Our (Current) Outlook on Dealing with Behavior

I’m often asked how we deal with behavior.  Let me start with-- we do not have “well behaved angels” with Down syndrome.  No, we have REAL people, REAL CHILDREN, REAL issues, REAL past hurts, and REAL trauma that we deal with around here.  That means REAL behavior issues.  For REAL!  So, when someone stops and tells me “your children are so well behaved!” I just might be jumping up and down inside.  Because we are SURVIVING!  It means that at that moment, no one is actively going nuts on me :D.  It’s a ‘win’!

Also, let me start off by saying that we are PARENTS.  We aren’t professionals.  Michael’s Master’s degree is in Organizational Leadership, not behavior management, and my Bachelor’s degree is in Education, not psychiatry (though I did minor in psychology! ;) ).  We don’t claim to have all the answers, don’t claim to do everything right.  We struggle through and are learning all the time!  We find something that works for one kid, for one month, then find out they’re no longer responding to it, meanwhile we have another kid it never worked for that something different did!  It’s a constant cycle of learning.  That’s why this list is far from exhaustive.  We are learning and trying new things ALL THE TIME.

We believe strongly that behavior is 2 things: Indicative of communication, and needing to be directly molded to be as appropriate as possible.

How we accomplish that is also a two-fold approach.  One is dealing with the behavior at hand, and the other is dealing with whatever it is communicating-- which can both work us through the behavioral challenge and help us to avoid it in the future.

None of this is anything spectacular or new, but it is sometimes just a reminder of what we already know that prompts us to be able to more effectively deal with behavioral challenges.  We don’t pretend to have all of the answers, and we are regularly met with behavioral challenges in all areas of life, so we are a definite work in progress!  I wrote this simply to share where we are at right now and to put it into one place.  

Remember, the ADULT behavior is also communication, and the adult’s response to the child is going to play a role in whether they want to repeat the non-compliant behavior in the future.

When met with a behavioral issue with a child, there are some initial things to keep in mind:

1. CONSISTENCY IS THE MOST IMPORTANT PART!
   
1. When a child is ‘surprised’ by a consequence to their actions, they can become even more non-compliant.  If they get away with something one time, then the next time there is a big consequence, they’re not sure whether they’re allowed to do that behavior or not.  These situations will lead to more testing, especially between different adults and authority figures.
2. Setting up an expectation of what will happen first, second, etc, while working through any given situation will help your child to understand that EVERY time a behavior happens, the same result will happen.  This gives predictability and helps a child to desire to change their behavior when it always brings about the same result.
3. If an adult cannot address a situation as the child ‘expects’ and the behavior CAN be ignored until it can be appropriately dealt with, it is likely better to ignore the situation and pretend it is unnoticed and then deal with it as soon as is appropriate rather than to give a different or unexpected response to the behavior.  Ie: child is in the middle of the mall and has been asked to come to the adult. They spit.  Spitting is a behavior often dealt with immediately, but in the situation with many people all over and a likelihood of escalation because of the attention that would be given to the situation, deal with the child not coming to the adult and NOT the spitting.  If the spitting continues when in an area where it can be dealt with as well, then take the determined actions to address it if necessary.
4. As in the example above, also consider that if more than one behavior is happening at the same time, deal with the more immediate need.  In that case it was removing the child from the area first.  If the behavior determined to be secondary continues after the first priority behavior is dealt with, then it can be addressed at that time.  Ie: the child is still spitting when they have arrived in a quieter hallway.
2. Behavior is communication.
1. If the child is disobeying an adult, are they looking for attention?  Testing the boundaries to see whether they are the same as other boundaries?  Attempting to “sabotage” a positive experience?
2. If the child is not participating in an activity, are they doing one of the above or are they avoiding a difficult task?  Nervous about compliance?  Not understanding the directions of the activity? Past their attention span?  Getting bored?  Already accomplished the necessary skills (activity is below their ability level)? Unable to accomplish the necessary skills (requires more than they are able to produce at the moment)?
3. If the child is being disruptive with peers, are they seeking physical or auditory input from the reaction of the other child, adult, or a supervising adult?  Seeking their own input in ‘hurting’ the situation (ie: hitting feels good to them)?  Attempting to avoid the activity they’re taking part in?  Inappropriately attempting social interaction?

