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Individualizing Coping Strategies to Improve Behavior

The use of coping strategies is an evidence-based intervention that improves behavior.  It is commonly used in school positive behavioral support programs and mental health interventions to improve functional skills.  Coping strategies enable individuals to manage their strong feelings of sadness, anger, or anxiety with out violence or other functional difficulties.  Coping strategies are a proven component of school Positive Behavioral Support programs (Second Step, PATHS, DECA), Dialectic Behavior Therapy (DBT) and CBT (Cognitive Behavior Therapy).

Learning to use coping strategies to manage depression, anxiety, and aggression can be particularly challenging for individuals with behavioral, mental health, developmental, trauma history, and/or sensory processing challenges.   Learning to consistently implement coping strategies is a long process that can be facilitated by teachers, family members, as well as occupational, speech/language, physical, and mental health therapists.  It is important when evaluating coping strategies with clients to assess their efficacy in facilitating short-term and long-term frustration tolerance and functioning.  For example, some client attempts to cope with strong feelings provide short-term relief (e.g., self-injurious behaviors, risky sex, drug and alcohol abuse) but worsen long-term coping and functioning.  It is often necessary to exert considerable effort to help clients find the best fit of coping strategies to improve their functioning across settings.

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Careful consideration of client’s interests, developmental level, sensory processing, as well as success and challenges in implementing coping strategies is a good place to start.  Coping strategies involving physical movement are usually most successful when teaching new coping strategies to clients.  Inclusion of physical exercise, music, sensory equipment and adaptive techniques, mindfulness strategies, yoga, and touch strategies can be particularly helpful for individuals with special needs.

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A helpful tool is having clients select 3 items from each page of triggers and coping strategies on the FABTriggerCopingForms

An understanding of the client’s unique environmental triggers (situations such as “being told no”) and body triggers (e.g., “breathing fast; crying”) that precede disabling anxiety or aggression are helpful in teaching coping strategies.  When evaluating the effectiveness of coping strategies those that show the greatest effectiveness with slight environmental and body triggers can be expanded on.  Repeatedly practice and reinforce clients for successfully using coping strategies in controlled settings, while gradually increasing their stress levels.  Once strong feelings can be consistently managed with coping strategies in controlled settings, begin practicing and reinforcing them in supported naturalistic settings.  While coping strategies are difficult to learn they are worth the effort, as they are extremely helpful in increasing client’s functioning.

References:

Miller, A.L., Rathus, J.H., & Linehan, M.M. (2007).  Dialectical behavior therapy with suicidal adolescents.  NY, NY: The Guilford Press.

Kovacs, M. & Lopez-Duran, N. (2012).  Contextual emotion regulation therapy: A developmentally-based intervention for pediatric depression.  Child and adolescent psychiatric clinics of North America, 21(2), 327.

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Strategies to Improve Body Awareness & Mental Health

Intervention strategies promoting body awareness can improve behavior in children and adolescents with sensory processing, trauma history, developmental, and mental health challenges.  Improving youngster’s body awareness is particularly important for children and adolescents because it impacts development and provides the foundation for functional motor planning skills.  Many children with internalizing behavioral challenges including depression and repeated complaints of pain can be helped through enhancing their body and emotional awareness skills.

Although body and emotional awareness difficulties are commonly described in children and adolescents with trauma histories and psychiatric disorders, limited attention is given to body scheme and emotional awareness by mental health therapists. The sensory integration, massage, mindfulness, and yoga frames of reference offer effective body awareness assessment and intervention strategies. FAB Sensory Modulation Strategies that promote body awareness include: Touch vibration on the Back and Arms, FAB Pressure Touch, arm traction, Back X, Spine crawl, Wall pushups, Nose breathe, Mindful clock, Bird, Tense & relax, Focus on feet, Focus on palms, and the Body scan.

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Light touch to reduce somatic pain and improve body awareness can be provided using the FAB Back X and Spine crawl strategies in the BackX & SpineCrawlGame

 References:

Beider, S., & Moyer, C. (2007).  Randomized controlled trials of pediatric massage: A review.  Evidence-based Complementary and Alternative Medicine, 4(1), 23-34.

