Help!! He’s Still Driving Me Crazy!

1. Help!! He’s Still Driving Me Crazy! More Behavior Management for Difficult Children

2. Difficult Children Normal behavior management techniques are not usually effective with children who have serious disabilities, such as Asperger’s Syndrome, Bipolar Disorder, and Emotional Disturbances. These students require behavioral analysis and planning in order for teachers to be successful in working with them in class. The law requires positive behavioral supports and interventions to help these students be successful in class.

3. Goals for Today • Understand the characteristics of Asperger’s Syndrome, Bipolar Disorder, and Emotional Disturbances • Gain Techniques for managing behavior in students with these conditions • Learn how to do basic Functional Behavioral Assessment and design a Behavior Improvement Plan • Understand the law as it relates to children with these conditions

4. Asperger’s Syndrome • Students with Asperger’s Syndrome are characterized by difficulty in reading social cues, social ineptitude, difficulty with relationships, obsession with narrow topics, and adherence to nonfunctional, ritualistic types of routines and behaviors. They require routine and structure in order to be successful. These students are often mainstreamed because they have average to above average intelligence.

5. Key Features of Asperger’sSocial Interaction • Average to above average IQ • No verbal/performance split • Socially isolated • Tense with social demands • Difficulty reading social cues • Lack of friendship strategies • Immature and socially inappropriate

6. Key Features of AspergersSocial Communication • Language tends to be stilted and formal or pedantic • Voice may lack expression • Difficulty in interpreting and using non-verbal communication • Often understands things literally • May fail to grasp implied meanings • May not read vocal tones of others • May tend to recite dialogue from movies, etc.

7. Key Features of AspergersOther Social and Motor Skills • Often has an all absorbing interest • Rigid-Insists on certain routines • May be limited in ability to think and play creatively • Often has difficulty generalizing skills • Motoric clumsiness • Organizational problems • Orthographic difficulties

8. Thought Processes • Think in concrete terms • Fail to understand metaphorical or abstract concepts • Take figures of speech literally • Have a form of “mind blindness” in which they do not understand that others have needs, desires, and beliefs that are different from theirs • Difficulty with predicting, reading intentions, understanding emotions, explaining behaviors, understanding and reacting to other’s interests, understanding social interactions • Susy, Johnny, and the tapping pencil

9. Sensory Issues • One or mores sensory systems usually affected-normal sensations are felt as unbearably intense • Anticipation of a stimulus can cause anxiety or panic • Most common-sound and touch • Can also be light intensity, taste, colors, smells • Approximately 40% of people with Autism Spectrum disorders have some abnormality of sensory sensitivity

10. BehaviorThe Lens of Interpretation • All behavior serves a purpose • Behavior is functional or is intended to be • It is necessary to understand the function of the behavior from the viewpoint of the child • In order to impact behaviors, we must look at things through an Asperger’s lens and determine the functions of the behavior and find another way to meet that need

11. How to Help5 Part Approach • Identify the signs of overload • Identify situations that are problematic • Identify current strategies • Identify environmental factors and modifications • Teach student how to read sensations and how to manage behaviors • This process is Functional Assessment

12. What to DoCommunication and Environment • Reduce distractions • Give instructions in the most efficient sensory channel • Provide auditory frames • Provide visual frames • Use graphic organizers • Use “Low and Slow” • Use cognitive portfolios to remind students of strategies and behaviors • Use timers or visual cuing for changes in activity

13. What to DoActivity Level and Arousal Management • Slow, rhythmic activities-deep breathing, walking, rocking, music, pressure-ask student and parents what works • Tolerate reasonable levels of movement • Provide frequent motor breaks • Engage entire class in motor breaks-wall pushups, stretching, deep breathing • Walk and talk • Allow student to stand while working or talking • Teach allowable movement strategies

14. Social Supports • SOCCSS • Social Scripts and Stories • Social Autopsies • Cue Cards • Direct Social Skills Instruction • Social “clues”

15. SOCCSS • Situation • Options • Consequences • Choices • Strategy • Simulation (Rehearsal)

16. Social Scripts • Helping the child to structure the behavior by working with the student to design a script of what to do and say in a particular situation • For example, you may work with a child to design and rehears a script for joining with a group who is playing at recess or asking someone for a date

17. What to DoEmotional and Social Support • Teach 5 part approach • Help the student to interpret social situations-utilize rehearsals • Use SOCCSS • Use Social Autopsies (why did this situation “die”) • Use Social Stories • Use cognitive portfolios/social scripts • Use blunt, easy to understand social skills instruction

18. Social Stories • A social story is a story that describes social situations specific to individuals and situations. A social story is written for a specific child and a specific situation. Social stories are particularly helpful with younger children. They tend to lose effectiveness in upper grades.

