Understanding special needs

1. Understanding special needs Behaviour management EBD Families

2. General advice for ALL children • An approach to dealing with specific behaviours

3. Reference “Bringing up responsible children ; will our children be okay?” John Sharry Veritas Publications 7/8 Lower Abbey St Dublin1 ISBN 1 85390 4147

4. Introduction • Many approaches to discipline • Greatest influence is when child is 2-10 • Misbehaviour is normal • On average, children comply with one third and two thirds of parents requests • Why behavioural problems? • Child’s particular temperament • Special needs • Parents’ own difficulties • Each family is different • Nine steps to better behavioural

5. Step 1 – parents caring for themselves • Examples of caring for themselves • Going for a daily walk • Spending time alone • Self nurturing things e.g. special bath • Build on strengths as parents • Start looking for what you are doing right • You can’t be a perfect parent so be a ‘good enough parent’ • Tips for going forward • Do something you enjoy every week • Think positively about yourself as a parent

6. Step 2 – providing positive attention to children • Young children will do anything to get their parents attention and this can mean being naughty • Young children do not know the difference between good and bad attention • Catch the child being good • Give positive attention • Positive attention can divert misbehaviour • Children can only be given too much negative not positive attention • Focus on what you want • Make a list of goals for yourselves as parents and for your children

7. Step 3 – play and special time with children • The value of play and special time for children • How best to play • Set aside a special time • Spend one-on-one time • Choose interactive, imaginative activities • Encourage children during play • Have special time as a family

8. Step 4 – specific encouragement and praise • Make a list of behaviours you want to discourage and encourage in your children • Skills of specific encouragement • Encouragement should be clear, specific and personal • Exceptions/steps in the right direction • Don’t always wait for perfection or a finished task e.g. homework • Double encouragement • Use others too • Persist with encouragement • Think about new ways to get your encouragement through

9. Step 5 – using rewards • Star chart – gold and silver stars • Making rewards effective • Be clear about the behaviour you want • Use motivating rewards • Staying up later • More time on the play station • Having a friend to play • Involve children in the planning • Start small • Use lots of encouragement

10. Step 6 – setting rules and helping children to keep them • How many rules? • Encourage children to make as many decisions for themselves as possible • Give children choices even when imposing a limit • Keep the rules you set with children to only those that really matter • Effective commands/assertive commands • Use positive commands - examples • Give children time to comply • Praise co-operation • Following through on commands • Logical consequences • When-then command e.g. when you do your homework then you can go out and play

11. Step 7 – ignoring misbehaviour • What is ignoring? • Not easy • Need to pay as little attention as possible • Ignoring is not an alternative to positive approving attention • How to make ignoring work • Target specific behaviours • Ignore thoroughly and consistently • Return positive attention as soon as possible • Remain calm • Think differently • Talk things through • Practice relaxation

12. Step 8 – time out and other sanctions • Explain time out in advance • Which behaviour? • Where? • How long? • Use back-up sanctions to make time out effective • Short • Affect mainly the child • Within control of the parent • Logically related to the misbehaviour • Time out for parents

13. Step 9 – talking things through • Active listening • Give child your full attention • Reflect back what they have said • Acknowledge child’s feelings • Speaking up • Generating solutions • How do you think we can solve this? • Plan • Work with the child on deciding on the best solution

14. More specific help • The ABC of behaviours • A – antecedent i.e. what may have caused the behaviour • B – the behaviour itself • C – what were the consequences of the behaviour

15. Emotional and behavioural difficulties

16. Common causes of EBD • ADHD • ASD • Physical or sensory impairment • Learning difficulties • High abilities • Childhood depression • Emotional deprivation • Child abuse

17. Types of behaviour • Withdrawal or passivity • Aggression • Inappropriate social behaviour • Verbal aggression in the older child and defiance • Sleep disturbance • Bedwetting • Soiling • Breath holding and temper tantrums beyond expected developmental age

18. Types of behaviour • Head banging and rocking • Short attention span, difficulty with concentration • Extreme restlessness • Phobias or irrational fears • Difficulty in trusting and forming relationships with adults and children

19. Good practice • A child with behavioural difficulties needs structure and consistency in management and a routine developed to meet his individual and developmental needs • Always consider your own attitude to working with children who have behavioural and emotional difficulties and to their parents and carers • Does your body language give off negative or judgmental messages?

20. ADHD Attention deficit hyperactivity disorder

21. General information • Emotional/behavioural disability • May be linked to autism, dyslexia and may be associated learning difficulties, depression and conduct disorders • Thought to be the result of a dysfunction of the brain’s filtering system • May affect up to 5% of school aged children – more boys than girls • Symptoms must be frequent severe and long lasting for confirmation of the condition

22. Symptoms • Poor concentration particularly with tasks requiring long-term effort • Over activity-often requiring minimal sleep • Inability to curb immediate reactions and impulsivity • Poor physical co-ordination • Rigidity in response to problem solving • Disorganisation • Mood swings and tantrums • Low self-esteem

23. Diagnosis • Made by a multi-disciplinary team • Child is observed in a number of environments – school, home etc. • Must display 6 out of 9 inattention symptoms • Must display 6 of 9 hyperactivity/impulsivity symptoms • Such behaviours must start before child is 7 years old and last at least 6 months • Behaviours must not be caused by anything else

