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Challenging behaviour and what to do


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Hi

Just after some advice. I have a little boy that will be 4 yrs old in a couple of months. He has been with us for nearly a year and he is in the proess of being referred to a paediatrician by GP (hopefully) as we have concerns about his behaviour and he shows some autistic tendancies. I really cant say for sure if he has behavioural problems or is on the spectrum. I have referred to our sen team but they will not take him on as he is not severe enough. He has little clear langauge but does try to communicate and we can understand some of what he says. He has also uses learnt phrases eg help me please, no thank you.

 

For the last 2 months I have been completing ABC form for behaviour. I have sat and assessed it all and there are recurring things - sharing/turn taking, sitting down for register/story, washing hands, coming inside from outside, not letting children in eg home corner (new one), eating sandwiches. Now this is not every time. Some days he will happily sit on the carpet, wash hands, come inside, eat all his dinner etc so i have determined it is not sensory. No pattern in children, times, lights, noise, smells etc and when I asked why he does not want to he said "dont want to". He has good understanding. I have now determined that some is avoidance behaviour (tidying up/sitting for reg) and some is wanting particular items. We are using visual time tables, first and then boards, gving choices etc. However whenever staff intervene he has melt downs resulting in him saying no, crying, hitting, pushing, throwing near items. We have set up a calm corner for him but he does not want to use it! We then find that we have to move the other children away from him to keep them safe. With avoidance behaviour from what i understand they must not be allowed to avoid the task otherwise that re-inforces the behaviour. So how would we go about getting him to sit for reg but keeping the other children safe. For eg tidy up once calm he is asked to put 1 item away and he will but sometimes he has not calmed down quickly enough to sit with others or when he has clamed down and we ask him to come sit back down some times he will happily, sometimes he starts again. There is no reasoning whilst he has his meltdown, we have to wait until he is calm. We do provide choices for him but one day he will sit lovley for story and then the next he refuses.

It's all very tiring! I have been reading lots about interventions but just wondered if anyone else had any ideas?

He likes the train track to be complete and gets upset if it isnt, is happy to play in water, sand, playdough, skips from one side of the room to the other in own world, gives eye contact, points to items he wants/things of interest, limited pretend play. We have changed setting, new staff in Sept and he coped amazingly..no issues during the first week back!

He has IEP/behaviour support plan

Thanks

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what are his rewards and praise systems? does he like high fives/stickers etc etc ...I would load the praise too it's easy to get in to a downward spiral. Rewards need to be exciting/motivating and frequent! ;) It is really hard work so share his care between you ...does the way one person say something affect his response?

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We have used an exercise book in the past, got the child to help decide what to put on the cover, print out their favourite character etc, they colour in or paint etc. We then write in the book each day all the good and bad things that have happened and add a sticker for each of the good things. The book then goes home and parents can do the same, we try to focus mainly on the positives and try to get as many stickers as possible. This has worked for us but obviously it depends on each individual child. I'm surprised that the SEN team won't help! I thought that was what they were there for, to help and offer advice. We were struggling with one child in the past and all it took was one visit from the area SENCO to observe and advise us, even though it was simple advice and as soon as she said things, we realised that it was obvious, but we had become blind to it as we were in the situation day in, day out. I hope you get the support you need and find a way to help this child.

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Your little boy is so like one we have at the moment. He has an "obsession" with his main friend and when his friend goes to do something else, the little boy gets really angry, shouts and storms off .We have asked for Inclusion support and they are coming to visit in a few weeks. We need some strategies for handling him. Anything useful, I will share.

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It sounds like a referral to a paediatrician is a good idea and, if a neurodevelopmental assessment follows, it should give you some good guidance for helping him.

Sensory issues and demand avoidance are both well recognised features of autism spectrum disorders and they can both vary from day to day, even minute to minute.

A child can be having a good day, where lots of things has been a little easier than usual, perhaps they have slept well and the breakfast happened exactly how they expected it that day, nobody has brushed against them by accident and the toy that makes a noise that irritates them isn't out that day. This could be the day when this little boy can sit nicely for story time or help clear up.

On other days, they may have struggled to sleep, the breakfast cereal they were expecting has run out, a label in their clothing is digging in but they don't recognise the problem and they've come to pre-school in dad's car because mum's is being serviced. This could be a day when this little boy's stress bucket is already almost full. It only takes one flickering light or not being able to find the car he wanted for everything to fall to pieces for him.

You won't have any idea what all those background issues are for him and will be wondering why he can do something on one day that sends him off the scale the next.

