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Good&Evil
12-12-2005, 05:37 PM
You would expect that after two days of excellent training by Andy all problems would have been discussed and settled here in Malta. Anyway...

Next Friday (16th December) we will be calling an emergency meeting with regards to a client who is exhibiting challenging behaviours when in the presence of his mother. The client behaves very well at STEP (Structured Training and Education Programme - programme for children with PDD and other related conditions) and quite well at school (where he has the support of a full time facilitator). Until recently the parent reported that "he played up" only when he and she were in the company of others - "to show off" in some ways. We used to observe challenging behaviours upon his reunion with his mother; we tackled this situation by disrupting the routine. The keyworker now goes down to speak to the parent before the children go down so she can pick up the child and leave before the situation escalates. However, since about a month or so the parent has become more upset suggesting that he is exhibiting these behaviours in other moments and has made requests for further support.

About the behaviours: The child kicks, punches, pinches, pulls and bites hair and he directs these to sensitive parts of the mother's body. The child does not exhibit these behaviours when in the presence of his father.

What happens after: The parent has been instructed on how she should try to redirect his attention onto other things. At times she tries this but if the behaviours persist she becomes emotionally distressed and very wary of social evaluation. When she breaks down she slaps the child whilst telling him to stop.

About the child: He is 5 years old. He is very agile and restless. When he first started his main goal was to sit for 2 minutes engaged with entertaining toys - that was considered as ambitious at the time. Now he is sitting for a 60-minute work session involving tasks such as writing in imitation, colouring, etc.. He is socially responsive and takes interest in peers whom he tries to engage in 'catch' games (he touches their back, waits for them to turn then runs away). He has a problem with his diet - he likes to eat Crisps and drink Sprite. Recently he has started to eat some bread.

The question: In the meeting should we try to teach the mother Studio 3 methods on how to handle behaviours such as pinching, biting, etc? Or would this serve to justify the situation? Would behaviour management techniques be preferrable in this context?

Thanks beforehand for the help and sorry for making you go through such a long post.

andy
12-12-2005, 10:07 PM
I think the analysis you provide looks reasonably clear. Youn seem to suggest that the evidence is that the problem is at home (primarily). If I have interpreted this correctly there are two types of answer to your question.

Type 1: Train mum in redirection in the home setting. Teaching her distraction strategies 'in situ'. This is going to be more effective.

Type 2: Teach some methods of avoiding high risk situations like the studio3 methods. This is also better done in situ.

A combination of the above could be tried.


Mum is clearly requiring support, but, I am unfamiliar with what could be on offer. I am concerned that the improvements in the childs behaviour at STEP may actually make mum feel worse. has Mumm been formally offered counselling sessions? How does she get a break from the child etc etc.


Best wishes



Andy

Good&Evil
13-12-2005, 10:39 AM
I am concerned that the improvements in the childs behaviour at STEP may actually make mum feel worse. has Mumm been formally offered counselling sessions? How does she get a break from the child etc etc.


Best wishes



Andy

I definitely agree with this. I think that when she hears that her child has been so good she feels threatened, that she is not a good mother and so on. The thing that she reiterates (andwhich I think she feels insecure about) is that the child loves her and she is very wary of what others think about her as a mother.

Unfortunately we have no structured counselling services available at STEP but the session on Friday will be with the psychologist and we could point for a referral. Starting from 2006 Doreen was also thinking about re-establishing a parent support group.

Thanks for your reply Andy!

forumAdmin
13-12-2005, 04:57 PM
thanks for posting this interesting issue

please keep us up to date

Good&Evil
18-12-2005, 01:11 PM
The meeting was held and it proved to be very cathartic for the mother who could just get off her chest what she was going through.

Some practical solutions were offered, generally focusing on the option of avoiding confrontation and seeking solutions that prevent the escalation of challenging behaviours. The parent was also offered the option of having a staff member observe some child-parent interactions at home and then offer constructive criticism on how the child could be better handled.

As an aside it was interesting to observe the language used. The father detached himself completely from the problem and used language such as 'she', 'her' and so on to address the mother and the daughter (don't know whether in English such forms of expression have exactly the same effects that they have in Maltese). It is sad how often mothers have to face the worst of the children and then ALSO get the blame that they are doing something wrong.

forumAdmin
18-12-2005, 03:30 PM
Glad it went sort of OK

I think you are probably right you can pick up alot from those sorts of conversations


It is sad how often mothers have to face the worst of the children and then ALSO get the blame that they are doing something wrong.

too true and we generally hear staff say how
it is such of an issue dealing with the family........

Good&Evil
18-12-2005, 10:55 PM
Oh and I wanted to thank you for your suggestions. We did go through your suggestions with the psychologist before the meeting started.

10x for the help