Navigating Behavioral Challenges: Understanding Disruptive Behavior Disorder

January 8, 2018
Two people engaged in conversation in a office

Disruptive behavior, whether in children or adults, can threaten the safety of an environment and the well-being of the individuals within it. It poses immediate and long-term risks to the individual exhibiting that behavior and their bystanders. It can include defiance, overt verbal or physical aggression or threats, passive-aggressive or covert behaviors, intimidation, or escalation into physical aggression. It may be the product of a clinical disorder or an expression of stress or trauma, but whatever its roots, adverse outcomes stemming from displays of challenging behavior can be addressed safely and positively through effective crisis intervention training.
Developing an informed awareness of behavior can help providers, caregivers, administrators, educators, paraprofessionals, and even peers take safe steps to constructively and proactively cope. At CPI, we’ve spent nearly 40 years studying the roots of behavior and training individuals to respond to it in ways that support the Care, Welfare, Safety, and Security of all people. We’ve documented a broad range of positive outcomes that result from pairing evidence-based strategies with a nonviolent, person-centered approach.

Manage Disruptive Behavior in Children—Positive Supports, Safer Interventions

CPI Meritorious Instructor and Milwaukee Public Schools Lead Instructor Maria Navone says of managing behavior in children, “While I believe that there should be consequences for actions that disrupt a safe learning environment, my experience is that consequences only make a difference when we first—and foremost—address what’s causing the behavior.”
Disruptive behaviors in children may be rooted in the trauma of adverse childhood experiences, they may be fueled by environmental factors such as school climate, or they may be co-existing disorders that accompany a diagnosis of a neurodevelopmental disorder such as attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). Understanding these behaviors can be challenging, and intervening to redirect them can seem daunting for even the most experienced professional. So it becomes critical to implement consistent staff training in nonviolent interventions that reduce the need for restraint and seclusion, and keep the focus on a supportive educational environment.
From how a teacher arranges their classroom to the volume and cadence of a paraprofessional’s voice, there are ways of proactively addressing a challenging behavior that can serve to prevent it or lessen its detriment to children and the staff who care for them. “Kids behave in all kinds of ways for all kinds of reasons, and effective behavior intervention has to be individualized to meet their circumstances and their needs,” says PBIS expert Cyndi Pitonyak.
In her interview with CPI, counselor and child behavior expert Signe Whitson observed, “One of the things I really like is that instead of this being an in-your-face, authoritarian type of approach that breaks a person down, benign confrontation builds a person up by strengthening the relationship, by increasing self-awareness, by modeling skills for assertive anger expression, and by helping kids find areas of competence. So, I can tell you with all honesty, it’s a strategy I use regularly with my students.”
While in some cases clinical modes of treatment may address aspects of a child’s behavior, it’s crucial for adults to be trained in the best ways to support the children in their care, so that adverse outcomes are minimized or prevented. A team approach provides the consistent support and limit setting that can help children overcome behavioral struggles, and compliments formal treatments for children who are dealing with neurodevelopmental diagnoses that may increase their likelihood of exhibiting such behavior.

5 CPI Resources for Safely Addressing Disruptive Behavior in Children:
Secrets From a Behavior Intervention Pro
When Life Deals Kids a Handful of ACEs
Making Sense of School Climate
Putting PBIS to Work in the Real World
5 Ways to Take a Supportive Stance in Your Classroom

Safely Address Challenging Behavior in Adults—Peaceful Spaces, Nonviolent Strategies

