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Understanding your

child’s behaviour
Information for families Incorporating The Lady Hoare Trust
1 Understanding your child’s behaviour
UK
Introduction

This guide is for parents who are worried about their


child’s behaviour. Your child may be beginning to
develop some behaviour that challenges you, or may
already have behaviour that challenges. They may have
a recognised disability, be in the process of getting
a diagnosis, or you may be wondering if they have
additional needs.

Whatever the case, parents can feel under a lot of


pressure to ‘solve’ behaviour problems and are naturally
very worried about the best approach to take. Parents
can feel very alone and it can be a relief to discover that
other parents feel the same.

All children are different and there is no single answer to


any of the difficulties or problems you may face. There
are often complex reasons behind a child’s behaviour
and it is rarely anyone’s ‘fault’.

Fortunately, there are ways you can help your child and
a number of people and organisations who can help. In
this guide, we offer suggestions that may help, explain
who else can help and how, and where you and your
child can get support.

Note: this guide covers the whole of the UK


with any differences in the nations highlighted.
National contacts are listed at the end of the
guide for more detailed advice.

2 Understanding
Understandingyour
yourchild’s
child’sbehaviour
behaviour
For example, your child may be trying to
Contents express one or more of the following:

Introduction.................................................. 2 • frustration: they can’t do something or


Understanding behaviour........................ 3 can’t tell you what they want
Getting support........................................... 4 • fear: they are frightened of something
Setting the scene for good behaviour..5 • strong feelings: they are unhappy or
Recognising behaviour triggers.............. 7 angry about something
Dealing with behaviour issues.............11 • hyperactivity: they have excess energy
When is behaviour ‘challenging’? .......14 and cannot seem to burn it off
The teenage years....................................18 • discomfort: they are in pain and can’t
If your son or daughter is in tell you
trouble with the police...........................20 • attention: they have learnt they get
Sources of outside help..........................23 your attention by behaving in a certain
Useful organisations................................25 way, and carry on using that behaviour
About Contact a Family...........................30 to get your attention
• lack of understanding: if your child
has limited understanding, they may
not know what is expected. They may
need time to work out what you mean
Understanding behaviour and so don’t respond to an instruction
when you expect them to
It is not always easy to spot a behaviour • difficulty processing or making
that will challenge us during its early sense of sensory experiences in the
stages. Many young children naturally environment: for example if they
have tantrums and some teenagers have hearing or sight problems.
seem to enjoy ignoring their parents. But
behaviour becomes challenging when it Some behaviour that challenges is more
is harmful to the child or other people likely in children with particular medical
and when it persists and is severe. If it is conditions or disabilities. For example:
very difficult, it may be called ‘behaviour
that challenges’, or ‘challenging behaviour’ • children with attention deficit
(see ‘When is behaviour challenging?’ on hyperactivity disorder (ADHD)
page 14). may find it very hard to stay still or
concentrate for long periods of time
It is helpful to remember that it’s likely • children with an autism spectrum
that all behaviours are a way of your disorder (ASD) may become unsettled
child trying to tell you something. The by changes in their routine, causing
challenge for parents is to work out
what your child is trying to tell you
through their actions, and to help them Freephone helpline: 0808 808 3555
find other, more acceptable, ways to www.cafamily.org.uk
communicate.
Understanding your child’s behaviour 3
making friends, being tearful, or not
wanting to go to school
• children with specific learning
difficulties or speech and language
difficulties may find learning at school
difficult without good support. If
support is lacking a child’s behaviour
may change or become challenging.

Getting support
It is important to tackle issues with your
child’s behaviour early. If you notice
certain behaviours getting more frequent,
occurring over longer periods of time
them to become upset or anxious. and becoming unmanageable, look at
They can also react strongly to their strategies to manage them (see page 7).
environment, for example they may
not like being in crowds If your child has a specific diagnosis, the
• some children who have sensory support group for their condition can
impairments may be over- or under- usually offer tips and strategies to prevent
stimulated by sounds, sights smells or manage behaviours that challenge.
and noise. This can affect the way Many parents say the best advice comes
they behave from other parents they meet at groups.
• some children have physical Our freephone helpline can put you
disabilities that mean they have in touch with a support group for your
no speech. These children need child’s condition. Call 0808 808 3555.
alternative ways to communicate their
needs. See ‘Setting the scene for You may also need to seek help from
good behaviour’ on page 5) professionals involved with your child,
• some behaviours happen because (see ‘Sources of outside help’ on page
of a genetic condition. For example, 23). You can speak to any professional
a child may have a tendency to be involved in your child’s care – like your
obsessive, anxious, over eat, sleep GP, health visitor or children’s centre or
badly or self harm. If your child has school staff. They should be able to refer
a genetic condition, you may want your child for more help if necessary.
to find out more about the condition
and whether there are strategies to Help at school or nursery
help with behaviours If you’re concerned about your child’s
• some behaviour is classified by behaviour, it’s helpful to know that schools
professionals as an ‘emotional and and early years’ settings have legal
behavioural’ difficulty. Signs of this obligations to support children who have
include low self-esteem, difficulty difficulty learning, and to treat disabled

4 Understanding your child’s behaviour


children fairly. Behaviour and discipline Setting the scene for
policies should take into account a child’s
disability or special educational needs.
good behaviour

Laws are in place to help protect All children will communicate their needs
disabled children from being seen as and respond to situations differently.
simply naughty or deliberately disruptive, But there some general rules that will
because behaviour that challenges help you manage your child’s day-to-day
may arise because of their disability, behaviour. These rules are particularly
or because of a lack of reasonable important for children with disabilities,
adjustments to accommodate their who may be struggling to make sense of
disability. School staff should receive a very confusing world.
adequate disability training so they can
recognise disabled children and respond Establishing daily routines
to their needs. Most children cope more easily if they
know in advance what is going to
Depending on the age of your child, happen. Carrying out tasks in the same
you should talk to your health visitor, way, or at the same time, every day helps
someone in their early years education children become familiar with what is
setting, their teacher or the special expected of them. Children with severe
educational needs coordinator (SENCO) learning and communication difficulties
or other member of staff in an early years can start to respond more positively
setting or a mainstream school who is and appropriately as they develop this
responsible for coordinating help for understanding.
children with special educational needs.
Tell them what your concerns are, giving Routines can also be used to set
examples to illustrate your concerns, and up clear boundaries and acceptable
ask what support can be put in place. behaviour, which can be reinforced
The school should work with you to with rewards (see ‘Rewards’ on page
ensure your child’s needs in early years 7). For example, if your child won’t sit
education and school are met. See page at the table and eat a meal, you can
21 for where to get help with school. try to establish firm meal-time routines
and reward them for cooperating. For
More information about where to get routines to work, it’s important that
help, including condition support groups, everyone involved with your child follows
can be found in ‘Useful organisations’ on the same routines, so let them know
page 25. what you are doing and why.

