Managing Challenging

Behaviour – Level 2

February 2014

Programme

• Welcome and introductions

• Understanding Challenging Behaviour

• Causes and triggers

• Defusing a situation

• 6 stages of crisis

• De-escalation

• Physical intervention

• After physical intervention and reporting

• Behaviour Plans

• Summary and finish

Aims of the day

• Understanding the causes and triggers of challenging

behaviour

• To offer techniques in working and dealing with children

who have this behaviour

• How and when to use physical intervention

• Create behaviour plans

Learned outcomes

• Definition of challenging behaviour

• Identifying triggers

• De-escalating a situation

• Understanding physical intervention

• Use behaviour plans successfully

Official definition of Challenging Behaviour

Challenging behaviour refers to behaviour of such intensity, frequency or duration that the physical safety of the person or others is likely to be affected and seriously limits or delays access to the use of ordinary community facilities.

• Causes harm to one self

• Causes harm to others

• Causes stress to others

• Impedes learning

• Is contrary to social norm

Some of the Causes

• Biological factors – syndromes • Ecological factor

- social background

• Neurological problems – anxiety - family situations

• Physical illness/Pain • Development factors

• Poor communication skills • Limit testing (pecking order)

• Stress - transport

• Social setting - Smiles, open looks, nods of approval are so much preferable to frowns, refusal to meet our eye and disapproving shakes of the head. Sadly some children have such a poor experience of getting positive attention that they have given up hope of receiving it and have learnt to be satisfied with the attention that comes with being disapproved of.

Some of the causes

Attention Seeking

Recognising triggers – Clockwork Mice

Look at Neil’s behaviour. What do you think has triggered it off? How would you of dealt with the situation?

Defusing a situation

Remember what will work with one child may not work with another

Six stages of crisis

De-escalation

Stage 1 (Anxiety/Trigger) – Low Level Behaviours

· Individual shows signs of anxiety

· Hiding face in hands or bent over

· Pulling up collar or pulling down hat

· Rocking or tapping

· Withdrawal from group

· Refusing to speak or dismissive

· Refusing to co-operate

· Adopting defensive postures

Low Level Positive Handling Responses

· Read the body language and behaviour

· Be aware or personal space – inner/outer circle of danger

· Reduce anxieties early

· Communicate – “Talk and I’ll listen”

· Use appropriate humour

· Use the child’s name and at the beginning of the instruction

· Talk low, slow, quietly, directly and at their level

· Offer reassurance – use their name, Positive Touch, “shhh”

· Divert and distract – introduce another topic of conversation/activity

Stage 2 (Defensive/Escalation) – Medium level Behaviours

· Individual begins to display higher tension

· Belligerent and abusive

· Making personal and offensive remarks

· Talking louder, higher, quicker

· Adopting aggressive postures

· Changes in eye contact

· Trying to get up and down

· Breaking minor rules

· Low level destruction

· Moving towards objects which could be used as weapons

· Challenges – “I will not…you can’t make me”

Medium Level Positive Handling Responses - continue to use Level One de-escalation technique

· Fight only the battle you need to

· State desired behaviours clearly

· Set clear limits which you can enforce – i.e. “Yes, you can have the window open as long as you sit down”

· Offer alternatives and options

· Offer clear choices – “Would you like to sit next to me or by the window?”

· Assess the situation and consider making the environment safer and calling for help

· Consider using your “Code word”

Stage 3 (Crisis) – High Level Behaviours

· Shouting, screaming, crying

· Damaging property

· Moving towards danger

· Tapping or threatening to break glass

· Picking up/getting out objects which can be used as weapons

· Hurting self

· Grabbing or threatening others

· Hurting others (kicking, slapping, punching, pulling hair)

High Level Positive Handling Responses

· Continue to use all the Level One and two de-escalation techniques

· Make the environment safe – get others out the way, stop the vehicle, return to school/home if applicable, assign a job to the most responsible (if appropriate)

· Move bags and other belongings which may be seen as weapons

· Guide assertively – hold or restrain if absolutely necessary and applicable

· Ensure face, voice and posture are supportive not aggressive

· Get help – a change of face may help

Stage 4 (Recovery) - Behaviours

· This stage can be confused with stage 1

· Individual may sit quietly in a hunched position

· They can revert back to extreme violence without the build up of stage 1 and 2

Recovery Positive Handling Responses

· Support and monitor

· Give space

· Not a good time to touch/invade personal space as this can provoke and revert back to crisis

· Look for signs that the person is ready to talk

Stage 5 (Depression)

· After a serious incident people can become depressed (as can you)

· They may not want to interact

Depression Positive Handling Responses

· Continue to monitor and support

· Respond to any signs that the person wants to communicate

· Do not expect the individual to show remorse or say sorry

· Show concern and care but do not try to implement changes at this stage

Stage 6 Follow up

· Listen and Learn

· Ask individual to reflect

· Report and communicate back to the office/school

· Plan and review to avoid similar events in the future

Physical Intervention

Legal definition

“When a member of staff uses force intentionally to restrict a child's movement against his or her will.”

The use of physical intervention may be used when a child is:

• Injuring themselves or others

• Damaging property - including their own

• Committing a criminal offence

Physical Intervention should never be used as a way of controlling behaviour or in an angry, frustrated or threatening manner

Everyone has a right to use reasonable force to prevent actual or potential injury to people or damage to property.

