Managing Challenging Behaviors

Whereas the teacher establishes classroom rules and consequences for not following the rules, and positive behavioral support is embedded throughout the curriculum, there are some specific common behaviors for which the educational staff will establish guidelines to maintain consistency throughout the school and home environments.  Whereas these are behaviors that many children with Down syndrome have in common, they are not characteristic of the syndrome—they are not ‘in the genes’—but rather the behaviors are characteristic of the individual’s means of coping with situations and trying to get control with limited communication and cognitive skills.  Over time, as these undesirable behaviors are reinforced unintentionally by adults, they become problem behaviors that interfere not only with the child’s development, education and wellbeing, but also with the wellbeing of the family.  This section provides strategies and tools for dealing with specific behaviors.

Learned Helplessness and Avoidance Behavior

From an early age some children with Down syndrome use strategies to avoid learning situations where the tasks are too difficult, too easy, too boring, too much trouble, or too threatening.  These strategies include distracting the teacher or caregiver, refusing to cooperate, making random choices, purposeful mistakes, and finding another agenda.  Initially, these strategies were likely used to avoid failure, to avoid the task, or to engage the adult in the child’s own agenda, but they soon become a pattern of behavior that generalize to all learning situations. The child learns helplessness and fails to ‘learn to learn’. 

Misuse of social behaviors to avoid tasks

Jennifer Wishard, a Scottish researcher, describes how young children with Down syndrome misuse social behaviors such as smiling, clapping their hands, catching the adult’s eye and staring at her, and doing  ‘party tricks’ to distract the adult who is teaching cognitive tasks. These counter-productive behavior patterns were not seen in infants with Down syndrome, who were more efficient learners.  Ms. Wishard theorized that these behaviors in young children were learned, rather than being inherent. These strategies are used to avoid failure—by not trying, they eliminate the possibility of making a mistake.  They are secure with the social behaviors that have always brought them approval from adults.

Purposeful mistakes, random responses, and teasing

In addition to the misuse of social skills to avoid cognitive tasks, some children make mistakes on purpose and make random responses without attending, trying to engage the adult in a ‘teasing’ game. They do this so the adult will not know when they make a mistake.  These avoidance behaviors are seldom seen in children who have the advantages of systematic instruction where programs are individualized and programmed for success.  However, you will encounter many children who have not had such benefits and have learned these avoidance behaviors. In these cases, adhere to the following guidelines

First examine the program:

  1. Is it too boring? If so, make it more interesting—change the materials and become more dramatic—you have nice ‘social’ skills too; 
  2. Is too easy? If so, move on to a more challenging level;
  3. Is it too hard? If so, go back and provide practice at a lower level where the child is successful;
  4. Is it meaningful and useful to the child? If not, drop the task and change the objectives to better meet the child’s needs and abilities.   

Second, after determining that the program is appropriate, it is time to take control and give the student the problem

  1. Start with a task that you know that the child can do.
  2. Take control of the game that she is playing with you. Make some rules and have a powerful consequence for making mistakes: 
    • The teacher scores when the child gets it wrong
    • The child scores when she gets it right
  3. Provide token jars, one for the child with her name or photo on it and one for the teacher with her name or photo on it. Make it visual.
  4. Tell the child you are going to try to ‘trick’ her. If you ‘trick’ her, you score.  If she is not ‘tricked’ and gets it right, she scores.  She has been trying to ‘trick’ you, so you are playing the ‘trick’ game with her.
  5. If she continues her ‘tease’ and makes a mistake (as is typical to test the rules), drop a token in your jar and say “I score! I tricked you.”
  6. If this upsets her, as it usually does, you know it is working. Be sympathetic and take the token out of your jar to calm her down and say, “Do you want to try again?”
  7. Usually, the child is eager to perform and make it right. In this case, you drop the token in her jar, saying, “You score!” I didn’t trick you!” 
  8. Continue ‘trying to trick her’, but failing to do so—telling her she is too clever for you, but you will keep on trying! 


Make it important and motivating for the child to try her best. This game has a consequence for not trying or making an incorrect response. Therefore, you will know that incorrect responses are not intentional. Give help for incorrect responses, such as repeating the cue and pointing to the correct response, saying “Try again.” Remember you are teaching, not testing, and you are giving her every opportunity to learn.  It is important for children to ‘know when they know it’ and to ‘know when they do not know it’. Therefore, you don’t encourage guessing, but teach the child to say, ‘Help me’ when they do not know the answer, and praise them for asking for help—it’s the smart thing to do.  After the good working behavior is established, the ‘tricking and scoring’ will naturally be phased out, but the student should keep the jar for correct responses. It’s important to provide visual feedback for good work.

