Neurologically-Based Behaviour: Chapter 3 Explained

1. Neurologically-Based Behaviour: Chapter 3 Explained Prepared by Ellen Young, Krista Heisinger Frost, and Michelle Hancock

2. What is Neurologically-Based Behaviour (NBB)? • NBB is behaviour that results from cerebral processes occurring in an abnormal manner that results in information not being processed correctly in the brain. The resulting behaviour is challenging, unpredictable, inconsistent and unresponsive to ordinary discipline.

3. 3 Indicators of NBB 1. Behaviour difficulties - atypical, inconsistent, compulsive or immune to normal behaviour management 2. Language Difficulties – problems understanding, processing, and expressing information verbally 3. Academic Difficulties – memory, fine and gross motor skills, comprehension, language and math skills deficits

4. Common Behaviour Issues • High degrees of: • Inattention • Hyperactivity • Impulsivity • Excess emotionality • Anxiety • Inconsistent emotional responses • Unpredictable intense mood swings • Withdrawal • Episodes of rage

5. Common Diagnoses within NBB: • Brain injuries • Attention-Deficit Hyperactivity Disorder • Oppositional Defiant Disorder • Bipolar Disorder • Anxiety Disorders • Fetal Alcohol Spectrum Disorder • Sensory Integration Dysfunction • Autism Spectrum Disorder • Learning Disabilities

6. Misguided Assumptions • Discipline and classroom management models typically “rely on the assumption that students are cognitively, neurologically, and socially capable, equal, and motivated to do well” • This may not be the case for students with NBB due to possible: • organic neurological differences and executive functioning deficits that affect their ability to recognize cause and effect • Learning disabilities that have impacted academic and social skill development • Differing values and life experiences

7. Sensory Overload and NBB Behaviour • In classrooms that are exciting and stimulating, students with NBB can experience sensory overload, resulting in unusual behaviours. • The student with NBB sees his/her behaviour as completely appropriate/logical at the time it occurs due to their misperceptions of internal and external environmental influences.

8. Behaviour Responses • Processes in the brain (varying from chemical imbalance, congenital brain differences, brain injuries or diseases, or undiagnosed brain differences) activate the brain’s fight/flight/freeze response. • This response is designed to ensure survival • “Extreme behaviour is self-protective… not always wilful or planned,” (31) • video

9. To Understand how to Approach NBB You have to Understand the Brain

10. Survival brain (reptilian brain): bottom Function: ensure survival, controls heart rate, blood pressure, and other bodily functions Governs fight or flight response The Brain: 3 layers

11. Midbrain believed to be the area of emotional arousal Includes hippocampus (which stores painful/emotional memories) and amygdala (senses danger/threats to survival) Emotional brain (limbic system)

12. Reads the environment (including visual facial cues of others and auditory cues such as tone of voice), then acts to protect the organism by triggering the fight/flight response. Amygdala Hijack - it can happen to everyone The Amygdala

13. The Logical Brain • Neocortex:does not fully develop until late teens/early 20’s • Governs language, decision-making

14. What does this mean for educators? • Paula Cook believes the reason that behaviour management strategies such as token economies, restitution, and behaviour modification don’t work for students with NBB is that they work from the “top down” • → start with the logical area of the brain (neocortex) which can’t be engaged until the mid-brain (limbic system) calms down

16. NBB Model of Support Attempts to provide behaviour support from the bottom and mid-brain, working up to the logical brain, by adding language, social skills and socially appropriate behaviour Approach involves: environmental modification, body awareness, somatic understanding, calming techniques, and meditation to calm the mid-brain Once calmed: cognitive behaviour therapy, conflict resolution, mediation can be used to help students process information correctly

17. Somatic Understanding Somatic understanding relates to the way in which we can know the world through our physical senses. The emphasis is on how our body frames our engagement with and understanding of the world, starting in our pre-language-using stage of childhood, but extending throughout our lives.

