In this very short article we are going to explore the organic causes of challenging behaviour. We will consider why the destructive behaviours seem so entrenched. We will also consider what the individual gets out of this behaviour.
Don’t we all get challenged by behaviour? Aggressive behaviour, destructive behaviour self harming and non-compliance are all behaviours identified within most definitions of challenging behaviour. The Challenging Behaviour Foundation’s web site http://www.challengingbehaviour.org.uk/ gives a good introduction to these elements of challenging behaviour. If we use these definitions, then challenging behaviour is not just confined to those working in the special needs sector. All parents expect that quite often their children are going to challenge them. Are there any teachers who haven’t faced challenging behaviour? Well if there are it is most likely a very, very small few. Its not just children who challenge, lots of adults in their professions have to face aggressive, abusive and even violent behaviour. It is also not a new experience, so although we often have a more positive view of society in the past life was just as challenging if not more so. This is primarily because aggression and survival went hand in hand. Dealing with challenging behaviour is about understanding and managing millennia of evolutionary development within the brain that has helped us survive. This short article though isn’t intended to provide answers to such a wide ranging issue. It is much more specific and is going to look at why children on the autistic spectrum, children with cognitive issues or emotional issues to name but a few of the labels commonly linked with challenging behaviour, can and do present with such challenging behaviour.
We will all have our own views about what exactly is challenging behaviour but mine is fairly straightforward. Behaviour that challenges us is behaviour that causes stress in the individual themselves, others around them and staff supporting them. Historically challenging behaviour was generally a concern because of the problems it created for staff supporting the individual. Attitudes have changed greatly over the years with a much greater focus upon the effects of challenging behaviour for the individual concerned. Challenging behaviour in all its forms puts them at risk of harm and exclusion, exclusion form their schools, centres, families and community. Our attitudes to support have similarly changed. Previously most strategies revolved around attempts to change the individual’s behaviour, using behaviour modification, rewards, inducements, negative consequences, (punishments) and finally restraint. There is now a greater focus upon supporting the individual to develop skills that will reduce the incidence of the behaviours.
Knowledge and attitudes to challenging behaviour have moved on significantly and recent research identifies the link between between anxiety and sensory issues as a prime cause in challenging behaviour. My personal experience within the field of learning disabilities and supporting those on the autistic spectrum has been strongly influenced by the insight provided by the many individuals on the autistic spectrum. They have given us a greater understanding of the impact of their environment and the individuals around them on their behaviour. They have provided us with an insight into the impact of sensory issues and their responses to the anxiety driven world they inhabit. It is now understood that to effect a real reduction in challenging behaviour there is a need for a high degree of support specifically targeted to help individuals to make sense of their sensory environment. Support should be aimed at reducing the fears that provoke anxieties that trigger the challenging behaviour.
Sensory input and challenging behaviour
Let us begin by examining why there should be a link between our senses and challenging behaviour.
Our sensory system is the end result of evolutionary developments aimed primarily at keeping us alive. Sight, hearing, smell, taste in all living creatures developed to identify danger or to identify resources, food water etc. necessary to keep us alive. The sensory system that achieves this is an incredibly complex system receiving and acting upon billions of neural inputs every second. The brain incredibly manages to regulate all this information, focusing upon important signals and putting those that do not need to be responded to on a back burner so to speak. Without this system the brain would become overloaded and would not be able to prioritize sensory input that threatens us above sensory input that is of no risk. The ability to tune out background sensory input is known as sensory regulation. On occasions we struggle to block out some of these signals and become distracted. People on the autistic spectrum tell us that for them they struggle permanently to block out competing sensory signals. They have sensory regulation problems.
Sensory processing disorder.
Research has identified that in some individuals this regulation function does not work as it should. The individual is unable to focus upon important sensory input and ignore sensory input that is not relevant at that moment in time. The individual is being bombarded with sensory input. The effects are massive on many levels. Remember we use our senses to keep us safe, not being able to focus upon critical elements because we can’t tune out all the background noises will create anxiety.
