Behaviour Management Flashcards
What are the main basis for behaviour assessment and management?
-Effective communication
Understanding of:
- Motor, cognitive, language development
- Psychosocial development
- Learning theories
- Behaviour assessment scales
What are the learning theories?
Classic
(classical conditioning)
-Stimulus/response
-Creates association between otherwise non-related things (e.g. needles and white coats)
Operant
-Reward/punishment reinforces and discourages certain actions
Social Learning:
-Modelling, learning by copying others (imitation and observation)
What aspects of operant conditioning can you take advantage of?
- Younger children are more susceptible to operant conditioning
- The more consistent the enforcement, the greater the likelihood for desirable outcome
- Praise child if they do what you ask, be inventive, consistent and age appropriate
How can operant conditioning be misued?
- Promising bigger and bigger rewards for child to behave while they are misbehaving
- Cuddles after tantrums
What are some useful and inappropriate enforcers?
Useful:
- Motivational advice for OH practices
- Verbal praise
- non-verbal actions (smiles, cuddles, hi-fives)
- Charts/calendars
- Tangible rewars (Toys, etc.)
Inappropriate:
-Food or drink such as sweets or a botle
Which is more effective between punishment and reward?
Reward
What are some examples of modelling behavioiur?
- Live model (parent, sibling)
- Dental model
- Peppa Pig, Playschool
How is a child’s behaviour assessed after procedure?
Frankl Scale:
++Definitely positive
(Good rapport, interested & enjoyng dental procedure)
+Positive
(Accepts procedure but at times cautious)
-Negative
(Reluctant to accept procedure, some tears)
–Definitely negative
(Refusal of procedure, crying forcefully or fearful)
What is used to assess child’s behaviour on first impression from waiting room?
Wright Scale
Cooperative:
- Relaxed, minimal apprehension, enthusiastic
- Can be treated by simple behaviour shaping approach
- Applies to most children
Potentially cooperative:
- Behaviour problems but has capability to perform
- Cooperatively with appropriate behaviour modification
Lacing in cooperative ability/pre-cooperative
- Very young
- Special needs
What is the max appointment time allowed in clinics?
2 hrs
What are some behaviour management techniques?
-Pre-appointment behaviour management
(Pleasant waiting room, receptionist reassurance, books, videos, internet, etc.)
-Modelling
(Get parent to demonstrate first)
-Tell-show-do
(Pt told what will be done, shown by simulation what will happen, then procedure done at a pace pt can accept)
-Voice control
(Project sense of authority, tone of voice critical, facial expression must reflect tone)
-Distraction
(triplex used with LA, wriggling toes, suggestive imagery/imagine yourself at the beach)
(Attempt to get older children to identify and alter belief)
-Positive reinforcement
(Tangible or social reward to desired behaviour), must be instant, specific and consistent
-Systematic desensitisation
(Work through variouis levels of anxiety from least to most)
-Aversive conditioning
(Punishment, not used now)
-Behaviour shaping
(move child from potentially cooperative to cooperative via reinforcing cooperative behaviour and retracing steps if misbehaviour occurs), uses all other techniques
What euphemisms can be used for children?
Magical water: LA Wind/tickle spoon: triplex Tooth button: clamp Vacuum cleaner: suction Little fingers: forceps Germs/bugs: Plaque Rubber raincoat: rubber dam Coat hanger: Frame Fire engine: ?????? Robot tooth: Stainless steel crown
What are some ways you can give the child controL?
- Signalling
- Ask for breaks
- Stop when child appears uncomfortable
If you try to use tell-show-do
e.g. showing prophy on finger nail
and patient nervous (withdraws hand), what can you do?
Retrace step:
Try to show in a different way (e.g. on parents, etc.)
Can offer to work on front teeth first (because patients generally more comfortable with front teeth); give them mirror so they can see
