Sulky, Rowdy, Rude?
Why kids act out and
what to do about it
Bo Hejlskov Elvén
Clinical psychologist
Challenging
behaviour?
Who's challenged?
- We define a behaviour as
challenging when we are
challenged
- By our own lack of tools and
skills
This definition is about our
own powerlessness
The principle of
responsibility
He who takes on
responsibility can make a
difference
Bernhard Weiner
The principle of
responsibility
If our methods are bad
we often try to get rid of
our responsibility
The principle of
responsibility
We often try to place the
responsibility on those
who cannot take it
-
Next of kin
Politicians and leaders
Culture
The kids
The principle of
responsibility
One way to place
responsibility on the kids
is to describe them as
-
Stubborn
Unmotivated
Demand avoidant
Oppositional
Disobedient
Do we want our
kids to grow up
and be obedient?
Elven's car work shop
We work in a car work shop
- Who's responsible for service and
repairs in the work shop?
- The owner of the car?
- The car?
- Cars don't have to cooperate
- Cars can't just stop being broken
- The mechanic needs to use the proper
tools and procedures
Elven's car work shop
We work in a car work shop
- Who's responsible for service and
repairs in the work shop?
- The owner of the car?
- The car?
- Cars don't have to cooperate
- Cars can't just stop being broken
- The mechanic needs to use the proper
tools and procedures
The meter maid
If you get a parking ticket you have
two possible thoughts
- I put the car in the wrong spot. That was stupid
- The meter maid is an idiot
- The last thought doesn't make you choose
another spot tomorrow
- And you will get a new parking ticket
- Which confirms your opinion: They are idiots
- And you do not learn anything
Elven's car work shop
We work in a car work shop
- Who's responsible for service and
repairs in the work shop?
- The owner of the car?
- The car?
- Cars don't have to cooperate
- Cars can't just stop being broken
- The mechanic needs to use the proper
tools and procedures
Elven's car work shop
We can't use tools or
procedures that might
damage the car
Kids do well if they
can
Ross W. Greene
Or they cannot live up to our
demands or expectations
regarding
- Understanding the consequences of one's
own behaviour
- Flexibility
- Endurance
- Impulse control
- Social abilities
- Ability to tolerate stress
- Surplus
- Acquiescence
Kids do well if they
can
Ross W. Greene
Fostering
This means that we have
to rethink what we
learned as kids
- Special needs mean that
ordinary methods are
useless
- We sometimes hit the
skill ceiling and start
using fostering methods
Methods that do not work
should not be used!
Methods?
Reprimands
Limit setting
Punishment
Consequences
Kids don't learn
from failure
Conflicts
Acting out and other conflicts are
often reciprocal problem solution
- I have a problem that I solve
- My solution becomes a problem for
the child that he or she must solve
- In a way he or she becomes a
problem for me to solve...
This kind of conflict can only be
solved by one of us using solutions
that do not become a problem for
the other
Solutions
We would like to teach the
kids to use solutions that do
not cause problems for us
Often it is more logical that
we find solutions that do not
create problems for the kids
In order to avoid
powerlessness and lack of
control
The Principle
of Control
You have to have self control in
order to cooperate
The Principle of Control
Everybody wants to avoid lack of control
in order to avoid
- Severe anxiety
- Hitting
- Kicking
- Biting
- Throwing of furniture
- Severe self harm
The Principle of Control
That's why everybody has solutions and
strategies in order to keep self control
- Refusing
Affect regulation
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Affect Regulation
No control
Affect intensity
Self control
Affect trigger
Time
Affect Regulation
Strategies
-
Refusing
Lying
Running
Spitting
Hitting
Threats
Bad names
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Affect Regulation
Affect intensity
Kaos
No control
Self control
Affect trigger
Time
The Principle of Control
That's why we must strive to
-
Make sure the child keeps his or her self
control
Help the child regain his or her self control
if he or she has lost it
Use methods that helps the child lend
control to us
Tools
The basic rule:
1. Manage best you can
without escalating the
situation
2. Evaluate
3. Change what needs to
be changed so that it
doesn't happen again
Tools
The basic rule:
1. Manage best you can
without escalating the
situation
2. Evaluate
3. Change what needs to
be changed so that it
doesn't happen again
Affect Contagion
Affect is contagious we feel other's affects
Using mirror neurons
Mirroring muscle
tension
Affect Contagion
All children are born with the
ability to mirror affect
It is the basis of empathy
development
Some kids do not have a
