Dealing with Challenging Behaviors – Part 3

Hi I’m Virginia Spielmann. I’m the
associate director here at STAR Institute for sensory processing
disorder in Colorado and this is the third part of the three-part series
about managing challenging behaviors. A lot of this material is coming
from other resources. So the first thing I want to point you towards is
Diane Cullinane’s excellent book we will put a link so that you can find it
really easily Behavioral challenges in children with autism. and other special
needs it’s a developmental approach and much of what I’m saying is really
inspired by this book which really resonates with the STAR frame of
reference it’s very much in synchrony with how we like to support children
here but it organized my thinking about this so nicely and it gives three really
nice manageable steps which is what we’re going to talk about today. We’re
going to expand on the three steps for supporting challenging behaviors in the
moment and we will touch a little bit on managing aggression but obviously we’re
not going to solve all of the world’s problems in the next ten or so minutes.
So this is just a start of the conversation and I’d love to (if you
want to learn more) encourage you to read this book but also ask questions in the
comments and let us see what discussion happens going forward from here. We
talked in the first week, the first part of this series, about really needing to
look at the behaviors as communication of something going on deeper down, as the
tip of the iceberg. We were talking about being detectives and asking
what’s going on. We talked as well previously about what defines a
challenging behavior and that some of the behaviors that we’re uncomfortable with might be our responsibility to deal with our own stuff and rather
than impose that on the child. So when we’re talking about challenging
behaviors we’re not talking about compliance and normalization type
goals. We’re talking about when our children are out of control,
unhappy, they might be in a place of rage anger and complete dysregulation. How
do we support them to make better decisions and also, just to really
establish where we’re coming from with this, when we’re helping our
children with challenging behaviors we’re not just punishing them, we’re not
just making them feel bad. This isn’t just a consequence driven approach to
managing challenging behaviors. It’s saying this is an opportunity for
learning and we want our children to develop more sophisticated ways of
managing the external world and their own emotional responses to the things
that happen inevitably in life. So challenging behaviors as teaching
opportunities and discipline only as a way of teaching and supporting and
helping. That word helping; we’re helping our children, we’re coming alongside and
collaborating. And so how do we do that? There are three basic steps that we
touched on in part two and they are attunement. Step one, attuning to the
child – what’s going on and helping them get organized – organizing the
effective experience. And then there’s also helping the child, second point, to
move back up the developmental ladder. So we help them recover and then we help
them hopefully regain their baseline and we want them to ultimately level up a
tiny bit each time, as much as is realistic developmentally. So for
teachers think about Vygotsky’s zone of proximal development for OTs think about
the just right challenge. We’re thinking about that little place of growth that
should be available in every organic everyday experience. The third
step is coming to a genuine resolution of the event. That true repair – that we want to happen. And that may not happen in the moment, we talked
about that as well. That might need to take place later. And often we want our
kids to move very quickly to saying sorry, but what we’re saying with this
sort of approach is that true repair happens after everyone’s had time to
take a really deep breath, process and get to that place internally rather than
as imposed by an adult from the outside. Attunement, helping and resolve and
repair are really what we’re talking about. So what does attuning and
organizing mean? First of all make sure everything’s safe, immediately
stop the aggression and we talked about as adults putting on the brakes a
little bit and trying to figure out what’s going on for the child.
What often happens when we see aggressive behavior is that our arousal
goes awry and we get dysregulated as adults and so if we can put on the
brakes in the moment, take a deep breath and be safe, then we can just take
that time to check on what’s really going on. We’re trying to observe
the child, be empathetic with the child. What is the child experiencing? Feeling?
