Bea Inclusive TV and Podcast
The last time I told you about PDA and I guided you on how to prepare yourself and where to find help if your school is looking after a child with PDA.
In this episode of Bea Inclusive TV I will:
answer one of the questions that I received from a special needs teaching assistant, a case study, and I will give you my strategies on how to support a non-verbal child that expresses the challenging behaviour.
SO, welcome to Bea Inclusive Thursday Q&A!
If you are new to me – my name is Bea and I’m advocating truly inclusive school provision. I support an eclectic and holistic approach and as the Autism Lead Practitioner, I was using many different interventions to suit my individual children’s needs. One of the best therapies that I’m passionate about is Lego-based Therapy as I saw the effectiveness of this approach and the positive change in children and adults’ emotional and behavioural responses, language, communication, and social skills.
So, here is me inviting you to follow my journey in creating truly inclusive provision that helps you to support children and develop your skills. Are you ready? Let’s go!
Looking after, helping, and supporting non-verbal or pre-verbal children can be extremely difficult and rewarding at the same time. If you did not support this type of special needs yet, then you can listen to this case study to check how it looks like. Looking after children with no speech is not rare even in mainstream school. I was working in the mainstream primary school and I had 3 non-verbal and pre-verbal children. OK. Let’s listen to the letter.
I work as a level 2 TA in a special school. A lot of children are non-verbal.
Any tips for dealing with behaviour issues, hitting, biting, removal of clothes, deliberate urination, to name a few, for children who lack verbal reasoning skills would be great.
I refer to one child, who after a difficult start to the academic year, is being educated individually.
As I mentioned before, we are a special school. This measure is a last resort, not taken lightly. The aim is to reintegrate the child back into a class.
The child is midway through their primary education, is non-verbal aside from about 10 words. One of which is a noticeably clear No!
Unable to self- occupy, the child will empty draws, throw objects, hit others, and remove their clothes.
We are currently supporting the child on a two to one basis, with a child-led timetable, and minimal demand. Even with these measures in place, the child will only sit for a moment. The demand for simple tasks such as shape matching will involve the child dropping to the floor to avoid the workspace, having to have an adult either side to restrict movement away from the workspace. If it’s a good day, the child will complete the task with minimal intervention. On the bad days, which are most, the child will get off the chair and attempt to slap, bite and head-butt to getaway. The child will also attempt to slide off the seat and under the table.
He will slap and pinch for no reason, being apparently perfectly happy. The child will remove clothes and refuse to put them back on. Efforts to redress the child are met with, slapping, biting, kicking. The child will also remove clothes when cross and then urinate and/or defecate deliberately. This will often result in the child trying to rub themselves in the urine and smear the faeces.
We use speech, widget symbols, photographs and sign along as methods of communication. However, the child is strong-willed and self-driven. Unless it is something the child wants, they seem unwilling to engage in communication.
The child is generally happy, cheeky character, and well-loved by staff. Whilst the child has always been a bit of a handful, sadly we have come to the situation that the child can no longer be educated with their peers due to the amount of disruption caused, and the number of staff required to assist.
The staff are a dedicated team, our children’s best interests are paramount, and we strive for the best outcomes possible for each child.
The child can access all playtimes and maybe a group outing or active play session once a week. Even at those times, the child is very closely supervised and often removed from the activity early. This is because of physical behaviours which often indicate the child wants to finish the activity. The staff know the child well enough to spot the early warning signs, so in most cases, can remove the child prior to anyone getting hurt.
The child is much more manageable, and the behaviour has improved massively. However, the child lead timetable has its own drawbacks, any tiny, and I mean tiny, attempt to lead the child to a more usual class routine, is met with immediate refusal and aggression. This is creeping towards the child having even more control of the environment.
We are trying every trick we have. Not even bribery, as nothing interests the child for more than a couple of uses, or the child is so obsessed, it becomes its own issue.
In addition, we are aware that sensory processing is an issue, but you must wear clothes in school, and in the playground. That child is not the only offender in the public nudity department, but the others are less frequent and generally easier to return to a clothed state.
We have also tried, where possible, planned to ignore to behaviours and non-reaction to more physical behaviours. The child reacts to this by targeting children, knowing we must react”.
You will probably agree that is a lot on the staff plate. I can hear the frustration from that letter but also extreme determination to help that boy.
There is plenty of things that we can do for that child. I’ve chosen the most important ones:
The first challenge in helping to manage his behaviour better is to understand why he is doing what he is doing.
