Children and adolescents exhibiting challenging behaviour is one of the prime reasons therapeutic services are sought. Managing challenging behaviour can be extremely difficult at times, especially if your child cannot communicate and you do not know why he/she is engaging in the challenging behaviour in the first place. Through engaging in what we may consider ‘challenging behaviour,’ your child is trying to express something to you, whether that is an unmet need or desire or emotion he/she is feeling but does not know how to cope with. It is essential to set up a communication system that works for your child. It is also imperative to try to understand why the individual is engaging in challenging behaviour. Research suggests 4 general functions or reasons for problem behaviour as outlined below:
- Escape: individual engages in challenging behavior to escape and/or avoid tasks and demands
- Attention: individual engages in challenging behaviour to gain another person’s attention
- Tangible: individual engages in challenging behaviour to gain access to a toy and/or activity
- Automatic: individual engages in challenging behavior to gain sensory stimulation
Although this may simplify why an individual engages in certain behaviours, it is a good starting point. Developing a general idea of why an individual is engaging in challenging behaviour can help with generating strategies to manage that behaviour.
Initially, it is important to identify triggers. Triggers are what set off or start the behaviour, such as placing a demand on the individual, transitioning between environments or being told that play time is finished. It is also important to identify reinforcers. Reinforcers are items/activities/places etc. that you can use to reward your child when they engage in desired behaviour. What motivates one child can be very different from what motivates another. Reinforcers can be locations (swimming pool, playground, toy store), food (cookies, crackers, popcorn), physical (hugs, tickles, high-5’s), items (iPad, books, toys) and can be highly idiosyncratic depending on your child’s preferences.
Although all behaviour plans are unique to the individual’s specific needs, below are some general strategies to consider when managing challenging behaviour:
Before the challenging behaviour occurs:
- Set up a work/visual schedule. Whether you want your child to sit longer during meal times or finish their homework, it is important to have some sort of visual schedule that your child can refer to. This can be done in the form of token economies (child earns a set number of stars before accessing reward), first-then schedule (child is shown what they need to do before accessing reward), rules and perfect day chart (child is shown their rules and reminded what they need to do to get a ‘perfect day’). The perfect day needs to be tied with some reward. Pair this with contingency reviews or verbal reminders of what they are expected to do as well as the reward they will get for completion of the required activity.
- Teach replacement behaviours. Ensure you are teaching your child appropriate behaviours rather than just focusing on the ‘bad’ behaviours your child exhibits. Teach communicative responses, waiting, coping with difficult situations, following instructions etc. Keep in mind these skills may need to be taught slowly, in a broken down manner in order to be successful. For instance, if your child does not follow the instructions you deliver, start with easier instructions that don’t require a high response effort, such as, “stand up,” “come here,” and “give me high-5.” Social stories are also helpful for teaching children appropriate behaviours.
- Fade demands in slowly. Rather than getting into a fight with your child about completing a set task, ensure to make the task as easy as possible to begin with. For instance, if tidying the room causes problem behaviour, initially tell them to put just one toy away in order to access a reward. Gradually increase this to two toys and then a section of the room until the child is tidying the whole room.
- Give your child sensory breaks. Particularly with long work tasks or if your child exhibits stereotypy, ensure to give them sensory breaks throughout the day. This could include sensory toy play, movement breaks, or physical input in the form of massages.
- Environmental enrichment: ensure to have plenty of toys and stimulating activities for your child to functionally engage with.
- Isolate highly reinforcing items for tasks that are particularly aversive but necessary for your child to engage in. For example, if taking a bath causes challenging behaviour, consider using a specific toy that your child likes and allowing the child access to that toy IF and ONLY IF they have a bath without exhibiting challenging behaviour. Your child would not be allowed to play with that toy at all during the rest of the day. It would only be for successful bath behaviour.
- Use visual signals and timers. These can complement the visual schedule that you have in place.
- Use a fidget toy/competing item if your child has difficulty keeping still or exhibits stereotypy. Make sure to alternate among a variety of fidget toys to prevent boredom. Examples of fidget toys can include: spinners, Rubik cube, stress balls, twisty/bendy sticks, water wiggler toys and many other small items.
- Allow your child to choose between different activities he/she needs to perform. If your child understands visual schedules and is able to make choices, allow them a certain degree of control over their daily routine and schedule.
After the challenging behaviour occurs:
Any consequence based procedure should be implemented on the basis of the function of the challenging behaviour (why the child is engaging in the behaviour). Some consequence procedures include the following:
- Planned ignoring: this strategy involves simply ignoring the behaviour as if it is not occurring. This could be helpful if a child is engaging in challenging behaviour in order to access attention. Once the child stops engaging in the challenging behaviour, it is important to teach the alternative/appropriate behaviour and provide a lot of attention for successfully engaging in the desired behaviour.
- Remain neutral and prompt follow through: this involves ensuring that your face is as neutral and expression free as possible. When prompting follow through, you will need to consider the types of prompts that are most effective with your child. Types of prompts include verbal cues, physical guidance, gestures, modelling etc.
- Response blocking involves preventing the behaviour from occurring or being repeated. For instance if a child is trying to hit themselves, a cushioned blocking pad may be placed between the areas where the child is hitting to reduce the potential damage.
- Prompt incompatible behaviours. For instance if your child is engaging in hand flapping, you may prompt the child to play with a fidget spinner or reinforce keeping hands in pockets. Ideally this should also be taught before challenging behaviour occurs.
- Prompt alternative behaviours. It is important to teach and prompt functionally alternative behaviours to replace the challenging behaviour. For instance, if your child is tired of doing table top work and then decides to flop and roll on the floor, teach your child a way of asking for a break. Ideally this should also be taught before challenging behaviour occurs.
- Safety is always priority! Always seek assistance if you need it. Your safety as well as your child’s is always the number one priority.
While these are general tips and strategies, it is imperative to understand the function of the behaviour and to tailor the behaviour plan in accordance with the function. Each child’s behaviour plan will look slightly different as there is no one-size-fits-all approach. Seeking professional support early on is also vital as research shows that early intervention is crucial to seeing positive outcomes in the future. Check in your area and see what behaviour therapy, speech and language, occupational and psychological or counselling services there are.
Moreover, it is important to remember that the backbone of these therapies is REINFORCEMENT – rewarding appropriate behaviour. Although it is easy to focus on what your child is not doing, it is essential to reinforce what your child is doing. Remember, you will get more of what you reinforce!
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