Some children may need a much-desired food, rather than a token. Food reinforcement can be phased out, once the child starts enjoying the learning experience, discovering the joy of accomplishment and being a ‘winner’.

Natural and Logical Consequences

The secret is to figure out how to give the child the problem—the consequences of their behavior.  Consequences come in two general categories, natural and logical. Natural consequences are those that happen ‘naturally’ as a result of the behavior; logical consequences are those that are related to the behavior—are logical—and imposed by parents, educators and caregivers.  Consequences, like feedback, to be effective, must be immediate, specific and consistent.  

Natural consequences

Natural consequences are often neither immediate nor specific and therefore not effective in managing behavior. In addition, some natural consequences often put the child in danger. Therefore, systematically teaching children ‘cause and effect’—choices and the consequences, natural and logical—of their choices, ‘good’ and ‘bad’—is an important part of the Saut social studies curriculum. 

Natural consequences that are immediate, specific, and do not harm the child are often the most efficient options—they take care of the problem quickly and are hassle-free.  For example, if the child refuses to wear a coat when it is cold out, allow him to go outside without wearing the coat rather than getting into a power struggle.  The natural consequence of being cold will change his mind. 

Some natural consequences are specific but not immediate. For example, consistently failing to brush and floss your teeth will, in time, lead to tooth decay and gum disease; consistently eating and drinking more calories than you need, will, in time, lead to obesity.  We all know about these consequences, they are specific, but because they are not immediate, we tend to overlook them and let ‘instant gratification’, which is immediate, win.  Years may go by before we are faced with the full consequences of our behavior—before we fully comprehend (if ever). If you had a toothache each time you failed to brush and/or floss you teeth, most likely you would not fail to do so. If you gained weight immediately after you ate too much, and lost it again immediately after you reduced the amount you ate and exercised, maintaining a healthy weight would be much easier.  The natural consequences of these behaviors (avoiding oral hygiene and healthy eating and exercise) occur by default, over time, when there has been no effective intervention. The natural consequences of children’s behaviors will also occur by default, when no effective intervention has taken place.   

Logical consequences

In the guidelines given for dealing with avoidance behaviors, the teacher’s ‘scoring’ is the consequence for the child’s making errors on purpose, not attending to the task, or making random responses. The ‘scoring rule’ is an example of a logical consequence, specific and delivered immediately. The natural consequence for such behavior would be that the child would fail to ‘learn to learn’—she would continue to avoid learning situations, and, unwittingly, sabotage her own education, as many children have done and will continue to do as long as effective intervention strategies are not in place. Children who misuse social skills to avoid learning situations are unaware of these long-term natural consequences—and so are many of their teachers.    

Learned helplessness in self-management

Learned helplessness is not limited to avoiding cognitive tasks, but occurs to avoid self-management tasks as well. It is not unusual for a person with Down syndrome to reach adulthood and still require help and/or supervision in completing routine self-management tasks such as bathing, dressing, and following a schedule. Even when they have the skills to perform these tasks, individuals with learned helplessness require supervision and wait for help and instructions.  They are sometimes so slow, inefficient, and distracted, caregivers find it easier to do everything for them than to teach independence. Learned helplessness is developed and maintained by parents and caregivers who either do not know how to teach independence, or they know how, but find it too much trouble and/or time consuming. The natural consequence is that the individual with learned helplessness has a valet and a personal manager.  Who is the smart one here? 

We are all guilty of doing things for children when we are in a hurry and simply don’t have the time; this is acceptable.  An occasional relapse into providing assistance when time is a factor, the individual isn’t feeling well, or in the event of other unplanned circumstances, will do no harm and is nothing to feel guilty about.  However, it should be the exception and not the rule. Children should learn to follow illustrated schedules and sequences of self-care skills at home as well as at school, transferring and generalizing these skills in all environments so that they become a habit. It is not difficult.  In fact, once in place, parents will be rewarded with the natural consequences of having more competent children, a more pleasant home life, and more time on their hands.  Teachers should provide the materials and train the parents—it is the student’s homework.

Beat the clock

To build independence in performing all tasks required before leaving for school, coach parents on how to teach their children to play ‘Beat the Clock’.  The student follows a schedule that states the time allowed for task. The learner sets a timer for the amount of time allowed for each task before he starts it, and works to ‘Beat the Clock’.  For each task completed before the timer goes off, he receives tokens—the number of tokens may vary with each task.  The tokens can be cashed in for desired objects, food, or privileges.  One mother said that if her son earned enough tokens, he could watch a favorite DVD before leaving for school.  The timer paces students and keeps them on task, and they learn to ‘live by the clock’ as we all do.  The important cognitive concept of time and space is practiced in this game—this is the learner’s important homework, practicing, transferring, and generalizing skills learned at school.  True cognition is to transfer learned concepts into new situations.  