Freephone helpline: 0808 808 3555


www.cafamily.org.uk

Understanding your child’s behaviour 5


Building communication workers (for pre-school children), speech
Children who wish to communicate and language therapists, psychologists
their needs and wishes but can’t, can be (see ‘Sources of outside help’ on page
deeply frustrated. This may mean their 23 for more information).
frustration is acted out as behaviour that
challenges. Minimising risks
It is important to find ways to reduce the
It is vital to have two-way communication risk of children hurting themselves and to
with your child. It’s important to find make them as comfortable as possible.
a way to communicate with them Simple ideas include using locks on fridge
about your daily routines to help them and cupboard doors, cooker guards,
understand what it is you would like wall-mounted televisions and electric plug
them to do. socket covers.

If your child has limited understanding, The charities Fledglings and the
or little or no speech, there are ways of Disabled Living Foundation can give
communicating you can try. This may be advice and information on what is
by using simple language; for example available and where to find aids,
one-step instructions, or key words. equipment and clothing to keep your
Giving children time to understand what child safe and comfortable. See page 26.
you’ve said or signed and repeating key
instructions is important. You may be entitled to certain equipment
from your local authority through the
Don’t forget the power of your own occupational therapy service. Call our
non-verbal language/behaviour. Your tone freephone helpline on 0808 808
of voice, warmth, posture, eye contact 3555 for information about this or for
and facial expression all speak volumes our free guide to Aids, equipment and
about your own feelings and will affect adaptations.
how your child responds to you.
Play and exercise
You can also learn to communicate by Research has shown exercise is very
using picture exchange communication effective in relieving stress and getting rid
systems (PECS) symbols, by signing, of frustrations. It can also have a positive
learning Makaton (a mixture of signing effect on behaviour generally.
and symbols), by showing photographs
or other familiar pictures or objects. For Trampolining in a safe garden or
example, show your child their coat to let swimming can work wonders in using
them know it’s time to go out. up a child’s excess energy. Exercise can
also be very helpful for children with
You can get help to find the best sensory processing difficulties. Most local
communication system for your child by authorities have sports, play classes and
speaking to professionals such as portage clubs for disabled children.

6 Understanding your child’s behaviour


Living Made Easy for Children is a website
and helpline run by the Disabled Living
Foundation who can help you find play
equipment (see page 26).

If your child has very limited mobility/


understanding or is very unwell you may
need advice about exercises, therapies
and treatments that may be helpful.
Call our freephone helpline for more
information.

There are a range of organisations Examples of rewards may be verbal


across the UK who organise activities praise and attention, favourite activities,
for disabled children, from days out to toys and tokens. Make it clear which good
summer programmes of activities and behaviour you are rewarding and what
adventure holidays. For more information the reward is. For this to work, you have
on organisations in your area and to order to be sure your child really wants and
a free copy of our Holidays, play and values that particular reward.
leisure guide, call our freephone helpline
on 0808 808 3555.
Recognising behaviour
Rewards
If you make a point of highlighting
triggers
or praising appropriate behaviours
throughout the day, you will reinforce In some situations, children become
and increase good behaviour. If you are anxious or distressed, which can trigger
thinking of using a reward system, it behaviour that challenges. You may know
might be helpful to discuss it with the these triggers, or at times you may be
professionals involved with your child. baffled and caught off guard. It can take
time and practice to work out the triggers
It’s important that the reward system you but it’s important you do, so you can find
choose to use is appropriate for your child ways to deal with the behaviour.
and takes into account any medical or
other condition that may be causing the If your child does start to display
behaviour that challenges. For example, behaviour that indicates they are anxious
Prader-Willi syndrome can cause children or distressed, try to work out the cause
to over-eat. So offering food as a reward and address it.
would make over-eating worse.

Freephone helpline: 0808 808 3555


www.cafamily.org.uk

Understanding your child’s behaviour 7


Children who can speak can find it very
difficult to say what is upsetting them.
Children with limited communication
are likely to find it even harder to
both understand and communicate
their feelings. Your child may have
particular likes or dislikes, or may feel
overwhelmed. Questions you might
consider include:

• do they understand what they are being


asked to do?
• is the task you want them to do that can encourage or discourage
too difficult? (whether you mean to or not) the
• are they familiar with the person behaviour from recurring.
working with them?
• are they hungry? Remember
• are they thirsty? Your child may be trying to tell you
• are they in pain? something with their behaviour. For
• are they tired? example, they may be screaming
• is the situation too noisy for them? because they cannot bear the door being
• are they too hot or too cold? shut and they have no words to say this.
• are they finding change too difficult Your child’s behaviour may be serving a
to cope with? purpose, for example, they are screaming
because it gets your attention. If their
Devising strategies that remove or challenging behaviour gets your attention,
reduce the effect of triggers they will do it again.
If a behaviour keeps happening and you
are unsure about the triggers, it can be Using an ABC chart or a diary may help
helpful to keep a diary, or a behaviour you identify and remove triggers (see
chart, to try to learn more about it. A figure 1 and 2 on next page).
good example is an ABC chart:
What if you can’t remove a trigger?
• ‘A’ stands for antecedents – the things It won’t always be possible to avoid
that lead up to the behaviour. For certain triggers. For example, your child
example, where people are, what loves going out for walks in the park but
is happening, who is there, what the is really frightened of dogs and runs out
time is of the park into the road, or screams or
• ‘B’ stands for behaviour – what the attacks you if a dog approaches.
child is actually doing
• ‘C’ stands for consequences – what You will need strategies to reassure
happens in response to the child’s your child and gain their trust in these
behaviour. It’s these consequences (continues on page 10)

8 Understanding your child’s behaviour


Figure 1– ABC Chart
Once you have filled in the ABC chart, you then may be able to devise a strategy to
remove the trigger, for example:

Date and Antecedents Behaviour Consequences Other comments


time

10/6/14 I ask my child He hits and I tell him off I feel


5.30pm to stop playing, kicks me and try to get exasperated. I
come to the and screams. him to sit up, have gone to all
Child is table and eat He moves but he won’t the trouble of
four years his dinner. I from the move from cooking beef as it
of age and explain that it chair to the the floor. is his favourite to
displays is his favourite floor under encourage him
difficult meal. He ignores the table. to cooperate.
behaviour. me. I pick him up
and bring him to I realise that
the table. he may not
understand
complex
instructions.

