Do you have any tips for dealing with challenging behaviour?

Chris_Alumni

We're currently working to produce an informative tips page aimed at helping parents and carers of children and adults with complex needs to deal with difficult and challenging behaviour. To this end, we're keen to hear what tips our community members have to share on the subject, and the best will be included on the finished tips page. 

If you've got a tip for dealing with challenging behaviour, let us know by commenting below.

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iza

Hi @Chris_Scope, 

I think the best one I learn throughout life is to make the person/ child to count to 10 and take deep breathe at the same time. 

I think that my little tips could count here  

Iza 

MrsLogic

My son has ASD and ADHD and can be very challenging at times, as am I with my own diagnosis.  Planning seems to work well - especially with visual clues.  I think that I'm right in saying that writing a step-by-step guide to future events is a key to success.

paulamarie1222

Hi Chris_Scope,
My son is 19 now with a diagnosis of atypical autism with speech and language delay. He had big behavioural problems which were escalating.
   At the age of 3 we embarked on a home teaching programme under the supervision of the London Early Autism Programme.  We did individual 1-1 ABA teaching of an individual structured program, tailored for his needs. He was taught what items were to begin with, by touch first (receptive), and then by expressive, which helped to reinforce what he had learned. There's so much more to this but I don't want to write an epic. lol.
This teaching is Applied Behavioural Analysis which is tailored to each individuals need. There are 3 ABA schools in the uk now, one being The Treehouse school. 
If anyone is thinking of embarking on this as a home programme, I'd be more than happy to talk about our experience.

 A lot of his behavioural problems were out of frustration of not having the language to express himself or communicate plus he had difficulty in processing the language which he heard. He had the double wammy too, of finding busy places and sudden change difficult to cope with. This home tutoring was costly and time consuming but the long term benefits to the child, is huge. We fund raised in the beginning. We also secured 17,500 from the Local Education Authority on an annual basis because they had no school that could meet his educational needs. I can share my experience and give tips on this too.

Doing research into other support provisions out there is key (for those who have time to do it) as information is not forthcoming and very fragmented (but charities like this are very useful).

We also found the same as MrsLogic, that visual clues and step by step guides to future events, are so helpful.

will22

I’ll quickly rack my brains….

Tips on dealing with challenging behaviour are quite tricky. What behaviour are you actually dealing with? Self-injury? Aggression? Refusal? I’m going to steer away from tips on dealing with specific behaviours towards something a little broader.

 

1. Remember you’re ‘dealing’ with a person. Behaviour does not occur in isolation. It’s part of a dynamic between people and the environment and the disability/deficits/difficulties that a person has. And underneath all these layers of complexity there is a person who just wants to get on in the world and be happy, whatever that means for them.

 

2. Understand the person. Steve is a 6 year old boy who is banging his head off a wall. Susan is a 47 year old woman who throws furniture at people. Pam is a 19 year old woman who refuses to get out of the car….

Any plan, any intervention and management strategy must be built on understanding why these behaviours are happening. Why does this person, with these needs at this point in their life in these situations show these behaviours? You can manage an incident as well as you possibly can, but if you’re serious about managing these behaviours long term, and most of all supporting this person in a way so that they are in a position where they do not need to show these behaviours then you have to try and understand them. Can you really answer the question ‘these behaviours occur because…’ Can the person providing you with a support plan or any form of intervention answer this question?

3. He hits me when he’s angry is not explanation enough. Many behaviour assessments or support plans sum up a particular difficulty with ‘When so and so happens the behaviour occurs. When so and so gets angry/doesn’t get their own way the behaviour occurs.'

These are good pieces of information about when a behaviour might happen. But they’re not enough on their own. I get angry but rarely hit people. When I don’t get my own way I very rarely break the furniture (Christmas day board game rage aside). Sometimes when people with learning difficulties or complex needs don’t get their own way they can show challenging behaviour –but to truly find a way around this you have to be able to try and understand what skills this person doesn’t have or that are impaired in order to help support them to not show behaviour when they’re angry. Can they communicate their feelings? Can they understand their feelings? Is it fair to pin the blame on someone 'Kicking off when they don't get their own way' if their functional impairments make it hard or impossible to control their emotions in situations that cause them distress?

 

4. Support plans should be more than, ‘what do I do when….?’ The biggest question on everyone’s lips when faced with a behaviour, particularly aggression, is ‘what do I do when it happens?’

But the bigger question is always, ‘how do I make it not happen?’ Not just what do I avoid, but what can this person learn so that when they are faced with a situation they don’t like they do not need to show a behaviour.

 

5. Its ok to get angry at any advice that starts with ‘You just need to stay calm…’ Take a deep breath and explain to them that staying calm when someone you care about is hurting themselves or others is one of the hardest things a person can do. If they don’t acknowledge this then hit them over the head with the furniture while reminding them to ‘Just stay calm’.

 

6. But learning how to calm down is really useful…. Sorry. It is hard, but learning how to keep your own body calm and regulate your own behaviour when faced with challenges is a very very useful skill. When under stress your body pumps out adrenaline and this interferes with your body’s ability to do some things, like think clearly. Learn how to recognise the responses your body has to stress and separate yourself from them. But it is hard. Don’t let anyone tell you that staying calm is easy. And if they do, pick up the furniture.

 

7. Living with challenging behaviour is hard work. Having a family member demonstrate challenging behaviour in your home for years on end can be frustrating, challenging, emotionally draining and difficult. Acknowledging this, acknowledging that you need help and support and every now and again the opportunity to get away and drink some wine is acknowledging that you’re only human. It doesn’t mean that you don’t love the person you’re supporting. It doesn’t mean that you’re a bad person. It means that you’re a human being. I’ve met many families whose capacity to keep going in the face of huge challenges leaves me truly humble, but no one’s perfect. Cut yourself some slack.

8. Change is possible. No situation is hopeless. While achieving an elimination of whatever behaviour your experiencing may be optimistic, there are many many stories of people in truly dreadful situations who come out the other side and turn things around.

9. Medication is not automatically the enemy. I’ve lost count of the number of parents I’ve met who have rejected medication out of hand because they don’t want their child ‘doped up’. This is so far from reality – many times when medication is finally broached it’s done so gently and cautiously that that fear quickly turns to frustration that things aren’t moving quickly enough!

Medication shouldn’t be used (outside of truly difficult situations) to manage behaviour directly. But part of the dynamic of behaviour can be things like anxiety. In autism in particular anxiety can be a huge he issue in a confusing and frightening world. If I struggled with anxiety I may access medication as part of a package of support. People with learning difficulties and complex needs should have the same right to explore these options as everyone else.

10. Getting everyone to agree is a nightmare. Why is this happening? That’s the key question. The teachers think they know. The LD nurse things she knows. The parents are the experts. They definitely know. But everyone disagrees.

Getting a group of people to agree on something as emotive and complex as the occurrence of a behaviour is like herding cats. There’s usually a lot of noise (none of it pretty) and a few scratches, and no one goes in the right direction.

But if you want to achieve real change then everyone needs to work together, or at least together-ish. Sometimes that means backing down from your firmly held view and acknowledging that you may not be right, or at least being open to the suggestion that there is an alternative view.

 

10 seems a good number to stop at (whoever heard of 11 top tips?). 

Chris_Alumni

Thank you to all for your contributions, and thank you Will for your great tips just now - I'll get those added in!