image by blunight 72

Having attended a PD by The Centre for Applied Behaviour Analysis recently, many of the suggestions and advice offered by Geoff Potter, were wonderfully inspiring and it was great to see what a long way we have come in recognising and respecting the dignity and rights of individuals with disabilities.   I am sharing some of the highlights of the session especially for those who work either with adults or students with special needs.

There are of course students with varying degrees of special needs support, emotional and behavioural disorders, learning difficulties and life imbalances, all of which contribute to how they react, respond and relate to peers, teachers,  the demands of school life and other life situations as well as beyond school life. Many  teachers also experience challenging behaviours in students without disabilities, so some of the strategies here can be applied in the general classroom also.

Punishments will not change the behaviour – the behaviour will return when the punishment ceases. This has been proven over time when such treatment as electric shock used to be given to deter individuals from doing the wrong thing – it stopped them at the time but when the treatment ceased, the behaviour returned.

Reactive Strategies

In designing a reactive strategy there are a number of observations and questions that need to be assessed:

  1. What does the behaviour look like?
  2. What precedes it?
  3. What are the consequences?
  4. Cycle?
  5. Course?
  6. Strength?
  7. Frequency?

Every student with disabilities should have a positive behaviour support plan with reactive strategies identified and antecedent control where needed.  The student concerned should be involved in the data collection process to assist with developing strategies to help them.

The purpose of a reactive strategy is to  solve the incident as quickly as possible and safely as possible.

Antecedent Control

The best reactive method is not to have an incident in the first place.  Antecedent control strategies involve the removal or elimination of events, objects or situations that may “set-off’ the behaviour problems should be described including persons, times of day, demands, demand styles, etc. to help avoid triggering the behaviour. A list of the suggested preventative procedures and reactive strategies can be made up – a list of “do’s” and “don’ts.” An example of antecedent control  is: an adult with II became paranoid after hearing about shootings on the news.  Don’t let him watch the news. Write this into a supportplan.

Key to antecedent control effectiveness:

  • Events that cue the presence of the challenging behaviour
  • Events that cue the absence of the behaviour identified
  • Events that cue the absence of the challenging behaviour presented systematically
  • Interrupt the behaviour: redirection, stimulus change etc.
  • Proximity Control: go up close (if safe) and tell them you understand.
  • Facilitate communication: “let’s go and have a cup of tea and talk about it.”
  • Instructional Control: give an instruction to do something.
  • Humour: use humour, funny masks, do something silly etc.
  • Facilitate problem solving: ask for their advice.
  • Facilitate relaxation: give them the relax cue.
  • Active Listening: its special value is when people have strong emotions one major value is that since it is non-directed non-judgemental and it does not serve to further escalate already difficult situations involves reflecting back to the person “the message that they are sending.”  Scenario: someone is screaming close to Mary. She appears to be upset is looking at the person screaming, she is holding her ears and staring at the person screaming. Response: “Tom’s screaming seems to be bothering you. It looks like it is hurting your ears!”

When people begin to show signs of agitation frustration, and they show the early signs of escalating to more severe behaviours, every effort might be taken to determine the problems, and to encourage them to express themselves. Specific questions that might be used include:

Do you have a problem?

Do you need help?

What is wrong?

Counter intuitive strategies

These may run counter to common sense in what many of us believe is appropriate in a support plan for somebody who has severe and challenging behaviour. However, counter intuitive strategies can be powerful in their abilities to avoid or to get rapid control over an escalating or potentially dangerous situation.

For example a man with II would always request a cup of coffee when going past the particular coffee shop. Attempts were made to redirection and refuse him would escalate to physical aggression. The best option is to assist him to get a coffee when he asked even if it meant him having four or five cups of coffee on going out.  To counteract the potential of reinforcing his challenging behaviour in this case by providing the coffee, rules were put into place. The coffee was made available to him and other times in other environments to negate the relationship between aggression and the coffee at a particular coffee shop.  He had a proactive support plan which included specific strategies to teach him to cope with not being able to have a coffee when he went past coffee shop such as relaxation training and covert positive reinforcement imagery training.

There were accurate data collection systems in place to evaluate his progress on his proactive plan.

Stimulus Change

At the time of incident, or when the person is beginning to escalate, the introduction of a novel stimulus or unexpected events may interrupt the course of the escalation.  However, this strategy has limited use and the effect is only temporary. The more often the same ‘novel’ event is used, the less effective it is. For this reason people need to have a wide repertoire of novel things to do and to say they need to remember that one method may work two or three times, but be wary. It is used. These are strategies that can be used to help reduce escalation.  The following have been used on adults in care so not essentially appropriate for school use.

Examples include:

  • Pretend to faint
  • Hooter sound or other unexpected sound
  • Pretend you can smell smoke and go outside to have a look
  • Start singing or dancing
  • Drop a handful of cash on the floor
  • get down on the floor and start searching for something that’s been dropped e.g. contact lenses
  • School appropriate stimulus change:
  • Send student to office with a dud note

Managing Stress:

Symptoms:  Abusing others, tiredness, over reaction to others

Techniques to reduce stress – anyone with challenging behaviour should be taught a relaxation strategy as a coping skill

Progressive Muscle Relaxation (practice until it becomes natural to say  ‘relax’ and person is able to apply)  (there is a book on the CD)   (Note: don’t use this technique with people with cerebral palsy – tightening muscles can cause a spasm). Model and teach the technique (see handbook Relaxation Methods, G Drive).

The goal is to achieve an involuntary response – person doesn’t have to think about it when you say ‘relax’.  They know what it means and can apply it whenever needed.

(A good tip is to use lavender oil in a spray mist bottle to induce relaxing environment).

Alternative strategies can be used with those who don’t have the cognitive capacity to respond. For example, an autistic person may respond better to deep pressure brushing – brushing with a hairbrush.

It is important when designing reactive strategies to be built into a support plan to maintain records to identify progress.  Data collection is an important step in the process to identify the effectiveness of strategies built into support plans.  It is also important to record the incident severity to be able to determine progress or success.   If a strategy is not working, it needs to be changed.  All stakeholders should be aware of what support plans are in place.