Advice please...child with behavioural issues

[Guest]

Hi i writing hoping for some advice. We have a child (just turned 3) with us who has very limited speech, and is under S/L, who commented today to mum they have seen some improvement since his last appt. The previous appt was noted there was minimal improvement, so that's a huge positive for mum. There are some behaviour issues where the child will not always listen, often runs around crazy (mums words although I'm sure she worries far too much when around the school doing pick ups for older children) but she is really struggling with his behaviour at home. She dropped off in tears this morning and made a hasty retreat but emailed me later on asking for a meeting to help with his behaviour as she is finding it really hard.

 

We have had our area senco in who doesn't think he is in the autism spectrum (after mum voiced concerns). He has begun potty training but it's very hit and miss, often having several accidents a morning session. It's very hard as he has limited speech, and very strong headed! I will be suggesting a cars reward chart for potty training as he loves cars so much, am planning on doing that over the weekend so we can use it Monday morning with him.

 

I'm interested in others views, and tips for helping mum with his behaviour with some strategies we can both put in place. I've offered sure start (Barnardos) referal but mum is very hesitant at this stage as she is really worried about him being labelled. She would like a meeting this week, and I'd like to go armed with possible strategies for us both to begin using. I will be suggesting 'stop, look, listen' routine as well as the car chart, plus run and touch listening game. Would be grateful for any advice or suggestions......

 

 

Many thanks

[AnonyMouse_15046]

If the mother is struggling this much to manage him at home and has raised concerns herself about whether he has Autism, I would recommend that she asks her GP to refer him to CAMHS/developmental paediatrician/community paediatrician for a neurodevelopmental assessment.

 

It is very unlikely that the area SENCo has sufficient knowledge and understanding of Autism to make or rule out a diagnosis and, quite frankly, I think it's inappropriate for her to have expressed an opinion. Autism is a very complex condition with enormous variations in presentation and decisions on diagnosis are usually made by teams of highly qualified and experienced professionals referring to specific diagnostic criteria. You can't just observe a child for a short period and decide he doesn't have it.

 

A diagnosis isn't a label. It's a ticket to the support and understanding the child needs. A diagnosis can help professionals adapt their interventions to suit the child's needs better and it can also make a great deal of difference to the level of support a child receives in school. A neurodevelopmental assessment commenced now followed by a statutory assessment could very easily take more than a year so it needs to begin as soon as possible to ensure he will have any provision he needs in place by the time he starts reception.

 

It is very hard to suggest any ways you can support the mother with behaviour management without more information. What sort of behaviour is she finding most difficult?

[Guest]

We have previously spoken to mum about going to the Gp and right now it's something she really doesn't want to do. We simply mentioned it in passing to our area senco, she wasn't the final decision on it. However I feel she is there to support us, and that is all she simply did. I feel like I'm being told off here, and regret posting asking for advice.

[AnonyMouse_39998]

do you have a children's and family centre locally? we have a child very similar to yours, we contacted the centre with mums permission and she has an outreach worker who comes to the home to support her there. We use basic behavior strategies at preschool, let me see if I can add a file on this post, first time i have tried so bear with me lol. You need to make sure all the adults in the child's life use the same strategies or it will not be very useful, good luck, I have found this sort of issue is never going to be a quick fix, its all about managing the situations rather than stopping them.

hope that helps.

positive behaviour statagies.doc

Edited April 18, 2015 by twinthinguk

[AnonyMouse_6721]

Don't feel told off, there is some really good advice there but in my area even going to the Gp wouldn't help if the area senco wasn't on board.

 

We have a little boy that sounds similar, very much on this own agenda, single words and huge tantrums. We run small groups for him. Use makaton picture cards and don't expect too much. Very happy when he started signing to me. Problem is mum and dad are very relaxed and don't seem to worry.

 

Good luck, you can suggest but if mum says no there's not a lot you can do. As long as he isn't hurting people.

[AnonyMouse_19782]

We have previously spoken to mum about going to the Gp and right now it's something she really doesn't want to do. We simply mentioned it in passing to our area senco, she wasn't the final decision on it. However I feel she is there to support us, and that is all she simply did. I feel like I'm being told off here, and regret posting asking for advice.

I'm surprised you feel this way - I must say reading Upsy Daisy's post that is the last thing I would feel. Upsy Daisy has an immense amount of experience in these matters - her advice is invaluable, and if you could explain to the mum how a diagnosis would help in the way Upsy Daisy has suggested it might be a very good way forward.

