Understanding special Understanding special needsneeds

Behaviour managementBehaviour management

EBDEBD

FamiliesFamilies

General advice for ALL childrenGeneral advice for ALL children An approach to dealing with specific An approach to dealing with specific

behavioursbehaviours

Reference Reference

““Bringing up responsible children ; will Bringing up responsible children ; will our children be okay?”our children be okay?”

John SharryJohn Sharry

Veritas PublicationsVeritas Publications

7/8 Lower Abbey St7/8 Lower Abbey St

Dublin1Dublin1

ISBN 1 85390 4147ISBN 1 85390 4147

Introduction Introduction Many approaches to disciplineMany approaches to discipline

– Greatest influence is when child is 2-10Greatest influence is when child is 2-10 Misbehaviour is normalMisbehaviour is normal

– On average, children comply with one third On average, children comply with one third and two thirds of parents requestsand two thirds of parents requests

Why behavioural problems?Why behavioural problems?– Child’s particular temperamentChild’s particular temperament– Special needsSpecial needs– Parents’ own difficultiesParents’ own difficulties

Each family is differentEach family is different Nine steps to better behaviouralNine steps to better behavioural

Step 1 – parents caring for Step 1 – parents caring for themselvesthemselves

Examples of caring for themselvesExamples of caring for themselves– Going for a daily walkGoing for a daily walk– Spending time aloneSpending time alone– Self nurturing things e.g. special bathSelf nurturing things e.g. special bath

Build on strengths as parentsBuild on strengths as parents– Start looking for what you are doing rightStart looking for what you are doing right– You can’t be a perfect parent so be a ‘good You can’t be a perfect parent so be a ‘good

enough parent’enough parent’ Tips for going forwardTips for going forward

– Do something you enjoy every weekDo something you enjoy every week– Think positively about yourself as a parentThink positively about yourself as a parent

Step 2 – providing positive attention Step 2 – providing positive attention to childrento children

Young children will do anything to get their Young children will do anything to get their parents attention and this can mean being parents attention and this can mean being naughtynaughty

Young children do not know the difference Young children do not know the difference between good and bad attentionbetween good and bad attention

Catch the child being goodCatch the child being good Give positive attentionGive positive attention Positive attention can divert misbehaviourPositive attention can divert misbehaviour Children can only be given too much Children can only be given too much

negative not positive attentionnegative not positive attention Focus on what you wantFocus on what you want

– Make a list of goals for yourselves as parents Make a list of goals for yourselves as parents and for your childrenand for your children

Step 3 – play and special time with Step 3 – play and special time with childrenchildren

The value of play and special time for The value of play and special time for childrenchildren

How best to playHow best to play– Set aside a special timeSet aside a special time– Spend one-on-one timeSpend one-on-one time– Choose interactive, imaginative Choose interactive, imaginative

activitiesactivities Encourage children during playEncourage children during play Have special time as a familyHave special time as a family

Step 4 – specific encouragement Step 4 – specific encouragement and praiseand praise

Make a list of behaviours you want to Make a list of behaviours you want to discourage and encourage in your childrendiscourage and encourage in your children

Skills of specific encouragementSkills of specific encouragement– Encouragement should be clear, specific and Encouragement should be clear, specific and

personalpersonal Exceptions/steps in the right directionExceptions/steps in the right direction

– Don’t always wait for perfection or a finished Don’t always wait for perfection or a finished task e.g. homeworktask e.g. homework

Double encouragementDouble encouragement– Use others tooUse others too

Persist with encouragement Persist with encouragement – Think about new ways to get your Think about new ways to get your

encouragement throughencouragement through

Step 5 – using rewardsStep 5 – using rewards Star chart – gold and silver starsStar chart – gold and silver stars Making rewards effectiveMaking rewards effective

– Be clear about the behaviour you wantBe clear about the behaviour you want– Use motivating rewardsUse motivating rewards

Staying up laterStaying up laterMore time on the play stationMore time on the play stationHaving a friend to playHaving a friend to play

– Involve children in the planningInvolve children in the planning– Start smallStart small– Use lots of encouragementUse lots of encouragement

Step 6 – setting rules and helping Step 6 – setting rules and helping children to keep themchildren to keep them

How many rules?How many rules?– Encourage children to make as many decisions for Encourage children to make as many decisions for

themselves as possiblethemselves as possible– Give children choices even when imposing a limitGive children choices even when imposing a limit– Keep the rules you set with children to only those that Keep the rules you set with children to only those that

really really mattermatter Effective commands/assertive commandsEffective commands/assertive commands Use positive commands - examplesUse positive commands - examples Give children time to complyGive children time to comply Praise co-operationPraise co-operation Following through on commandsFollowing through on commands Logical consequencesLogical consequences When-then command e.g. when you do your When-then command e.g. when you do your

homework then you can go out and playhomework then you can go out and play

Step 7 – ignoring misbehaviourStep 7 – ignoring misbehaviour What is ignoring?What is ignoring?