Flook, L., Smalley, S., Kitil, M., Galla, B., Kaiser-Greenland, S., Locke, J., Ishijima, E., Kasari, C. (2010).  Effects of mindful awareness practices on executive functions in elementary school children.  Journal of Applied School Psychology, 26, 70-95.

Koester, C. (2012).  Movement based learning for children of all abilities.  Reno, NV: Movement Based Learning Inc.

Intervention strategies promoting body awareness can improve behavior in children and adolescents with sensory processing, trauma history, developmental, and mental health challenges.  Improving youngster’s body awareness is particularly important for children and adolescents because it impacts development and provides the foundation for functional motor planning skills.  Many children with internalizing behavioral challenges including depression and repeated complaints of pain can be helped through enhancing their body and emotional awareness skills.

Although body and emotional awareness difficulties are commonly described in children and adolescents with trauma histories and psychiatric disorders, limited attention is given to body scheme and emotional awareness by mental health therapists. The sensory integration, massage, mindfulness, and yoga frames of reference offer effective body awareness assessment and intervention strategies. FAB Sensory Modulation Strategies that promote body awareness include: Touch vibration on the Back and Arms, FAB Pressure Touch, Back X, Spine crawl, Wall pushups, Nose breathe, Mindful clock, Bird, Tense & relax, Focus on feet, Focus on palms, and the Body scan.  Light touch to reduce somatic pain and improve body awareness can be provided using the FAB Back X and Spine crawl strategies in the Back X & Spine Crawl Game.

 

References:

Beider, S., & Moyer, C. (2007).  Randomized controlled trials of pediatric massage: A review.  Evidence-based Complementary and Alternative Medicine, 4(1), 23-34.

Flook, L., Smalley, S., Kitil, M., Galla, B., Kaiser-Greenland, S., Locke, J., Ishijima, E., Kasari, C. (2010).  Effects of mindful awareness practices on executive functions in elementary school children.  Journal of Applied School Psychology, 26, 70-95.

  Koester, C. (2012).  Movement based learning for children of all abilities.  Reno, NV: Movement Based Learning Inc.

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Transdisciplinary School Strategies Enhance Inclusion

It is common for early education classes to include undiagnosed special needs students.  While the students often eventually qualify for special education services their teachers need strategies to meet the immediate needs of these students within the regular classroom.  This is important for both the special needs students and the ability of all the other students to learn.  Fortunately, transdisciplinary use of positive behavioral support strategies improve behavior and learning in regular and special education students in a variety of settings.

Teachers are becoming overwhelmed with the demands of increasing academic standards and students with developmental, behavioral, and mental health challenges.  Meanwhile, related services personnel are recognizing the importance of working in conjunction with classroom teachers to best serve students.  There has been much hostile criticism of related services staff by some early childhood faculty and organizations.  Despite this teachers, parents, and students have increasingly recognized the contribution of related services staff including occupational, speech/language, physical, and mental health therapists (social workers, school psychologists, guidance counselors). Teachers and related services staff have particularly found value in teaming together in implementing evidence-based positive behavioral support interventions.

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Teachers and related services staff learn from working together to more effectively educate students using positive behavioral support interventions.  In my over thirty years working as a school occupational therapist with regular and special education students I have learned from teachers and other special services school staff many strategies to improve student learning and behavior.  Particularly using positive behavioral support strategies we have effectively integrated special and regular education students in activities to improve their behavior and learning.  My attached list of Evidence-BasedClassBehaviorStrategies has resulted from this collaboration.

References:

Riggs, N.R., Greenberg, M.T., Kusche, C.A., Pentz, M.A. (2006).  The mediational role of neurocognition in the behavioral outcomes of a social-emotional prevention program in elementary school students: Effects of the PATHS curriculum.   Prevention Science, 7(1), 91-102.

Simonsen, B., Fairbanks, S., Briesch, A., Myers, D., & Sugai, G. (2008).  Evidence-based practices in classroom management: Considerations for research to practice.  Education and Treatment of Children, 31(3), 351-380.

Simonsen, B., Britton, L. & Young, D. (2010).  School-wide positive behavior support in an alternative school setting.  Journal of Positive Behavioral Intervention, 12(3), 180-191.