Positive Approaches to Challenging Behavior
First Steps in Positive Behavior Support
There are two first steps before starting a PBS plan:
- Make sure the child or adult has had a physical and/or mental health check with the doctor
- Use a wraparound plan or person-centered plan to begin addressing quality of life
The reason these two steps are important is because either action can eliminate challenging behavior before a PBS plan is needed. Addressing medical/mental health needs and improving the quality of life for a child or adult may naturally address the function maintaining challenging behavior and , as a result, remove the need for problem solving further. The visual on this page describes the social functions that maintain challenging behavior.
As you can see in the visual on this page, challenging behavior can occur for social or nonsocial functions. Sinus problems, internal health issues, and illness can all trigger challenging behavior. Nonsocial functions can also include anxiety, depression, psychotic episodes, and other internal physiological experiences.
Challenging behavior can be viewed as a form of communication that has a social function. A person may be seeking to communicate the need to escape or avoid something such as attention from certain people, tasks, or events.
In other cases, challenging behavior may signal that a child or adult is trying to gain or maintain access to what is important to them (reaching out to a person, signaling the need for someone to pay attention) or to gain access to an item or to objects.
A key part of PBS planning is to understand that when challenging behaviors occur it is important to learn more about its function.
Wraparound and person-centered planning are also first steps in PBS because these team-based strategies often highlight the types of quality of life issues that are occurring in someone’s life. These planning strategies can address the function maintaining challenging behavior by building relationships, improving communication, and helping improve the social and physical environment.
A small child begins banging her head on the kitchen table at home. The child’s mother schedules a doctor’s appointment and discovers that the child has an ear infection. This form of self-injury often occurs in young children and appears to relieve the pain coming from the earache.
A young person who engages in a repetitive form of behavior called self-stimulation or stereotypy that usually does not result in injury. However, self-stimulation can become a form of self-injury when these behaviors suddenly increase in intensity. For instance, a young person who taps her hand in a repetitive way on her face may start slapping or hitting herself with her hand as this repetitive behavior increases in intensity. A trip to the general physician identifies a possible reason for this increase in intensity - the young person is diagnosed with irritable bowel disorder. The disease has resulted in higher levels of discomfort and pain which has become the function maintaining self-injury. Treating the irritable bowel disorder results in decreases in self-injury.
Kenji is a 55 year old man with an intellectual and developmental disability who recently moved to a city to be closer to his aging parents. Kenji started a new job working as a janitor at a local restaurant. At work, Kenji has been pushing and shoving his supported employment colleagues so that they lose their balance, especially during times of day when the restaurant he works in is really busy.
During Kenji’s person-centered plan it became clear that Kenji really dislikes his job because it is very noisy in the kitchens with everyone yelling out orders and playing loud music. Kenji decided to change jobs and started stocking shelves at a nearby mail order shop. The shop owners are very calm and somewhat introverted. They like that Kenji appreciates calm and quiet work settings. Over time, Kenji's challenging behaviors gradually disappeared.