I don't agree that forcing demand avoidant children to complete tasks is the best way to manage them. It is likely to trigger greater anxiety and increase the avoidance (I speak as a parent of a child who is diagnosed with PDA).

A better approach might be to try to avoid placing unnecessary demands in the first place. Consider whether is really matters if he sits with the other children for story time when he is finding it difficult. Could he have an alternative quiet activity available for that time that he will find easier to cope with?

 

It's good that you've realised that you cannot reason with him during a meltdown. Children who are truly in this state can lose the ability to process speech and thought so they are literally unable to understand what you are trying to say to them. Meltdowns are frightening experiences for children and they need adults to help them calm down and feel safe again afterwards. Repeating the request that triggered the meltdown may not be a good idea as children recovering from this high state of arousal are easily sent right back into it.

You can help him by carrying out lots of observations to try to identify less obvious triggers to his anxious and avoidant behaviour. He may be feeling wound up by something sensory like perhaps the aprons used for water play or a particular person's perfume without even knowing it himself.

This sensory audit might help you with things you could consider;

http://www.aettraininghubs.org.uk/wp-content/uploads/2012/05/37.1-Sensory-audit-tool-for-environments.pdf

 

Also spend some time talking it through with his parents and finding out what he finds difficult at home, what might trigger a meltdown there, what they find helps to calm him down and if there are any repetitive activities he seeks out as they may be things you could support in the setting and help him feel more relaxed.

 

Edit to suggest that you could offer to provide your observations for the paediatrician appointment as they could help the parents explain his difficulties more effectively and be used as part of any assessment.

Edited by Upsy Daisy
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not sure if this would help in your situation but could you provide a quiet place for him to go to ?

this could be an area with soft toys etc., where he goes when he feels he needs some space away from everyone -this could be with an adult (if he wants one with him) or without - it would give him time to calm down and feel less stressed.

once a melt down starts that is it - the child will need to work through it before anything else can happen - they need lots of positive support afterwards too so we found a quiet space worked well for this - lots of cuddles and support but only when the child is ready/ wants it.

it is a very hard/stressful time so defintiely needs to be shared out amongst staff.

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Hi all. Thanks for the advice and ideas. It seems that we are on the right track with how to support him. He has his own quiet space with blanket..calming bottle..car and tape measure he likes. It's just he won't go there even when encouraged to! Will keep trying.We also do heavily praise all the times he does sit down etc with thumbs up and high fives. Using countdowns helping and been advised to give him first choice of where to sit or even stand at register so will see if that helps. Mum always tells us in the morning how he has been eg sleeping etc. Thanks daisy it's good to be reminded that we may never know what causes the behaviour one day to next. He is a lovely little boy.Thanks again.

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Your little boy is so like one we have at the moment. He has an "obsession" with his main friend and when his friend goes to do something else, the little boy gets really angry, shouts and storms off .We have asked for Inclusion support and they are coming to visit in a few weeks. We need some strategies for handling him. Anything useful, I will share.

Further developments for us with this little one is that other parents are telling us that their child has gone home and copied some of the things they hear him shout when he is having an angry episode, e.g. "Go away" or "Stop telling me what to do".

Our approach is to ignore this behaviour from him but it seems the other children are picking up on it. Any advice on how to handle the other children and especially the parents who are concerned about their children's behaviour now.

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I would say to the parents that their children are just exploring the new language they are hearing, as children do, and, if they model and encourage more appropriate ways of expressing themselves, their children will follow their lead.

With the little boy in question, I would re phrase and reflect back his comments so he learns a more appropriate way to express his needs, e.g. would you like me to leave you to calm down for a moment?

Can you work out what it is the friend is providing by being around that this little boy needs? If you can, perhaps an adult could step in when the other child moves away and replace him for a while. Is he providing some sort of commentary or explanation of what others want, shielding him from other children, participating in a particularly predictable form of play perhaps? Could you find one consistent adult to support him whenever possible so this person becomes as familiar as the friend?

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Thanks Upsy Daisy for replying. Its always good to get other's take on the situation. The little boy just reacts negatively when ever his friend moves off to do something else, shouting and chasing after him, and being aggressive to any adult who tries to intervene. He seems to have a default setting of always saying No to any suggestion from an adult, e.g. Let's go and read Shark in the Park (his favourite book). We are coping with his behaviour most of the time. But its the effects on the other children which are particularly challenging. The parents of his friend are also worried because he is now copying. They want us to keep them apart which isn't easy in a free flow setting, especially as they do gravitate together a lot of the time and can play quite nicely sometimes.

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