RW: Responding to Challenging Behaviours

Question 1

Intellectual and Developmental Disability

Answer 1

an umbrella term for a variety of disorders and disabilities

DSMV:

• group of conditions with onset in developmental period
• developmental deficits that produce impairments of personal, social, academic and occupational functioning
• cognitive impairment based on standardized testing

Question 2

Deficits in mental ability

Answer 2

Includes:
reasoning, problem solving, abstract thinking, judgment, academic learning, and learning from experience
-2nd percentile and below as benchmark

Question 3

Deficits in adaptive functioning

Answer 3

Failing to meet the standards of personal independence and social responsibility
- difficulties with IADLs and ADLs

Question 4

Autism Spectrum Disorder

Answer 4

Persistent deficits in social communication and interaction across multiple contexts

• restrictive or repetitive behaviour, interests or activities
• differences in sensory processing
• insistence on sameness

Question 5

Severity of ASD

Answer 5

Level 1 - requires support
Level 2 - substantial support
Level 3 - very substantial support

Question 6

Challenging behaviours (2 categories)

Answer 6

Organic aggression
- medication, side effects, delirium, pain, encephalitis

Learned through consequences

Question 7

Four functions of challenging behaviour

Answer 7

1. Escape
2. Attention
3. Tangible
   - to get something
4. Automatic
   - pain or discomfort
   - to feel good

Question 8

HELP Framework

Answer 8

Used to guide treatment, and to piece things together

Health
- medical condition, health issue

Environment

• problem with support or expectation
• changes to routine

Lived experience
- trauma, emotional issues

Psychiatric disorder

Question 9

Three Term Contingency Model

Answer 9

Used to capture information about challenging behaviours

Setting Events
- medication, changing schedules, sleep deprivation, pain

Antecedents
- events that happen right before challenging behaviour
- predict behaviour
TREATMENT: offering choices, stimulus control, altering task difficulty

Behaviour

Consequences
- stimulus change that follows a behaviour
TREATMENT: response blocking, redirection
- token economies
- systematic desensitization

Question 10

First-Then Strategies

Answer 10

Using a visual calendar to help client anticipate what will happen next and when it will happen

Whenever possible, offer choice:
- what special treat to get afterwards

Question 11

Other Tips for managing challenging behaviours

Answer 11

• Break task down into smaller steps
• Look for patterns, when behaviours are occurring
• Compare to baseline to avoid diagnostic overshadowing
• Preferences may change

Question 12

Tips for communication

Answer 12

1. Make sure client is paying attention, eye contact
2. Be specific - “hands down”
3. Short simple directions
4. One instruction at a time
5. State direction positively - “nice hands”
6. Tell, don’t ask - “time for potty”
7. Offer extra assistance - visuals, repeat direction
8. Repeat, practice and praise - develop habits and routine