How to sort out

developmental
brain dysfunction from “behaviour”
and
from everything else

Nathan E. Ory, M.A.

Challenging Behavior Analysis and Consultation, Ltd

Special Education Council of the

Alberta Teachers’ Association
Kananaskas, Alberta
October 15, 2010
 Before “dealing with behaviour”
first approach at
level of emotional maturity.

P Consider the individual’s level of emotional

maturity.

P - Establish expectations and approaches that

are appropriate to the estimated emotional as
well as physical age.
 Developmental approaches

- Adjust approaches to reflect the

individual’s actual, developmental age.
(Level of cognitive development)

- Reduce individual’s reactions to social and

environmental factors that come from
uninformed developmental expectations.
 Before “dealing with behaviour”
first
check out sensory and
emotional regulation factors

P Poor regulation of emotional states.

< Easily triggered.

P Poor recovery after being over-aroused.

< How do you know it’s over when it’s over?
 Emotional approaches

P Be aware of “emotional mirror” and “emotional

magnifier.”

P Remain calm: Offer security, safety and

belonging.

P Do not respond with unpredictable

confrontation.
 Emotional approaches
What to do
when you don’t know what to do?

Make it a safe, accepting place to be.

P Drop demand for immediate action
Drop cognitive demands
P Increase sensory interaction and emotional
feedback

< Lower your voice, slow your pace of speech, say

less, hum a tune

< Self-calm, say familiar things, shift mental and

emotional gears (look at happy pictures)
 Before “dealing with behaviour”
check out

Wide discrepancies in learning style

- Review the individual's specific cognitive

dysfunctions that will respond to alteration
in approach and teaching strategies.

- Work to their strengths.

 Before “dealing with behaviour” ask, are
complexity, confusion and anxiety
triggering “shut down”
P Wide range between what they can do very
well, and not at all.
P Aware of what they “should” be able to do on
their own.
P Anxiety causes shift from “cognitive” to
“sensory” mode of functioning. When anxious
they can’t think.
 Causes of “shut down”
and/or
hyper- arousal

P Overwhelmed by sensory input

P Overwhelmed by memory input

P Overwhelmed by anticipation input

P Overwhelmed by inability to predict

 “Shut down”functional questions
P What does “shut down” look like for this person?
P What do you know that triggers “shut down?”
P What are examples that show the individual “Doesn’t
know what to do when they don’t know what to do?”
P Are there any examples of the individual becoming
“stuck in arousal?”
P What methods have you found that work best?
< Do’s and Don’t Do’s.
< Are these included in a behaviour or teaching
plan?
 Before “dealing with behaviour”
check out
Neuro-developmental brain dysfunction

- Observe dysfunctional behaviors to identify what

may be non-remediable brain dysfunctions that must
be accommodated.

- Inability to follow daily routine

- Inability to organize own behavior
- Inability to follow any sequence
- Inability to focus without external prompt
- Not learning from experience.
- Every day is start all over again.
 Normal function
and developmental brain dysfunction

P Quick processing of new information.

< Slow speed of thinking

< Slow processing what they see and hear.

 Slower rate of thinking and processing:
functional questions
Experiment and record

P How long does it take to respond? Is there a

pattern?
P How do you tell when they are ready for next?
P Is their processing time variable? What influences
this?
P What methods have you found that work best?
< Do’s and Don’t Do’s. Are these included in a
behaviour or teaching plan?
 What you can do when you
don’t know what to do!

It is always helpful to give more time to

process.

It’s always helpful to only give

one thing at a time.

Wait for completion

before giving the next thing to do.

It’s always helpful to let them watch you

showing someone else first.
 Normal function
and developmental brain dysfunction

P Good attention span. Able to focus and

concentrate.

< Distractibility due to partial processing.

< Hard to focus attention.

 Distractibility due to partial processing:
functional questions
P Attention deficits

P Motivation

P Language processing

P Memory

P Sensory auditory processing

 What you can do when you
don’t know what to do!
Accommodate to disabilities in
distractibility and inattention

Gain eye contact

Keep language short (4-5 words)

Pause:
Repeat

Demonstrate:
Be visual and concrete, use props
 Normal function

and developmental brain dysfunction

P Good long-term and immediate memory.

< Immediate memory may not stick.

< Can only hold one thing in mind at a time.

< One track mind: No room for two.

 What you can do when you
don’t know what to do!

To assist with poor working memory and

one-track mind:
P engage with single-step, high interest activity.
P protect them from distraction.
P provide continual external focus with concrete
reminder of what they are doing: picture lists,
numbered lists.
P keep refocusing the person with repetition, extra
feedback and reminders.
 Normal function
and developmental brain dysfunction

P Can see other’s point of view and their place

in this.

< Difficult to see other’s point of view.

< Can’t consider alternatives.

 What you can do when you
don’t know what to do!
When trying to “explain” to someone
who can’t see alternatives

P Use concrete, literal, explicit language

< Say exactly what you mean, mean exactly
what you say. Show what you mean.

P Fill in all the blanks for them.

P Give personal reasons for everything. Work

from inside their point of view.
 What you can do when you
don’t know what to do!
When trying to “question” someone
who can’t see alternatives
P Stay “in the moment” with them.
P Get on their side of their “teeter-totter.”
P Consider use of “20 questions” to assist them to
find their own “answers.”

P They may not be able to tell you what they do

want, but they may be perfectly able to tell you
what they don’t want!
 What you can do when you
don’t know what to do!

When working with someone

who may not understand
what you are asking or explaining

P Offer life as a “multiple-choice” test, but give them

the answer key before asking them the question.
P Show someone else before asking them. Give
them a model to shadow.
P Ask them to “keep you company” while you do it
first.
 How to “set up” a person for success

P Don’t look for unsuccessful independence.

P Look for successful acceptance of and dependence

on external structures.

P Look for independent functioning within these

external structures.
Nathan E. Ory, M.A. © 2010
Challenging Behavior Analysis and Consultation, Ltd.
543 Marine View
Cobble Hill, BC
V0R 1L1
Canada

phone: (250) 743-1667

http://www.psychologists.bc.ca/pro/nathanory

challengingbehavior@shaw.ca

“Working with people with challenging behaviors: A guide

for maintaining positive relationships” 2nd edition 2007

www.fasdconnections.ca
www.autismtodayory.com