Behaviours of concern
Challenging Behaviour is any behaviour that is associated with risks to the person or to society and we can provide children and young people and their families with advice and support.
Learning Disability Nursing provide advice and support to children and young people with learning disabilities, their parents/carers and the healthcare and education professionals they rely on.
Children and young people may show challenging behaviours through aggression towards others, such as hitting and kicking, throwing things, running away, hurting themselves, verbal aggression and stereotyped behaviours.
These behaviours may be of such intensity, frequency or duration that they can impact on the safety of the person or others. They can also limit or result in denial of access to community facilities, so that the child and young person can be at risk of social exclusion due to the behaviours they are displaying.
How can we help?
We understand that caring for a child and young person with a learning disability who has challenging behaviour can be a stressful and exhausting time. Everyday activities, such as going to the park or to school, can become difficult when parents are worried their child may get upset or angry with those around them. As such, a good understanding of the underlying reasons for the challenging behaviour across different settings is crucial in planning any intervention for a child and young person with a learning disability who displays challenging behaviour.
Our aim is to work with children and young people and their families to prevent, reduce or stop behaviours which are perceived to be challenging. Our focus is not to change your child and young person, but to improve their support and increase their skills by understanding what factors drive their behaviours. We do this by working with you and drawing on research and knowledge about child development, learning and behavioural theory and emotional development.
Guidance and helpful information
If you feel that you need support to understand and manage your child’s challenging behaviour, you should make an appointment to see their GP to discuss this. The GP may decide to make a request for service to the community Learning Disability Team. The request should include information about services your child is currently involved with or has seen in the past, where this is appropriate. If your child has an EHC plan (Education, Health and Social Care) and/or a single assessment/my pathway plan this should also be provided or referenced as supporting information.
The information we receive will determine if the referral to our service is appropriate to meet your child’s needs. If it is decided that your child does not meet the criteria for our specific service, we might suggest that a request is made to another service.
If your child’s case is accepted, they will go onto a waiting list until you are offered a first appointment. Whilst you are waiting you will be sent a pack containing forms for you to record your child’s behaviours over the next few weeks. During your initial appointment you will be able to describe and discuss the difficulties you are experiencing and how we can support you and/or your child.
Toolkits and Strategies
The following toolkits are available to support you to record behaviours, sleep patterns and other information which will be useful in assessing what the support a child or young person requires:
This toolkit includes basic information and advice on behaviour. The pack will allow you to record information which is useful during a clinic assessment to allow the clinician to assess the help needed.
This includes sleep hygiene information sheets to give you basic advice for promoting healthy sleep patterns. We only support families with severe sleep problems but this information is useful for all families and children. The sheets here allow you to record information on sleep patterns and approaches which will be useful for the clinican when you attend an appointment with us.
This pack includes a basic explanation of techniques which may be useful for a family and help to reduce anxiety.
What happens next?
Once the request for service has been accepted, you will be notified and sent an appointment. We try and see all children within 18 weeks of acceptance onto the waiting list. Where this is not possible, we will write and advise you of the anticipated time frame.
In order to find causes of your child’s behaviour, our team will carry out a detailed assessment of your child and their environment to identify the function, or purpose, of their behaviour.
This assessment involves:
- discussing your child’s difficulties with parents/carers and/or teaching staff;
- discussing the behaviour with your child where appropriate; and
- observing your child at home and school.
You may be asked to record details about your child’s behaviour over a period of time. For example, their environment, the time of day, what happened before the behaviour occurred, who was present and what happened next. This helps our assessment and to gain a better understanding of your child’s behaviour.
When the assessment is complete, the clinician will share an understanding of the function of the challenging behaviour and work with you on a care plan to try to prevent or reduce the behaviours. This can include:
- advice to you, your family and/or school on triggers for behavioural difficulties; and
- strategies that can be used at home and in other settings to support your child, such as structured timetables, symbols and social stories to aid communication.
If appropriate, our team may work with other people who support your child or young person, such as staff at your child’s school or respite centre, to support them in using strategies to promote positive behaviour. We will also work with other health and social care professionals who may be supporting your child, such as Paediatricians, GPs, Occupational Therapists and Social Workers.
Whilst your child is engaged with our service, the clinician will work with you on a targeted goal (episode of care). They will contact you regularly to keep you updated with the assessment process, and will arrange to see you and/or your child or young person through either home visits, school visits and/or clinic appointments. The clinician may offer strategies and/or visual resources to put in place at home and they will regularly check up on your progress. If appropriate, the clinician may participate in one-to-one work with your child.
Once the episode of care is completed we will discharge you from our service. This may sound worrying, but your child may be re-referred whenever new goals are identified and appropriate re-referrals will be discussed by the team.
You can now self-refer your child into this service. For more information please view this guide on how to self refer.
For details of what the service supports and what supporting documentation you require for your referral, please view the request criteria page.
What is the process?
Location of Centres
We will arrange to see you at a location convenient to you or near to your home, which may or may not be listed below. You should not visit the locations below unless we have sent you an appointment and requested that you do. If you need help please contact us using the number on this page.
Lescaze Offices (South Devon) Shinner’s Bridge, Totnes, Devon TQ9 6JE
Springfield Court (North Devon) Roundswell Business Park, Fishleigh Road, Barnstaple EX31 3UD
Capital Court (East) Children and Family Health Devon, 1a Capital Court, Bittern Road, Sowton Industrial Estate, Exeter EX2 7FW