Behaviour


1 Challenging behaviour

Tips for dealing with problem behaviour in disabled children and adults

Plan ahead for activity transitions and give advance notice

Lots of children and adults with complex needs struggle with transitions – such as when a favourite activity ends, when heading from A to B, leaving the shops or leaving the house or the car. Using a visual timer so that they can ‘see’ how much time remains in an activity before they will be expected to transition can help a great deal with managing behaviour. At the same time, try to give your child advance warning of any changes in planned activities so that they can prepare themselves.

One of our community members says, “My son has ASD and ADHD and can be very challenging at times. Planning seems to work well - especially with visual clues. I think that I'm right in saying that writing a step-by-step guide to future events is a key to success.”

A timer can also be used to provide a finite and expected end to enjoyable activities that the child might otherwise be upset or angry about finishing.

Set boundaries and reward self-control

Even in the face of challenging behaviour, it’s important to establish and maintain boundaries. Children with learning disabilities respond positively to boundaries, so don’t accept unacceptable behaviour as the norm. 
If the child is aggressive and shouting, it is often advisable to lower the volume and pitch of your own voice, while keeping your face neutral. This can encourage them to behave in order to hear what you are saying. When they have calmed down acknowledge and congratulate them on their self-control.

Mind the messages you send out

Many of our community members say that their child picks up on their moods. If you are visibly stressed or feeling down, their behaviour may worsen. With this in mind, make sure that you take the time and effort to look after yourself as well, as doing so can benefit both of you.

Giving instructions 

Phrase your instructions positively

When your child is acting up or in some way misbehaving, your natural impulses may be to tell them to stop doing what they are doing such as ‘stop kicking’ or ‘stop hitting’. But it can be much more constructive to say what specific positive behaviour you would like to see, rather than forbidding a negative behaviour.

So, in the examples above, ‘stop kicking’ may become ‘put your feet  down’, and ‘stop hitting’ can be rephrased as ‘put your hands down’. Rather than telling your child to ‘stop shouting’ meanwhile, you might offer positive praise when they speak more quietly, such as ‘well done for using your small voice'.

Be creative

If you are having trouble getting your child to follow instructions or do things in a correct manner, you might need to try a different approach. For example, one community member explains: 

“We use puppets to manoeuvre our daughter through stuck moments, like getting dressed/brushing teeth/eating dinner. What she refuses to do for us, she will often do for a puppet, especially when accompanied by a funny voice! I now have a little case of finger puppets that I carry around with me.”

Try to understand the triggers for challenging behaviour

It can be useful to figure out what triggers challenging behaviour in your child, and what they think they will gain by behaving in that way.

For example, a child with autism's aggression may be triggered by unexpected changes – they might be thinking that if they are aggressive the change might not happen again. Once you understand the reasons for their behaviour, you can begin to help them understand why the behaviour is problematic and what other ways there are to deal with the situation.

Emotions and communication

Help with teaching emotions

Emotions can be difficult to understand for children with complex needs. Fortunately there’s lots of help available online. One community user explains, “we use an online game featuring Thomas the Tank Engine and his friends to teach our son about emotions. Another good website for emotions is symbolworld.org. You can find more online tools for teaching emotions to children with complex needs."

Allow self-talk

One community member says, “Don't make a person with learning disabilities feel bad for self-talk, or attempt to get them to stop. It can be an important coping or preparation mechanism. Instead, talk about it and encourage appropriate/socially acceptable places and times for it.”

Check for medical reasons for extreme emotions or behaviour

Children with complex needs often have trouble communicating difficulties and pains that they may be experiencing, so these may instead arise as extreme emotions or bad behaviour. It may help to get into the habit of first checking whether this behaviour may be being triggered by unseen factors, such as headaches, toothaches, or even side-effects from medicines.

Pay attention to communication attempts

One of our community members comments that, “Behaviour is communication. Just because you care for someone who doesn't talk doesn't mean they aren't trying to communicate with you. And, if they're angry, it's probably because they trust you to still like them when they calm down.”

Another points out that, “challenging behaviours are usually messages: work out what is trying to be said.”

Take early action and remain calm

If you can spot early warning signs that your child is going to have an emotional outburst or begin another form of challenging behaviour, you can intervene and attempt to disrupt the behaviour using distraction techniques. 

One community member stresses the importance of managing your own outward emotions in these situations: “I find calm but assertive instructions and body language are the most important assets when dealing with any challenging behaviour. Any more emotion into an already emotional situation can only cloud judgements and cause greater confusion.”

To help the person or child to calm down meanwhile, you can get them to slowly count to 10, taking deep breaths at the same time.

Use a ‘break card’

Using a ‘break card’ – a simple coloured card which means that the child or person is going to have a break from the situation – can be useful for averting meltdowns. It gives a person the means to communicate their wish to leave an unpleasant situation. They simply need to hand the card over, this could be in school (following discussions with teachers) or out and about.

Keep a behaviour journal

Keeping a journal and recording incidents can help you to look back and see if there are any patterns or contributing factors for certain behaviours. It may also be worthwhile looking through the journal with the child or person you are caring for, talking about both the positives and negatives. 