standard empathy
development
They do not develop the
ability to separate their own
from somebody else's affect
Affect contagion
Chaos
Affect intensity
No control
Self control
Time
Low arousal approach
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Low Arousal
Approach
Keep calm
Avoid dominating by eye
contact
Use a relaxed voice
without jaw tension
Divert - shift the child's
focus from the affect
Low Arousal
Approach
Keep the distance
- When the child steps
backwards you step
backwards as well
- Step backwards in demand
situations
- Do not stand opposite the
child
Low Arousal Approach
Low Arousal Approach
Low Arousal
Approach
Sit down when the child is
agitated
Avoid a marked body
language
Pretend to be walking
home from the pub
Avoid being infected by
the child's tension
Make sure your calm is
contagious
Low arousal approach
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Control and
restraint
I never saw a restraint that
looked as controlled as this
picture
- In my experience restraints
are characterised by chaos
Still the most used
argument in favour of
physical restraint is taking
control of the situation
Control and
restraint
I believe that most people restraining children actually believe
that they are solving a problem in the best possible way
Control and
restraint
But it is very dangerous
More than 150 documented restraint related deaths among
children in the last 25 years
Low Arousal
Approach - When In Chaos
Wait- it is often enough
Make other kids leave
Avoid touching with tense
muscles
Relax when a child grabs
you
Low Arousal
Approach - When In Chaos
And in emergency situations
when you need to grab a
child
- Use the child's own movement
instead of restraint
- Let go after a few seconds
- Avoid pain!
- Use reflexes
Low arousal approach
Affect intensity
Chaos
No control
Self control
Affect trigger
Tid
Low Arousal
Approach
Stay calm
Wait
Clean up the mess
Divert onwards
Low arousal approach
Affect intensity
Chaos
No control
Self control
Affect trigger
Tid
Calm again
Evaluate
Tools
The basic rule:
1. Manage best you can
without escalating the
situation
2. Evaluate
3. Change what needs to
be changed so that it
doesn't happen again
Evaluate
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Evaluate
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Evaluate
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Evaluate
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Evaluate
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Affect intensity
Calm phase
- What were happening just before
the crises?
- What did we expect the child to be
able to?
- Did the child fail to live up to our
expectations
Chaos
because of a lack of
supporting structures? No control
Affect trigger
- Did our behaviour triggerSelf
thecontrol
crises?
- How can we make sure it won't
happen again?
Affect intensity
Escalation phase
- What strategies did the child use?
- Were they OK?
- Did the child have any chances of calming
down on his own?
- Did we cause the escalation by using
Chaos
strategies that were counter
productive?
No control
- Did we raise the demand level?
- Did Affect
we trigger
use deescalation strategies?
Self control
- How was our body language and use of
voice?
- Did we use diversions in order to
deescalate?
Chaos phase
Affect intensity
- Was there immediate danger?
- If there was:
- Did we manage theChaos
situation without
escalating it further?
Affect trigger wasn't:
- If there
- Were we able to resist intervening?
- Was our behaviour shortening or
prolonging the crises?
No control
Self control
Affect intensity
Deescalation phase
- Did we manage to secure
calm and space enough
for the child to calm
Chaos
down?
- Or did we make the
situation escalate once
again?
Affect trigger
No control
Self control
Affect intensity
Calm again
- Evaluating which structures
and routines that need
changing in orderChaos
to avoid a
next time
- Do we have an action plan
for the next time it happens
anyway?
Affect trigger
No control
Self control
Change
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Adjustment
of Demands
Moving with the child
- Participation
- Demands according to skills
- Kids do well if they can
- Making sense
-
Validating
Promts
A sense of finished
Knowing what's going to happen
Choices
Getting ready
Snoozing
Change
Affect intensity
Chaos
No control
Self control
Affect trigger
Time
Action plans
A good plan has five levels
1. Create space and time for the child's
own strategies
2. Use a documented effective
diversion - concrete
3. Use a documented effective
diversion - affective
4. Use a documented effective
diversion - affective or perceptual
5. Abort - everybody leave or a low
arousal physical intervention
Never force
Never abandon
Petra Björne
Sulky, Rowdy, Rude?
Why kids act out and
what to do about it
Bo Hejlskov Elvén
Clinical psychologist