19. Social Autopsies • Debriefing a social error in order to determine: • The cause of the error • The damage done by the error • How to prevent the error from happening again

20. Social Skills Instruction • Conversational skills-exchanges, vocal tone, responses, etc. • Cooperative play skills • Relationship skills • Classroom skills • Maximize by: Instruction and interpretation Coaching-generalization

21. Positive Supports • Priming-previews activities where student is likely to have trouble • Home base-at end of day or after stressful subjects • Safe person-safe place • Transitions-routines, warnings, activities, signals, buddies

22. Modifications • Highlight texts • Sample problems worked out as a guide • Directions given individually • One direction at a time • Cue cards • Graphic organizers • Cognitive portfolio for steps

23. More Supports • Provide information visually-written directions, schedule • Preferential seating-near compliant peers, away from bullies, away from high traffic • Assistance with organization-picture cues (take a picture of the desired outcome-clean desk, organized locker, etc.)

24. Resources • Asperger’s Syndrome: A Guide for Parents and Professionals by Tony Attwood • Asperger Syndrome and Adolescence by Teresa Bolick • Asperger’s Syndrome -Difficult Moments by Myles and Southwick • Asperger Syndrome-Practical Strategies for the Classroom • Power Cards by McAfee • Pretending to be Normal by LeeAnn Holiday-Wiley • The Incredible Five Point Scale by Buron and Curtis

25. Students with Bipolar Disorder • Bipolar Disorder causes extreme shifts in mood, energy, and functioning • Depression-persistent sad mood, anhedonia, significant changes in appetite, sleep patterns, loss of energy, feelings of worthlessness, difficulty concentrating, suicidal ideation • Mania-abnormally elevated mood, overly inflated self-esteem, decreased need for sleep, racing thoughts, pressured speech, risky behavior, physical agitation-may also be irritable • Mixed State -both mania and depression present at same time-depressed mood accompanies manic activation Severe mania or depression may be accompanied by psychosis

26. Managing the Bipolar Student • Develop and maintain a positive relationship with parents-preferably with a person who will be an advocate for the student and who can maintain the relationship between settings • Monitor medications carefully-be familiar with the meds and side-effects of them • Inform teachers as to what to look for in medication effects and side-effects • Staff with teachers regularly to make sure plans are being followed and to head off developing difficulties

27. Managing the Bipolar Student • Plan schedule around student’s cycle of behavior • Look closely at teacher personalities and try to place student with teachers who are firm, calm, fair, and organized • Maintain detailed records and keep them in a central place, such as an administrator’s office • Watch for and deal swiftly with harassment issues • Provide a safe place and a safe person for cooling off, cooling down, regaining control

28. Common Problems • Distractibility • Disorganization • Difficulty managing materials • Argumentativeness • Difficulty with transitions • Distorted perceptions • Difficulty with peers • Impulsivity/hyperactivity • Anxieties/obsessive behavior

29. Dealing with Distractibility • Provide a secluded area in the classroom such as a study carrel • Provide an area outside the classroom available on request or by recommendation • Seat the child at a corner of the classroom, flanked by calm, self-directed, patient students • Develop a signaling system to indicate when it is time to refocus or to move to another area • Check up on the student if he is asked to move to another area

30. Dealing with Organization • Provide one notebook for all classes-use double pockets for each class with finished/unfinished work slots • Provide a time slot at the end of the day to organize materials to take home • Maintain contact with parents regarding assignments-e-mail, FAX, etc. • Use task cards to help with beginning and sequencing tasks • Use color coding

31. Managing Materials • Allow a set of books at home • Keep a book and materials in every class • Use task cards to signal what should be out on desk for an activity • Regularly have one person work with the student to organize locker, notebook, etc. • Reward student for taking care of needed materials without reminders • Do NOT allow student to call parents repeatedly for things left at home

32. Argumentativeness • Assign teachers who are flexible, mature, calm, and who will state demands in a no-nonsense manner without arguing • Use verbal techniques such as broken record, fogging, restatement, etc. to avoid arguing • Staff with teachers and remind them of the importance of not engaging in arguments with this student • Reward the child for compliance without arguing

33. Languaging for Behavior Management FOGGING-Agree with what the student says, then restate the demand. “This is too much homework. I’ll never finish it.” Fog: “I know you think this is too much homework, but you are to finish it tonight” or “You may be right,…” TO YOU-TO ME- Recognize what the student feels, then add your feelings or opinion. “This assignment is too hard. I’m not doing it” TYTM: “To you it seems too hard, but to me it is a fair assignment and one you can do.