However, in all situations you should always use a less distressing technique first. i.e. “stop”, defusing, deescalating, etc and be in the child’s best interest.

What is reasonable force?

• Reasonable force is using an amount of force in proportion with the circumstances and risks of the situation.

• Use as little restrictive force as necessary in order to maintain safety

• Use for as short a period as possible

• Do not use to control or punish or in anger or frustration

Physical Intervention

You must not act in a way that might cause injury including:

• holding a child around the neck or collar

• restrict their ability to breathe – in particular holding a child around

the chest cavity or stomach

• slapping, punching or kicking

• twisting or forcing limbs against joints

• tripping a child

• holding a child by the hair or ear

Before physical intervention

• Ask parent/school to staff to calm child down before boarding the transport and allow them some time.

• Do not travel in danger – we can suspend violent children

• Consider that physical intervention can often escalate violent behaviour. Some children panic about being touched and will become more aggressive.

• Use all reasonable efforts to avoid use of physical intervention

• Call for additional support

• Avoid using the “frontal” or “squaring up” approach – this exposes the sensitive parts of your body and may be perceived as threatening. Instead adopt a sideways stance, with your feet in a wide stable base. This keeps the head in a safer position, as well as turning the sensitive parts of the body away from punches and kicks

• It is recommended that you open your palms as this gives the perception that you are not there to fight

• Warn a child that you may have to use physical intervention

When physical intervention is necessary

• Aim for side-by-side contact with the child to reduce risk of being kicked.

• Keep your back as straight and untwisted as possible

• Hold children by long bones – avoid grasping at joints where pain and damage are most likely. For example, aim to hold on the forearm or upper arm rather than the hand, elbow or shoulder

• Use the Caring C’s

• Attempt to have no gap between your body and the child as this minimises the risk of impact and damage

• Be aware of head positioning, to avoid head clashing

• Do all you can to avoid lifting the child

• Keep talking to the child – e.g. “When you stop kicking me, I will release my hold” unless it is judged the continuing communication is likely to make the situation worse

• Use as little restrictive force as is necessary in order to maintain safety and for as short a period of time as possible

• Don’t expect the child to apologise or show remorse in the heat of the moment.

After physical intervention

• Report any form of physical contact to the School Transport team and School immediately

• Complete physical intervention form – this must be done within 24 hours of the incident, either by yourself or the transport office

• Once you have restrained try to go back to the norm – “This is all finished now – tomorrow is a new day”

• Ask for any further advice from school/parents

• A risk assessment will be carried out to identify risks and plan for the future

• You may require additional support or advice about what happened. Restraining a child or just observing it can be extremely distressing. Often the emotion can kick in later. If you and anyone involved requires any support or advice please contact the school or School Transport Office in the first instance. You can also ring Hampshire County Council’s Employee Support Line on 02380 626606

Summary

• Focus on the cause of child’s stress

• Remember your own behaviour can effect the child's

• Children with challenging behaviour can lack empathy

• Praise and reward for good behaviour – use positive language

• Reflect on the day after you have dropped the child off. Did it go well - if so why and repeat it

• Defuse the situation by doing something the child enjoys

• Use physical intervention only as a last resort and never use it as a way of controlling behaviour

• Report any form of physical intervention to the School Transport Team

and School

• Complete a behaviour form for your most challenging children and carry it with you at all times

• We can organise for you to into the school for additional training

• Ring us for any advice or support.

Positive behaviour plans

Behaviour Plan for Emma Gibson – 07/09/05

Causes i.e. Medical Condition, Special Educational Need, Learnt Behaviour’s, Physical Illness, any other info - which may include difficult family relationships etc
· Aspergers syndrome – can be obsessive
· Only Child
· Often gets her own way
Triggers i.e. Excitement, heat, tiredness, bored (long journey), Been told off, arguments, obtain something.
· Hyperactivity
· Tiredness
· Having arguments at school/home
Behaviours i.e. Fight/Flight, hit, kick, spit, punch, swear, refuse instructions
· Uncooperative
· Swearing
· Potential to become violent – kick/hit
Personal likes (could be loves Man Utd, loves playing handheld games/enjoys reading etc)
· Reading non viction books – esp on buildings
· Horseriding
Positive Behaviour Plan (to be completed on the training day)

Physical Intervention Report Form

Witnesses:

Name / Organisation / Involvement: Physically?(P) /
As observer? (O)

Did you or the child suffer any injury? Yes / No

If yes please detail here. Include names of any other injured person and brief details of injuries
………………………….…………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………….……….
………………………………………………………………………………………………………………………………………….

Were the emergency services called? Yes / No

Reason for physical intervention?

Injuring to themselves (incl endangering themselves) / Injury to others / Damaging property
Committing a criminal offence

Why do you think the child displayed this behaviour?

Attention / Emotional release/upset / To obtain something
Escape – task avoidance / Escape – from people / Other. Please state:

Parents/carers were informed Yes / No

Date / Time / By direct contact, telephone, letter?
Form completed by: / Name / Title / Date and time

Your Signature…………………………………………………………………………………………………………….

School Escort Manager’s Signature…………………………………………………….………………………….

Please return this form to:

For office use only:
Action: In discussion with school escort i.e. risk assessment, training, equipment ordered, etc.
Last risk assessment? …………………………………………………………………………………………………..
Is a further risk assessment required? Yes/No
Completed by………………………………………………………………………………………………………