When Special Needs Kids Are Bigger Than You!
By Mary Fratianni – NYS LEAH Special Needs Coordinator

Frustration and meltdowns are common place for many children with special needs. The primary reasons for these outbursts include inability to communicate, slow processing, poor memory management, poor executive skills, and/or physical limitations (including blind, deaf, mute, paralysis, etc.). Children with significant expressive language delays, non-verbal or minimally verbal, tend to have more severe behavioral problems than those who are verbal and can adequately communicate their needs. The way a parent, teacher, or other adult/caregiver deals with the outbursts can either further escalate them or de-escalate them. It is easy for parents and teachers to forget about the challenges in processing that these kids face every second of every day. Sometimes these kids understand what we say and other times they do not. Whether they get it or not depends largely upon their prior exposure to the material or issue at hand, their cognitive abilities, and how the parent, teacher, or other adult/caregiver handles the situation.

Editor’s NOTE: For the purposes of this article “Adult” will refer to the parent, teacher, caregiver, or other supervising adult person who is caring for, teaching, or watching the special needs child/teen.

There is always a root cause, or precursor, of an outburst. A caregiver must be very observant to see when precursors begin to happen. If the root causes/precursors of the outbursts are not addressed and a plan put in place early in the child’s life that will allow the child to “decompress”, the outbursts will get worse as the child gets older. A special needs child who slaps an adult in frustration will continue to do so if the root causes of the frustration are not dealt with early on. As that child grows, that small slap can turn into an all out assault. Assault endangers the lives of all persons involved! Explosive outbursts negatively impact the special needs child/teen, the adults caring for them, and others who they are in contact with on a regular basis.

A few foundational principles must be in place before dealing effectively with outbursts.

  1. Adults must understand the learning disabilities that the child/teen has.
  2. Adults must be willing to seek outside professional assistance as needed to address the needs of their child/teen if the behaviors/outbursts are negatively affecting the child/teen and family.
  3. Adults must be willing to keep behavioral records when trying to identify precursors to outbursts.
  4. Adults must be in agreement in decisions regarding setting up behavior plans.
  5. Adults must be consistent in carry-through with behavior plans and consequences.
  6. Adults must allow enough time for the plans to work.

A child/teen who self-inflicts (hurts themselves), throws objects, and/or damages property in an outburst is a danger to themselves and others. No adult wants to see or believe that their child/teen is capable of harming themselves and/or another person, but reality states that in some cases this does happen. In many of these cases the child/teen is unable to self-regulate and understand the consequences of their actions in the heat of the moment. Some of these children/teens will never be able to connect actions with consequences, some will. Adults need to be prepared with an open mind as to the mental and physical abilities of those children/teens with special needs in their care.

All adults wishing to help the special needs person(s) in their care should approach the resources listed below not as quick fixes but as means to make permanent changes in the way they, the caregiver, lives their life in dealing with and teaching acceptable behavior to the special needs person(s) on a daily basis. Change in the special needs person can only come through patient teaching, support, and encouragement. A violent response to a violent action only perpetuates violence. When a parent spanks a child who does not have special learning needs, the child is able to connect their actions to the consequence. Many children with special learning needs can have a very hard time making this connection. Whether or not they are able to make this connection depends largely upon their cognitive functioning. Once a caregiver understands this, they are better able to change their responses to the special needs person’s actions and be better able to de-escalate a potentially explosive situation. A person’s special need(s) should NEVER be used as an excuse for inappropriate behavior. Even a person with the most severe special needs can be taught. If you need help in changing your reactions, seek out another adult to help keep you accountable. Raising a special needs child/teen is not easy, and the road ahead presents greater challenges as that special needs person gets older.

1. How Difficult Can This Be? The F.A.T. City Workshop DVD and Discussion Leaders Guide by Richard Lavoie

(PICC LEAH Lending Library Item #T25)

Why recommended:

F.A.T. stands for Frustration, Anxiety, Tension–three all-too-familiar feelings for the families of children with learning disabilities. This unique program lets viewers experience the frustration, anxiety, and tension faced by children with learning disabilities. Workshop facilitator Richard Lavoie presents a series of striking simulations emulating daily experience of LD children. By dramatizing the classroom experience so vividly, Lavoie lets us see the world through the eyes of a child. At the end of the workshop, participants discuss strategies for working more effectively with learning disabled children. 70 minute DVD.

