Dated 20/7/18 to 26/7/18
Challenging Behaviours are a type of behaviour to adjust to a situation.They can be disruptive,offtask or avoidance behaviours.
The discussion mainly focussed on identifying the triggers,observing addressing and managing challenging behaviours as well.Though challenging behaviour is manageable in an early age,it's quite stressful for the parent of a teen or adult in the spectrum.
Triggers for disruptive behaviour
*gain attention from adult or peer group
*gain an object,activity or event
*unbearable pain,health issues(ADHD,epilepsy,OCD,psychiatric comorbidity)
*a feeling of no control over the situation or event
*communication deficits and incapability to understand what is happening around them
*problems in decision making
*change in routine
*transition between activities
*sleep disorders and tiredness
*anxiety and stress
*Sensory issues (proprioceptive,gustatory,kinesthetic,visual,auditory...) and so on..
Parents pointed out that a child who insists for a car ride or on a swing at any hour of the day could be to satisfy his sensory needs.Discussion moved to the relevance of identifying core temperament traits like the degree of adaptability,mood swings,attention span,intensity of reactions,considering sensory threshold etc
Self abuse was said to be common in children with emotional regulation problems.Biting (self or others) would be providing strong proprioceptive inputs for jaws as well as to arms.Sensory overload,uncertainty and physical pain is at the root of self abuse.
*Gina very well explained the role of testosterone surge during puberty as a cause for aggression. She also pointed out that kids who are abused at home or are bullied in public places are prone to disruptive behaviour
*Asha Sanjeev revealed performance anxiety as a cause for aggressive behaviour.
*Damage to limbic system of amygdala which controls emotions is another cause for aggression. Mutation of Monoamine oxidase A is another reason to site.MOA deficiency is associated with a wide range of problems including aggression.
*Chitra Chandran very well explained the triggers and ways to tackle the behaviour according to ABA methods.She suggested that functional communication,self concept and motivation as the key to control aggression.
*Maya Suresh explained on how to manage aggression. According to her analysing the situation,followed by calming the child using coping mechanisms with minimal verbal instruction is the necessity of the hour.She also pointed on the emotional health of the caretaker (parent/others) who's dealing with the situation.
*Chitra Paul suggested that frustration can lead to aggresion. Playing sound tracks of the child's choice would help to calm down.She also mentioned that some kids in the spectrum once calmed down would feel resentful and apologise for their behaviour.She explained the disadvantages of physical punishments in dealing an aggressive behaviour.Asking to take deep breaths and typing instructions might work as there are high chances for the auditory processing to shut down.
*Rosemy pointed at physical illness as the culprit for aggression
*Ditty Sheebu,Principal ,Vigyan Valley provided information on how they deal with their students who throws an aggressive behaviour which was well appreciated by many and their behaviour management strategies were quite positive.
How Homeopathy can Help Aggresion.
Mr Karthik Ramaswami described the role of Five Phos.6x, Kali Phos, Ferr phos,Nat Phos and Calc Phos in calming the kids down.Parents suggested Rescue remedies gave temporary relief from aggression.Mrs Saswati Singh pointed out that holistic approach and homeopathy helped to deal with aggression.
Controlling aggressive behaviour in public places
*planning is the key ,show Google pic of the place in advance
*avoid peak hours
*make sure the child is well fed and hydrated
*carry emergency reinforcers
*move to less crowded area
*use shortest phrases for communicating
*visit the child's favourite place at the end of the trip.
Managing Challenging Behaviour
*Help to develop self control
*Respect their opinions but at the same time be firm on behavioural limits
*Be a good role model for the child
*Model of ABC Recording sheet was provided (antecedent,behaviour,consequence)to better understand how to help aggression.
*Modify the environment
*Teach presocial behaviour and social skills which are alternatives
Discussing further on behaviour management, it was adviced to remove edibles for efficacious management and to introduce socially contingible reinforcers (pat on the shoulder,words of praise and so on).Punishment was told to be a temporary fix and dint provide a long lasting behaviour.
The discussion ended on a positive note with a single question from Mr Karthik Ramaswamy."Is aggression a means of communication?"
Definitely Yes
Aggression is a VOICE.It is an attempt to communicate ,but since they lack skills to communicate in the right way, teaching functional communication is the key to tackle aggression.
Participants
Dr Gayathri.S
Dr Roshni Anirudhan.
Priti Vadakkath
Veena
Eilu
Beena Balakrishnan
Thank you all
(The discussion is in no way conclusive or decisive.It definitely holds the scope for extension studies. )
#Asd parents and Therapists Group,Kerala
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4922773/
http://PDFcampbellmgold.com
https://www.google.co.in/url?sa=t&source=web&rct=j&url=http://campbellmgold.com/archive_health/biochemic_handbook_schuessler.pdf&ved=2ahUKEwjp-NGB0K_cAhXDvI8KHYaNA3cQFjABegQIBRAB&usg=AOvVaw2TXxdGD7BIwhL86LZ2Cae3
https://www.ncbi.nlm.nih.gov/pubmed/10904119/
http://orthomolecular.org/library/articles/webach.shtml
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