Monday, June 8, 2009

Behavior, B Word

Dr. Ken's third task was to address tantrums. These were not your everyday tantrums, they were self injurious and violent. As I have said, Jess would bite herself in anger or frustration. Mostly her hands, but she would bite her arms as well leaving bruises. When she would bite her hands, she would put the front side of her hand in her mouth just above the thumb and violently pull it out leaving large welts which became open sores. To wrap her hands only made her angrier but at least would allow her hands to heal somewhat until she worked the bandages off.

Other times in anger she would throw herself backwards on the floor and bang the back of her head relentlessly. Any move to stop her would result in more anger and the chance of being bitten as well. It is a painful situation on so many levels.

Dr. Ken began by showing me how to restrain Jess without hurting her or myself. Sitting behind her with legs crossed over her and holding her arms crossed over herself was very effective. You did have to watch that you position yourself slightly askew so that her head could not find contact with your breastbone as it has been discovered by many that a broken breastbone is very painful.

This restraint had to be performed with any tantrum that could not be controlled by any other means - time out chair, ignoring. Using other means were always the primary goal. Sometimes Jess did respond to ignoring for any kind of contact, if only a look, she would take as attention and would only repeat the inappropriate behavior. As I mentioned before and I think it is important to mention again, eye contact to a child is affirmation that this behavior will get attention. This is not good.

To use the time out chair, proved a little more difficult than 'typical' children as well. You could not just say "go sit in the chair and calm down". If the chair was used, Jess would need to be physically encouraged to sit on it. This did not work the best and you would spend more time holding her which did not give her the right message either.

No, if she was hurting herself and others, it more often than not resulted in full restraint until she calmed down.

The important thing to remember is that you have to try to fill the day with opportunities for appropriate behavior so that you didn't have to address inappropriate behavior all the time.

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