A similarly supportive approach is critical for safely intervening when adults display disruptive behavior. It’s important to address it in a safe, person-centered way. CPI Global Professional Instructor Dan Lonigro has observed that, “Crisis behavior is ‘needy’ behavior. Please meet my needs. This will have a calming effect on me. In most every case, people act out because their needs are not being met or their needs are being threatened in some way.” Understanding that behavior impacts behavior and effective mediation of challenging behavior in adults requires us to recognize we can’t control what other people do, but we can control what we do.
Behavior in adults can have distinct Precipitating Factors that aren’t always immediately apparent—that’s where trauma-informed care can help de-escalate individuals safely and constructively, and help prevent future incidents. This deeper understanding of common causes of Anxiety behaviors can help you set limits effectively, while keeping a calm awareness of your verbal and nonverbal actions. Training empowers staff to accurately gauge the likelihood and severity of a possible escalation. Says CPI training consultant Matt Danek: “When thinking about decision making, it’s important to think about the process in terms of a much larger picture, rather than as solely the decision of whether to use the last-resort tool of physical intervention. If we only begin the decision-making process at the third level of a crisis, we are likely to have missed several opportunities to decelerate the behaviors of the individual in crisis.”
With training, you can not only confidently intervene in a crisis, but you can significantly reduce the likelihood of one occurring at your organization. One case manager reported that implementing crisis prevention training at their government agency led to significant reductions (50% or more) in challenging behaviors, use of force, and compensation claims. At another facility, the administrator reported a reduction in injuries, staff turnover, and liability, in addition to the reduction they tracked in disruptive behavior. Training empowers staff to succeed, deepens positive engagement in their roles, and enriches the effectiveness and safety of the organizations and populations they serve.

2 CPI Resources for Safely Addressing Disruptive Behavior in Adults:
Team Intervention Strategies
CPI’s Top 10 De-Escalation Tips

Facilitate Positive Behaviors in Adults with Dementia—Person-Centered, Abilities-Based

“It’s hard to imagine a life of well-being borne out of seeds of negativity. So our paradigm and our language must shift. I believe our elders who have been diagnosed with dementia have many remaining abilities that must be seen and capitalized upon,” writes president and founder of Dementia Care Specialists, Kim Warchol, OTR/L. And as the baby boomer generation grows older, the urgency for meaningful care for individuals with Alzheimer’s or related dementia diagnoses only increases. The Alzheimer’s Association advises that when it comes to the treatment of behavioral and psychotic symptoms of dementia (BPSD), restraint therapies and pharmacologic approaches should be avoided.
Behavior is just as critical a form of communication at this stage of life as any other. A dementia diagnosis adds a layer of complexity to understanding and constructively responding to challenging behavior, but the strategies are similar—looking for the triggers to a particular behavior is still critical. Dementia does not negate the presence of Precipitating Factors that can cause an individual to display a certain type of behavior, but it does require a more specialized, thoughtful approach in the intervention process.
The training of caregivers, the design of living environments, the prescription of medications, and the application of supportive therapies all require a person-centered perspective that focuses on the abilities that still remain. With this type of approach, it becomes possible to constructively cope with disruptive behavior in adults with dementia while supporting their well-being.

Practical Changes Can Make Our World Safer—It’s Critical to Implement Training Now

No matter where you work or what population of individuals you serve, training is the secret ingredient to effectively preventing disruptive behavior or safely intervening when it is not preventable. When you visit our Results page, you’ll see measurably positive outcomes in fields that span from health care to education to law enforcement and many, many types of orgs in between—serious improvements in Care, Welfare, Safety, and Securitythat were achieved because the staff committed to training and working as a team.
Understanding challenging behaviors is just the beginning of a bigger conversation about creating safer environments for children and adults around our world. We’re at a crossroads in our culture where incivility and institutional violence have left profound scars on our perception of crisis and how to cope with it. It can feel as if the demands of this moment in time require us to grow numb to trauma, keep our heads down, and focus on thickening our skins.
But that’s not how it has to be. Each of us has the potential, no matter what we do for a living, to build a culture in which a nonviolent, person-centered approach to handling crisis is the best practice. An organization of any size can be a powerful agent of this change, because one trained staff member may positively impact countless patients, students, or clients when they utilize their expertise to de-escalate disruptive behavior.
We’re all capable of coming together to facilitate safer environments on a global scale. But this can only be achieved if you commit to implementing practical training locally—with your staff, right where you work. If you can see the need to safely address disruptive behavior, there’s no time to be lost. It is possible to reduce the risks of harm and prevent challenging behavior—it’s up to you to start the conversation.

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