Not being able to focus upon sensory input from our environment makes it difficult for individuals to make decisions about what is important for our safety. Lack of focus is what leads to anxiety. Anxiety is not simply a state of mind. As stated earlier our senses main role in life are to keep us alive. In many cases the brain needs to react instantly to stand a chance of survival. A section of the brain, ‘the limbic system’, is developed to assist with this role. The limbic system stores memories and can categorise them into those that produced agreeable or disagreeable experiences or effectively, safe, unsafe experiences. For our purposes the most interesting aspect is that the limbic system is responsible for developing and managing aspects of emotion, behaviour and motivation and helps create the brains memories of good or bad experiences. The amygdala, a little almond shaped structure, is the most import section of the limbic system from the behaviour viewpoint. Its role is to link strong sensory stimulus with memory to allow us to respond appropriately to sensory input. It seems to be most strongly linked to danger and thus fear, possibly because dangerous situations have to be reacted to instantaneously. Thus early scary experiences remain fixed in the memory via the amygdala.
To understand the importance of the amygdala in behavioural issues we need to examine its role further. Our emotions, those of fear, happiness, anger, contentment and so on need to be attached to memories associated with those emotions. We have to have experienced happiness, contentment etc. and this memory must be stored before we can experience a situation and respond to it with an appropriate emotion. Some of these experiences can be learnt and not actually experienced to still create an experience such as the knowledge that fire is hot. We do not have to experience being burnt to be afraid of fire but simply need to have been constantly told that fire is dangerous. So with these memories laid down within the limbic system sensory input will attach to the appropriate memory and trigger the hippocampus to respond with an appropriate emotion. The amygdala is the actual trigger within the limbic system that enables the person to respond appropriately to sensory input. It seems to be most strongly linked to danger and thus fear, possibly because dangerous situations have to be reacted to instantaneously. Thus early scary experiences remain fixed in the memory via the amygdala. If sensations that are linked to danger are passed to the amygdala, it gives rise to feelings of fear and anxiety and prepares the body to cope with these dangers.
Fight or flight
The amygdala has the ability to initiate defensive behaviour, which can be aggressive, “fight” or defensive “flight”. It does this by triggering hormones that impact upon the body. Most notably adrenalin, known in the United States as epinephrene. It works by stimulating the heart rate, contracting blood vessels, and dilating air passages, all of which work to increase blood flow to the muscles and oxygen to the lungs. This gives increased ability to run, to fight, it fires up the body.
This would be absolutely essential in a real life or death situation but for many of the individuals whose behaviour challenges their carers, their fears stem from a sensory or cognitive inability to make sense of their surroundings. The amygdala has built up a host of stored memories from anxieties. Or the brain may become overwhelmed by too much sensory input that the individual cannot interpret or social interactions the purpose of which are unclear. Another incident finally overloads the individual’s sensory system raising anxiety to a level where the individual is compelled to react.
So the individual’s body has been flooded with chemicals designed to help us survive and for nearly all of us the first instinct is ‘flight’. For children, we the adults or carers often block this flight, even in schools when all they want to do is hide under tables or in cloakrooms we keep them where we can see them, “for their safety”. The fight ‘build up’ now needs an outlet and still they try to avoid attacking their carers. So the individual directs their response towards their surroundings, they swipe equipment of tables, they throw objects, they tip over furniture. Most of this behaviour is contained by carers or teachers often until they attempt to tear down wall displays, the most hallowed of all artefacts in a classroom. Staff then often feel duty bound to intervene, to pull the child away from this final act of destruction. At this point the child then retaliates, a backward blow with the head, kicking out or turning and pushing.
So a sensory process to preserve life, linked to some organic breakdown in the brain preventing sensory regulation leads for many of the individuals that we work with, to a state of almost permanent anxiety.
In the next section of this article we will look at how we can support the individuals to reduce the anxiety and thus the challenging behaviour.