This DVD is a MUST watch for all adults caring for special needs children/teens. It helps adults understand what is happening in the child/teen’s head as they process incoming information, decide what to do with it, and output a response. This DVD will help adults change the way they interact with the special needs person. The special needs person may not be able to change the way they process information, but the adult caregiver can change the way they present the information to the special needs person. The interaction between the adult and the special needs person can be significantly improved when the adult is able to make accommodations for the special needs person and through the way they interact with them.

For parents/caregivers just beginning the home school journey, this is one DVD that they should watch prior to setting up and beginning their home school teaching! Adults can too easily duplicate the same classroom environment that they pulled their child from in public school right in their own home! The DVD helps adults to remember that each person is an individual who learns differently from the next. This program does not sugar coat special needs. It presents the challenges as they are and puts forth strategies for more effective teaching.

2. Beyond F.A.T. City: A Look Back, A Look Ahead by Richard Lavoie

(PICC LEAH Lending Library Item #T33)

Why recommended:

This 90 minute DVD offers practical strategies as well as inspirational messages for those who teach children with learning disabilities who constantly struggle with Frustration, Anxiety and Tension (F.A.T.). This program is designed to give teachers and parents the opportunity to become involved in candid and thought-provoking discussions on how to play a more effective role in the life of a learning disabled child. Beyond F.A.T. City: A Look Back, A Look Ahead is filled with powerful and provocative stories about the history and philosophy of the F.A.T. City project, major trends and issues in the field of learning disabilities, and the challenges ahead for parents and education professionals. The DVD includes a printed Viewer’s Guide. Copyright 2005. It should be noted that PICC LEAH is not in agreement with the author’s comments on homeschooling contained in this guide. This program does not sugar coat special needs issues. Richard Lavoie tells it like it is.

One thing that is clearly shown in this DVD is that many special learning needs are life long and will always be present to some degree in the life of the special needs person. This program drives home the point that there is a need to teach special needs person strategies for dealing with their special needs as they move beyond compulsory education and on into adulthood.

3. Treating Explosive Kids – The Collaborative Problem-Solving Approach by Ross W. Greene and J. Stuart Albon, The Guilford Press, NY. ISBN 978-1-59385-203-0

From the book jacket:

From tantrums and defiance to verbal and physical aggression, “explosive” kids present tremendous challenges to parents, teachers, and mental health professionals. This indispensible book is the first presentation for clinicians of the groundbreaking approach popularized in Ross W. Greene’s acclaimed parenting guide, The Explosive Child. Provided are innovative, practical strategies from working with families to reduce unmanageable outbursts and produce lasting improvements in interactions between difficult kids and their stressed-out caregivers.

Within a developmental framework, the authors offer a lucid reconceptualization of noncompliance and its causes. Illuminated are ways in which specific factors – deficits in executive skills, language processing, emotion regulation, cognitive flexibility, and social skills – can seriously impair a child’s ability to tolerate frustration and solve problems. The clinician learns how to identify and remediate these factors while also helping parents and other caregivers handle conflicts more successfully. At the heart of the Collaborative Problem-Solving approach are procedures that help caregivers pursue realistic behavioral expectations and respond effectively when expectations are not met. Many vivid examples and sample dialogues bring the intervention techniques to life and helpful Q&A sections clarify common clinical dilemmas. Two special chapters focus on intervention in schools and in therapeutic/restrictive facilities.

Written in a straight-talking accessible style, this book reflects the extensive clinical experience and research of its highly regarded authors. It is an invaluable guide for all mental health professionals working with children and families, including child psychologists, child psychiatrists, family therapists, social workers, counselors, and school psychologists.

Why recommended:

Adults need to understand why a special needs person reacts the way they do to various situations. Once that is understood, they are better able to handle a potentially explosive situation. This book helps adults be in each step of the de-escalation process.  The key to success with the Collaborative Problem-Solving Approach is with the consistency of application. Inconsistency in the application of any program works to erode at the progress that has already been made. This approach works for all levels of special needs.

4. Setting Limits with Your Strong-Willed Child – Eliminating Conflict by Establishing CLEAR, Firm, and Respectful Boundaries by Robert J. MacKenzie, Ed.D. Three Rivers Press, NY. ISBN: 0-7615-2136-4

From the book jacket:

Does your child constantly misbehave and ignore or refuse your requests? Is your relationship with your child based on conflict instead of mutual respect and cooperation? With the help of this groundbreaking book, you can create a positive, respectful, and rewarding relationship with your child.

