How to Improve Communication Using Strategies from Positive Behavior Support
Maddie has an 8-year-old daughter, Sara, diagnosed with Cerebral Palsy and Intellectual Disability. Sara is generally a happy little girl, however sometimes she has trouble communicating and becomes frustrated when Maddie cannot understand her. When this happens she usually hits herself on her legs and sometimes this causes bruising. One day, Sara guides Maddie to a colouring book. Maddie thinks she wants to colour. Maddie brings out some crayons and guides Sara to the living room to color. Sara then runs away from the living room into her room and hits her head against a wall repeatedly. Maddie tries to soothe Sara, but this only makes her more upset.
Many parents with a special needs child have likely encountered a scenario much like this one. Sara is having barriers communicating her wants and needs, and this is hindering her quality of life. It’s likely having an effect on Maddie as well because she wants to help her child as much as possible.
Positive Behaviour Support (PBS) aims to increase a person and family’s quality of life. One key element of quality of life is the ability for children to communicate their wants and needs and for families to be able to understand and support these needs.
Sometimes young people, especially where people have a disability, struggle to communicate clearly and independently and this results in behaviours that are experienced as challenging. In previous issues of PSN, we have discussed how all challenging behaviour communicates important information and how PBS aims to understand the communicative message behind challenging behaviour to support the person to communicate in a way that is easy and effective. If a person is unable to communicate clearly, it can lead to situations like what is happening with Maddie and
Sara. Every human needs a way to communicate their wants and needs. Some children learn that challenging behavior acts as communication to get their needs met. Other children may become frustrated if they try to communicate and it’s not working. In this article, we will focus on how children use challenging behavior to communicate and how PBS can help teach them other ways to communicate that are not as dangerous.
If you want to feel what’s it’s like to have people not understand you when it’s really urgent, try playing the board game ‘Pictionary’. Remember the frustration in that moment when your game partner is not able to understand that wonderfully clear picture you have just drawn (but are not allowed to speak about). Imagine that frustration every day. This is the experience of many young people with a disability who are unable to get their message across.
Key communication messages are sometimes ‘I want’ or ‘I don’t want’ messages but also include ‘I need help’, ‘I need a break’, ‘I want choice’ or ‘Spend time with me’. In order to understand if your child is using challenging behaviors to communicate, you must evaluate or assess the circumstances around the behavior.
An assessment of challenging situations will give important clues to the specific message(s) a child is trying to communicate. One way will be to look at what we are doing before our children begin to escalate.
Some questions you can ask yourself are:
- Did I ask my child a question or to do something?
- Are there any items or activities my child usually wants are around, but not available?
- Has my child has been doing an activity alone or I’ve been busy with something else for some time?
The answer to either of these questions will help parents better understand what their child is attempting to communicate. Once we understand the message, we can teach alternative ways to communicate. This is called functional communication.
When we teach a communication skill, especially one that replaces a challenging behavior it is important that we provide every support to promote success.
Here’s a checklist that helps to support families to notice, respond to and encourage communication.
The communication message should be important from the person’s point of view, meeting their needs and wants
The communication act (speech, sign, visual, etc.) should be easy for the child to understand how to do and easy to do immediately (e.g., any materials are always at hand)
The communication message should be easy for other people to understand and then responded to quickly, positively, and consistently
Parents should set up varied opportunities for communication to encourage communication across days, communication partners and in different settings
Parents can use different technologies to support their child in communicating their wants and needs
Unfortunately, even when we know what communication message to teach, it is at this step that our strategies often fail, but why?
Sometimes we teach a message that is convenient for us and not for the person. Sometimes the message is too difficult to communicate – perhaps we rely on verbal communication which a person struggles to use well when they are overwhelmed or we insist on ‘please’ and ‘thank you’ at the expense of the core message. Sometimes we teach only in specific situations which does not encourage the person to communicate whenever and wherever it is important to them. Sometimes we fail to respond to the communication, even when it is used appropriately (perhaps we are busy or frustrated).
Here’s one example:
One child’s picture communication board at school was never used by the student. On inspection of the board, the only pictures made available were of academic work – no wonder the student didn’t use the picture board – who among us would communicate if all we could do is keep asking for more work!
Sometimes we will need to go back to the drawing board, and that’s okay. Teaching someone to communicate is a complex thing and can take a lot of work from multiple people. In order for us to be more effective in teaching our children this critical skill, another strategy is to be collaborative. This can mean working with multiple types of providers for support including teachers or therapists. The cliché “it takes a village” is used for a reason, and parents of children with special needs may need more people in their circle of supports. Within this nurturing environment, we hope to see communication blossom. In order to see it continue, it’s important to have communication tools for multiple people and settings (e.g., home and school).
Going back to our story, we find that Sara wanted to use her new special markers that Maddie bought her the weekend before. Maddie didn’t know this. She originally didn’t provide these because she wanted to wait for an upcoming party. Once Sara calmed down, Maddie asked Sara to show her what she wanted, and Sara was able to communicate by holding her mom’s hand and placing it on the markers. Maddie provided the markers which taught Sara that if she guides her mom that way again, it might be easier for her to get what she needs.
It’s important to remember to maintain the strategies that are working as well. This can help our children continue to grow in their journey to communicate for themselves.
Holly Downs is the Director of Ethical Compliance at [PBS Corp] (https://www.teampbs.com/). and an instructor at Capella University. She is a certified behavior analyst with over a decade of experience in various populations.