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Challenging Behaviours

Challenging Behaviours

Behaviour can be described as challenging when it is of such an intensity, frequency or duration as to threaten the quality of life and/or the physical safety of the individual or others and is likely to lead to responses that are restrictive, aversive or result in exclusion.
The term challenging behaviour is socially constructed. It represents the interaction of both individual and environmental factors, and the relationship between them. Any assessment and intervention for challenging behaviour must include these three elements.

What Is Challenging Behaviour

The Learners Perspective

Often what is considered to be problem behaviour is no more than a person finding different ways of making sense of their world (Donellan 1990). Staff, parents, volunteers and teachers need to avoid the tendency to look at the actions of a person and attach a series of labels to that person’s behaviour such as aggressive and non-compliant.

For example, have you seen any of these behaviours:
  • aggression, hitting others, verbal abuse, pinching etc.
  • bizarre verbalisation - strange talking about something, strange sounds
  • inappropriate oral behaviour
  • inapproriate anal behaviour
  • self - injurious behaviour - hurting oneself
  • self - stimulation, twiddling things, arm flapping, spinning objects etc
  • tantrum
  • gazing/staring
  • inappropriate laughing/giggling
  • screaming/yelling
  • gesturing/pointing
  • hugging/kissing
  • masturbation
  • pushing/pulling
  • standing to close to another person
  • echolalia - meaningless repetition of speech
  • swearing
  • whining/crying
Reconsider….......Could they be…..????

 Requests for attention
  • someone to talk to them
  • someone to play with them
  • affection
  • permission
  • assistance/help
  • food

     or a way to

  • say No
  • say Stop
  • protest
        or be a statement about

  • events
  • mistakes
  • humour

    or be a statement about feelings like

  • confusion
  • frustration
  • anticipation
  • pain
  • boredom
  • fear
  • pleasure

    Think about it ......... from the “learners perspective”.
source: Meyer L. Hand Evans (1988). ‘Non Aversive intervention for behaviour problems. A manual for home and community’. Paul H Brooks, Baltimore

Demystifying Behaviours

The following extracts are taken from Herb Lovett.

Aggression
Every now and again, a stranger will phone me for advice about someone I have never met. Someone called recently: “Hi my name’s Phyllis, and we’ve got a 21 year old autistic who’s really assaultive all the time. He was looking around the refrigerator last night and we told him to shut the door so he hauled off and belted a staff. We’re going to have him checked for frontal lobe seizures, but if that isn’t it, then what are we going to do?”

“What is the man’s name?” I asked.
“James” she replied.
“Who calls James other than his family?”
“No one.”
“Who are his friends?”
He doesn’t make friends.”
“Why was he looking in the refrigerator?”
“He likes attention.”

There was a time I would have found this conversation infuriating. I still flinch when I hear someone called an autistic, and I would be pretty condescending (if only in my heart) to anyone thinking that people look for a social life in refrigerators. Still, if I really want to see a world where James is taken seriously as a person, then - I have only slowly come to recognise this - I have to begin with myself. Would my abrupt dismissal of this woman be any different from her misunderstanding of James? I am constantly discovering how I have yet to learn to listen not only to people’s words but to their larger meanings as well. I am still learning how to listen to learn.

It has always been too easy for me to respond to my own reactions and judgements first and last. I find I am happier with myself and my work, though, when I remember that:
1. most people are doing the best they can. If they see a way, they will often change to do better, but most people won’t see new possibilities if they come from hostile critics.
2. Phyllis did not call to get my opinion of her. She was desperate. People were getting hurt and she was scared.

As we talked, she recognised that people had been giving James orders when they might better have asked him questions and that they had not been as thoughtful towards James as they were toward one another. By the time we finished talking, Phyllis decided that James probably had a lot of reasons not to be happy about his life. He lived with six people he didn’t choose to live with. He worked for very little money at a job he didn’t like. As this perspective became clearer to her, she concluded, “we can do better”.
                                                                                                          Herbert Lovett 1996