[AnonyMouse_51737]

Hi, due to his age I would look at is it possible to not potty train yet he is still only young this will allow mum and yourselves to focus on behaviour strategies without the added pressure of toilet training, if mum is already stressed and then he does a wee all over the house it's going to add to her stress levels and a positive approach will be lost its not easy to toilet train at best of times as a parent but could this be the wrong time for them both?

 

I would compile various behaviour strategies, talk and explain the ignore negative reward positive strategy, explain she must not even give eye contact when he's being negative and to catch the positive then over exaggerate the praise, also that he simply doesn't give two flying fluffs if it's a negative or positive reaction he just cares he's got one!

 

You could sit with mum and go through what she wants, what does she feel 'good behaviour is' this will help you compile a list of what's stressing her the most stressful situations such as hitting, screaming, throwing down to less stressful things such as wont sit to eat. You can then get a picture of how severe her needs and her child's are, this will allow you to pin point strategies more also are something's that he's doing to upset mum 'normal' is she just expecting too much?

 

Does he require a visual timetable like you have in nursery to support him at home, help mum also be clear using now and next. Visual support aids help the adult to also use the correct language and keep it simple driving home a consistent message to the child.

 

Talk to mum about how it might feel to be her child! "Your talking to me mum, I can see your mouth is moving, but I don't understand, you look very mad I don't get it! oh just a minute you said biscuit, I can have a biscuit- but you won't let me have one I don't get this I'm now going to scream and shout" when infact mum was telling him off for climbing up to biscuit tin and sliding things off the side to get to it and to ask next time"

Talk about how the lack of speech can cause such frustration within a child and that over 200 processes are needed to listen, process, speak its a very complex thing and enlighten her as to how she can help.

 

Previously we let one of our struggling parents come into pres school for 30 mins twice a week and they initially would observe a staff member playing/interacting/dealing with behaviour of her child then we moved onto them playing with their child with staff support, this was fantastic as the parent watched first hand how we dealt with behaviour and praised all kinds of behaviour. If something happened with another child we would deal with it as you would then explain our technique to mum. There's nothing better than seeing it in action! Also we saw quickly mum couldn't play so we set up activities for that session with including her into them in mind, things like she would tell him off for building a big tower then knocking it down, we then explained the rationale behind cause and effect and modelled play skills. It also helped mum and son have a quality half hour where they just played it was fantastic to see it develop and her sons face was lighting up as they played.

 

Talk to mum about giving choices so two choices and that's it. Child feels like they have been successful in getting what they want but indeed its mum who's got what she wants, not only will this help with behaviour but will help his speech.

Can mum have a set coffee morning with you once a fortnight to just chat, it's important to regulate mum to be able to be positive and function in a better way in turn she will support and care for her son in a more positive way as you have allowed an off load point for mum.

 

Most of all just listen! hope that's helped give you at least one idea to suggest good luck x

[AnonyMouse_15046]

I feel like I'm being told off here, and regret posting asking for advice.

I'm sorry. It wasn't my intention to make you feel like that. It is not you that I feel has acted inappropriately.

 

I know far too many children who have missed out on early intervention because someone without the necessary knowledge and experience has declared them free of Autism at this stage. It is a ridiculously common scenario which causes harm to children and families and simply shouldn't happen.

 

When a child has additional needs, the parents can go through a process which is similar to grieving. One part of that process is denial. Maybe you could help her find out about the assessment process so she feels less fearful of it and can see it as a positive process for child; an opportunity to identify his particular difficulties and give her recommendations of how to help him at home.

 

One of the biggest challenges for managing behaviour in children with Autism is that some common strategies can be counter-productive so, without a deeper understanding of the child's difficulties, it's hard to know how to help.

 

What are the behaviour problems that she feels are the least manageable for her at home?

[AnonyMouse_30128]

Do you have a triple P programme running in your area? this would help Mum with coping. I see from your post that she has other children...has she had trouble with her others?

[Guest]

Since she has already asked for a meeting, could you organize one and also suggest it would be good to invite the Health Visitor? Obviously I don't know how long you have known the family, but having the HV there would ensure you get a longer-term view of the family history. The HV would also be able to follow up if there is need for other referrals (Pediatrician etc). Also support from an outreach worker from the Children's Centre could be very helpful to Mum. Whilst you have clearly spent time trying to come alongside her, you, no doubt, have limited time for this. An Outreach Worker would visit at home, and provide a listening ear - whether it is a behaviour difficulty or there is a diagnosis to be made.

[Helen]

Hi everyone,

Tilly1 has asked that I close this conversation for privacy reasons. Thank you all for your helpful advice. :1b