Violent child on the spectrum (kinda long)

Discussion in 'Special Education' started by Ghost, Aug 25, 2008.

  1. Ghost

    Ghost Habitué

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    Aug 25, 2008

    I have a 2nd grade student who can be the sweetest little boy ever, however the moment he's crossed, he pinches/scratches/bites. My aides and I are covered with scabs and bruises. Mother absolutely flips out when anyone even thinks about medicating him or putting him in a more restrictive setting, but she lets him do what he wants at home and never makes him do something he doesn't want to do. To complicate matters, he is very particular about what he will eat and suffers from chronic bowel blockages as a result. When he is in pain, he lashes out at everyone in the near vicinity.

    Today he decided he didn't want to do his work station, something that he's done every day and can do in 2 minutes if he works. He threw things and was made to pick them up (hand over hand). That didn't get him out of work. So he started yelling. I told him, "You don't want to work. You want to play. Work first, then play." That didn't get him out of work. Then he began to scratch/pinch the aide working with him....the aide was going to put him in time out--a procedure from last year. I stopped him from putting the child in TO. That didn't get him out of work. So he did one task, then tried biting/scratching/pinching. I did put him in TO for biting (and cut his nails while he was in TO), but he went right back to his station after it was up and had to finish. It took two of us to have him complete his tasks hand over hand. One to hold the free hand and stick his chewy tube in his mouth when he tried to bite and one to actually do the work (stamping letters). It wasn't anything he couldn't do independently, he just didn't want to.

    I can tell when he bites himself or pinches his belly that he is in pain. I usually give him tummy rubs from behind and he calms down. Today he was lashing out for no apparant reason (besides the attempt to get out of work). I've already got an FBA going, but I can tell already 3 things. 1) If he doesn't know what's next, he flips---begining to understand picture schedule and that helps. 2.) If he just doesn't want to do something, he goes off--too bad, he's going to learn to do it. 3.) If he has down time that isn't structured, he will go for the other kids--working on a sensory diet during that particular period of the day. Any other ideas??
     
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  3. SpecialPreskoo

    SpecialPreskoo Moderator

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    Aug 25, 2008

    This is me... if it were my student and he started lashing out like that, first I would put him in a therapeutic basket hold to keep him from hurting himself or others and he would stay there until he calmed down. I don't tolerate being abused by any child or having them hurt other children no matter the disability. Do you have a time-out room? Our ED/EC/BD (whatever your school calls it) has time-out rooms for when the kids get violent and start having lash out fits.

    Once he realizes you won't give in, I think things will get better, especially with the pic schedule and such. As for the pain... bless that child's heart!! You would think that mama would sneak in some benefiber in his food that he does eat to make him regular.

    If all else fails, when he has those fits, call her to come get him. Maybe after a while of picking him up daily, she will get tired of it and do something about it. If she gets to where she refuses to pick him up or answer the phone, call CRS on her.
     
  4. Zelda~*

    Zelda~* Devotee

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    Aug 25, 2008

    Was there something in the air today?

    My first grader didn't want to do letter stamping today....no biting or anything like that, but he did cry and whine, shove items on the floor, and inform me I'm a jerk and mean. (My other student God-bless-him, completly ignored this and did his work.)

    I'm sorry I don't have any other ideas for you...I don't suppose he'd tolerate a warm water bottle for his tummy?
     
  5. Proud2BATeacher

    Proud2BATeacher Phenom

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    Aug 25, 2008

    I find that when my students don't want to do their work, they strike out in attempt to be removed (to get out of doing their work). Once they had calmed down and problem solved with an adult in our quiet room (what we called our time out room b/c we did not close the door) they did not want to return to class to finish their work. They were content to hang out in the quiet room, so that they wouldn't have to do their work.

    Have you thought of doing some sensory diet activities throughout the day rather than just during less structured time? I am assuming that you are going through his picture schedule with him before he does his work job. Have you thought of having him choose pictures for what he wants to do during unstructured times (or you could choose it for him)?
     
  6. teachersk

    teachersk Connoisseur

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    Aug 25, 2008

    I'm not sure, but I think it's illegal to send a kid home or require a parent to come get them. Let me know if I am wrong... but I was told that in my last district I could not call the parent of a child that was constantly screaming, biting, head banging, etc. because it meant that the parent had grounds to say the school was not providing a FAPE....