34. Language cont. TABLING-Set aside a time when the student can come in privately. “You always pick on me. I can never do anything right in here!” T: “I understand you are upset with me. Here is a pass. Come in tomorrow at the end of 6th period and we’ll talk about it.” REFLECTION-Acknowledge the feeling without judgment, then restate the demand/consequence. “I’m not going to the office! You can’t make me!” R: “You’re tight-I can’t make you. But if you do not go on your own, I will call for the office to send someone to escort you.”

35. Language cont. RECORDER-When a child says something completely outrageous, stay calm. Record the exact statement by writing it down, then repeat it.” “You can’t do that. My uncle is on the school board and he’ll get you fired.” R: (writing) “Let me be sure I have this right. Your uncle on the school board will have me fired if I make you…”

36. Language cont. BROKEN RECORD-Simply repeat your initial demand until compliance or a consequence stage is reached. Child continues to work on reading after you have instructed the class to move on to a math assignment. BR: “Johnny, it is time for you to put away your reading and get your math book out.” (back off for compliance) REPEAT DEMAND (Pause) You are telling me by your choice to keep your reading out that you want to (state the consequence). Number of repetitions before consequence depends on the individual student.

37. Managing Transitions • Never allow the child in the hall without an observer or a pass • Check on the child to make sure that transition has been made • In class, give a warning that allows the child to prepare for transitions-visual, auditory, touch • Use a visual timer to signal transitions and remaining time for activities • Plan for and rehearse transitions during calm phases

38. Distorted Perceptions • Adapt classes such as PE to accommodate sensitivities • Keep notes on conversations and have the student sign off on what has been said • Keep careful logs • Stay in touch with parents regarding areas where there might be conflicting reports • Use counseling sessions to help student see misperceptions

39. Difficulties with Peers • Teach social skills explicitly • Teach communication skills • Set up group settings to practice social skills • Do whole group guidance lessons with classes the student is in • Reward student privately for observed positive social interactions • Encourage parents to engage child in out of school peer group activities • Teach and practice conflict-mediation

40. Impulsivity/Hyperactivity • Schedule frequent breaks • Teach acceptable movement strategies • Develop a signaling system to allow the child to monitor levels • Walk and talk • Teach self-calming techniques-visualization, deep pressure, wrapping • Allow the use of fidgets • Do social autopsies to analyze failures and plan successes

41. Anxieties and Obsessions • Allow the use of a calculator or computer to reduce writing and math difficulties • Reduce workload • Teach visualization techniques to reduce anxiety • Allow to finish one task before moving to another

42. Final Notes • EVERY child with a diagnosis of bipolar disorder should have behavioral analysis and a behavior improvement plan, even if the child is not in Special Education • Good record keeping is essential • Every child is different, and plans should reflect these differences • If you say you are going to do something-DO IT-you are legally obligated to!

43. Emotionally Disturbed Students • Students with emotional disturbances are those who meet the guidelines under IDEA-a mental health diagnosis is not necessarily an emotional disturbance-there must be academic need-so a child diagnosed with depression who is functional and making adequate grades and progress in school is not necessarily emotionally disturbed.

44. Definition • Inability to learn that is not explained by a learning disability • Inability to build or maintain satisfactory relationships with peers and teachers • Inappropriate types of behaviors and feelings under normal circumstances • A pervasive mood of unhappiness or depression • Tendency to develop physical symptoms or fears associated with personal or school problems • Must have had these symptoms for an extended period of time and they must negatively impact school performance

45. Functional Analysis and BIP’s • Diagnosis of emotional disturbance requires that positive behavioral supports and strategies be addresses • Functional behavioral analysis is needed to target behaviors of concern and the functions of those behaviors • A Behavior Improvement plan then addresses those behaviors with the intention of decreasing target behaviors and increasing positive behaviors

46. When to Develop a BIP • In cases of a change in placement due to disciplinary action a functional behavioral assessment must be conducted to facilitate the development of a behavior intervention plan • In the case of a child whose behavior impedes his or her learning or that of others, consider, when appropriate, strategies, including positive behavioral interventions, strategies, and supports to address that behavior

47. The Functional and BIP Process • Collect information • Describe the behavior • Determine the functions of behavior • Develop a plan of intervention • Implement the plan correctly • Evaluate the outcome of the plan

48. Functional Analysis • Data Sources • Describe behavior • Settings • Frequency • Intensity • Duration • Describe previous interventions • Educational impact

49. Behavior Improvement Plan • Describe the expected outcomes and goals for the plan • Specify the interventions used to achieve the goals • Specify person who is responsible for specific interventions • Specify a review date

50. Outcome Data to Collect • Amount of work turned in • Discipline referrals • Grade report • Frequency of time outs or direct intervention • Student report • Parent report • Structured Observation