1. Look at what happened before the behavior as well since it may give insight into why the child is acting that way.

3. It is important to distinguish whether removal or prompting is a more appropriate response to the behavior.
1. If the child is in a desired activity- playing, for instance, then removal is a completely appropriate response.  Overwhelming sensory activities may require removal.  Areas that the physical atmosphere is directly impacting the behavior would also be appropriate for removal.
2. If the child would prefer to NOT do the activity, removing the child due to behavior communicates that the negative behavior is an acceptable way to avoid the non-preferred activity in the future.  
3. If the behavior isn’t affecting the activity- physically or socially- then it may be best to ignore and not engage the behavior at all.
4. The adult’s reaction or non-reaction plays into the entire situation.
1. If there is a gasping response, a rush to the child, a raise in volume, a significant facial expression, or quick and jerky movements, the child is going to interpret those things either to their benefit or detriment.  ANY response is reinforcement.  Reinforce what you want to see repeated.  Do not reinforce what you want to stop.
2. A non-reactive approach, straight faced, firm but not angry nor nonchalant, and with a very ‘intentional’ and not reactive nor harsh movement to take care of the situation is usually going to be the best way to diffuse and gain compliance.
3. Safety issues need to be dealt with quickly and safely, however after everyone is safe, evaluate and be intentional.  This may be a quick (loud) call out to the child for them to stop, or an immediate stepping in to remove a child.  Then, consider the other areas of behavior listed below to deal with the situation.

There is extreme importance in setting a child and adult up for success!  Here are some tools that can be used to avoid or prepare for behaviors:

• Incremental rewards within a given activity
• This is especially helpful when an adult knows that a situation may draw negative behavior.  Setting up incremental rewards prior to the point where there is an expectation of difficulty may provide a better route to success
• “Safe place”
• Having an area the child knows they may ‘retreat’ to if needed that is a safe place for them to wind down when over stimulated.  The child may need prompting to use this space, but it would be somewhere they will naturally calm down and are comfortable.  It will look different for each child, but may include being quiet, having a preferred ‘seat’ (bean bag chair for instance), and a quieting activity (sensory bottle, calming musical toy, etc)
• This can also be an adaptive stroller or wheelchair when moving about in public places, which provides boundaries and ‘safety’ to a child.
• Intentional avoidance
• Does he really need to go grocery shopping when he’s already overwhelmed?  Sometimes the answer is yes, but if it’s no, then be reasonable and let him stay home with someone else.
• Positive reinforcement for specific activities
• Setting up a “step one, step two, step three, REWARD” helps a child work through difficult tasks successfully because they understand that the reward will be given if they successfully navigate steps 1-3.  This may need to be modified to fewer steps, etc, but keep the ‘rewards’ reasonable to be accomplished immediately.  A sticker, 10 minutes on an electronic device, or a favorite short video for instance.
• Provide choices to give some ‘ownership’ to required but non-preferred tasks
• “We will stack blocks and do Mr. Potato Head.  Stack blocks or Mr. Potato Head first?”  Is an appropriate choice to give.  “Come to me or I’m coming to you!” is not an appropriate choice for ownership.  That is interpreted as a threat, not a choice.  A choice needs to incorporate two activities that the child can choose between.   Often choices are given when BOTH activities will be accomplished and the choice is which one the child does first.  
• Get out before you’re in too deep
• When a situation is not going to go well and there’s obviously a ‘disconnect’, redirect, abandon post, and start over on your terms.  It’s not always necessary to see everything through to full completion, and finishing ONE STEP then leaving is ok!  AS LONG AS the child’s behavior is not the direct cause of the abandonment.  Ie:  The task appears to be too difficult, boring, etc, and the child is not complying, then do “just this” then change course.  Attempt to finish on a high note before changing activities.
• Prepare the child ahead of time
• Talking through an activity, using video modeling, visual schedules, or social stories can help when an adult is preparing a child for an experience that may be challenging in a behavioral aspect.  For instance, a trip to the dentist or even an amusement park!

Even when setting up a child for the best chance of success, there are still times when behaviors need to be dealt with.

Here are some ways we work to change the situation in order to bring the child back into cooperation with the task at hand that can be used when the child is having difficult with any of the following types of situations and more: following a request to come to the adult or do another independent task, hitting or throwing during play, or being non-compliant during a work task.  