Don't reward challenging behaviour

Often, challenging behaviour can be a result of attention seeking so disengaging until the child settles can be very helpful. That way, you are not rewarding challenging behaviour with attention, and so encouraging more of it.

Help release the energy

A community user writes: “My son's behaviour went very bad as he started puberty. We found a punch bag helped loads. He used to yell at it too when beating it up! Also we scheduled lots of exercise to get rid of some of the overload of stress/anger. We built it into his home-from-school routine as a daily thing.”

Seeking professional help

Find your local Child Development Centre (CDC)

Many hospitals have a dedicated Child Development Centre where families with concerns about the development of their child can seek help and support. The CDC may include services provided by speech and language therapists, clinical psychologists and therapists. You can find your nearest one by searching online for ‘Child Development Centre’. Referral is usually through the child’s GP or another professional.

Consider seeing an occupational therapist

One parent says, “We worked out what Chrissie’s sensory needs are and asked an occupational therapist to put together a short menu of ideas to help her. For example when she feels stressed she has a doll which she squeezes/twists/bites which has stopped her from squeezing/twisting my skin and hurting me.”

Contact your local Child and Adolescent Mental Health Service

Check your local Child and Adolescent Mental Health Service (CAMHS) to see if they have learning disability specialists who can help with difficulties like challenging behaviour and other behavioural problems. Many places now have dedicated teams with learning disability nurses, psychologists, and other professionals who can offer assessments and support.

Explore applied behaviour analysis

Applied behaviour analysis (ABA) looks at the causes and consequences of behaviour, particularly in the case of children with autism or ASD, and seeks to develop changes in behaviour based on this information. You can find out more about ABA and available services at ChildAutismUK or Autism Partnership UK.

One community member described their experiences of this approach: “My son is 19 now with a diagnosis of atypical autism with speech and language delay. He had big behavioural problems which were escalating. At the age of three we embarked on a home teaching programme of applied behaviour analysis, under the supervision of the London Early Autism Programme. We did individual 1 to 1 ABA teaching of an individual structured program, tailored for his needs. He was taught what items were to begin with, by touch first (receptive), and then by expressive, which helped to reinforce what he had learned.”

De-stress box

We have put together a de-stress box of familiar and sensory items for Eva. When she is upset she can take her box to a quiet safe area and chill down.

Jacob's worry box

"My son Jacob is 7 years old and has Asperger’s syndrome and high functioning autism. He has very high anxiety levels and worries about lots of things. Every night, after story, we do worry time. We talk about all my son's worries that he has put in his worry box (in his head) throughout the day. We also have a deep worry box which we open up too. It's a fab way of helping him deal with his anxieties/worries with lots of reassurance and cuddles from his mum."

Settling in

Give your child time to settle into a new environment, for example a new playgroup. Don't rush them. Allow them time to adjust. Find a nice quiet spot where you can sit, allow your child to be at ease with the surroundings and other children and adults who are there.

Give them a job

Try giving someone a job to do if they are withdrawn or having difficulty adjusting to a group – for example, if it's music time, ask them to hand out the instruments or switch on the tape player.

Gradual steps

Implement a de-sensitization programme with gradual steps. For example, allow the person to observe an activity. As they become more comfortable they can be encouraged to engage for a small amount of time. Increase the time slowly.

Running commentary

My daughter used to hate going anywhere in the car. I discovered it was not knowing where she was going, added to the car sounds when slowing down or when cars passed. I started to do a running commentary from the start of the journey, eg "We are going to the shops, then home", "we will slow down now red traffic light stop, green for go". It really helped.

Backward chaining

To encourage people to do more for themselves, try 'backward chaining' – you do most of the task but then ask them to do the very last step. Over time increase the last steps until they are doing the complete task independently.

Write it down

George used to get very frustrated and angry, so one time I got a piece of paper and wrote on it 'I am worried about...' He filled in 'going to school when it is raining without a coat'. I replied 'How can we make sure that doesn't happen again?' and we went on to have a really good conversation about all sorts of things. It allowed him to explain how he felt by writing it down rather than having to express himself verbally and the silence that surrounded us calmed his anger down. He has since called it his 'worry book' and now asks to do it again if he has a problem. 

Left - right!

I taught my son to understand left and right by getting him to look at his hands flat stretched out, thumbs pointing down. The side where the thumb and pointy finger make an L shape, that is left. The other is right.

Break it down

When I teach a new task I use a method I was taught in the army to break it down into easy-to-grasp pieces. It's great for cooking and household chores in particular: Explain: explain the task. Demonstrate: show them how to do it. Imitate: they copy you. Practise: supervise and provide support where necessary.

Ask a Scope community advisor

If you need advice on a specific issue with your child’s behaviour, don’t hesitate to get in touch with Scope’s volunteer parenting advisor on our online community.

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Using these tips

These tips have been contributed by members of our online community. We hope they will give you some ideas to try, but if you need further help why not post a question to the community or talk to one of our community advisors. If you have any concerns about your health or the wellbeing of someone you are caring for, please consult a doctor or qualified professional.