EBL Newsletter EBL_Newsletter_Summer_2019_Digital2 | Page 14

Intellectual disability means a Positive Behaviour Management Strategies for Family Members significantly reduced ability to Challenging & Complex behaviours: the ABC approach understand new or complex It can be very stressful dealing with behaviour issues, but the ABC model is Health Management for Associated Healthcare Conditions + Links Defining Intellectual Disability information and to learn and apply new skills (impaired intelligence). This results in a reduced ability to cope independently (impaired social functioning), and begins before adulthood, with a lasting effect on development. Disability depends not only on a child’s health conditions or impairments but also and crucially on the extent to which environmental factors support the child’s full participation and inclusion in society. The use of the term intellectual Preparing for the antecedent An inability to cope with chaos, unpredictability and lack of routine is common after a brain injury. For example, if Chris finds the activity and noise of a supermarket unpleasant, it can help to talk about expected reactions and ways to cope before the event. Snapshot Of Causes Of Id In Australia • Down syndrome – 12–15% of all Australians with ID (Bittles & Glasson, 2004) Behaviour • Autism spectrum disorder What happens during the behaviour (what does it look like?) (causing severe or profound a handy way to understand what is happening, and respond instead of just Before you respond to an actual behaviour, the key is to understand the limitation) – 0.5% of Australians, reacting. It involves looking at the: purpose of the behaviour and what it may be expressing about unmet needs. with 71% experiencing severe or Although emotions can be running high, there are still strategies that can prove profound limitation (Australian useful during the behaviour itself: Bureau of Statistics, 2014a) • Antecedents (what happened before the behaviour?) • Behaviour (what is the actual behaviour?) • Consequences (what happens afterward?) This is an effective technique for taking the emotions away from challenging behaviours, analyzing these behaviours, then creating effective responses. When creating a behaviour support plan, it will be important to work out which strategies you will use. These strategies are not to be used occasionally, but will need to be applied consistently by everyone who encounters the targeted behaviours. While they may be difficult at first, your chosen techniques will eventually become second nature. Antecedents What occurs before the behaviour (and may have triggered it)? • Cerebral palsy (with ID) – 0.07– • Stay calm and speak in an even tone • Give simple directions and prompts about coping mechanisms • Use non-threatening hand gestures 0.2% of Australians (Australian Cerebral Palsy Register, 2013 • Fragile X (with ID) – <7,000 • Manage your personal safety and remember the strategies agreed on for Australians (Brown, 2010) dangerous incidents • Recognize when it's time for disengagement/exit strategies for crisis situations. Defining Quality Of Life • Ignoring the behaviour The World Health Organisation In some cases, behaviour occurs to get attention, so the best strategy may be defines Quality of Life as to ignore it. As with many of these techniques, tactical ignoring is best linked “individuals” perception of their position in life in the context of the disability in the context of the The antecedents are simply all the relevant things that happened before the with positive reinforcement. For example, a child is ignored during a tantrum, WHO initiative “Better health, behaviour occurred. They can also be considered as triggers for the behaviour, but is rewarded with praise, a treat or favourite activity once the tantrum is culture and value systems in which such as: over. they live and in relation to their • things that other people did or said Consequences children who have been placed in • emotional state (e.g. depressed, tired, anxious etc.) What are the immediate and delayed reactions from everyone involved? institutions because of perceived • the environment (e.g. hot, noisy, cramped, smell, bright lights). The consequences, or our responses to a challenging behaviour, are very way by the person’s physical important. For example, a pleasant consequence can simply reward the health, psychological state, level of behaviour, while a negative consequence may discourage it. independence, social relationships, better lives” includes children with autism who have intellectual impairments. It also encompasses disabilities or family rejection and who consequently acquire Managing these antecedents, or triggers, is a proactive way to avoid developmental delays and behaviours occurring in the first place. Here are some useful strategies: psychological problems.” (WHO) • Build and maintain good rapport • Avoid or minimize known triggers • Sometimes a distraction or redirection away from the trigger may be all that is necessary • Involve the brain-injured person in discussing triggers • Work together on possible coping strategies in dealing with triggers • Suggest and encourage these strategies when a trigger occurs. Graduated exposure to the antecedent This is useful when antecedents can't or shouldn't be avoided. With time and patience, it can be a powerful technique. For example, Kirsten starts screaming in supermarkets due to sensory overstimulation. Her mother says they will just stand outside the supermarket for 30 seconds then go home. The next time, they go in for 30 seconds then go home. This is gradually lengthened until Kirsten has adapted to this difficult environment. 14 EBL QUARTERLY NEWSLETTER goals, expectations, standards and Pleasant consequence: "When I yell everyone gives me what I want". concerns. It is a broad ranging concept affected in a complex personal beliefs and their relationship to salient features of Negative consequence: "When I yell everyone ignores me completely". their environment.” (World Health When we use the ABC technique to analyse behaviour, we tend to stop Organization, 1997, p. 1). reacting emotionally in ways that often make the situation worse. A consistent Source: www.nds.org.au/images/ response from everyone to challenging behaviour can have a very strong effect LearnNDevelop/Chronic-Illness- over time. and-People-with-Intellectual- “ Disability.PDF ” Our vision is to passionately support individuals and their families to lead fulfilled lives. EBL QUARTERLY NEWSLETTER 15