0

Special Needs Behavior Plans

Students with complex behavioral problems including cognitive limitations need to be taught to behave appropriately so they can learn in school. An individualized understanding of the student’s developmental level, trauma history, sensory modulation, and effective coping strategies are helpful in developing a behavior plan. It is helpful to develop a trauma informed behavior plan that addresses the student’s feelings and developmental challenges.

Often “big” feelings need to be managed to prevent problematic behaviors. Visual supports help students become aware of their problematic big feelings. Emotional learning follows a developmental sequence with the first feelings learned being sad, mad, glad, tense and relaxed. Once these are learned more complex and combined emotions can be taught. Emphasis is given to current feelings that lead to problematic behavior. Ask student to use different colors to draw all the feelings “in my head”.

FeelingsinmyHead

Next, feelings which are always O. K. things to feel need to be distinguished from problematic behaviors like hitting, which are not O. K. in school. Particularly with cognitively impaired students desired results are emphasized not morality. It is also helpful to use a trauma informed approach that repeatedly emphasizes “I will like you no matter what. Some behaviors will be rewarded that will make you successful, while other behaviors will be punished so you don’t have a bad life”. A rainbow goal is a useful art activity is used to help the student plan behavior goals.

RainbowGoal

For cognitively impaired students goal planning emphasizes what they want to do “Be safe” rather than what they won’t do “hit”. Each rainbow beneath the top pot of gold goal is a related step. The student can dictate or write, chooses the color, and draws. Participation is encouraged, rather than just scribbling and saying “done”.

Finally a safety plan is visually depicted with objectively specified behaviors for reaching their rainbow goal. The students favorite sensory coping strategy options for replacing the inappropriate behavior are included. Coping strategies are “non-contingent reinforcement (NCR)”, always immediately available options that do not need to be earned. This transdisciplinary behavior plan was developed by the student’s occupational therapist, social worker, and speech/language pathologist.

Visual Safety Plan

The objective behaviors include a definition of “Be safe” that the student and all teachers and therapists understand clearly “No hitting, threatening, or throwing objects”. A baseline is taken and specific point chart or rewards are given for progress toward the goal. Visual supports and art activities can help students with complex behavioral challenges improve their behavior for learning.

Advertisements
0

Sensory Strategies For Teens With PTSD

Adolescents with PTSD and sensory processing challenges can benefit from sensory strategies to improve their behavior. Sensory strategies are particularly helpful for improving attention and decreasing aggression. While too seldom used for PTSD I have found that deep pressure touch sensory strategies can be particularly effective for reducing aggression and improving attention in teenagers with PTSD.

Therapists can help help teens understand that past traumatic stress experiences can lead them to overreact to stress. I tell teens “some people who have experienced bad things in the past overreact and get into trouble when they have really big feelings, and benefit from noticing when they first start having big feelings so they can use coping strategies to be successful”. The energy level meter strategy can help teens identify whether their current energy level feels “High”, “Medium” or “Low” and whether they feel “OK and Comfortable” or “Not OK Uncomfortable”. If a teen is too hyper to behave appropriately but rates his current energy as “High Energy and O. K. Comfortable” then the therapist is alerted that the teen is use to having a high energy state. The therapist would try to gradually modulate down the teen’s energy level by beginning with quick and intense tasks then gradually decreasing the speed and intensity in a structured way.    http://www.traumacenter.org/

Visual chart for rating arousal level and if it feels comfortable

Visual chart for rating arousal level and if it feels comfortable

Other teens find it more helpful to use an anger meter that monitors how angry they are feeling so they can leave the situation or use coping strategies to avoid aggressive and self-injurious behavior.

AngerMete

 

Many teens are helped by using movement and deep pressure activities rather than only talk therapy as a coping strategy. This is because our joint receptors (e.g., muscle spindle fibers and Golgi Tendon Organs) convey deep pressure touch input that is typically calming and nurturing, like when a parent calms an upset child by hugging them. An example of input from our joint receptors is that we can identify our index finger with out looking at it, and our experience when walking down stairs in total darkness of feeling off balance because we thought there was another step but we were at the bottom of the stairs. It is important for teens with PTSD to understand that experiencing PTSD as a child can interfere with typical neurological development, the development of body awareness, and functional attention skills https://fabstrategies.org/2013/07/06/sensory-strategies-for-childhood-trauma/

Activities combining deep pressure input (through our body weight as well as lifting or pushing heavy objects) with linear movement can be an extremely effective coping strategies for improving self-control. Teenagers can use pushups, wall pushups, and isometric exercises as coping strategies to avoid aggression and help maintain attention.

Wallpushups http://www.traumacenter.org/products/pdf_files/Can%20the%20Body%20Change%20the%20Score_Sensory%20Modulation_SMART_Adolescent%20Residential%20Trauma%20Treatment_Warner.pdf

It is also helpful to teach teenagers to incorporate deep pressure and linear movement into their daily routines to maintain attention at school (e.g., moving tables, passing out books) and home (e.g., weight training, lawn mowing, vacuuming).  Research supports the use of occupational therapist guided sensory processing strategies to improve self-control of teens with PTSD challenges http://www.traumacenter.org/products/pdf_files/Body_Change_Score_W0001.pdf

Although it is considered a taboo by some mental health professionals I have also found that offering touch, brushing, vibration and massage with FAB Touch Pressure Strategies http://www.youtube.com/watch?v=W8fMdJ6l0AM is a powerful sensory strategy for teenagers with PTSD. Particularly with teens who did not receive nurturing touch growing up and show significant differences in sensory processing on the Sensory Profile sensoryprofile.com I have found FAB Pressure Touch Strategies useful in improving their self-control. It is extremely important to first teach about personal boundaries and always get the parent and teens permission before using touch, but with these guidelines I have found this an extremely effective intervention.