18. Be Proactive to Reduce NBB Establish a positive and nurturing rapport Make classroom environment sensory friendly-reduce clutter, visually pleasing All time periods should be structured (recess and lunch) Use and teach humour Be careful of eye contact and stern voice → seen as a threat Provide students choices you can live with

19. Rage Cycle - Not Goal Oriented

20. What to Do when Rage Cycle has been Triggered • Recognize that you may not be able to stop the process • Look for physiological responses (flushing, body language) • Stay Calm: Use non-emotional, direct, and simple language • Maintain a non-confrontational stance – make sure s/he can see your hands • Deflect control elsewhere and suggest an alternative behaviour, “Clock says it’s time to clean-up”

21. Escalation: Separate and Supervise • Stay calm – ensure safety of other students: room clear or move student to a quiet space to calm down • If student threatens you – walk away • Use short, non-emotional phrases • Use supportive empathy to acknowledge student’s feelings • Use logical persuasion to provide an alternative

22. Rage/Meltdown • Allow physical manifestations • Restrain only if safety is an issue • Do not question or talk student out of rage • Support others in the room to understand what is happening or room clear

23. Post-Rage • Reassure the student that s/he will be all-right • Once calm, put language to the event • Strategize with student to find a better way to cope for next time → go to sensory refuge and remain until calm, using words to get what you want • Take care of yourself, document (especially possible triggers), debrief with others

24. Paula Cook’s NBB Model of Support

25. ATTITUDE Begin with your attitude Continuously reflect on your service delivery and professional role SENSORY INTEGRATION Be aware, plan, and teach strategies to address implications of possible skewed sensory systems ENVIRONMENT Behaviour is reciprocal Be aware of and consider home, school, community, work, and social environments LANGUAGE Remember: Language is often perceived, interpreted, comprehended, used, and understood differently with students with NBB

26. Discussion • Do you think students with NBB choose to rage (Glasser would suggest student behaviour is a choice) and have the capacity to change their behaviour? Does biology determine our destiny?

27. Discussion • Would the most effective approach to reduce episodes of rage look at changing students’ perceptions of reality in order to reduce their frustration and improve their ability to make better choices and increase their self-awareness? • We would argue that until the student’s “Internal Distractions” have been dealt with, it is very difficult for students to succeed at school!

28. Discussion Do you feel adequately trained to deal with students with NBB behaviour? Do you think your level of training affects your Attitude?

29. Discussion • What do you do when a student’s behaviour is extremely disruptive to the daily functioning of your classroom? Is inclusion in the best interests of all students with NBB? Are our schools meeting their needs? • We would argue that students that have NBB are the least likely to experience academic success and that more support is required for teachers and students.

30. Critical FriendYou Can’t Do This Alone! • Model of support is not a team approach and doesn’t consider transferring of skills from school environment to the Community: • Circle of Care: • Where is the support from the clinicians (psychologists, social workers, OT, speech and language pathologists, reading clinicians), administration, outside agencies (CFS, Justice, Community Mental Health Professionals), families

31. Critical FriendRole of Child’s Internal Environment Role of Medication: Barkley would argue that medication is the most effective way to deal with ADHD Physical activity to increase the production of endorphins (natural feel-good chemicals) Empathetic Listening and Psychological support – CBT – to learn how misperceptions affect our thinking and behaving

32. Critical FriendLearning New Ways You have to believe the underlying assumption that kids can learn to change their behaviour, and acknowledge that it may take a lot of time and energy, or else you will likely give up on these kids!

33. Resources on the Wiki Using Sensory Tools Mental Health Guide Disorder Websites List

34. References Cook, P. (2011). How do I recognize and deal with atypical behavior that is neurological-based? Charles, C.M. Building classroom discipline. (10th ed.). pp 41-60 . Boston, MA . Pearson Education Inc. Cook, P. (2009).  An investigation of the sustainability and practicality of a neurologically based behaviour model of support.. Winnipeg, MB: University of Manitoba. Glasser, W. (2011). How does William Glasser Use Choice Theory and Quality Education to Establish Class Discipline? Charles, C.M. Building classroom discipline. (10th ed.). pp. 138-155. Boston, MA: Pearson Education Inc.