– Not easyNot easy– Need to pay as little attention as possibleNeed to pay as little attention as possible

Ignoring is not an alternative to positive Ignoring is not an alternative to positive approving attentionapproving attention

How to make ignoring workHow to make ignoring work– Target specific behavioursTarget specific behaviours– Ignore thoroughly and consistentlyIgnore thoroughly and consistently

Return positive attention as soon as possibleReturn positive attention as soon as possible Remain calmRemain calm

– Think differentlyThink differently– Talk things throughTalk things through– Practice relaxationPractice relaxation

Step 8 – time out and other Step 8 – time out and other sanctionssanctions

Explain time out in advanceExplain time out in advance– Which behaviour?Which behaviour?– Where?Where?– How long?How long?

Use back-up sanctions to make time out Use back-up sanctions to make time out effectiveeffective– ShortShort– Affect mainly the childAffect mainly the child– Within control of the parentWithin control of the parent– Logically related to the misbehaviourLogically related to the misbehaviour

Time out for parentsTime out for parents

Step 9 – talking things throughStep 9 – talking things through

Active listeningActive listening– Give child your full attentionGive child your full attention– Reflect back what they have saidReflect back what they have said– Acknowledge child’s feelingsAcknowledge child’s feelings

Speaking upSpeaking up Generating solutionsGenerating solutions

– How do you think we can solve this?How do you think we can solve this? PlanPlan

– Work with the child on deciding on the best Work with the child on deciding on the best solutionsolution

More specific helpMore specific help

The ABC of behavioursThe ABC of behaviours– A – antecedent i.e. what may have A – antecedent i.e. what may have

caused the behaviourcaused the behaviour– B – the behaviour itselfB – the behaviour itself– C – what were the consequences of the C – what were the consequences of the

behaviourbehaviour

Emotional and Emotional and behavioural difficultiesbehavioural difficulties

Common causes of EBDCommon causes of EBD

ADHDADHD ASDASD Physical or sensory impairmentPhysical or sensory impairment Learning difficultiesLearning difficulties High abilitiesHigh abilities Childhood depressionChildhood depression Emotional deprivationEmotional deprivation Child abuseChild abuse

Types of behaviourTypes of behaviour Withdrawal or passivityWithdrawal or passivity AggressionAggression Inappropriate social behaviourInappropriate social behaviour Verbal aggression in the older child and Verbal aggression in the older child and

defiancedefiance Sleep disturbanceSleep disturbance BedwettingBedwetting SoilingSoiling Breath holding and temper tantrums Breath holding and temper tantrums

beyond expected developmental agebeyond expected developmental age

Types of behaviourTypes of behaviour

Head banging and rockingHead banging and rocking Short attention span, difficulty with Short attention span, difficulty with

concentrationconcentration Extreme restlessnessExtreme restlessness Phobias or irrational fearsPhobias or irrational fears Difficulty in trusting and forming Difficulty in trusting and forming

relationships with adults and childrenrelationships with adults and children

Good practiceGood practice

A child with behavioural difficulties needs A child with behavioural difficulties needs structure and consistency in management structure and consistency in management and a routine developed to meet his and a routine developed to meet his individual and developmental needsindividual and developmental needs

Always consider your own attitude to Always consider your own attitude to working with children who have working with children who have behavioural and emotional difficulties and behavioural and emotional difficulties and to their parents and carersto their parents and carers

Does your body language give off negative Does your body language give off negative or judgmental messages?or judgmental messages?

ADHD

Attention deficit hyperactivity disorder

General information Emotional/behavioural disability May be linked to autism, dyslexia and may

be associated learning difficulties, depression and conduct disorders

Thought to be the result of a dysfunction of the brain’s filtering system

May affect up to 5% of school aged children – more boys than girls

Symptoms must be frequent severe and long lasting for confirmation of the condition

Symptoms Poor concentration particularly with tasks

requiring long-term effort Over activity-often requiring minimal sleep Inability to curb immediate reactions and

impulsivity Poor physical co-ordination Rigidity in response to problem solving Disorganisation Mood swings and tantrums Low self-esteem

Diagnosis

Made by a multi-disciplinary team Child is observed in a number of

environments – school, home etc. Must display 6 out of 9 inattention symptoms Must display 6 of 9 hyperactivity/impulsivity

symptoms Such behaviours must start before child is 7

years old and last at least 6 months Behaviours must not be caused by anything

else

Diagnosis Parent and child interviews Parent and teacher complete child

behaviour rating scales Parent self report measures Psychological tests Review of school and medical records Intelligence/educational achievement tests Paediatric examination Other assessments as required e.g. SLT,

vision, hearing screening

ADHD drugs

3 basic drugs – each has varying strengths– Methlphenidate – brand name is Ritalin– Dextro-amphetamine- brand name is