So, the first and the main thing would be to:
use ABC method of analysing the child behaviour from day one (If you have never done that – there is a simple form to fulfil each time when the child expressed challenging behaviour, where you are describing what happened, what did you do and say, what the child did, what was the consequences. Somebody else (not involved in supporting the child) will analyse and make suggestions about that. This can only help you to make decisions and change your actions or adapt to the child’s environment so make sure you are putting as many details as possible.
assess the child individual needs and decide on the next goal (not the school goal which always will be to integrate the child into the class). In this case, you can clearly see that the child is not ready to integrate. I would suggest the shorter school day (only mornings) to limit inappropriate, challenging behaviour, lower his anxiety and makes it easier for the teacher to target his communication skills. I would change the child target/goal and the new target should be focusing on functional skills, following a routine and tackling child’s inappropriate behaviour (when the child master above with the child one to one then you will be able to integrate the child by slowly introducing one extra child, then small group, bigger group and eventually the child will be able to join the class.
The next important change will involve management of the child environment.
you must manage your environment to limit unwanted, inappropriate behaviour (the child is clearly not ready to work in the classroom) He hits, bites, throw resources, refuse, physically targets his pears. Very clearly the child did not master the routine even with adults so there is no point of trying to re-integrate him into the class yet. He should be taught in a different room, and for the time being until he masters the routine and follows the adult direction – he should stay away from children – especially that he targets them to get adults attention. The room should be almost empty – no drawers with toys, things to trash, no free access to the resources, etc. The attention should be on adults in this room, so the child will have to use the adult, communicate with them. This is how the room should look like and let me tell you that this works extremely well if you would like to teach structure, independent skills, communication skills, social skills, etc. You should divide the room into different areas.
Transition area (with the marked spot od chair to wait, daily schedule/plan)
Play area with no toys there as this will be the way to work on communication skills. The only thing there should be a PE mat – where the child can play or read a book with us.
The safe place where a child can go and chill/self-regulate, hide when he is sad, tired, or angry),
Independent workstation facing the wall to practice his independent skills so we can check what the child is able to do it independently.
Group table with 2 chairs on to each end of the table.
There should be a simple shelf out of child reach with toys and items (such as sensory toys) that the child would love to play or use them. We must prepare visual representation – pictures of those items so when the child will approach us, we can use this as the learning opportunity. We want the child to ask or point for toys/items. The toys should be used for a short time and we should use a timer, rotation of the toys is necessary. You should place the toys in transparent jars or boxes with the closing mechanism. A great idea would be to make it difficult to open them and access the toy for a child. This way, by using this sabotage technique you can increase the chance of communication so you can practise positive communication.
tackle the stripping, urination etc by immediately removing/guiding the child to the bathroom and not making comments about the behaviour except positive on (you want a toilet, showing the picture of the toilet and saying, good boy)
write a list of the words that he can say verbally and think about the words that he will need to understand and communicate his needs in the school and prepare the visual support – graphic/picture presentation (with the text) This is my proposition of the words that I think would help the child to communicate his needs in the first stage: the names of the toys in the jars/boxes, yes and no, class (which in this case is the intervention room), outside, toilet, bag, please, thank you, sad, happy, help, choosing time, workstation.
Use the DTT to teach the targeted words to monitor a child’s progress.
Make sure that you thoroughly researched what are the chid strengths and interest and start building the relationship and child independency through them. This way the child will feel safe and he will trust us. Follow the teacher planning but make sure that the work is adapted and differentiated. You mention that the boy is struggling with simple matching objects. Make this activity short start with matching only two objects and when he did it make a big deal of it. Give the boy high five and praise his good work. It is important to show the child that the task is achievable. You can increase the amount of match next time to two pairs.
Gather the simple but interactive games or objects such as bubbles, pop up pirate, skittles, and play with the child simple turn-taking games. You can play at the table or on the mat. You can mix teaching with the play (that works best) especially when you are using DTT. Remember that you must teach the child how to match first before you ask him to do the same at the workstation.
There is plenty more that I could add to help that child, but I already feel the amount of information is overwhelming and the video is too long.
There you have it!
I’m curious what do you think? What would you do? How would you help that boy? Did you work with non-verbal children with challenging behaviour? Do you have more ideas on how to help?
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Thank you for your comments in advance as I am going to give away The Lego Captain America Collaborative Set – of course after making the video review next week.