Attention Seeking
I have many friends in the field of human services. Most, like me have had training in behavioural shaping. From time to time, I find myself too bored to watch television or too restless to read. It’s too early to go to bed, and it’s still too close to dinner to eat again - so I start phoning. I have nothing in particular to say but I do want to talk. Perhaps you yourself have never done this, but certainly someone you know has done it to you. The only point of the conversation is the company. I have never (yet) had any of my friend’s say to me. “This seems like you are just looking for attention. What I will do now is hang up, but you can call me (tomorrow/next week/next year) when you have something meaningful to say and I will talk with you then.
                                                                                                          Herbert Lovett 1996

Compliance?
Two other common and demeaning labels for behaviour are non-compliant and avoidant.Some of us recognise non-compliant behaviour at once as our own. Asked to choose which animal they would most like to be, few people would pick a sheep. Most of us identify, I think more with eagles and weasels, seeing ourselves as people who can soar above it all or think of some clever way to burrow down and around unfair expectations. Not one of my acquaintances has said, “I am proud to do what I am told without question”.Many of us get away with bending and breaking rules because we are adroit enough to avoid notice. If, however, our evasions or authoritarian demands were not relatively sophisticated, or if we were already perceived as different, then we might well find ourselves further diminished by being labelled non-compliant.

Avoidance?
Avoidant behaviour also seems to be a vice most often found in others. A service user who chronically refuses to leave for work can become the object of a behaviour program that uses incentives for being punctual or a series of increasingly unpleasant consequences (from loss of pleasurable activity to being forcibly removed) for being stubborn. This strict standard is considered reasonable, apparently, because no dedicated, self-motivated professional would ever call in sick while enjoying good health. For one thing, that would be wrong. For another we would expect our supervisor and a large assistant to visit us, determine if our claim of illness was really the case, and, if they found it not so, escort us physically back to work. If anyone did this to you, you would reasonably call the police or your lawyer - unless you are a client and your team has approved this sort of intervention for your avoidant behaviour.
This is not to imply that a person’s sudden decision to act
independently may not be a problem. It may well be. But just because
the problem is real does not grant us the right to dictate a solution.
The people I have met who refuse to go to work are avoidant always have
good reasons for their actions. Often work is really just daycare for people with disabilities and is unpaid and meaningless. Or the person may have a medication schedule that makes him or her sluggish in the morning and would be better off working evenings. The reasons that these people might not want to go ahead with the day planned for them are as numerous as those anyone has for not wanting to go to work on any given day.
                                                                                                          Herbert Lovett 1996

Some Basic Questions to Ask about Challenging Behaviour - The Environment

Where does the power sit in this situation?
Who is able to make the decisions here?
Are there ways to give this person more control?

Who is in this person’s life?
Who are their friends?
Who supports this person?
Who do they really enjoy (or not enjoy) spending time with?
Is there anyone missing or absent?

How does everyone feel about what is happening?
How do I feel about what is going on?
How do others feel about it?
Is my perspective affected by what others think?
Do I/we believe the person has feelings about the situation?
Do I/we believe they are aware of our perception of them?
How would I feel if I were in this person’s situation?

What do we know about this person?
Do I/we believe this person has hopes and dreams?
Do I/we know what they are? Do we know the things they like to do?

Can I/we look at this ’ problem” differently?
What could we do to avoid this situation altogether?
Is it possible to re-frame what is happening to find positives?
Does the “problem” sit with the person or with others?
Have things changed for me or others that may affect the person?
Where will my support come from to make changes?

Some Basic Questions to Ask about Challenging Behaviour  - The Individual

Could this person be telling us something?
Is what they are doing unusual or more common for them?
Is the person usually able to tell us if they need or want something?
Is this their way of letting us know they need more control of their life?
Could they be anxious or unwell and unable to say what it is?
When did they last have a medical check-up?

What are this person’s hopes and dreams?
What are the unique things that this person needs to be happy?
Are these currently being met?
Are there significant absences?
Are things happening that may cause anxiety for the person?
Could the person be bored or  unhappy with the way things are for them?
Are there any changes or additions that could make their life more interesting?
Can we find more things for them to do that they enjoy?

Have there been any recent changes in the person’s life?
Have there been any changes to routine?
Has any person or special thing been absent?
Is the person aware of the expectations placed on them?

What are this person’s strengths and abilities?
How can we build on these to find a solution?
Are there new skills we could teach?
Does the person have adequate coping strategies for problems/anxieties?