What’s going on for them? What’s happened in the past that might add more meaning
to this particular event? We’re asking those times of types of questions. It does take time but you’ll be surprised the amount of time it takes to
put the brakes on and think like that is actually minimal. It feels effortful at
first when you’re really practicing. In fact, let’s be let’s be real, it feels
effortful a lot of the time! But in the longer run it does save time as
hopefully our children learn and so these resolutions come faster and then
eventually our children are able to control their impulsive responses to
things. That’s our ultimate goal – that they’re the problem solvers
and social problem solvers So we’re attuning to the child, we’re
giving ourselves time to say what is this child’s experience right now, what’s
going on for the child – so not just that they’re a bad kid. What’s really
going on? What do we know about the child in this context? What are this
child’s individual differences? This is where we really want to think about
potentially some sensory pieces that might be coming in and being
disorganizing here. So a great example of this might be in the school cafeteria
where there’s a lot of noise, there’s a lot of hustle and bustle and touch,
there’s a lot of unpredictability there’s a lot of visual stimulation and
something small might get a response from a child or student that looks
aggressive but if we can take into account that, hang on, on top of
everything else, that this child is dealing with right now – that
wasn’t a small thing, then we can help with that attuning and organizing this
first step we can say, wow, this is a lot for you right now. And we can just take
that moment to recognize all of those pieces. And so a really important
question in this step one is just asking does the child who is historically
seen as the aggressor but does this child with the challenging behavior feel
safe right now? Does that child feel safe? As well as everyone else in the
situation. So when we talk about safety we’re not just talking about
the person on the receiving end of the challenging behavior but also this child –
do they feel safe, do they feel secure? What do these relationships feel like
for this child? Are they in a state of fight-or-flight? Are they feeling
threatened? How is their nervous system
processing what’s going on right now? Is this child’s body trying to
keep the child alive? So safety, safety is one of these pieces in the
first step. So what we do is we ask those
questions and then we just try to join the child in that moment – that
tells them a lot of things. It tells them that this is a tolerable experience,
because you as an adult are modeling that you can tolerate this okay
so that’s kind of a big thing here. Often we move very quickly to soothing our
children and we don’t really show them that these big emotions are tolerable
and so they don’t know that this is actually okay we can be here and we’ll
still be alive and safe and okay the other side. So we join the child
and we be with them. It also helps the child to come to a place where they
feel really heard when we can just join them in that moment. So we would use
sincere emotional messaging to show empathy and understanding with that
child and we need to find a way to be sincere. An example I often think of
is when a child says to their mother “I hate you” and the mother says “well I love
you too” and the words really don’t match what’s going on for the mum and so how
do we respond differently? Well we might say something like “that must be really
hard, that feels so difficult” and that’s just a really different way of
coming into these things. So joining the child and being with them in the
moment and sincerely meeting what’s going on with them – that’s part of
this step one. We might provide them with information to help them feel
heard – that you’re with them and get organized. So that might be
nonverbal it might just be going whooa. It might be saying “wow that’s a lot, this
feels difficult”. Often there’s fewer words, it’s a lot about your voice, your
face, your pacing of your body your movement. But this is about organizing,
helping them know that this experience is tolerable, that you acknowledge where
they’re at, that they’re heard. This helps them get to
that state control – that level of arousal where
we want them to recover – to regulation And we have to
get to regulation before we go anywhere else and if all you can do is step one
then that’s actually okay. Because if we’re dysregulated and our
nervous system has taken over, our upstairs brain is not online and we are
not able to be logical and reasonable and say sorry in a way that helps us to
learn why on earth we should be sorry. So recovering that state
of regulation is really important. So we want to get to that place of emotional
organization and that the nervous system, the physiological response – we’re
recovering. And that may take a little bit of time, with some of our kids it
might take a long time, but doing that with them being with them, sitting with
them while they recover can be really important. Then they can start to
have shared attention because they recovered, their upstairs brain is
starting to come online more, their limbic system is in a more level
place, they can acknowledge what else is going on in everyone else’s world and
they can start to be organized in their emotional response. An example for
this for me as a child who has a splinter and they need to have the
splinter taken out, right, and that’s a painful thing and they don’t want to do
it and they get really really crazy upset and if you if you try to shout
them down and meet them in their crazy place then you’re never gonna get that
splinter out. But if you’re able to go “whoa this feels really awful right now” and they can go “yeah that’s what I’m trying to tell you” and
then you can say “you’re really telling me you don’t want the splinter taken out”
and they’re like “oh”. That kind of language if they can internalize that,
that helps our emotional arousal come down and then you’re able to say
“I hear that you don’t want it to be taken out but we have to take it out
because of your safety it’s the right thing to do and I’ll try and make it
hurt as little as possible”. So that’s what I mean by it feels like it
takes a little bit of time and effort to support children in this way but
actually in the long run hopefully it’s it’s time effective because you get the
splinter out and you don’t have to all have timeouts and different things
afterwards. So there’s just that kind of different way of doing things
that way around. We want our children to recognize that they’re no is being
heard – consent is a huge issue and it’s still an issue in these challenging
behaviors. We need to respect that when our children say
no – and we need to show respect for that, whether they consent to
something or not. Then we need to help them organize that global distress
and and connect with why something may still need to happen if it really does.
So being organized around particular feelings so that we can get to that
place is really really important. So step two is help and helping begins after the
attunement after we’re getting a little bit calmer and we’re trying to help the
child’s – you can see there’s some developmental progression
here. We’ve helped the child recover, we are now trying to help them –
they’re at their baseline – we’re now trying to help them get a little bit
more sophisticated in their thinking and really what we mean is problem-solve. So
we want them to be able to express themselves and hear other people. So
first of all they need to express their current experience and feel acknowledged
so you’ve done the meeting you’ve done the nonverbal you’ve used your words can
they use theirs to tell you a little bit more about what’s going on? And you say
“wow I really hear you”, you hear that This takes calm confidence from the
parent and it’s not about letting down boundaries it’s not about
being permissive. You maintain your safe boundaries but you
also, with your attitude of helping, you just ask them what’s really
going on. You can use statements of help in the helping section as well.
