Managing

difficult
behaviour
By Dr Emmanuel
Lecturer: Dr Akimana, Psychiatrist
 Introduction
• Difficult behaviors are child’s reaction to becoming
overwhelmed and not yet having the skills to cope.
• Difficult behaviour is caused by a lack of social or emotional
skills to respond to situations or behave in certain ways.
• Consider how your feelings are affecting the way you react to
your child.
• If problem behaviour is causing parent or his child distress, or
upsetting the rest of the family, it's important to deal with it.
 Causes of difficult behavior
• are influenced by both biological and environmental factors or related
to family life,
• Often it might not just be one thing causing the behaviour but rather a
combination of things.
Causes of challenging or inappropriate behaviour may include:
• Lack of sleep, Hunger, Illness
• Life transitions or changes in family circumstances (such as parents
getting divorced or moving to a new home)
• Mental health or medical issues, Emotional or physical trauma
 Causes of difficult behavior
• Classroom Environment: Noise, Disruptions, Temperature
• Child Specific Conditions: Medication Effects, Peer Issue,
Allergies Anxiety ,Fatigue, New Person ,Teacher Interaction
• Instruction: Work too hard/easy ,Transitions Length of
Assignments, No Choices
• Multiple interacting factors that contribute to divergence in
outcomes of infants who demonstrate early problems in
feeding, emotionality or disruptive behavior
 Causes of difficult behavior
• What a child does is not necessarily related to the function
of the behavior.
• To get something :Attention, Approval, Reward, Power,…
• To escape or avoid something: attending school, peers or
adults, doing work , to have control,…
 The Importance of Paying
Attention to Challenging Behaviour
• It can be hard to know what’s classed as “normal” behaviour and
what challenging.
• By understanding why they are behaving in a certain way, you
can possibly put steps in place to prevent the behaviour in the
future.
• When a child’s behaviour starts to affect things like their health
or safety, it’s important that the adults in their life pay attention.
• A child’s behaviour, particularly when it’s challenging, can start
to have serious consequences.
 Approach to Child Behavior
Management
• Managing a child’s behaviour isn’t always easy.
• The problem is not just with the child, but in the
relationships between the child and the environment.
• Interventions must involve the school and home
environment as a whole, not the child alone.
• A positive and constructive approach will get the best
results.
 Approach to Child Behavior
Management
• Assessment and intervention efforts across problem behavior
types have focused on changing child behavior, parent behavior
and resources, and
the quality of parent–child interaction.
• This style of approach where you create a positive
environment for learning helps to equip children with the skills
they need to behave in more appropriate ways.
• A negative approach to behaviour management only stops
behaviour in the moment. It doesn’t give them the skills they need
 Approach to Child Behavior
Management
• In early childhood intervention, similar parent management strategies
are often used to manage apparently dissimilar problems (e.g., infant
feeding or sleeping problems, preschool disruptive behavior).
• Self-regulation involves the ability to control impulses and expressions of
emotion;
• thus, children with difficulties in self-regulation might show a range of
problems,
including higher rates of tantrums, irritable mood and oppositionality,
and disturbances in sleep, eating, activity or attention.
Positive behavior interventions and
supports (PBIS)
• A research-based approach to eliminate problem behavior
based on the assumption that children and youth can
develop new behavioral skills when adults:
• Teach the expected behaviors
• Recognize and reward those behaviors when they occur,
and
• Consistently enforce meaningful consequences when they
don’t occur.
 School environment
• Discipline strategies vary among classrooms.
• School safety is based on reacting to problem behaviors.
• Academic skills are taught; behavior is controlled.
• The emphasis is on systems of support that include proactive
strategies to define, teach, and support appropriate student
behaviors.
• School safety is based on preventing behavior problems. – Teams
anticipate and plan for problem behaviors. – Behavior skills are
taught specifically
• Repeated punishment does not help children develop
appropriate behavior skills
• PBIS is a better solution
• A positive intervention plan is NOT the same as a
discipline plan!
• Be sure the expectation is positive!
 Goal of Changing Behavior
• Teach or Re-teach the behavior
• Provide Meaningful Incentives
• Provide Meaningful Consequences
 Teach expected behavior
• Begin with simple, broad rules.
• Be safe, be responsible, be respectful.
• Describe what each of those means.
• Clearly state the expectation.
• Provide examples of appropriate behavior.
• Provide examples of inappropriate behavior.
• Re-teach expectations regularly.
 Teach expected behavior
• Once the new behavior is taught, practice in different settings
• Define the expected behavior in different locations.
• State the behavior in terms of what you want to see.
• Discuss and model the expected behaviors to use: – In the
classroom – In the locations where specific behavior is expected
• Re-teach regularly and when necessary.
• Keep the expectation positive.
 Provide meaningful incentives
• Teaching is not enough to change behavior.
• Children need to be recognized and rewarded when they
meet expectations.
• Positive recognition must occur at least four times as
frequently as negative recognition for behavior change to
occur
 Enforce Logical Consequences for
Negative Behaviors
• Logical Consequences should:
–Be stated clearly in advance
–Be understood
–Be enforced consistently
–Apply to all in a classroom
 Why should Schools use PBIS?
• To increase academic success!
• To promote a safe, predictable learning environment!
• To reduce the incidence of problem behaviors!
• Children’s behaviors can change through instruction!
• Changing behavior through PBIS takes the effort of a “village.”
• Partnership between families and schools promotes a clear
message of shared responsibility involvement
Functional Behavior Assessment
• What is the behavior of concern?
• Where does the behavior occur and not occur?
• What are the antecedents to the behavior? (what happens
beforehand)?
• Is there a consistent pattern? Can the behavior be predicted?
• What does the student “get” from using the behavior?
• What are some possible reasons for the behavior?
• What replacement behaviors can be taught that serve the same
function?
 Behavior Intervention Plan
• The child’s team develops a plan that usually includes:
– Skills training to increase appropriate behavior
– Changes that will be made in classrooms or other
environments to reduce or eliminate problem behaviors
– Strategies to replace problem behaviors with appropriate
behaviors that serve the same function for the child
– Supports for the child to use the appropriate behaviors
General Principles for Selecting
Treatments
• Knowing the causes of a problem can be helpful for
understanding and selecting treatment;
• however, at the same time it is vital that clinicians use, wherever
possible, interventions that have a strong evidence-base,
• There is better evidence about the effectiveness of parenting
interventions for food refusal and other mealtime behavior
problems
• parenting intervention might be the treatment of choice in eating,
sleep, oppositional or attentional problems.
THANK YOU