For the month of September, the Handwriting is Fun! Blog will be sharing insights about the role of Occupational Therapy in the classroom. In recent years, the role of OT, in general, has been changing with the waves of healthcare and education reforms. Despite a certain amount of turmoil and confusion where those changes may have thrown us a curve ball, most often they have provided us with an opportunity to make a difference in an area in which we’ve longed to see an improvement. Occupational Therapists have recently received an increasing number of referrals to consult with teachers and staff about the behavioral needs exhibited by their clients, as well as those displayed by other students in the school. In that light, this week’s article focuses upon techniques for becoming a “behavior detective” to guide us in uncovering the underlying causes for students’ behaviors in school and to offer tried-and-true strategies for helping them to manage their feelings and stresses.
By: Cara Koscinski MOT, OTR/L
No child wants to misbehave. Rules exist in homes, schools, and communities in attempt to maintain a peaceful and calm environment. It’s important that children with and without special needs learn to follow the rules of the classroom setting. As students grow into adulthood, their success is dependent on their own ability to adhere to rules while controlling impulsivity and behavior.
Children often exhibit behaviors when they are overwhelmed, confused, or asked to complete a non-preferred task. The creation of rules is critical to helping students know exactly what to expect. Therefore, rules should be consistent throughout all settings and consequences delivered. It’s critical to remember that children with special needs often experience co-morbid conditions. Examples include: reflux and other gastro-intestinal disorders, sleep disturbances, and processing delays. School settings themselves can be quite overwhelming for students with sensory processing disorders. There’s so much to consider when working with children who exhibit difficult behaviors.
What’s our responsibility in the school setting? As clinicians, we need to determine the root cause of the behavior. As a veteran clinician and parent to two sons with autism and behavioral challenges, I consider myself to be a ‘behavior detective.’ Let’s look some critical steps therapists can take to help figure out the problem. In my book, The Special Needs SCHOOL Survival Guide, there is an entire chapter about behavior in school. It offers a plethora of helpful techniques I’ve figure out over the years. Here are five of the most important:
1) Be objective. Don’t form opinions of a child based on a specific diagnosis or from a written report. There’s a saying I use often, “If you’ve seen one child with autism, you’ve seen ONE child with autism.” It’s true for all children with special needs! They are people first.
2) Consider the skill level of the child. If a skill has not been learned and rehearsed, then the child will have difficulty generalizing the skill. Perhaps, bad habits were formed in earlier years or grade levels. Re-evaluate what’s already been done and rehearse again. Remember that no child wants to fail.
3) Evaluate for receptive and/or expressive language delays. Many children simply need more time to process a directive. This is especially true in a busy classroom setting. Ensure the instruction giver has the child’s full attention prior to giving a command.
4) Consider time of day. Often, my new OT students forget that everyone has a different time of day in which they function best. We all experience different body rhythms in sleep/wake cycles, hunger/thirst/digestion, etc. I’m a late morning person. I am simply not at my best first thing in the morning. No one can change that as it’s my body’s physiological condition (interoception).
5) How has the task been presented? This is the ‘before’ or antecedent. Antecedent information includes the tone of voice of the direction giver, visual vs. auditory command, child’s sensory arousal/state prior to the command, child’s attention to command and child’s underlying ability to actually follow commands. Not many people consider the BEFORE…..in fact, it’s more common in the school setting to consider the RESULTING behavior. It’s a veteran behavior detective who can form non-biased conclusions as to the events that occur prior to the child’s tantrum.
BONUS tip…Does or has the child been given attention for the behavior? Is he perhaps seeking a reaction from the teacher, clinician, or students? If this is the case, keep an even tone when giving directions and choose your battles. For example, I was called in to observe a third grader with lower-functioning autism. She consistently threw her paper onto the floor when the teacher gave a writing assignment. Upon observation, the teacher instructed her to ‘pick it up’ each time. The teacher and other students were consistently distracted and frustrated. I suggested the teacher simply ignore the behavior. The student threw everything from her desk onto the floor and no one looked or responded. After a week without attention, she stopped tossing paper onto the floor. Yes, this is a simple example, but it’s applicable to many other situations.
I’d like to offer some advice to help children transition smoothly. Review rules and consequences BEFORE a tantrum and when the child is quietly listening. Remember that fight or flight reactions are CHEMICALLY driven and once the hormone (adrenaline) is released, it takes time for a child to calm and organize. Please don’t attempt to teach a child who is in a tantrum. I’d bet you do not want to learn a new skill or receive a lecture when you are upset and need to re-group.
Finally, utilize visual strategies for transitions. Adults rely on the use of calendars, timers, and electronic devices for transitions and reminders. In the school, provide a written or picture schedule of transition times. Give verbal warnings or countdowns prior to changing activities. It’s best to provide consistency and use the same strategies consistently throughout the day. If the student prefers to learn visually, allow the use of a visual timer or schedule for transitions. For others, provide verbal warnings at various intervals of time beginning at least ten minutes prior to transition time.
The most important takeaway from my post today is to remember that there is ALWAYS a reason for everyone’s behavior and it’s our job to investigate. Being a behavior detective is not easy, but the rewards are well worth your effort. Your students will thank you for it!
Cara Koscinski, MOT, OTR/L, is passionate and excited about providing quality treatment to children with special needs. As a homeschooling mother to her own children born with autism, Cara co-founded Aspire Pediatric Therapy, LLC, to provide quality therapy for autism and Sensory Processing Disorder at schools, in homes, and in centers around the Pittsburg area. Cara is the author of The Pocket Occupational Therapist, winner of the 2015 Family Choice Award and recommended in the Autism Spectrum Quarterly as a “Great Resource for Families and Professionals.” In addition, she has authored her latest publication, The Special Needs SCHOOL Survival Guide, and The Weighted Blanket Sensation (coming in Winter 2015). Cara has served as an adjunct clinical instructor for the Duquesne University Occupational Therapy program and was the recipient of the Duquesne University’s Innovative Practice Entrepreneur Award. For more information about Cara, or to contact her directly, please visit her website, The Pocket OT.
Photos are the property of Cara Koscinski and are not to be used in any fashion except as links to this blog post or the Pocket OT website without the expressed, written permission of the author.
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