So you might say “I’m gonna hold you and help you stop” or “I’m going to
suggest that we go and sit over here so that we can help you calm
down” or “I’m gonna help you get down from there it’s not safe up there”. So you can
move from step one to step two very smoothly, very quickly in some cases.
“I’m gonna hold your arms I’m holding your arms because I need
to help you stop hitting”. So these are statements of helping and
they’re the same as saying no, but they’re collaborative and they’re
empowering instead. Helping is respectful of the other person but also maintaining
safety with that calm confidence and so you might take a break with the child,
you might go and sit with them while they recover. A timeout might work in
some cases but often when we put our children in a room by themselves, they’re
not actually going to get regulated recover and learn in the same way as
they will in relationships, so we talk about ‘time-ins’ we talk about going and
having breaks together and wherever possible keeping the communication going,
keeping the conversation going and there are ways that you can do that, you can
offer choices “we’re gonna go and take a break do you want to do it in the
library or do you want to do it outside the classroom” –
those sort of control choices. And again you’re being sincere with
your gesture and your affect. I’m trying to not take up too much time as I
talk about these different steps and I’m hoping that there’s
some interesting discussion happening as you listen to this. We’ve gone through
helping, we’ve gone through attuning and organizing and I’m going to quickly jump
to resolving. Resolving is when the upstairs brain really has come
online so for some of our children that happens much further after the event and
for some of them you can see that you might be able to quite smoothly move
from attuning and organizing to helping and to resolving and what we’re thinking
about with resolving is helping the child make amends – so that’s the real, meaningful apology and also how to function when experiencing these
emotions next time. That’s step three – how to function when experiencing these
emotions next time is a really key piece of this kind of approach so we will use
whatever supports we can for that child so that they can be calm and organized
and logical. So we might need to use sensory motor supports for some of our
children with those sensory differences. Comfort, safety based on the
relationship. We’re looking and reading the signs of that child’s physiological
states. We’re asking them if they’re ready and then we’re able to go to
that next stage and so we need to help them reflect on what happened in the
other child’s world as well as what was triggering for them and we need to help
them resume the activities and relationships with grace. How are we
going to open the door so that this child can come back in successfully
without shaming them but also having that learning experience and so we might
rehearse the apology with the child we might wait for them to be ready to understand why they should say an apology
and I’ve had children need to go out the room for a few minutes they’re okay but
they just needed that time to process that processing time and we honor that
and then they’re able to come back in and go “you know, I am really sorry I’m
disappointed in the way I made that decision” and these are kids who
otherwise would not be capable of such sophisticated language. They might need
to actually fix what was broken or replace what was damaged to really
understand the consequences, those are natural consequences of doing something.
You fix something that you broke, you replace something that you damaged, you ask ‘please forgive me’ – you give the other person that place
of saying “yeah I forgive you” rather than “I’m sorry okay”. Those different
types of ways of thinking about things – those are natural consequences to
challenging behaviors. They might need to do a good deed, they might need to –
something that’s really connected to what happened. This recovery repair and
review and then rehearsing for what happens if it happens again that kind of
reflection might come a lot later. Really what we want is for the child to
bring closure to the incident and then be able to learn, increase their pride.
Wow – imagine that being a goal of a situation where there’s been
aggression or challenging behavior. That the child would feel better coming out
of it and that their self-esteem would grow. So those are the
three steps – we want them to return to that baseline of emotional equilibrium
we want them to be able to be logical to be online to think about what happened
and then we want them to be able to repair any harm done to objects or
relationships and then those natural or planned consequences of actions come in
as a learning opportunity so that there’s recovery review and repair. So
those are the three steps. We haven’t really touched on aggressive
behavior yet – aggressive behavior really needs its own three-part series but just really really quickly to just talk about the fact that, when we’re
trying to do those three steps with a child who’s being violent or aggressive
our regulation is one of the most critical things to be mindful of as well
as safety and so those kind of helping phrases and all of those pieces – you might need someone else to be helping regulate you it might need to be
a two adult thing if you have that luxury. But if you meet the child in a
dysregulated way you are definitely fueling the fire the rage the anger
especially with our sensory sensitive kiddos
they are often emotionally sensitive too and they pick up on other people’s
signals. So we act with that calm confidence and that’s really helpful for this piece of aggressive and violent behavior so that the child can access –
you can be the frontal lobe for that child and they can access that sense of
safety and security from the limits that you’re setting in the calmness that you
have and that can take a while to cultivate and then in that way you
can help the child redefine the experience and you show that tolerance
for what’s going on and you communicate a different perception of what’s
happening maybe it’s not as life or death as the child perceives it to be. So
safety is always a priority and containing the child’s behavior in a
safe way and you need to check on your policies and what’s going on in your
area and if you’re in a school but also letting that child know that their
emotions are being acknowledged, that they’re recognized and that you’re there
to help them calm down – those helping statements are really helpful. So I hope
that wasn’t too long and it was helpful and you enjoyed it and I’m looking
forward to reading your comments.

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