3.1 - behavior management

communication

behavior = _____________

dysregulation

_______________ may look like refusal, shutdown, avoidance, impulsivity, aggression, elopement, poor motor planning, clumsiness, and fatigue

• state regulation

• sensory input/reduction

• physical comfort, pain, fatigue

• predictability

• autonomy/control

when a child shows dysregulated behavior, what are the 5 possible needs that aren’t being meant

learning

regulation comes before ____________

• therapist tone, pacing, facial affect, proximity (close)

• session structure

• embedded regulation (warmups, breaks - jumping in a ball pit)

what are 3 ways you could regulate PT sessions to keep the child calm

A - antecedent

which part of the ABC framework:

Environment, task demands, transition timing, fatigue, pain, medical factors, and emotional load

B - Behavior

which part of the ABC framework:

Refusal/shutdown, aggression, elopement, crying/emotional dysregulation, and attention-seeking behaviors

C - Consequence

which part of the ABC framework:

Does behavior end the task? Increase attention? Reduce demand?

positive reinforcement

(positive or negative) (reinforcement or punishment) increases the target behavior by adding something desirable

negative reinforcement

(positive or negative) (reinforcement or punishment) increases the target behavior by taking away something aversive

positive punishment

(positive or negative) (reinforcement or punishment) involves the addition of an aversive stimulus to decrease behavior

negative punishment

(positive or negative) (reinforcement or punishment) involves the removal of a desirable stimulus to decrease behavior

• intrinsic

• extrinsic

what are the 2 types of motivation

intrinsic

___________ motivation is doing something because it is PERSONALLY rewarding

extrinsic

____________ motivation is doing something to EARN a reward or avoid punishment

• quiet sleep

• active sleep

• drowsiness

• quiet alert

• active alert

what are the 5 behavioral states of an infant

• eyes = closed

• breathing = regular

• movement = no

• crying = no

during the quiet sleep behavioral state, describe what is happening in the following:

• eyes

• breathing

• movement

• crying

• eyes = closed

• breathing = irregular

• movement = small

• crying = no

during the active sleep behavioral state, describe what is happening in the following:

• eyes

• breathing

• movement

• crying

• eyes = open/closed

• breathing = regular

• movement = small

• crying = no

during the drowsiness behavioral state, describe what is happening in the following:

• eyes

• breathing

• movement

• crying

• eyes = open

• breathing = irregular

• movement = gross

• crying = no

during the quiet alert behavioral state, describe what is happening in the following:

• eyes

• breathing

• movement

• crying

• eyes = open/closed

• breathing = irregular

• movement = gross

• crying = yes

during the active alert behavioral state, describe what is happening in the following:

• eyes

• breathing

• movement

• crying

quiet alert

the ___________ behavioral state is the ideal state we want to see the child for PT

• peak of crying

• unexpected

• resists soothing

• pain-like face

• long lasting

• evening

what does PURPLE stand for

period

the word _____________ means that the crying has a beginning and an end

2; 3-5

keeping “PURPLE” in mind, peak crying would be most expected at ____________ age and then less at __________ age

• swaddle

• side/stomach position

• shush

• swing

• suck

what are the 5 S’s to use to regulate PURPLE response

• refusal/shutdown

• elopement

• crying/emotional dysregulation

• attention-seeking behaviors

• aggression (hitting, throwing, biting)

what are the 5 common challenging behaviors

no

avoid saying ___________ to support child autonomy

• protective positioning

• maintain calm demeanor

• give physical space

• create a space for the patient to vent big emotions

• express understanding when patient is ready

5 tips for de-escalation

A - antecedent

which ABC is this an example of:

Verbal cue to stop preferred scooter activity & transition to obstacle course

B - behavior

which ABC is this an example of:

Crying, dropping to the floor, refusing to move

C - consequence

which ABC is this an example of:

Visual schedule reviewed, 30 second countdown provided, child transitioned with minA