Understanding and Managing Challenging Behaviour ID CAMHS Liam Gondelle

Aims of the workshop To support you in having a clearer understanding of the reasons that a child may display ‘challenging’ behaviour. To develop skills in finding out what the reason/ function of a behaviour is. to understand the cycle of behaviour To start to develop a tool kit to help manage/reduce behaviours that are challenging.

What is challenging behaviour? What comes to your mind when we say the word challenging behaviour?

What is challenging behaviour Challenging behaviour is something that you/others find difficult to support or manage. Challenging behaviour is something that will cause limitations on the child’s, yours, or others quality and day to day life.

Why behaviour occurs Behaviours that are challenging to manage can be seen for lots of different reasons. Often we refer to the reason as the function or the unmet need. The common functions of behaviour include: Sensory Attention/interaction Escape To get something/tangible Physical/health reasons

What we can clearly see around why a behaviour is occurring Why behaviour occurs What we can clearly see around why a behaviour is occurring What is below the surface that we need to do a bit more investigation in.

Why behaviour occurs The picture on the previous slide highlights how often it may not be completely clear why a child is behaving in a certain way. It is important to remember that there is always a reason. Displaying a form of challenging behaviour is a way of communicating a unmet need. Children will often display that behaviour again, it is normally very effective in achieving their goal.

Cycle of behaviour Crisis Escalation De-escalation Baseline Baseline Post incident phase

Cycle of behaviour You might of heard of people talking about behaviour and traffic lights together. Green: This will be a description of the child when they are happy and calm Amber: When the child is starting to become anxious, slightly agitated or not just themselves. (often this can be hard to spot, but is can be the best time to put something into action. Red: Also sometimes called crisis. This is when clear challenging behaviours are being seen. The intervention at this stage should be about keeping people safe, and allowing the situation to calm. Blue: often following a large incident people can be slightly low/remorseful. During this period triggers can be heightened.

Managing challenging behaviour We have already said that often when a child displays challenging behaviour it is a way of achieving an unmet need. Once we have found out that need, we need to put something in place that will achieve that need/goal in a more appropriate way. What barriers might we be faced with then trying to do this?

Positive vs negative responses to behaviour that is challenging We often use the term ‘ignore the negative and praise the positive’. This does not mean that we accept negative behaviour, and there are no consequences. What is the difference between a punishment and a consequence? Evidence suggests that when putting in punishments/negative reinforcement, this will not solve the problem/behaviour, even if the behaviour does stop it is likely that it will come back or be transferred onto something else. Offering a reward/something motivating in relation to a positive behaviour teaches the child that their new behaviour is affective and will likely last longer and break down their previous view that the negative behaviour achieves the goal. Can we think of any examples of this?

General points/ possible interventions that may be useful Communications Aids Now/Next Visual schedules Emotion cards Objects of reference PECS/Visual Cards Signing/Makaton Sensory Adaptions Ear defenders/headphones Offering movement breaks/high movement activities before needing to be still (if appropriate) Manage/be aware of the environment that you are in.

General points/ possible interventions that may be useful Behavioural Strategies Reward/Working towards systems Social stories Five point scales House rules Scripts Take a step back Monitor your own mood/stress levels Distraction/intensive interaction Remember processing times/amount of information given.

Resources to support making changes ABC Charts Behaviour Support Plan templates

Questions