Strategy
You may find strategies such as stressing key words, using fewer words and more
visual cues, pictures or signs can also help.

Behaviour Strategy

My child won’t come to the table to Speak in simple and brief sentences, using
eat and tantrums when I pick him up. key words: ‘Dinner is on the table’, not,
He does not understand complicated ‘Come along and get your dinner – it’s your
verbal requests and I get cross when favourite, roast beef, come and sit down on
he does not respond. When he your chair at the table and enjoy it!’ Give your
senses I am cross, he lashes out child time to process the request, repeating
and cries. the command calmly if they do not respond
the first time.

Freephone helpline: 0808 808 3555


www.cafamily.org.uk

Understanding your child’s behaviour 9


Figure 2 – ABC Chart

Date and Antecedents Behaviour Consequences Other


time comments

10/6/14 My seven year old was She Brother told off It did not
3pm watching Teletubbies, screamed by me. She got feel fair or
which is her favourite and hit and her programme right on
Child is seven TV programme. Her kicked me. back. She either child.
years old and brother came in from Continued to stopped Her brother
has learning school and changed scream. screaming but is only five
difficulties. the TV channel. still lashed out years old.
at brother if he
came near her.

Strategy

Behaviour Strategy

My child loves Teletubbies and Set up a daily routine for when she can
screams and tantrums if she cannot watch Teletubbies without interruption and
watch the entire episode. an equal daily routine for her brother’s
favourite programme.

situations. It is likely that you will helpline on 0808 808 3555 or visiting
learn what works best. For example, our website at www.makingcontact.org
you may learn that telling a particular We also have a lively Facebook page
story, using a favourite toy, or singing www.facebook/contactafamily
a favourite song will help to calm
your child. Other help
You may find it useful to attend
Professionals and other parents may a parenting course on managing
be able to offer suggestions of ways difficult behaviour in children with
to remove triggers from your routine. additional needs. These courses can
Learning from other parents through give you lots of practical hints and
local support groups or linking services tips, increase your confidence and
can also be useful. allow you to meet other parents facing
similar challenges. Call our freephone
Contact a Family has a linking service helpline for information on local
you can access by calling our freephone courses.

10 Understanding your child’s behaviour


Dealing with behaviour ones you must tackle because they are
dangerous for your child and others.
issues
There is no single solution for dealing
You may have to wait to get outside with behaviour that challenges and not
help to deal with your child’s behaviour. everything can be solved at once. There
The first step would be to talk to your are some common approaches you can
general practitioner (GP) or another try, which may have some effect:
professional involved in your child’s
care, who can make the appropriate Rule out any medical or dental
referrals to other specialists. problems: in case your child is in
pain and cannot tell you. If they are
Remember, getting advice from constipated, tell the doctor as this can
support organisations and other also be a cause of discomfort. Work out
parents can be invaluable during this the triggers for the behaviour (see page
time. Assessments by professionals 7).
and referrals to services can take some
time, so try to access all the support Stay neutral: keep your responses to a
you can while you are waiting. In the minimum by limiting verbal comments,
meantime, there are useful techniques facial expressions and other displays
you can try yourself. of emotion, as these may encourage
the child to behave in this way. Try to
First of all, decide which behaviour speak calmly and clearly (using just key
you want to focus on if your child has
several worrying ones. This will avoid
confusing them (and you). For some Freephone helpline: 0808 808 3555
parents, this means deciding which www.cafamily.org.uk
behaviours you can live with and which
Understanding your child’s behaviour 11
11 Understanding your child’s behaviour
words and phrases) and keep your facial
expression neutral.

Focus on changing the behaviour: it’s


important for your child’s self-esteem
that they know you want to change their
behaviour, not them and who they are.
Otherwise they will be unhappy, which is
likely to affect their behaviour and may
make things worse.

Be positive: state or show how or what


you would like your child to do in a
positive way, for example, “Please
do… ” rather than “Do not do… ”. time, during which you ignore them and
Children can find it very hard to interpret make no eye contact. The time should
‘no’ messages. Just saying “Stop,” can be about one minute for children with
be more effective. If you can re-direct learning difficulties. You could use an egg
your child into good behaviour, reward timer to demonstrate the time visually.
them at once, for example with a hug ‘Time out’ should only be used if your
or praise. child has sufficient understanding to know
why you are doing this, otherwise it may
Be consistent: tell everyone involved cause confusion and distress. There are
about your strategy for this behaviour two advantages to ‘time out’: to allow
problem so that everyone is working the child time to reflect, which may be
on it in the same way. Children get a positive break if the child has become
very confused if handled differently. It overwhelmed and anxious; and to give
can sometimes be helpful to agree a the parent carer time to recharge ready to
written behaviour plan, with strategies engage positively with the child.
that work, for all involved with your child,
particularly if they go to day centres, Removing your child from the
have a support worker or short break situation, allowing them time to
support. Give this plan to everyone who calm, with limited interaction, then
looks after your child in your absence, distracting them onto a positive activity
such as friends, family or other carers would be more productive for a child
while you are having a short break. with severe learning disabilities.