Inside are proven techniques and procedures that provide a refreshing alternative to the ineffective extremes of punishment and permissiveness. Parents and teachers alike will discover how to effectively motivate the strong-willed child and achieve cooperation. You will learn how to:

  • Understand and empathize without giving in
  • Hold your ground without threatening
  • Remove daily power struggles between you and your child
  • Give clear, firm messages that your child understands and respects
  • And much more!

Many parents need this book even if they have never had to deal with the issues they now have to deal with. This book gives parents step by step procedures to follow. This book is appropriate for dealing with many causes of frustration in special needs children/teens. It may be especially helpful for adults of multiple children, both with and without special needs, where siblings purposely try to set-off the special needs child/teen. This can tax an adult’s patience to the breaking point and cause a bad situation to get worse.

5. Relaxation Routines

 A Relaxation routine is a series of progressive relaxation techniques that must be learned through repetition by the special needs person. A relaxation routine must be practiced multiple times each day everyday to be effective. The special needs person must memorize it. A child/teen must be aware of when they was getting stressed to be able effectively use such a routine. A caregiver will need to use cues in the beginning when the routine if first being learned to alert the special needs person of when they need to practice the routine. Over time the hope is that with constant repetition the special needs person will be able to recognize when they are getting stressed by a situation and can immediately do their relaxation routine to relieve their stress. This will allow them to relax and then be able to process though the situation at hand and take effective steps in dealing with it. Relaxation routine vary widely and can be customized to meet the needs of the person based their likes.

6. Skillstreaming the Adolescent – New Strategies and Perspectives fro Teaching Prosocial Skills by Arnold P. Goldstein and Ellen McGinnis with Robert P. Sprafkin, N. Jane Gershaw, and Paul Klein. Research Press, Illinois. ISBN 0-87822-369-X

Why recommended:

Though this book is written from a pubic school perspective, it examines the nature and impact of such youngsters as they currently exist in our primary and secondary schools. This book includes reproducible worksheets for parents/teachers, and students.  This book shows parents/teachers that implementing a successful skillstreaming program begins with awareness and responsiveness to the needs of the environment (school, home, workplace, etc.).  In chapter 4 of this book there is a description of the “how-to” details of procedures necessary to conduct a Skillstreaming group. A Skillstreaming group could consist of a small group of special needs children in from a family, a home school co-op, or other class. Step-by step, this book moves from skill introduction to skill modeling by trainers (teachers), role-playing by trainees (students), feedback by participants, and assigned homework outside the group. Chapter 6 contains 50 skillstreaming skills for adolescents grouped into the following areas: Beginning Social Skills (from listening to giving a compliment), Advanced Social Skills (from asking for help to apologizing, Skills for Dealing with Feelings (from knowing your feelings to dealing with fear), Skill Alternatives to Aggression (from asking permission to keeping out of fights), Skills for Dealing with Stress (from making a compliant to dealing with group pressure), and Planning Skills (from deciding on something to do to concentrating on a task). Other sections of this book cover types of trainee (student) resistance, simplification methods for reducing trainee (student) resistance, threat-reduction methods for reducing trainee (student) resistance, and transfer and maintenance enhancing procedures.

Appendices include Teacher/Staff, Parent, and Student Skillstreaming Checklists, and Skillstreaming Group Charts.

7. Crisis Prevention Intervention Training

http://www.crisisprevention.com/ 

From the CPI Website:

CPI — Educating, Empowering, and Enriching
CPI is an international training organization committed to best practices and safe behavior management methods that focus on prevention. Through a variety of specialized offerings and innovative resources, CPI educates and empowers professionals to create safe and respectful work environments. This enables professionals to enrich not only their own lives, but also the lives of the individuals they serve.

The cornerstone of CPI is the Nonviolent Crisis Intervention® program, which is considered the worldwide standard for crisis prevention and intervention training. With a core philosophy of providing for the Care, Welfare, Safety, and SecuritySM of everyone involved in a crisis situation, the program’s proven strategies give human service providers and educators the skills to safely and effectively respond to anxious, hostile, or violent behavior while balancing the responsibilities of care.

