Behaviour management for children with poor memory, communication or perception

Some children may have difficulty with communication and the perception of time. These children may or may not talk but they will definitely show a need to control their environment often through temper tantrums or aggressive behaviour. These children will not respond effectively to the usual methods of star charts or treats.

What are some of the common characteristics of this small group of children?

• Poor social interactions
• Poor at changing activity
• Poor at taking turns
• Difficulty in predicting outcomes
• Difficulty in understanding social time
• Desire to maintain control
• Fluctuating responses to situations

Typically these children will be very challenging although when compliant they are charming. Parents and teachers will have tried many different strategies to change the behaviour patterns to little effect.

You will need to spend a little time studying the behaviour. Keep a close observation of the child for at least five days. Write down the unwanted behaviours and describe exactly:

• What happened leading up to the behaviour
• What happened during the behaviour
• What happened after the behaviour
• What changed for the child as a result of the behaviour

Get external help if at all possible and examine the results very carefully. Be prepared not to like the outcome and you may want to talk through your findings and feelings with an objective relative, friend or professional.

Usually the behaviour results in a benefit for the child in some manner or other. Most of these benefits are not obvious so we do need to study the results very carefully to see what they are. The behaviour is a way of asking for the benefit and may be out of all proportion to that benefit.

Strategies to help reduce such behaviour

• The environment around the child needs to be very structured so that the causes of the behaviour are controlled.
• Using a picture time-line and a countdown to changing activity can help some children.
• Having structured times out of stressful situations before the child blows a fuse can also help.
• The child will no longer receive the usual benefit from that behaviour.
• The child must be taught another way of asking for and receiving the benefit.
• Use simple clear language.
• Always use positive direct language – “Put the plate on the table.”
• Avoid indirect or negative language – “We are all going to put our plates on the table.” or “Don’t tip the food off the plate.”
• If you need to hold your child’s hands down do this calmly and try not to look directly at your child so the attention he or she gets is minimal.

During times of agitation some children have difficulty communicating their feelings using words. They may need a lot of practice in order to feel able to use words at these times. Teaching a different, less difficult behaviour may be the arrangement for some children. Time out of class may be spent learning a relaxation routine or learning to recognise and express emotions.

It is very important to remember that the response to unwanted behaviour has to be very structured and neutral – try not to lose your temper.

Stevie was hemiplegic and autistic and had many difficult, obsessional behaviours. He used to indicate that he felt stressed by getting up and slamming a door. This was an unwanted and dangerous behaviour. Staff worked with Stevie to recognise the signs of agitation. They provided him with a throw toy that groaned loudly. When he showed signs of becoming agitated staff would assist him to throw the toy and then end the session. At the same time they wedged all the doors open so he could not get feedback from slamming. Within two weeks his behaviour had changed. They continue to work on using hand gesture or speech to indicate this feeling but have not achieved these as yet.

In order for these techniques to work, the same responses must be used by the whole school and at home. Any child with long-standing and difficult behaviours needs expert help and so do parents and staff dealing with him. Teachers of autistic children will probably have had the most experience of these sorts of structured interventions. Ask your Education Authority what services are available and what support can be offered.

For more information on Scope

Contact Scope Response for information, advice and support on cerebral palsy and disability issues. Copies of all our factsheets can be downloaded from our website or obtained from Scope Response.

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Scope acknowledges the help and support of everyone who has been involved in the production of this information. Although we have taken care to ensure the accuracy of this information, Scope cannot accept responsibility for errors or omissions. We always recommend getting independent advice from a professional before embarking on any process, therapy or medical intervention.

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This information was last reviewed June 2010

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