    (missing days because of being sent home...)

    I'm not sure though. I would check on that before doing it, though.

    My student that had these difficulties did very well from COMPLETE structure. We did not let her have a free minute in the day. We structured every second. She had to ask (PECS) to leave her seat. She had to put her pencil in a basket when she wasn't using it. She had a room divider around her seat at the table so she wouldn't slash other kids faces with her hands, pencil, paper, or any other tool she had in her hands. She had a visual schedule and followed it daily. She had a strict sensory diet that included a sensory room (visual sensory/auditory sensory) and a gross motor area (scooter board, mats, hula hoop, rolling toy thing, etc.). She was escorted to every class with an adult because we couldn't trust her with kids. It really truly was THE MOST RESTRICTIVE it could get aside from sending her to a non-public or residential placement. We had to get her a helmet because of her SIB (headbanging so hard she broke a window).

    I would check into maybe giving your student a card that says MY TUMMY HURTS (a picture of a tummy, with an ouch next to it? arrow pointing to it?) It seems like he might KNOW that this is what is causing the pain (his stomach, etc.) and that a back rub, laying down, that type of thing might fix it. Perhaps you could create something in Boardmaker that gives him some choices to choose from when his stomach is hurting. MY TUMMY HURTS. I WANT _____ (lay down, back rub, bean bag chair, break, etc.). Then if you can see it coming, you could ask if his tummy hurts? I don't know if he has the ability to cognitively take it this far but that's just an idea.

    I would also try using visuals (A First Then board) when he's upset, and simply showing him the visuals. Some kids like the attention they get when someone says FIRST __ THEN ___ to them, or other things like that. If you know he wants to play and he isn't doing his work, you could quickly get your First/THEN board and show it to him. If he protests, point to the board. You can say it maybe once or so. If he can read, you can say "What's this say?" "First...___" let him fill in the blank.

    I'd also try to get him on a pretty structured routine - don't change things - so he can know what to expect each day. Maybe all of his work sessions can be followed with play. You can start out with simple stuff (1 work box) and move towards (3 or 4 or whatever you have in there now) and he can work up to it. Let him see some success -- 1 box in there - YAY YOU finished your work - time to play! Then , the next day - 2 boxes in there - YAY you finished your work, etc. Build back up to it. It may seem like it's so easy for him but it would be good for him to see some success and feel good about it.

    Can you talk to mom about the bowel stuff? Maybe have the nurse speak with her? My parent was also very adamant that her child WOULD NOT be medicated and that it was HER CHOICE to make, not ours. Which is true... but a little bit off the wall when your kid is banging their head into windows and breaking them.

    GOOD LUCK to you. PM me if you'd like to see a sample PECS communication board for "making choices" when angry.
     
  7. Proud2BATeacher

    Proud2BATeacher Phenom

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    Aug 25, 2008

    When I taught in Georgia, we were able to phone parents to come and get their child if their child was in the time out room for a minimum of 1 hour. Some parents didn't show up and some students were unable to calm themselves down and spent a half of the day in the time out room (sometimes at one time, but mostly throughout the day)-- these were usually the students who were sent to school unmedicated...
     
  8. SpecialPreskoo

    SpecialPreskoo Moderator

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    Aug 26, 2008

    Hmm... it is hard to provide their FAPE is they aren't able to function so you can. I guess they would argue something was "A" and that is why the child is acting out. Who knows.
     
  9. Special-t

    Special-t Enthusiast

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    Aug 26, 2008

    If this boy is in pain frequently I'd start sending him to the nurse. He may have something seriously wrong with his colon or intestinal function that is not being treated or diagnosed correctly. The nurse has some clout with CPS to make sure this boy is getting adequate medical care. He may need to be on prescribed diet that can be enforced by CPS. And perhaps with more vigilant medical care, he might get the meds he needs for his emotional disturbance. Poor little guy sounds like he's really suffering. Don't assume his parents are actually taking him to the doctor if he's in chronic pain.
     