Time out: This should only be used Build in positive experiences for your
as a last resort, after other strategies child: if you make a point of praising
to prevent misbehaviour have failed. and rewarding appropriate behaviours
It involves removing your child from whenever possible, you will reinforce and
whatever they are doing and insisting increase good behaviour. Remember
they stay in a safe place for a period of to get advice from a health professional

12 Understanding your child’s behaviour


Top tips for managing behaviour

When difficult behaviours occur, it is It is less helpful to:


generally helpful to:
• look angry or upset
• take time, stay calm and neutral • lose your temper
• give reassurance in a way your child • intimidate
is able to understand • talk a lot
• make yourself appear less • confuse your child
threatening, for example by sitting • have other people chip in
down • look nervous
• keep language simple, give clear • do nothing
messages or demonstrate or show • re-ignite the situation
a visual cue card to show the • be negative, saying ‘naughty’, ‘bad’,
behaviour that you want ‘no’ or ‘don’t’
• remove other adults and children • threaten punishments, particularly
from the situation ones you are unlikely to be able to
• look and sound confident – even if see through.
you’re not feeling it
• intervene quickly, try diverting or
distracting your child.

before using a reward system. (see Look after yourself


‘Setting the scene for good behaviour’ on None of this is easy, especially when you
page 5 and ‘Rewards’ on page 7). are tired. You will need time to relax and
take care of yourself. Parents are often so
Punishment rarely works busy thinking about everyone else that
Punishment – for example using ‘time they can find it very hard to set aside
out’ for a child who can’t understand its time to do something they really enjoy.
meaning – rarely works because many This might be as simple as having a bath
children do not see the connection in peace, reading a book or seeing a
between what they did and the friend. Without taking a break from caring,
punishment that follows it. There are your health can suffer. If you are a single
rarely overnight miracles so remind parent or you do not feel that you can
yourself to be patient. Don’t worry if ask family or friends to help out, call our
things get worse before they get better.
Your child will take time to adjust to
your strategies. Freephone helpline: 0808 808 3555
www.cafamily.org.uk

Understanding your child’s behaviour 13


freephone helpline and ask for advice on have a website Youngcarers.net They also
how to get help or a short break on 0808 offer social opportunities for young carers
808 3555. who may need a break from helping
to care for their disabled sibling. Sibs is
Parents of disabled children have the an organisation that can help siblings of
right to ask for an assessment of need disabled children with ideas for coping
by social services, (see ‘Sources of with difficult situations and learn about the
outside help’ on page 23). They may experiences of other siblings. Contact a
provide you with some options for taking Family has a free guide Siblings, with hints
a break from caring for your child. If you and tips, available from our freephone
are assessed as needing a short break helpline on 0808 808 3555
from caring, then this must be supplied
by the local authority. When is behaviour
‘challenging’?
The break could happen in a number of
ways, for example, providing a carer to In some cases, children develop behaviour
support your child in a social or sporting that is persistent and severe. The behaviour
activity. Other types of short breaks may be a risk to the child or people around
include short breaks for the whole family, them and prevent them using ordinary
where your child stays with another family community facilities, like a leisure centre or
or goes to a residential centre for a short day centre. This kind of behaviour can also
while. It may be that a sitter could come have a severe impact on family life.
into your home to look after your child
while the rest of the family has a break. When a difficult behaviour reaches this
level of severity, it could be defined as
Parents of disabled children assessed as ‘behaviour that challenges’ or ‘challenging
needing services can opt to receive direct behaviour’. Often, behaviour that
payments. Direct payments allow you to challenges may be associated with a
receive cash instead of services so you severe learning difficulty and can lead to
can arrange your own help. aggression, self-injury or disruptive and
destructive behaviours.
This means you might be able to employ
a care worker who can then be trained It is important to seek outside help if your
to meet your child’s needs. To find out child’s behaviour has become challenging.
if direct payments would be suitable for A list of people and organisations that
you and your family, see our free guide can help you can be found in ‘Sources of
Getting direct payments for your disabled outside help’ on page 23.
child, available from our freephone
helpline on 0808 808 3555. If you have been experiencing problems
with your child’s behaviour, you may
find it helpful to discuss this with people
Support for siblings of a disabled child such as your GP, paediatrician, learning
is provided by the Carers Trust, who disability nurse or child development

14 Understanding your child’s behaviour


behaviour, to decide what help is most
Remember, getting appropriate.
advice from support
Examples of behaviour that challenges
organisations and include:
other parents can be
Inappropriate social behaviour
invaluable. This is a problem if a child is persistently
rude, disruptive, doesn’t cooperate at
school and is aggressive towards staff
team to get help in managing the and other pupils. They may also get
situation. into fights and it can eventually result
in children being excluded from school.
If your child’s behaviour becomes very Some children may also have other
challenging, they might refer you to a inappropriate reactions to situations. For
specialist such as a psychiatrist or clinical example, they may laugh when someone
psychologist. is hurt, swear at strangers in public or cry
a lot for unexplained reasons.
It is important to rule out any underlying
health problems like toothache or Who can help: school counsellor
earache, which may be causing pain. (although not every school has
If you find it difficult to take you child one), Child and Adolescent Mental
to the dentist, the community dental Health Teams (CAMHS) or any of the
services can help. professionals your child is in contact with.

Medical professionals should consider Kicking, spitting, hair pulling, and other
your child’s initial medical diagnosis, physical outbursts
as some behaviours are associated Some children with learning difficulties
with particular medical conditions (for may display extreme behaviour like
example, hand biting is common in regular or lengthy tantrums. They may
children with Fragile X syndrome). kick, pull hair, self-harm or damage
clothes or property. This type of behaviour
Sleep problems, incontinence, problems can cause harm to your child or those
with feeding and eating, self-harming, around them.
emotional and behaviour problems
may be associated with your child’s It’s important to discuss these behaviours
diagnosed condition, but could be due with your child’s clinical coordinator and/
to another underlying medical or mental or the professional that knows your child
health issue.

This is why different health professionals Freephone helpline: 0808 808 3555
might need to be involved in carrying out www.cafamily.org.uk
an assessment of your child and their
Understanding your child’s behaviour 15
What are multi-disciplinary teams?
These are teams which include Child and adolescent mental
health professionals with specialist health services (CAMHS)
knowledge and expertise. Different CAMHS teams promote the mental
specialists might be needed health and psychological wellbeing
for an initial assessment to of children and young people. They
understand what is causing the include professionals that work in
child’s behaviour and agree the a number of different organisations
best way to help them. Examples such as health, education and social
of multi-disciplinary/multi-agency services. The professionals can
teams include child development include occupational therapists, clinical
teams/centres (CDCs), Child and psychologists, psychiatrists, and social
adolescent mental health services workers. You may have a CAMHS
(CAMHS) and community learning Learning Disability team in your area.
disabilities teams (CLDTs). These teams specialise in meeting the
psychological and emotional needs
Child Development Team/Centre of children and young people with a
(CDC) learning disability.
This is a healthcare team
specialising in working with Community Learning Disabilities
children with disabilities or where Team (CLDT)
there are concerns about a child’s Some CLDTs promote what is called a
development. A child development ‘lifespan service’. This means they can
team usually includes help plan and arrange care and support
paediatricians, physiotherapists, for people of any age with learning
occupational therapists and speech disabilities and their carers. CLDTs are
and language therapists. They also made up of staff from health and social
work with child and adolescent care. They might include social workers,
psychiatrists and psychologists. learning disability nurses, psychiatrists,
psychologists and a range of other
therapists.

well to seek further help. As children get Who can help: as well as local
older and stronger, unless they’re helped professionals and CAMHS, some
to bring their behaviour under control, groups have specialist knowledge, like
it will become more of a problem and the National Autistic Society (see page
may mean they are denied access to 27). For children and young people
community facilities like youth clubs and with severe learning difficulties, the
leisure centres. Challenging Behaviour Foundation can
help (see page 25).