Dexedrine– Dextro – amphetamine-levo-

amphetamine – brand name is Adderall– Dextro – methylphenidate – brand name

is Focalin

Ongoing management

Behavioural management techniques – see later lecture plus circle of negative image

Intensive behavioural therapy Ritalin or other drugs– highly controversial Drug plus family therapy Food additives?? ?misdiagnosis

Alternative therapies

Movement therapies Brain gym EEG Herbal Homeopathic

Case study

Familes/parents

Families who have a child with a Families who have a child with a disabilitydisability

Relevant factors:-Relevant factors:-– Cultural backgroundCultural background– Religious backgroundReligious background– Value systemsValue systems– Coping stylesCoping styles– Social and economic backgroundSocial and economic background– Other factors e.g. alcohol or drug Other factors e.g. alcohol or drug

dependency, domestic violencedependency, domestic violence

Families who have a child with a Families who have a child with a disabilitydisability

May encounter some of the following:-May encounter some of the following:-– One parent at home full time or on reduced One parent at home full time or on reduced

hours and as a result are socially isolatedhours and as a result are socially isolated– There may be a lack of time for activities There may be a lack of time for activities

unrelated to the child and impact on social lifeunrelated to the child and impact on social life– Unable to spend time with other children in the Unable to spend time with other children in the

familyfamily– Strain on relationshipStrain on relationship– May be difficulty to leave the child or to find May be difficulty to leave the child or to find

suitable carerssuitable carers

Parents of children with disability Parents of children with disability need……need……

Grieving timeGrieving time Information at their own paceInformation at their own pace Time and spaceTime and space Acknowledgement that they know the Acknowledgement that they know the

child bestchild best To be as open as possible about the fact To be as open as possible about the fact

that their child has a disabilitythat their child has a disability To address the needs of the other children To address the needs of the other children

in the familyin the family To be aware of their entitlementsTo be aware of their entitlements To be aware that their child has rightsTo be aware that their child has rights

Carers/professionals need to…Carers/professionals need to… Respect and involve parents/close family Respect and involve parents/close family

membersmembers Listen to what they have to sayListen to what they have to say Obtain information about the child’s Obtain information about the child’s

abilities and skillsabilities and skills Communicate with parents to develop Communicate with parents to develop

positive and realistic expectations of the positive and realistic expectations of the child’s future developmentchild’s future development

Respond to parents feelings about their Respond to parents feelings about their child in an appropriate, non-judgemental child in an appropriate, non-judgemental mannermanner

Carers/professionals need to…Carers/professionals need to… Encourage parents to observe their Encourage parents to observe their

children and to participate with them children and to participate with them where appropriate and within the where appropriate and within the constraints of the settingconstraints of the setting

Involve siblings and other important family Involve siblings and other important family members offering advice, support and members offering advice, support and education as requirededucation as required

Be honest, open and ensure information is Be honest, open and ensure information is understoodunderstood

Offer practical and emotional support and Offer practical and emotional support and answer questions as appropriateanswer questions as appropriate

UK code of practice for effective UK code of practice for effective communication with parentscommunication with parents

This code of practice outlines 7 key This code of practice outlines 7 key principles that you should adopt principles that you should adopt when working with parents. They when working with parents. They emphasise the vested interest that emphasise the vested interest that parents have in their children’s lives parents have in their children’s lives and also the knowledge and and also the knowledge and contribution that parents are able to contribution that parents are able to give us as practitioners.give us as practitioners.

The 7 principlesThe 7 principles1.1. Acknowledge and draw on parental knowledge Acknowledge and draw on parental knowledge

and expertise in relation to their childand expertise in relation to their child2.2. Focus on the children’s strengths as well as Focus on the children’s strengths as well as

areas of additional needsareas of additional needs3.3. Recognise the personal and emotional Recognise the personal and emotional

investment of parents and be aware of their investment of parents and be aware of their feelingsfeelings

4.4. Ensure that parents understand any proceduresEnsure that parents understand any procedures5.5. Respect the validity of different perspectives Respect the validity of different perspectives

and seek constructive ways of reconciling and seek constructive ways of reconciling different viewpointsdifferent viewpoints

6.6. Respect the differing needs that parents Respect the differing needs that parents themselves may have such as a disability or themselves may have such as a disability or language barrierlanguage barrier

7.7. Recognise the need for flexibility in the timing Recognise the need for flexibility in the timing and structure of any meetings you may haveand structure of any meetings you may have

Reflect on your own practiceReflect on your own practice Recognise that parents may have a Recognise that parents may have a

different perspective on their child’s different perspective on their child’s development and may have different development and may have different priorities to youpriorities to you

Acknowledge that while you may be an Acknowledge that while you may be an expert on your setting, parents are experts expert on your setting, parents are experts on their childrenon their children