24. Diagnosis • Parent and child interviews • Parent and teacher complete child behaviour rating scales • Parent self report measures • Psychological tests • Review of school and medical records • Intelligence/educational achievement tests • Paediatric examination • Other assessments as required e.g. SLT, vision, hearing screening

25. ADHD drugs • 3 basic drugs – each has varying strengths • Methlphenidate – brand name is Ritalin • Dextro-amphetamine- brand name is Dexedrine • Dextro – amphetamine-levo-amphetamine – brand name is Adderall • Dextro – methylphenidate – brand name is Focalin

26. Ongoing management • Behavioural management techniques – see later lecture plus circle of negative image • Intensive behavioural therapy • Ritalin or other drugs– highly controversial • Drug plus family therapy • Food additives?? • ?misdiagnosis

27. Alternative therapies • Movement therapies • Brain gym • EEG • Herbal • Homeopathic

28. Case study

29. Familes/parents

30. Families who have a child with a disability • Relevant factors:- • Cultural background • Religious background • Value systems • Coping styles • Social and economic background • Other factors e.g. alcohol or drug dependency, domestic violence

31. Families who have a child with a disability • May encounter some of the following:- • One parent at home full time or on reduced hours and as a result are socially isolated • There may be a lack of time for activities unrelated to the child and impact on social life • Unable to spend time with other children in the family • Strain on relationship • May be difficulty to leave the child or to find suitable carers

32. Parents of children with disability need…… • Grieving time • Information at their own pace • Time and space • Acknowledgement that they know the child best • To be as open as possible about the fact that their child has a disability • To address the needs of the other children in the family • To be aware of their entitlements • To be aware that their child has rights

33. Carers/professionals need to… • Respect and involve parents/close family members • Listen to what they have to say • Obtain information about the child’s abilities and skills • Communicate with parents to develop positive and realistic expectations of the child’s future development • Respond to parents feelings about their child in an appropriate, non-judgemental manner

34. Carers/professionals need to… • Encourage parents to observe their children and to participate with them where appropriate and within the constraints of the setting • Involve siblings and other important family members offering advice, support and education as required • Be honest, open and ensure information is understood • Offer practical and emotional support and answer questions as appropriate

35. UK code of practice for effective communication with parents • This code of practice outlines 7 key principles that you should adopt when working with parents. They emphasise the vested interest that parents have in their children’s lives and also the knowledge and contribution that parents are able to give us as practitioners.

36. The 7 principles • Acknowledge and draw on parental knowledge and expertise in relation to their child • Focus on the children’s strengths as well as areas of additional needs • Recognise the personal and emotional investment of parents and be aware of their feelings • Ensure that parents understand any procedures • Respect the validity of different perspectives and seek constructive ways of reconciling different viewpoints • Respect the differing needs that parents themselves may have such as a disability or language barrier • Recognise the need for flexibility in the timing and structure of any meetings you may have

37. Reflect on your own practice • Recognise that parents may have a different perspective on their child’s development and may have different priorities to you • Acknowledge that while you may be an expert on your setting, parents are experts on their children • Do not make comparisons between children in the setting • Remember that trust can be shattered by breaches of confidentiality and thoughtless words

38. Confidentiality – case study Hannah has been working as a classroom assistant for 2 terms. One Saturday outside Dunnes she met one of the parents from school and they asked Hannah why one of the children in her class was getting extra support. Hannah told her it was because the child had behavioral difficulties as well as poor speech. She went on to tell the parent that the child was now having speech and language therapy and that the whole family was having some type of counselling

39. What should you do if you notice that the child’s behaviour is concerning? • Hopefully you will already have built up a good relationship with the parents • Find out when it would be suitable for parents to come to talk to you • Make sure your tone is reassuring rather than accusing • Begin the meeting by offering to share information to help the child

40. Continued….. • Talk through the child’s overall progress – emphasise the strengths in order for the parents to understand your perspectives on the child • Ask the parents for their perspective emphasising that they have a more global view of the child • Make sure that the meeting ends with everyone understanding the next steps

41. What should I do if I’m concerned about a child’s progress and the parent does not agree that there might be a delay/disability • Make sure you assessments are accurate – refer back to normal development charts • Remember to focus on child’s strengths as well as areas for concern • Listen to and acknowledge any different perspectives that parents may have • Avoid making meetings ‘adversarial’ ; parents should feel that you are on the child’s side

42. Continued…. • Remember that parents want the best for their child and want to protect him/her • Consider whether it is your setting that is ‘disabling’ the child • Talk to parents about any fears that they have • Link them in with other parents if appropriate

43. Siblings • Effects will vary according to their ages, birth order and the number of children in the family • Siblings may experience • Over protection • Neglect • Resentment at the amount of attention the child with disability gets including continual discussion about the child between parents and other adults

44. Siblings • Jealousy • a shift in the family balance meaning they may have to take on more responsibility • Worry and anxiety that they will ‘catch’ their siblings condition • Fear and concern at witnessing their parents’ distress or rejection of the child • Teasing and social isolation • Emotional swings, from being loving and protective to disturbed behaviour such as regression, attention seeking, moodiness, anxiety, low self esteem, embarrassment or guilt

45. Supporting siblings needs • Individual attention • Reassurance that they feel loved and valued • Opportunity for older children to express their feelings – Sib Shops • Time on their own with their parents • Correct information appropriate to their level of understanding • Encouragement to care for their brother or sister in small everyday ways e.g. playing, fetching nappies