16 Understanding your child’s behaviour


Sleep problems behaviour issues by getting help
Many children have problems around from professionals.
sleep and bedtime. These are
common in all children, and especially Other parents will have experienced this
children with learning difficulties, with behaviour and may have worked out
autistic spectrum disorders or with strategies that work, so get in touch with
sight problems. For example, they your child’s condition support group, or
may not settle in bed until late or get call our helpline for contact details.
up in the night, refuse to sleep in their
own bed, make noise which wakes up This behaviour can be very hard to
the household, as well as waking up deal with because of the extra washing
very early. and disinfecting, and the expense of
replacing ruined carpets, wallpaper and
These issues may not seem urgent at bedding. You may become exhausted
first, but long periods of poor sleep and anxious about the behaviour and
can mean you and your child are very the endless explanations you may feel
tired. Lack of sleep can cause feelings you have to make to other people.
of depression and make you feel less
able to cope. Contact a Family has a Who can help: Contact a Family,
free guide for parents Helping your occupational therapist. The Disabled
child sleep, (also translated into six Living Foundation and Fledglings have
community languages) available from clothing solutions/equipment that may
our freephone helpline on be useful (see page 26).
0808 808 3555.
Self-harming
Who can help: Having a child with behaviour that
Cerebra, Sleep Scotland, The Children’s includes self-harm is one of the most
Sleep Charity. difficult and distressing issues parents
may have to face. For severe self-harm,
Smearing faeces and urinating (for example, if your child has a
Some children and young people may fracture, injury to their eye or swallows
smear faeces or urinate in inappropriate a potentially dangerous substance), you
places. There can be various reasons will need to take them to casualty for
for this. It could be they simply enjoy emergency care. If the risk of self-harm
the feel of the faeces and need more is very great, children may need short,
sensory stimulation. You can use other medium and longer-term plans to help
ways to achieve this like giving them them manage this.
play dough, which has a similar feel.

They may be extremely upset and


agitated, or have a medical problem. Freephone helpline: 0808 808 3555
Try and rule out any medical or www.cafamily.org.uk

Understanding your child’s behaviour 17


For children with significant learning
disabilities and/or complex needs, there
is usually a need for careful, systematic,
multi-disciplinary team assessments.
These might include CAMHS/CLDT and
other child health professionals, together
with education and the local authority
to develop an individualised package of
care and support.

Behaviours can vary and, may include


the child:

• biting the back of their hand


• picking at areas of their skin
• scratching one particular area on their
body a lot
• head banging
• pulling hair out
• eye poking The teenage years
• sticking objects into ears or nostrils
• eating inappropriate things. Puberty and teenage years are times of
change and adjustment for all children
You can try to stop the behaviour and young people. Parents of disabled
by working out what is causing the children can find it difficult to know
episodes, but you will almost certainly what allowances to make for their child’s
need to seek help from an expert if puberty and hormonal changes. But even
your child is showing these types of allowing for hormones, there are some
behaviour frequently, intensively or real concerns for many parents during the
dangerously. teen years.

Who can help: CAMHS or CLDT should School transition


have specialists who can help with these Many children who have transferred
issues. Psychiatrists and psychologists from primary to secondary education will
may help and other parents may also be have appropriate, on-going support. in
able to offer support from having had place. But children who have had good
similar experiences. support in primary school may struggle in
a large secondary school. They can feel
overwhelmed by the size of the school,
the numbers of pupils, different teachers
and unfamiliar routines.

18 Understanding your child’s behaviour


Children become more conscious of Your child has the right to have their
their peers’ independence and the fact needs for support properly met. The
that they cannot keep up or are not school should work with you to ensure
allowed similar freedoms. They may feel your child’s needs in education and
they are ‘different’ and lose confidence further education are met.
in themselves.
Sexuality and inappropriate
Parents sometimes comment that their sexual behaviour
children’s behaviour and their mental This can be a major worry for parents.
health gets worse when moving from Parents of disabled young people
primary to secondary school. You may generally accept that their children will
find yourself despairing of teachers who naturally develop sexual awareness and
fail to see your child’s difficulties and feelings but they also worry about their
feel they blame them unfairly for ‘day extra vulnerability. Some disabled young
dreaming’ or for being aggressive and people find it hard to know where they
getting into fights. can express their sexuality and where it
is inappropriate.
Behaviour becoming more challenging
may also coincide with your child being Parents, young people and their
bigger and stronger and harder to control advocates need access to good
as they get older. information and support. It is important
to remember that professionals
Despite this, children and young people are often familiar with the sorts of
can be well supported in secondary behaviours that can occur, so it should
school (whether mainstream or more be possible to have honest and open
specialist provision) and settle happily. discussions without being embarrassed
It’s important that you prepare the way as by the nature of the problem. You may
much as possible. find it helpful to discuss this with your
child’s school as well.
Remember there are laws are in place
to help protect disabled children Other organisations also produce
from being seen as simply naughty excellent materials for young people
or deliberately disruptive, when their with specific conditions. For example
behaviour difficulties may arise because Brook has a web page dedicated to
of their disability. If you feel your child sex and disability and also produces an
is not receiving appropriate support information booklet on this topic.
at school, ask to speak to the person Talking to other parents can also be
resonsponsible for supporting children helpful and reassuring.
with additional needs in your child’s
school. Or call our Education Advice
Service on 0808 808 3555. Our parent Freephone helpline: 0808 808 3555
advisers can tell you about support your www.cafamily.org.uk
child may be able to get in school.
Understanding your child’s behaviour 19
Emotions and mental health
Sometimes you, or the professionals
working with your child, may notice other
emotional and behavioural changes.
You may be concerned about your
child’s mental health. If you are worried
about this, contact your GP, consultant
paediatrician or child health professional
to talk about it. They may suggest a
referral to your local Child and Adolescent
Mental Health Services (CAMHS) or a
CAMHS learning disability service for an
assessment to understand your child’s
behaviour, moods and feelings.