Teachers can work with the parents to develop the individualized, illustrated schedule that would include tasks such as turning off his alarm clock, going to the bathroom, getting dresses, eating breakfast, brushing teeth, and packing his backpack for school. Preparation for the game starts the night before with a consistent bedtime that allows for adequate sleep. As a part of the bedtime routine, ‘set up’ the game for the next morning.  Clothes and shoes should be laid out; the schedule, timer, tokens, and token jar handy; the sequence for each task posted near the place the task takes place (such as dressing and teeth-brushing, if needed); and an illustrated list of all items for his backpack at the place where the backpack kept. The learner should turn on his own alarm the night before.  In the morning, he turns the alarm off, gets up, and goes to the bathroom—the first things on the schedule.  The next task on his schedule may be for him to say good morning to other family members—announce that he is up on time—before starting the next task (a social script).  It’s good for him to initiate interaction with others after getting up independently—and to receive a good morning hug and praise for his accomplishments. 

(If someone other than the learner’s parent, such as a nanny, maid, or sibling, is responsible for the child in the morning, they, of course, should be taught to how to follow the program.  And, it is most important that this person has a language in common with the child.) 

Wandering off, leaving without permission, and running away

Wandering off, leaving without permission, and running away are the most frightening of the challenging behaviors that parents, siblings, caregivers, and teachers have to deal with. Whereas there is concern when any person is not where they are expected to be and can’t be reached, when a person with cognitive and communication disabilities is missing, it is an emergency. 

Because of the complexity of functioning in an unstructured environment, it takes years for children to learn the competencies necessary to navigate and communicate in the world outside their home and school—in the community.  The community-based curriculum is designed to teach these competences; however, it is an on-going process with each child progressing at his/her own rate.  In addition, the outcome will not be the same for all individuals—some will function independently in the community, and others will always need to be supervised.  It is advisable for individuals, especially those who have difficulty communicating, to wear an identification bracelet that includes an emergency number.  Modern technology, such as GPS devices and cell phones, are helpful in finding missing individuals, but they have to be on the person at all times—when you least expect it they disappear.  

Image trying to live in a house without walls and being held responsible for each time you step beyond the boundary.  That is what it is like for children when limits are not clearly defined and taught, and yet they are held responsible.  The more rules we know, understand, and are able to follow, the more freedom we have.  When infants become mobile, we ‘childproof’ the rooms they have access to and closely supervise them to assure their safety.  Limits are introduced gradually as they learn the rules, and the more rules they can observe, the more civilized they become and the more freedom they have.  Children that do not have cognitive disabilities can be trusted to function in home and community at age six without the worry that they will wander off or run away; however, a child with Down syndrome at age six is most likely to need intensive positive behavioral support to learn to stay within their limits, what to do when they are lost, and to respond and come when they are called by name.

From the time that the child can walk, teach him to answers when called by name and to come when requested to do so.  Play games—when he answers and comes, reward him.  Then you can teach him to call you, and you come when he calls you.  Then you can take turn hiding, and the person hiding calls out for the other person to find them—such as, ‘Mama come!’ The child should always be rewarded for coming when called—even if he has run away and you are upset, frightened, and angry.  Try to be calm and tell him how happy you are that he answered you. If a child is punished when he comes, he is not likely to connect the punishment to his leaving, but rather to his coming when called.  Next time he may be afraid to come, and this could be the making of a power struggle over which the child will remain in control.  The child can also be taught to come to a whistle, which has a longer range than a voice. The objective is for the child to want to come to you, and that he will call to you when he wants you to come to him.  If you don’t hear him, perhaps someone else will.

References

  1. Oelwein, P.L. (1988). Behavioral management: Guidelines for parents and teachers. In V. Dmitriev & P. Oelwein, Advances in Down syndrome. Seattle: Special Child Publications.
  2. Patterson, B. (2002). Behavioral concerns in persons with Down syndrome. In W.I. Cohen, L. Nadel, & M. E. Madnick, (Eds.), Down syndrome: Visions for the 21st century. New York: Wiley-Liss, Inc.
  3. Reese, E.P. (1966). The analysis of human operant behavior. Wm. C. Brown Company.
  4. Sandall, S.R. & Schwartz, I.S. (2008). Building blocks for teaching preschoolers with special needs, 2nd edition. Baltimore: Paul H. Brookes Publishing Co.