Training Options to Meet Your Specific Needs

Nonviolent Crisis Intervention® training focuses on prevention and offers proven strategies for safely defusing anxious, hostile, or violent behavior at the earliest possible stage. Choose from the following training options:

One-Day Introductory Seminar
Learn to organize your thinking about how behavior escalates and how to respond appropriately during moments of chaos.

Gain a basic understanding of crisis intervention methods.
On the first day of Nonviolent Crisis Intervention® training, the emphasis is on early intervention and nonphysical methods for preventing or managing disruptive behavior. CPI’s Personal Safety TechniquesSM for staff are also demonstrated and practiced in this seminar to prepare staff to safely remove themselves and others from a dangerous situation. You’ll learn:

  • How to identify behaviors that could lead to a crisis.
  • How to most effectively respond to each behavior to prevent the situation from escalating.
  • How to use verbal and nonverbal techniques to defuse hostile behavior and resolve a crisis before it becomes violent.
  • How to cope with your own fear and anxiety.
  • How to use CPI’s Principles of Personal Safety to avoid injury if behavior becomes physical.

Two-Day Comprehensive Workshop
Build on content from the Introductory Seminar by reinforcing preventive techniques and practicing the principles of nonharmful physical intervention.

Reinforce preventive techniques and learn principles of non-harmful physical intervention.
The second day of training expands on crisis intervention methods to include the study and practice of nonharmful Nonviolent Physical Crisis InterventionSM. These techniques are taught to be used as a last resort when an individual becomes an immediate danger to self or others. You’ll learn:

  • When it’s appropriate to physically intervene.
  • How to develop team intervention strategies and techniques.
  • How to assess the physical and psychological well-being of those involved in a crisis.
  • How to safely and effectively control and transport an individual.
  • How to maintain rapport with the acting-out individual.
  • Key steps for debriefing after a crisis.
  • How to properly document an incident.

Why recommended:

Adults who have chosen to homeschool their special needs children/teens or care for special needs persons who have a history of physical outbursts that have continued to escalate over time with or without professional intervention plans need to protect themselves, the special needs person, siblings, and others. Compromising safety is NOT an option! The bottom line is that caregivers are responsible for those in their care.  Violent outbursts can be against another person or object. An out-of-control person is a danger to themselves and to all those around them. If the special needs person has ever threatened to or has taken physical action against anyone or anything, it is strongly recommended that the parent(s)/caregiver(s) take this course. The parent(s)/caregiver(s) safety and the safety of the family are non-negotiable. If the special needs person has gotten violent in the past, they will likely get violent again in the future if appropriate intervention is not taken.

These seminars are NOT cheap, but are worth every penny if you are caring for a special needs person who has a history of violent outbursts. The one-day seminar costs approximately $600 per person and covers verbal intervention techniques. The two-day seminar costs approximately $1,000 per person covers verbal intervention techniques the first day and physical intervention techniques the second day. Before you say, “Forget it, it costs too much!” remember that you cannot go to your local Wal-Mart and purchase a replacement life! The cost of these seminars is NOT covered by insurance. If you work for a healthcare provider or in the special education field, this course may be a requirement for your employment and your employer may cover the costs of attending this course. The two-day seminar is strongly recommended for those caring for special needs persons who are bigger and stronger than themselves who have a history of violent outbursts.

It is strongly recommended that BOTH parents or adult caregivers attend these seminars. Techniques learned in these seminars should to be periodically reviewed by the caregiver.

Pharmaceutical Medications…

Many special needs children/teens are unable to self-regulate with holistic or other interventions alone. Some may require the use of pharmaceutical medications in addition to behavior plan inventions in order to self-regulate. Pharmaceutical medications should be considered when all other options have failed, if the child/teen’s behavior is preventing them from learning and progressing, and/or if the child/teen is a danger to themselves and/or others.

In conclusion, special needs persons vary widely in their abilities and cognitive function. Some of the resources noted in this article may not be considered appropriate for some but will be for others.  As special needs children/teens with histories of physical outbursts grow older and bigger it is critically important for the safety of all parties involved that the parents/caregivers fully understand the child/teen’s learning disabilities, keep a behavior journal to record precursors to outbursts, be in agreement in decisions regarding set up, carry-though, and consequences in behavior plans, allow enough time for the plans to work, and to seek outside professional assistance as needed.

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