The assessment may involve one or the Royal College of Psychiatrists (see
more members of the CAMHS team the ‘Useful Organisations’ section from
and will usually involve seeing you as page 25). For information about where
parents, your child and probably other to get help locally, speak to your GP,
members of the family. The CAMHS team health visitor, or your child’s consultant.
will usually ask for permission to request
reports from your child’s school and any If your son or daughter is
other professionals and services already
involved in supporting you and your child.
in trouble with the police
The assessment is likely to lead to an
intervention plan to help you and your Sometimes, a young person with
child manage their mental health and behaviour that challenges may come into
behaviour needs. contact with the police. If your child has
a particular learning disability or disorder,
Some mainstream secondary schools are sharing information with the police about
able to provide a school counsellor to their particular difficulties and needs
support emotionally troubled teenagers (communication especially) is important.
and some schools (including special The National Autistic Society produces
schools for children with significant information cards which can be carried
learning disabilities) have regular by a young person with communication
outreach clinics and links with community difficulties who may not be able to
specialist services. explain their situation.

Further information about mental health Some young disabled people don’t
issues is available from YoungMinds and realise it’s inappropriate to touch a
stranger or may take something from

20 Understanding your child’s behaviour


Help with school

England and Wales Northern Ireland

Parent Partnership Services The Special Educational Needs


Give advice, information and support Advice Centre (SENAC) in Northern
to parents and carers whose children Ireland, provides an independent
have special educational needs. To advice, information and advocacy
find your local service, contact the service for parents of children
National Parent Partnership Network. and young people with special
Tel: 0207 843 6058 educational needs.
www.parentpartnership.org.uk Advice Line: (028) 9079 5779
www.senac.co.uk
SNAP Cymru
Charity working throughout Wales Scotland
giving advice, information and
support to families, young people Enquire
and professionals around additional Offers independent and impartial
learning needs and disabilities. They advice and information to parents,
can help with choosing a school, carers, practitioners, children
getting support for your child in and young people.
school and help resolve disputes. Helpline: 0845 123 2303
They also have an advocacy service http://enquire.org.uk
for children and young people.
Helpline: 0845 1203730 For more information on your rights
http://www.snapcymru.org and how to get help at school
call our Education Advice Service
on 0808 808 3555. Our parent
advisers can tell you about the help
school should be providing at any
age.

Freephone helpline: 0808 808 3555


www.cafamily.org.uk

Understanding your child’s behaviour 21


a shop, not realising it must be paid If your child does get into trouble with
for. Perhaps your child’s behaviour and the police, it is useful for you to know
intentions have been misunderstood their rights.
by others.
Children under ten: can’t usually be
Some parents worry that their child held legally responsible for a crime.
is falling in with the ‘wrong crowd’ Social services are responsible for
outside of school and does not dealing with a young child who has
grasp the seriousness of the group’s committed an offence. Social services
anti-social behaviour. If you are may already be aware of your child’s
worried about this, it may be worth needs and behaviour and should assess
contacting your local youth offending whether the behaviour is a risk and
team (YOT). Every local council work closely with you.
has one of these teams who work
to prevent young people getting If your child is under the age of ten
involved in crime or re-offending. and has committed an offence, it is
They are generally well aware that important to seek outside help. There
young people with special educational are local family rights groups that offer
needs can get into trouble and they advocacy services and advice about
seek ways to prevent this and to help legal rights. Call our freephone helpline
them. on 0808 808 3555 and we can tell you
where your nearest advice service is.

Setting up a circle of friends to support your child

If your child is experiencing difficulties with the circle and the ‘focus child’ to
because of their disability or their help them with choosing their circle of
behaviour towards others, it could friends and problem solving.
be helpful for them to have a ‘circle
of friends’. The circle should help to After the early stages, you and your
improve the inclusion of your child in child and/or their teacher will probably
their mainstream school. be able to review the amount of help
the circle needs on a regular basis.
The circle of friends idea works by
getting other children in the school to If your child is in mainstream school,
provide support and help the child in talk to a professional involved in their
difficulty to solve problems. care, like the SENCO or their form
teacher. For more information visit:
In the early stages, an adult teacher/ www.inclusive-solutions.com/circle-of-
facilitator will probably need to meet friends.

22 Understanding your child’s behaviour


Children aged over ten: can be held
responsible for a crime if it can be
proved they were aware that their
actions were wrong. Parents must be
informed if a child has been arrested
and the parent or another ‘appropriate
adult’ (for example, a social worker)
must be present if they are questioned.

Children have the same right to a


solicitor as adults. If your child is
arrested, it is important that you make
their solicitor aware of any disability
or illness and what this means for
the child, for example, any link with
behaviour that challenges, and the
degree to which they can understand People who can help you
what is being communicated to them. Support groups: They may be local
(covering a certain area or region),
Sources of outside help national or even international. They may
be a generic (for all parents of children
In this section, is a list of the people, with any additional need), or condition
organisations and resources that exist groups (for example, for parents of a
to help parents cope with behaviour child with ADHD or Fragile X syndrome).
that challenges. Support groups offer a different services
according to their size.
There are a large number of professionals
and other sources of support that can be Even if you do not meet a parent of a
involved in helping you and your child. child with the same needs as your child,
These organisations include statutory you may still find it helpful to share
services such as local health, education experiences with other parents.
and social services. Condition support groups will be able to
give you information on the condition
Local and national support voluntary and how it might affect your child.
organisations and independent providers They may also be able to link you with
may also help, as well as condition other parents of children with the same
support groups, parent-led and other condition as your child. Support groups
types of support groups.