• Ignore (is it really causing an issue that needs to be addressed?  If not, ignore if that won’t cause it to escalate)
• Verbal prompts in single steps (stating what the adult wants done or not done broken down into each piece. Ie: “stand up”, “come here” instead of simply “come here”)
• Visual prompts (showing something that needs to be done either by modeling, using sign language, or pointing.  Ie: walking on a balance beam to show them to walk on it or pointing to the floor in front of the adult indicating where they need to come.)
• Hand-over-hand prompting (setting the child up for success by positioning them to begin the procedure to complete the task on their own, ie: the adult uses their hand to put the child’s hand on their fork when they have been told to eat)
• Physical prompting without reinforcement (putting hands over or on the child to prompt them to move on their own accord WITHOUT putting any pressure to get them to move in that direction ie: putting a hand out as if to help them stand up, but not providing resistance when they reach for it, so they still have to stand up on their own accord and will not ‘hang’ on the adult hand in order to receive feedback.  Ie: placing a hand on the child’s back without putting pressure to suggest they move forward.  Ie: loosely holding a child’s hand to prompt them to walk beside the adult)
• Full physical prompting of step 1 of activity (ie: standing a child up to their feet when they’ve been asked to come, with the expectation that they complete the task independently- adult then returns to where they were when the child was prompted initially to ‘come’)
• Time-out from a preferred activity (in a chair, stool, or specific ‘spot’ that is non-stimulating)
• Removing items causing an issue or removing child from area causing an issue (distractions such as balls in the room being hidden, or moving the child away from a door they want to open or knock on)
• Separating people who are conflicting with one another to both go to different activities
• Providing a ‘coping tool’ (ie: a musical object, calming lights, sensory bottle, fan, massage, etc- typically sensory related but not ‘thrilling’)
• Going to a “safe place” that has been set up for the child to use when overwhelmed
• Talk through the issue eye to eye (both the reason a they are not complying and what compliance will look like)
• Physical response (this is not appropriate for every child, depending on their history and disability, but as a piece of the tools in the tool box, a ‘swat’ can go a long way. This should always be thought-out and never ‘reactive’ or harsh.   Ie: A child is reaching for a knife, a ‘pop’ on their hand will quickly make them draw back and they are less likely to reach for the knife again immediately, whereas talking to them about safety and sharp knives may be above their cognition.  I again reiterate that it is not appropriate for every child depending on their history and disability, but it can be a useful tool for those that it IS appropriate for.  Strong opinions against this are understandable and it is mentioned as a piece of a tool box for dealing with behavior)
• “Proximity Control” (Putting the child close by the adult, or the adult close by the child, in order to be a physical reminder that they need to behave-- ie: standing with their hand on the arm of the adult’s chair, or the adult standing directly next to or behind them depending on the situation)
• Time-in (nearby the adult in whatever the adult is doing without changing what the adult was already doing)
• Time away in a secured and safe place (high chair, playroom, playpen, or even between adult’s feet on the floor)
• Logical consequences (these things are directly related to the thing that happened, and can be done with or without the child’s total comprehension of the consequence.  Ie: child is cranky- early to bed that night to get more sleep.  Child stole sweets- they used up their ‘sweets allowance’ for the week and are reminded of that for the following days)
• Attempt to have the child communicate to the most of their abilities what is going on, while avoiding giving too many suggestions as to what the adult thinks it may be.  

As I started out with, none of these behavior techniques are particularly novel in and of themselves, however as a whole, they are all tools to help adults to set up a positive environment for children and to deal with behaviors as they arise in different situations and with children who may have varying levels of physical abilities and cognition.  

((Recommended read: Stein Woodbine House Behavior and Down syndrome ))

~Meredith Cornish 2016 www.facebook.com/theCornishFamily

About us:

Michael and Meredith are parents of 11 children including 5 biological and 6 adopted children.  Seven of their children have special needs including Down syndrome, cerebral palsy, autism, hard of hearing, reactive attachment disorder, mental health disorder, prematurity, and visually impaired.  Their children range from 8 months to 13 years old, with their children with special needs all between 8 and 12 years old.  Michael is a very hands-on dad, and during the work day he is the network administrator at a Christian school.  Meredith takes care of their home front during the day including homeschooling, therapies, and medical care for their children.  Michael and Meredith are passionate about their relationship with Christ and about bringing children to know and have a relationship with Him.