Support non-verbal children. Bea Inclusive TV and Podcast Episode 013
The last time I told you about PDAs, I guided you on preparing yourself and where to find help if your school is looking after a child with PDA.
In this episode of Bea Inclusive TV, I will:
Answer one of the questions I received from a special needs teaching assistant, a case study, and I will give you my strategies for supporting a non-verbal child that expresses challenging behaviour.
So, welcome to Bea Inclusive Thursday Q&A!
If you are new to me – my name is Bea, and I'm advocating truly inclusive school provision. I support an eclectic and holistic approach, and as the Autism Lead Practitioner, I used many different interventions to suit my children's needs. One of the best therapies I'm passionate about is Lego-based Therapy, as I saw the effectiveness of this approach and the positive change in children's and adults' emotional and behavioural responses, language, communication, and social skills.
So, I invite you to follow my journey in creating a genuinely inclusive provision that helps you support children and develop your skills. Are you ready? Let's go!
Looking after, helping, and supporting non-verbal or pre-verbal children can be extremely difficult and rewarding at the same time. If you did not support this type of special needs yet, you could listen to this case study to check its appearance. Even in mainstream schools, looking after children with no speech is not rare. I was working in a mainstream primary school. I had three non-verbal and pre-verbal children. OK. Let's listen to the letter.
"Dear Beata
I work as a level 2 TA in a particular school. A lot of children are non-verbal.
Any tips for dealing with behaviour issues, hitting, biting, removal of clothes, and deliberate urination, to name a few, for children who lack verbal reasoning skills, would be great.
I refer to one child who, after a difficult start to the academic year, is being educated individually.
As I mentioned before, we are a special school. This measure is a last resort, not taken lightly. The aim is to reintegrate the child back into a class.
The child is midway through their primary education, is non-verbal aside from about 10 words. One of which is a noticeably clear No!
Unable to self- occupy, the child will empty draws, throw objects, hit others, and remove their clothes.
We are currently supporting the child on a two to one basis, with a child-led timetable, and minimal demand. Even with these measures in place, the child will only sit for a moment. The demand for simple tasks such as shape matching will involve the child dropping to the floor to avoid the workspace, having to have an adult either side to restrict movement away from the workspace. If it's a good day, the child will complete the task with minimal intervention. On the bad days, which are most, the child will get off the chair and attempt to slap, bite and head-butt to getaway. The child will also attempt to slide off the seat and under the table.
He will slap and pinch for no reason, being apparently perfectly happy. The child will remove clothes and refuse to put them back on. Efforts to redress the child are met with, slapping, biting, kicking. The child will also remove clothes when cross and then urinate and/or defecate deliberately. This will often result in the child trying to rub themselves in the urine and smear the faeces.
We use speech, widget symbols, photographs and sign along as methods of communication. However, the child is strong-willed and self-driven. Unless it is something the child wants, they seem unwilling to engage in communication.
The child is generally happy, cheeky character, and well-loved by staff. Whilst the child has always been a bit of a handful, sadly we have come to the situation that the child can no longer be educated with their peers due to the amount of disruption caused, and the number of staff required to assist.
The staff are a dedicated team, our children's best interests are paramount, and we strive for the best outcomes possible for each child.
The child can access all playtimes and maybe a group outing or active play session once a week. Even at those times, the child is very closely supervised and often removed from the activity early. This is because of physical behaviours which often indicate the child wants to finish the activity. The staff know the child well enough to spot the early warning signs, so in most cases, can remove the child prior to anyone getting hurt.
The child is much more manageable, and the behaviour has improved massively. However, the child lead timetable has its own drawbacks, any tiny, and I mean tiny, attempt to lead the child to a more usual class routine, is met with immediate refusal and aggression. This is creeping towards the child having even more control of the environment.
We are trying every trick we have. Not even bribery, as nothing interests the child for more than a couple of uses, or the child is so obsessed, it becomes its own issue.
In addition, we are aware that sensory processing is an issue, but you must wear clothes in school, and in the playground. That child is not the only offender in the public nudity department, but the others are less frequent and generally easier to return to a clothed state.
We have also tried, where possible, planned to ignore to behaviours and non-reaction to more physical behaviours. The child reacts to this by targeting children, knowing we must react".
WOW!
You will probably agree that is a lot on the staff's plate. But I can hear the frustration from that letter and the extreme determination to help that boy.
There is plenty of things that we can do for that child. But I've chosen the most important ones.
