Sunday, August 15, 2010

Coping with Behavioural Challenges in children with Down Syndrome

I currently have four children on my caseload with Down Syndrome. The oldest is 8 years old and the youngest 18 months. Anyone who works with these children is well aware of the specific challenges which these children present, from delays in speech and language development, oromotor and feeding difficulties, to one which we all know too well- the behavioural challenges. The latter particularly tends to impact on progress in the former areas.

My 4 year old patient loves to throw tantrums in the middle of sessions. She hits, pushes things away and runs all over the clinic. Putting some behavioural strategies into place such as visual timetables and reinforcers into place these behaviours have improved significantly much to mum's and my relief. Our biggest goal now is the carry over outside of the clinic setting.

My 18 month old patient is my newest and from session one he decided that he runs the show. He bawled for the whole session and pushed away everything we gave him (at least he knows how to protest). I remember thinking at the end of the session "what am I going to do if he does this every week???" This week's session (number 2) was a lot better. I realised that he liked physical manipulation, being lifted, spun, swayed etc, so I followed his lead and incorporated this into the session. I started by doing this only, building language around the lifts and turns, building anticipation etc, then moved to giving it as a reinforcer. There was still some crying but definitely reduced from last time, and we had a pretty good session. I also got a pretty good workout, phew!

I was doing some research this weekend and came across this article on the "down syndrome online " website. The title "Strategies to address challenging behaviour in young children with Down syndrome" was enough for me to save the page to my favourites instantly, so I've decided to share it with my readers. Hope it's helpful. Here is the link:

http://www.down-syndrome.org/case-studies/2008/

Also I encourage you all to comment and share some ideas on how you manage challenging behaviour in the clinic setting, at home, in the school setting etc. Lets make this interactive and informative :)

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