  10. Ghost

    Ghost Habitué

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    Some good ideas....yes, his mother is on top of it. I got the run down of all of his scopes. His diet consists of: Doritos, chicken nugget crusts peeled off the meat, fruit snacks, and chocolate chip cookies. He will only drink Capri Sun and very rarely apple juice, which usually contains his laxative. I am not going to judge his mother, but if he were my child, he would eat what is put in front of him or go hungry.

    We don't have a time out room. They were removed for being used incorrectly. We aren't allowed to send him home either. I've just introduced PECS to him....the two I gave him are "I feel bad" and "I need sensory." We do have sensory built in, but our OT hasn't come in to suggest a diet for him yet. I am going to try making all of his activities more structured. Today, he was in Time Out once--during calendar---and since it seems to be a trend, I'm going to give him a manipulative calendar to do with us to see if it's the verbal instruction/interaction part of the day that bothers him.

    I'm still waiting for my Boardmaker to come in, but I did borrow a friends and make a mini schedule for entering the room. Any other ideas??? I appreciate all the advice and suggestions.
     
  11. Justine Cognito

    Justine Cognito Rookie

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    Aug 26, 2008

    He's a little guy and still learning! I've been there...it's so exhausting with the little guys who have endless energy to keep the behaviors going.

    Of course the medical issues are affecting him, but it also sounds like task avoidance is HUGE with this kid. If it was me, I would do or re-do a preference assessment to make sure that he is getting reinforcers that are really motivating for him on an appropriate schedule.

    I would not call a parent to pick up a kid having behaviors. It's my job to do everything I can to arrange the environment to make the kid successful. If a parent is called the kid will figure out that all he needs to do is make a big huge fuss and he'll get to go home. Calling mom IS giving in, IMO. I'd also never, ever do any type of restraint (like a "therapeutic" hold) unless there was a threat of injury requiring immediate medical attention to the students or staff. In my state biting and pinching are NOT serious. I'd fully expect to be fired for doing something like that to a kid who pinched me.

    Behaviors will spike when they are addressed. It sounds to me like you're doing everything right.
     
  12. Ghost

    Ghost Habitué

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    Aug 27, 2008

    Thank you Justine! He's mostly non-verbal (echolaic), so it's really hard to tell what is reinforcing. He likes the Koosh type balls, so that has been a big incentive for speaking.

    As far as the holds, if we don't hold him, then he will severely injure someone. I wish you could see my arms...I'm an adult and can deal with it, but if he went for my guy in the wheelchair or one of the other kids, he could really hurt them. We've gotten to the point where the holds are more deep pressure than restraint and that helps a lot. I'd give anything to be in his head for a few minutes.
     
  13. sarypotter

    sarypotter Comrade

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    Aug 27, 2008

    One thing I learned last year was how to use a DRO, which stands for Differential Reinforcement of Other behaviors. (I don't know why it's not called a DROB. I guess that just sounded too silly.:confused:)

    Stop me if you know this already. I had never heard of it. Basically, the concept is to reinforce the child for intervals of time when he is not engaging in the target behavior. So for every, say, five minutes he goes without being aggressive, he earns a token, and when he gets X number of tokens, he gets a reward. This would be a reward only reserved for the absence of this behavior -- whatever reinforcer is most powerful for him.

    The way this looked in practice for the student who taught me about it was that she had a token board of ten tokens, an extra spot of velcro at the top, and a timer. She had been working on the system for over a year, and had worked up from 30-second intervals to 10-minute intervals. The timer was set for 10 minutes. At the start of the 10 minutes, a token was placed at the top of the board on the extra velcro spot. That was the sticker she was working for. If she exhibited aggression at any point before the timer went off, the token was removed. At the end of the interval, the timer was reset and a new token placed on the velcro spot.

    If, however, she got through the ten minutes with no aggression, the sticker was moved from the top spot to one of the ten "earned" spots, and a new sticker was placed on top to work for. Once she got all 10 stickers, she earned a preferred video.

    This treatment was paired with the teaching of replacement behaviors for aggression -- for her, a chew bin of items she could chew (as a replacement for arms), a picture exchange system for communication, a bin of squishy stuff to pinch instead of -- again -- arms, a help card she could use to get help before she got frustrated, etc.

    Sorry this was so long; I was just really happy to learn it and wanted to share it in case it would help. Good luck!
     
  14. teachersk

    teachersk Connoisseur

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    Aug 28, 2008

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