The first challenge in helping to manage his behaviour better is understanding why he is doing what he is doing.
So, the first and the main thing would be to:
Use the ABC method of analysing the child's behaviour from day one (If you have never done that – there is a simple form to fulfil each time when the child expresses challenging behaviour, where you are describing what happened, what you did do and said, what the child did, what were the consequences. Somebody else (not involved in supporting the child) will analyse and make suggestions about that. This can only help you make decisions and change your actions or adapt to the child's environment, so make sure you put as many details as possible.
Assess the child's needs and decide on the next goal (not the school goal, which always will be integrating the child into the class). In this case, you can see that the child is not ready to integrate. I would suggest a shorter school day (only mornings) to limit inappropriate, challenging behaviour, lower his anxiety and makes it easier for the teacher to target his communication skills. I would change the child's target/goal. The new target should be focusing on functional skills, following a routine and tackling the child's inappropriate behaviour (when the child masters the above with the child one to one, then you will be able to integrate the child by slowly introducing one extra child, then small group, bigger group and eventually the child will be able to join the class.
The following necessary change will involve the management of the child's environment.
You must manage your environment to limit unwanted, inappropriate behaviour (the child is not ready to work in the classroom). He hits, bites, throw resources, refuses, and physically targets his peers. Very clearly, the child did not master the routine even with adults, so there is no point in reintegrating him into the class. He should be taught in a different room, and for the time being, until he masters the routine and follows the adult direction – he should stay away from children – mainly because he targets them to get adults' attention. The room should be almost empty – no drawers with toys, things to trash, no free access to the resources, etc. The attention should be on adults in this room, so the child must use the adult to communicate with them. This is how the room should look, and let me tell you that this works exceptionally well if you want to teach structure, independent skills, communication skills, social skills, etc. You should divide the room into different areas.
Transition area (with the marked spot of chair to wait, daily schedule/plan)
Play area with no toys there as this will be the way to work on communication skills. The only thing should be a PE mat – where the child can play or read a book with us.
The safe place where a child can go and chill/self-regulate, hide when he is sad, tired, or angry).
Independent workstation facing the wall to practice his independent skills so we can check what the child can do independently.
Group table with two chairs on each end of the table.
There should be a simple shelf out of the child's reach with toys and items (such as sensory toys) that the child would love to play with or use. We must prepare visual representation – pictures of those items when the child approaches us. We can use this as a learning opportunity. We want the child to ask or point for toys/objects. The toys should be used briefly, and we should use a timer. Rotation of the toys is necessary. Place the toys in transparent jars or boxes with a closing mechanism. A great idea would be to make it difficult to open them and access the toy for a child. This way, by using this sabotage technique, you can increase the chance of communication so you can practise positive communication.
Tackle the stripping, urination etc., by immediately removing/guiding the child to the bathroom and not making comments about the behaviour except positive on (you want a toilet, showing the picture of the bathroom/toilet)
Write a list of the words he can say verbally, think about the words he will need to understand and communicate his needs in the school and prepare the visual support – graphic/picture presentation (with the text). This is my proposition of the words that I think would help the child to communicate his needs in the first stage: the names of the toys in the jars/boxes, yes and no, class (which in this case is the intervention room), outside, toilet, bag, please, thank you, sad, happy, help, choosing time, workstation.
Use the DTT to teach the targeted words to monitor a child's progress.
Ensure you thoroughly research the child's strengths and interests and start building relationships and independence through them. This way, the child will feel safe, and he will trust us. Follow the teacher's planning but ensure the work is adapted and differentiated. For example, you mention that the boy struggles with simple matching objects. Make this activity short by matching only two things and making a big deal of it when he does it. Give the boy a high five and praise his good work. It is essential to show the child that the task is achievable. You can increase the number of matches next time to two pairs.
Gather simple but interactive games or objects, such as bubbles, pop-up pirates, and Skittles, and play with the child simple turn-taking games. You can play at the table or on the mat. You can mix teaching with play (that works best), especially when using DTT. Remember that you must prepare the child to match before you ask him to do the same at the workstation.
There is plenty more that I could add to help that child, but I already feel the amount of information is overwhelming, and the video is too long.
There you have it!
I'm curious, what do you think? What would you do? How would you help that boy? Did you work with non-verbal children with challenging behaviour? Do you have more ideas on how to help?
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Thank you for your comments advance, as I will give away The Lego Captain America Collaborative Set after making the video review next week.
Until the Next Time
With love and xxx
Bea