Evaluation and Management of Behavior Flashcards
What is behavior?
- Observable
- Measurable
- Reproducible
What is behavior NOT?
the identity of the child
What is a challenging behavior?
- any repeated pattern of behavior that
interferes with learning - behaviors that are not responsive to the use
of developmentally appropriate guidance procedures - prolonged tantrums, physical and verbal
aggression, disruptive vocal and motor
behavior
Basic assumptions about challenging behaviors
- challenging behavior –> related to skill deficit or trauma
- Behavior that persists over time and is working for the child
what will reduce the likelihood of challenging behaviors?
Develop positive relationship, create supportive environments and focus on teaching social and communication skills
What is the potential impact of behavior on physical therapy intervention
- Not going to reach your goals
- Family will not keep coming
Key point to managing typical childhood behaviors prior to intervention
- Build relationships
- Carefully plan the environment
- Develop positive relationship, create supportive environments and focus on teaching social and communication skills
- Establish a routine and follow it consistently
- Plan for transitions
Build relationships
Ensure that all children, even those with the most challenging behaviors, have access to ongoing
POSITIVE relationships
Carefully plan the environment
- minimize large open spaces
- have toys ready with a plan B, C, …
- minimize obstacles and other hazards
- consider the needs of children with physical
and sensory disabilities - consider developmental level and potential
need for privacy
Plan for transitions
- Minimize the length of time the child spends waiting with nothing to do
- Prepare the child for transitions by providing a warning
- Structure transitions so that the child has something to do while he/she waits
- Teach the child the expectations related to transition
Kay Points to managing typical childhood behaviors during intervention
- Give Directions
- Establish Rules
- Ignore Misbehavior
- Redirection
- Provide positive feedback and support
Giving Directions
- Communicate the expectations
- Questions can be refused- ask indirect questions
- Gain child’s attention before you give the direction
- Minimize the number of directions
- Give clear direction
- Stay away from too many “NOs”
- Give child time to respond
- When appropriate give choices
- Stay positive- what you focus on grows
Establishing Rules
- Few simple classroom/therapy rules
- Involve the child in development
- Post the rules visually
- Teach the rules systematically
- Reinforce the rules
Ignoring Misbehavior
- Very effective techniques
- Maintains positive relationship
- Requires that adults reinforce positive and not negative behaviors
- Can be a powerful tool for changing behavior since access to attention is such a positive thing for children
How will most children initially react to ignoring misbehaviors
with an increase in the challenging behavior
Be prepared to wait out the testing period.
Be Consistent!
Redirection
- Can be nonverbal, verbal, or physical in nature
- Should not be confrontational
- Should focus on the behavior with
specific feedback - Turn behavior into a positive
Providing Positive Support and Feedback
- Give child attention for appropriate behavior
- What you focus on grows
What should you spend more time doing?
using positive descriptive language and less time giving directions or correcting inappropriate behavior
Prevention Strategies for managing challenging behaviors
- Figure out the antecedent
- Provide choices via language, photographs, visuals, or actual objects/toys
- Be consistent and predictable
★ Use a visual schedule
★ Use a “safety signal” - Visual Guidance
- Accommodation
What do you use a safety signal to do?
- Provide a warning
- Transition toy
- Give a countdown
- State ending activity and then what will follow
- If/then board
Prevention Strategy - Visual Guidance
- provide visuals to highlight boundaries
prevention strategy - accommodation
arrange activity, materials, toys to provide easy accessibility
replacement strategies
- teach alternative behavior that is efficient and effective
- consider skills that child already has and build from there
- make sure that the reward for the alternate behavior is consistent
rewards for appropriate behavior should be
equal or greater than rewards for problem behavior
What should you be aware of
tone of voice and facial expression
How to handle an aggressive situation
- Stay between client and the door
- Have parent present
- Move quickly
- Know policy of workplace
Conditions associated with behavior dysfunction
- sensory impairment
- cognitive impairment
- medial trauma
check out the vin diagram
Common behavioral issues with children who have cognitive impairments
- Easily frustrated
- Difficulty understanding instructions
- Impulsivity
- Choose inappropriate way to express frustration – hitting, etc
Suggestions for successful interactions
- Keep tasks and instructions simple and concise
- Keep expectations realistic keeping in mind cognitive level
- Talk to child, not the parent
- Watch tone- match child’s age
- Use demonstration, visual, auditory and tactile cues
- Ask if needs help
- Positive reinforcement
- Decrease distraction
- Allow adequate time for response
Legal Guidelines for behavior management
- Individual state guidelines and policies
- Informed consent of parent/child
- Certain types of behavior management practices require specialized training and legal input
1 trauma that kids are experiencing in early intervention
pediatric medical trauma stress
Get Help!
- Long standing behavior problems may be beyond your scope
- Document