Freephone helpline: 0808 808 3555


www.cafamily.org.uk

Understanding your child’s behaviour 23


offer a wealth of other services according Educational psychologist: behaviour that
to their size. challenges may occur in different settings,
including nurseries or school. Children
Please call our freephone helpline on can be referred by the parents, health
0808 808 3555 to find out about professional, nursery or school to an
groups in your local area. educational psychologist to look at setting
up strategies to help with behaviour.
Parents: often parents find the best
advice that they get is from other GP: your child’s General Practitioner or
parents who may have gone through, family doctor may be able to give some
or are currently going through, similar useful advice, but may also want to refer
experiences to their own. You can you on to a professional or community
link with other parents through parent team with more specialist knowledge.
support groups run by voluntary
organisations, carers’ centres, or Health visitor: health visitors are likely to
support groups for your child’s specific have had face-to-face contact with you
condition. Our freephone helpline has and your child and will have experience
details of these. You can also contact and expertise in the management of
other parents through our web-based common problems in childhood. Health
linking service at: visitors can also work with colleagues
www.makingcontact.org or our lively from other agencies (such as portage
Facebook page. and early years service) to contribute to
support for your child.
Professionals: the assessment of and
advice about the successful management Occupational therapists: can provide
of behaviour that challenges often advice on practical issues for children
needs a multi-disciplinary approach. In whose behaviour that challenges may
this guide, we have made reference be linked to a need for support in
to several different professionals and developing physical coordination and
services including: mobility.

Clinical psychologist: will look at the Paediatrician: a child’s paediatrician


child’s behaviour, assess its causes and may offer advice on how to deal with
discuss practical strategies you can use. behaviour that challenges or refer your
child to any of the other professionals in
Community psychiatric nurse: a this guide.
children’s nurse from either CAMHS
or Community Learning Disability Paediatric nurse: often come across
Teams, who provides support around different behaviours in their working with
mental health conditions and behaviour children who are ill or disabled. They can
interventions. They may have a wide have a wide range of knowledge and
range of knowledge and suggestions to suggestions to help.
help with specific behaviour.

24 Understanding your child’s behaviour


Physiotherapist: can help children
who require support in the physical
aspects of their life and who experience
limitations in their mobility, which may
be at the centre of their frustration and
behaviour problems.

Portage worker: as part of a team that


visits a pre-school child at home, the
portage worker may well have seen the
behaviours that are causing concern at
home and may be able to give some
suggestions on how to manage these.
touch with local play schemes or arrange
Psychiatrist: may be able to help for you to have direct payments, which
children whose behaviour is linked with you can use to buy in some help in
mental health issues. caring for your child.

School counsellor: a qualified Useful organisations


counsellor employed by a school so
that children experiencing difficulties General
can be referred to them to discuss their
concerns. British Psychological Society (BPS)
Tel: 0116 254 9568
Special educational needs www.bps.org.uk
coordinator (SENCO): a member of This is the regulatory body for
staff in an early years setting or school, psychologists in the UK. You can search
who is responsible for coordinating for details of psychologists on their
special educational needs provision in website.
mainstream schools.
Challenging Behaviour Foundation
Speech and language therapist: can Family Support Network:
offer strategies around communication 0845 602 7885
that may help to improve a child’s www.challengingbehaviour.org.uk
interpretation of some situations. Information and advice for families caring
for, or individuals with, severe learning
Social workers: are based in your local disabilities (both children and adults)
children with disabilities team. You have who display behaviour that challenges.
the right to ask for an ‘assessment of
need’ to see if your child’s difficulties
make you eligible for a regular short Freephone helpline: 0808 808 3555
break from care. If you are, they can www.cafamily.org.uk
arrange for a carer to help, put you in
Understanding your child’s behaviour 25
Family Lives Carers UK
Helpline: 0808 800 2222 Tel: 020 7378 4999
http://familylives.org.uk Helpline: 0808 808 7777
24-hour helpline for all general aspects www.carersuk.org
of parenting. Provides advice support and information
for carers, including short break
Call Contact a Family’s helpline for provision.
specific information about caring for a
disabled child. Continence

Royal College of Psychiatrists ERIC (Education and Resources for


Tel: 020 7235 2351 Improving Childhood Continence)
www.rcpsych.ac.uk Tel: 0117 960 3060
The professional body for psychiatrists Helpline: 0845 370 8008
in the UK. Its website has information www.eric.org.uk
leaflets covering many different mental ERIC is a national children’s health
health conditions affecting children, charity dealing with bed wetting, daytime
young people, their parents, carers and wetting, constipation and soiling in
professionals supporting them. children and young people.

YoungMinds Equipment
Tel: 020 7089 5050
Helpline for parents: 0808 802 5544 Disabled Living Foundation (DLF)
www.youngminds.org.uk Tel: 020 7289 6111
YoungMinds is a UK charity that is Helpline: 0300 999 0004
committed to improving the emotional www.livingmadeeasy.org.uk/children
wellbeing and mental health of children DLF is a national charity that provides
and young people by empowering their impartial advice and information on daily
parents and carers. living aids. Its website has a section about
equipment for children, some of which
Carers’ organisations has been mentioned in this guide.

Carers Trust Fledglings


Tel: 0844 800 4361 (England) Helpline: 0845 458 1124
Tel: 0300 123 2008 (Scotland) www.fledglings.org.uk
Tel: 029 2009 0087 (Wales) A national charity assisting parents and
www.carers.org carers of disabled children, or those
The Carers Trust has branches with additional needs of any kind, by
throughout the UK, providing quality identifying, sourcing and supplying
information, advice and support practical, affordable products to address
services, including short break provision. everyday issues.

26 Understanding your child’s behaviour


Communication

Picture Exchange Communication


System (PECS)
Tel: 01273 609 555
www.pecs-unitedkingdom.com
PECS is a way of using pictures to help
children request what they want.
The central resource for PECS in the UK
is Pyramid Educational Consultants UK
Ltd. They run PECS courses, and their
website has a wealth of information on
PECS. You can buy many resources from
their website.
Other picture and symbol websites that
are free of charge include: Growing up and sexual health
www.do2learn.com
www.symbolworld.org Brook
http://pdictionary.com Helpline: 0808 802 1234
http://trainland.tripod.com/pecs.htm www.brook.org.uk
Brook provides free and confidential
The Makaton Charity sexual health advice and services
Tel: 01276 606 760 specifically for young people under 25
www.makaton.org years old.
Uses signs and symbols to promote
understanding and language for Siblings
children with communication and
learning difficulties. The charity runs Sibs
Makaton courses for parents. Tel: 01535 645 453
www.sibs.org.uk
The National Autistic Society Sibs is a charity that supports siblings
Helpline: 0808 800 4104 of disabled children, they can help
(freephone) them with ideas for coping with difficult
www.autism.org.uk situations and help them learn about the
Produces information cards which can experiences of other siblings.
be carried by a young person with
communication problems who may
not be able to explain their situation.

