Who needs Intensive Interventions? For children who have very persistent and severe challenging behavior. These children do not respond to the typical preventive practices, child guidance procedures, or social emotional teaching strategies that would normally work with most children.
Key Social Emotional Skills Children Need as They Enter School Confidence Capacity to develop good relationships with peers and adults Concentration and persistence on challenging tasks Ability to effectively communicate emotions Ability to listen to instructions and be attentive Ability to solve social problems What do children do when they don’t have each of these skills?
They May Engage In Challenging Behavior What we are referring to when we say “challenging behavior” is: Any repeated pattern of behavior that interferes with learning or engagement in pro-social interactions with peers and adults. Behaviors that are not responsive to the use of developmentally appropriate guidance procedures. Prolonged tantrums, physical and verbal aggression, disruptive vocal and motor behavior (e.g., screaming, stereotypy), property destructions, self-injury, noncompliance, and withdrawal
Some Basic Assumptions Challenging behavior usually has a message- I am bored, I am sad, you hurt my feelings, I need some attention. Children often use challenging behavior when they don’t have the social or communication skills they need to engage in more appropriate interactions. Behavior that persists over time is usually working for the child. We need to focus on teaching children what to do in place of the challenging behavior (Replacement Skills).
“ If a child doesn’t know how to read, we teach. If a child doesn’t know how to swim, we teach. If a child doesn’t know how to multiply, we teach. If a child doesn’t know how to drive, we teach. If a child doesn’t know how to behave, we……..... …….teach? ……punish? Why can’t we finish the last sentence as automatically as we do the others?” Tom Herner (NASDE President ) Counterpoint 1998, p.2)
Challenging Behaviors May Be Internalizing or Externalizing Internalizing Behaviors Withdrawal Isolation Anxiety Depression/sad mood Somatic complaints (physical aches & pains) Poor appetite or over eating (severe weight gain or weight loss) Insomnia or hypersomnia Feelings of hopelessness or worthlessness Fatigue or loss of energy nearly every day Diminished ability to think or concentrate Recurrent thoughts of death or suicidal ideation Rejection by peers Repetitive behaviors that seem odd Inability to concentrate Extremely disorganized (as compared to peers)
Challenging Behaviors May Be Internalizing or Externalizing Externalizing Behaviors Disrespectful Breaks rules Inattentive Aggressive Steals Frequent Temper outbursts Excessive stubbornness Very fidgety – can’t stay in seat when developmentally appropriate Often interrupts or intrudes on others Runs or climbs excessively when not appropriate Impulsive behaviors that do not respond to behavior modification techniques Does not seem willing or able to follow directions
Can Be Both (Internalizing and Externalizing Behaviors) School truancy School refusal Substance abuse Self injurious behavior Trauma reenactment
Why Children Engage In Challenging Behavior Challenging behavior communicates Used instead of language by a child who has limited social or communication skills Challenging behavior works Challenging behavior results in the child gaining access to something or someone or avoiding something or someone
Dimensions of Communication Every communicative behavior can be described by the form and function. Form: the behavior used to communicate. Function: the reason or purpose of the communicative behavior. Before we can change the behavior, we need to determine what the child is attempting to communicate. The reason for the behavior is not always obvious.
Forms of Communication Words Sentences Point to a picture Eye gaze Pulling adult Crying Biting Tantrums ?
Functions of Communication Obtain something: An object, activity or person Help or information Social interaction Sensory stimulation Escape something: A demand, activity or person Sensory stimulation Social interaction ?
Positive Behavior Support (PBS): Key Elements An approach for changing behavior Is based on humanistic values and research Relies on understanding why the behavior occurs and teaching new skills to replace behavior. A holistic approach that considers all factors that impact a child
Research on PBS Effective for all ages Effective for diverse groups of individuals with challenges: mental retardation, oppositional defiant disorder, autism, emotional behavioral disorders, children at risk, etc. PBS is the only comprehensive and evidence-based approach to address challenging behavior within a variety of natural settings.
Old Way versus New Way Old Way General intervention for all behavior challenges Intervention is reactive Focus on behavior reduction Quick fix New Way Intervention matched to purpose of the behavior Intervention is proactive Focus on teaching new skills Long-term interventions
What do you see in this picture? By looking at what happens around the behavior, we can often discover causes or triggers for the behavior. Sometimes, viewing the big picture gives us more information
BUT WHAT IF NOTHING WORKS? Despite your best efforts, caring relationships, supportive environments, teaching social and emotional skills, and a great behavior support plan that was executed consistently- a child in your class continues to exhibit challenging behavior-----Now What?
You can choose a response and not “just react” Choose a response, prevent a reaction. If you want respect, be respectful. Keep your cool, stay in your “wise mind”. Assist children in seeing the “future”, help them think through consequences short and long term. Be calm and consistent. Be honest and empathetic. If you are “losing your cool” double the distance between you and the child, and lower your voice. Teach students want you want them to do, not just what you do not want them to do. Notice and praise appropriate behavior. Call parents with good news!
The following signs may indicate the need for professional assistance or evaluation: Decline in school performance Poor grades despite strong efforts Regular worry or anxiety A sudden increase or decrease in appetite Repeated refusal to go to school or take part in normal children’s activities Hyperactivity or fidgeting Persistent nightmares Persistent and/or excessive disobedience or aggression Frequent temper tantrums Self injurious behaviors like head banging, biting self, pinching, or cutting Fascination with matches, fire, history of starting fires Harming animals Depression, sadness or irritability that lasts more than 2 weeks
How to make a referral to the school counselor (or social worker/psychologist) Remember to respect student and family privacy! Don’t diagnose – beware of practicing medicine without a license! Know how to refer to your school counselor – keep forms on hand. Know how students or parents can refer themselves to the school counselor. Network with your local Community Mental Health Center-have someone (school counselor) on staff who knows how to access services. Universalize – let students and families know that LOTS of kids have this kind of struggle.