Do not make comparisons between Do not make comparisons between children in the settingchildren in the setting

Remember that trust can be shattered by Remember that trust can be shattered by breaches of confidentiality and breaches of confidentiality and thoughtless wordsthoughtless words

Confidentiality – case studyConfidentiality – case study

Hannah has been working as a classroom Hannah has been working as a classroom assistant for 2 terms. One Saturday assistant for 2 terms. One Saturday outside Dunnes she met one of the outside Dunnes she met one of the parents from school and they asked parents from school and they asked Hannah why one of the children in her Hannah why one of the children in her class was getting extra support. Hannah class was getting extra support. Hannah told her it was because the child had told her it was because the child had behavioral difficulties as well as poor behavioral difficulties as well as poor speech. She went on to tell the parent speech. She went on to tell the parent that the child was now having speech and that the child was now having speech and language therapy and that the whole language therapy and that the whole family was having some type of family was having some type of counsellingcounselling

What should you do if you notice that What should you do if you notice that the child’s behaviour is concerning?the child’s behaviour is concerning?

Hopefully you will already have built Hopefully you will already have built up a good relationship with the up a good relationship with the parentsparents

Find out when it would be suitable for Find out when it would be suitable for parents to come to talk to youparents to come to talk to you

Make sure your tone is reassuring Make sure your tone is reassuring rather than accusingrather than accusing

Begin the meeting by offering to Begin the meeting by offering to share information to help the childshare information to help the child

Continued…..Continued….. Talk through the child’s overall Talk through the child’s overall

progress – emphasise the strengths progress – emphasise the strengths in order for the parents to in order for the parents to understand your perspectives on the understand your perspectives on the childchild

Ask the parents for their perspective Ask the parents for their perspective emphasising that they have a more emphasising that they have a more global view of the childglobal view of the child

Make sure that the meeting ends Make sure that the meeting ends with everyone understanding the with everyone understanding the next stepsnext steps

What should I do if I’m concerned about a What should I do if I’m concerned about a child’s progress and the parent does not child’s progress and the parent does not

agree that there might be a delay/disabilityagree that there might be a delay/disability

Make sure you assessments are accurate – Make sure you assessments are accurate – refer back to normal development chartsrefer back to normal development charts

Remember to focus on child’s strengths as Remember to focus on child’s strengths as well as areas for concernwell as areas for concern

Listen to and acknowledge any different Listen to and acknowledge any different perspectives that parents may haveperspectives that parents may have

Avoid making meetings ‘adversarial’ ; Avoid making meetings ‘adversarial’ ; parents should feel that you are on the parents should feel that you are on the child’s sidechild’s side

Continued….Continued….

Remember that parents want the Remember that parents want the best for their child and want to best for their child and want to protect him/herprotect him/her

Consider whether it is your setting Consider whether it is your setting that is ‘disabling’ the childthat is ‘disabling’ the child

Talk to parents about any fears that Talk to parents about any fears that they havethey have

Link them in with other parents if Link them in with other parents if appropriateappropriate

SiblingsSiblings

Effects will vary according to their Effects will vary according to their ages, birth order and the number of ages, birth order and the number of children in the familychildren in the family

Siblings may experienceSiblings may experience– Over protectionOver protection– NeglectNeglect– Resentment at the amount of attention Resentment at the amount of attention

the child with disability gets including the child with disability gets including continual discussion about the child continual discussion about the child between parents and other adultsbetween parents and other adults

SiblingsSiblings JealousyJealousy a shift in the family balance meaning they may a shift in the family balance meaning they may

have to take on more responsibilityhave to take on more responsibility Worry and anxiety that they will ‘catch’ their Worry and anxiety that they will ‘catch’ their

siblings conditionsiblings condition Fear and concern at witnessing their parents’ Fear and concern at witnessing their parents’

distress or rejection of the childdistress or rejection of the child Teasing and social isolationTeasing and social isolation Emotional swings, from being loving and Emotional swings, from being loving and

protective to disturbed behaviour such as protective to disturbed behaviour such as regression, attention seeking, moodiness, regression, attention seeking, moodiness, anxiety, low self esteem, embarrassment or guiltanxiety, low self esteem, embarrassment or guilt

Supporting siblings needsSupporting siblings needs Individual attentionIndividual attention Reassurance that they feel loved and Reassurance that they feel loved and

valuedvalued Opportunity for older children to express Opportunity for older children to express

their feelings – Sib Shopstheir feelings – Sib Shops Time on their own with their parentsTime on their own with their parents Correct information appropriate to their Correct information appropriate to their

level of understandinglevel of understanding Encouragement to care for their brother or Encouragement to care for their brother or

sister in small everyday ways e.g. playing, sister in small everyday ways e.g. playing, fetching nappiesfetching nappies