Freephone helpline: 0808 808 3555


www.cafamily.org.uk

Understanding your child’s behaviour 27


Getting help from professionals

You, or any professional involved be helpful ask a friend or family


with your child, can ask for a member to come along and take
multi-disciplinary meeting between your child into a separate room
you and all the professionals while you discuss any behaviour
involved with the care of your that’s causing concern
child. This allows communication • write down all your questions in
between social care, healthcare advance of the meeting – it is very
and educational professionals and easy to forget some of the things you
ensures everyone can contribute to are concerned about when face-to-
your child’s care plan. face with the professional
• don’t be afraid to ask questions,
Here are a few tips to help you especially if you are nervous about
get the most out of meetings with some of the advice given, or if you
professionals helping your child: don’t understand anything
• make your own notes if you would
• take a partner or friend with you if like to, and ask for a summary of
you can – it makes it easier when the advice you receive to be written
there are two people listening to and sent to you by email or post –
the advice whatever suits you best
• it’s helpful if the professional • keep everyone informed – ask for
you are meeting has met your copies of minutes or notes to be
child before. If this has not been circulated to all present and any other
possible and you have to take your relevant people.
child with you, then it might

28 Understanding your child’s behaviour


Youngcarers.net Organisations with support
www.youngcarers.net groups for specific conditions that
A website for young carers and siblings can help
with moderated chat room, resources for There are more than 400 medical
siblings and a place to share experiences. conditions and disabilities listed on the
Contact a Family website, with details of
Sleeping support groups where there is one.
If your child has a diagnosis of a
Cerebra specific condition, the support group
Tel: 01267 244 200 for that condition will almost certainly
General Helpline: 0808 328 1159 have information about coping with
Sleep Assistant: 01267 244 210 challenging behaviour common in
www.cerebra.org.uk that condition. This information will
Cerebra have resources for help with have been developed by parents with
managing sleep issues for children experience of bringing up a child with
with brain related conditions. Trained the condition in question. You can
phone counsellors can give advice, and access the medical information on our
sleep practitioners may be able to visit website at www.cafamily.org.uk or by
your home, or you may be able to go calling our freephone helpline on 0808
to a sleep clinic near you. 808 3555. They will be happy to send
you any information. If a condition isn’t
The Children’s Sleep Charity listed on our website, we may still be
www.thechildrenssleepcharity.org.uk/ able to find you information about it on
Offers training around sleep for parents our database, so please do call.
and professionals.
Benefits and financial help
Sleep Scotland
Tel: 0131 651 1392 Extra financial help available to parents
www.sleepscotland.org of children with behaviour problems
A charity providing support to families includes Disability Living Allowance
of children and young people with (DLA), which is payable if your child
additional support needs and severe needs significantly more care or
sleep problems in Scotland. supervision than other children of the
same age because of a disability, and if
Scope – Face 2 Face Sleep Solutions your child has mobility issues.
Tel: 0844 800 9189
www.scope.org.uk/face2face
As well as providing information and
workshops on sleep, Scope have
trained sleep counsellors in England.
Freephone helpline: 0808 808 3555
www.cafamily.org.uk

Understanding your child’s behaviour 29


Contact a Family publishes a number of Linking
guides on money issues, available free We run a web-based linking service,
from our helpline. You can also ask our which is available at
helpline to check that you are getting www.makingcontact.org. If there is no
all the financial assistance you are support group offering linking for a
entitled to. certain condition, then we can try to
arrange one-to-one family linking.
The Family Fund
Tel: 08449 744 099 Free guides
www.familyfund.org.uk We produce a range of free guides for
The Family Fund gives grants to families families which can be accessed at
who have severely disabled children up www.cafamily.org.uk/resourcelibrary
to 17 years of age. See their website for or by calling our helpline.
more details on their criteria.
Acknowledgements
About Contact a Family
Contact a Family would like to thank the
Contact a Family Challenging Behaviour Foundation for
Freephone helpline: 0808 808 3555 their comments on this guide.
Email: helpline@cafamily.org.uk
www.cafamily.org.uk This guide was contributed to and
agreed by the Royal College of
We provide advice, support and Psychiatrists’ Child and Family Public
information for the families of Education Editorial Board.
disabled children no matter what the
child’s disability or additional need. We
also campaign to increase investment
in services for families with disabled
children.

We have a team of parent advisers who


can put parents in touch with support
groups for the condition affecting the
child, offer a listening ear, offer advice on
rights and entitlements, give approved
medical information and give details on
our linking services.

30 Understanding your child’s behaviour


Written by Pauline Shelley
with contributions from Sheila
Davies, Carmel McDermott and
Karin Beeler.

Social networking
Contact a Family is on Facebook
and Twitter. Join us at:

Facebook
www.facebook.com/contactafamily

Twitter
www.twitter.com/contactafamily

Videos
You can watch videos on our
YouTube channel at:
www.youtube.com/cafamily

Freephone helpline: 0808 808 3555


www.cafamily.org.uk

Understanding your child’s behaviour 31


Getting in contact Other information
with us booklets available
Free helpline for parents and families This guide is one of a series for
0808 808 3555 parents and professionals. Guides
Open Monday to Friday, include:
9.30am–5pm • Concerned about your child? (UK)
Access to over 170 languages • Relationships (UK)
• Siblings (UK)
www.cafamily.org.uk • Fathers (UK)
www.makingcontact.org • Special educational needs (England)
• Benefits, tax credits and other
financial help (UK)
Contact a Family Head Office: • Holidays, play and leisure (UK)
209−211 City Road, London EC1V 1JN
Tel 020 7608 8700
Fax 020 7608 8701 All Contact a Family publications can
Email info@cafamily.org.uk
www.cafamily.org.uk
be downloaded from our website
www.cafamily.org.uk

Registered Office: 209−211 City Road, ® Contact a Family is a registered trade mark
London EC1V 1JN Although great care has been taken in the
Registered Charity Number: 284912 compilation and preparation of this guide to
Charity registered in Scotland No. SC039169 ensure accuracy, Contact a Family cannot take any
Company limited by guarantee responsibility for any errors or omissions.
Registered in England and Wales No. 1633333 The photographs in this booklet do not relate to any
VAT Registration No. GB 749 3846 82 personal accounts.

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32© Contact a Family,
Understanding yourJune 2014
child’s behaviour