How Functional Behavioural Assessment can Help Save the Child from Self-Inflicted Injuries - Essay Example

Behavioural Issues in Special Education: How Functional Behavioural Assessment can help save the child from self-inflected injuries There are many children with special needs in our society today. Many of these children with special needs come from homes that are less than suitable for children. In some cases, these children have suffered some physical and psychological trauma that compounded the effects of their disabilities and make them behave in a self-injurious manner. In a report issues by the U.S. Department of Education, it was reported that in the school year 2000-2001, about 473,663 children and youth who are suffering from emotional disturbances were given special education and other related services in the public schools all over the country [Department of Education, Twenty-fourth Annual Report to Congress]. Many of these children that are given special education are very disturbed and prone to inflicting harm against themselves. According to Fox, C & Hawton, K, self-injury does not really mean that the person wants to commit suicide but rather, a person who cuts or inflicts intentional harm upon himself or herself is hoping to relieve some of tension or emotional pain1 or just simply to manifest his or her frustrations over something. In the case of children with disabilities, their inability to communicate to others can be very frustrating. In most cases, these children express their frustrations by inflicting self-harm and to get the attention that they need. The failure on the part of the adult present to recognize the silent please of the child with disability can make the situation even worst. The child may continue to inflict upon herself or herself until such time when he or she gets what he or she needs. Schoeder, Mulich and Rojahn classified the Self-injurious behaviour (SIB) into two namely, the social and the non-social act. The social SIB often takes place in the social setting and was directly self-injurious such as head banging, self-biting, self-scratching, gouging, pinching and hair pulling [Weiss, 129-143]. Social SIB can happen frequently and may be associated with other forms of behaviour problems. On the other hand, the Non-Social SIB happens less frequently but may tend to inflict more harm upon the child. Non-social SIB can be manifested through stuffing orifices, mouthing, sucking, rumination, ingestion of faeces, excessive fluid intake and ingestion of air [Weiss, 129-143]. In extreme instances, the injuries inflicted by the child upon himself or herself are so serious that it requires hospitalisation for a few days. Self-injurious behaviour (SIB) in children with learning disabilities and autism is one of the critical problems that confront our education institutions today. SIB is a type of behaviour that is often “highly repetitive and rhythmic” (Fee and Matson p. 4) and it could inflict some serious harm to the child who is displaying such behaviour. In most cases, the behaviour appears without really any deliberate intent on the part of the child to cause self-harm. About 53% of children ages 4-5 who are affected with autism are reported to display chronic SIB [Poutstka and Lisch 69-73]. These children are still in there pr-school years. However, studies showed that SIB is not exclusive to children who are suffering from autism nor does is it limited to children of pre-school age. Reports have showed that children with other types of disabilities including those children, who are mentally disturbed, such as those who are suffering from schizophrenia, also manifest this disturbing behaviour at home and in school [Turner, 839-849]. How should the school authorities and teachers deal with children who are suffering from SIB? The issues surrounding SIB among children with disabilities are addressed by the promulgation of the Individuals with Disabilities Education Act 1997 (IDEA 1997). This Act provides for the protection of the rights of people, especially children, with special needs. In the Code of Federal Regulations, children with emotional and psychological problems are defined as those children that exhibits one of more of the following characteristics: having learning inability which defies “intellectual, sensory, or health factors” [Code of Federal Regulations Title 34, Section 300.7(c)(4)(i)(a)], those who are unable to create “satisfactory interpersonal relationships with peers and teachers” [Code of Federal Regulations Title 34, Section 300.7(c)(4)(i)(b)], those that display undue actions and behaviours “under normal circumstances” [Code of Federal Regulations Title 34, Section 300.7(c)(4)(i)(c)], those children which have are chronically unhappy or depressed [Code of Federal Regulations Title 34, Section 300.7(c)(4)(i)(d)] and those children that displays tendencies to develop fears and other disturbing symptoms which can be directly or indirectly connected with “personal or school problems” [Code of Federal Regulations Title 34, Section 300.7(c)(4)(i) (e)]. In IDEA 1997, the government prescribes Functional Behavioural Assessment (FBA) for children that are exhibiting behaviours that hinder the process of learning. The FBA is designed to pre-empt any untoward behaviour of children in special education that may be injurious to the child and to the people around him or her [Thomas p. 5; Skiba et al, pp. 24-25]. In an effort to prevent self-injuries behaviour of school children with disabilities, the Government issued “Guidance on Functional Behavioural Assessments for Students with Disabilities” in 1988. This document defined what the Functional Behavioural Assessment is all about. It talks of about FBA being a means to determine why the student is acting the way he or she is and how his or her actions are affecting the environment around him or her. This type of assessment is not new in the field of education. In fact, as early as 1957, Boring was already talking about functional psychology saying that this type of assessment is "more interested in the future than the past…" (Boring p. 551). In a more recent study, Quinn et al. defined FBA as the various techniques and strategies of diagnosing the causes of behaviour in order to come up with appropriate modes and schemes of interventions [Quinn et al, p. 3]. According this study, the FBA must cover the “biological, social, affective, and environmental factors” [Quinn et al., pp. 3-4]. On the other hand, Skiba et al. believes that the FBA is should be geared towards gathering information that will help educators and parents to understand the behaviour of a child in a learning institution. By understanding the behaviour of the child, the teacher will mostly be able to connect with the child better inside the classroom. Furthermore, the teacher will be able to identify the points of adjustments that must be done to moderate if not control the otherwise self-destructive behaviour of the child (Skiba et al, p. 24). For instance, is the child is known to be prone to self-scratching and self-biting when he or she could not get what he or she wants or he or she does not have the attention of the teacher, the teacher can prevent this destructive behaviour by positive reinforcement such as giving him or her easy access to the things that he or she needs and by paying extra attention to the child {Mace et al, pp. 122-152]. Consequently, the use of functional assessment helps the educational institution to address behavioural problem of the child and prevent the occurrence of self-inflicted harm. By giving the special education teacher some ideas on what may trigger a violent reaction from the child, the teacher is able to prevent such act by diverting the attention of the child. Furthermore, the assessment could help the teacher notice the early signs of distress that are specific to a child with disability under class. For instance, an agitated child may start by sucking his or her thumb but as the stimulus is continually fed on her or him, he or she may graduate from the thumb sucking stage to the finger biting or the hear banging state. If the teacher is alerted to the early signs of frustration on the part of the child with disability, there is a big chance that the situation will not escalate to another stage. Many causes mortality and morbidity among children with self-injurious behaviour can be prevented. Since teachers come in contact with their students daily, they are in the best position to observe the emotional and psychological state of their students. However, a common issue in the special education in the country nowadays is that many teachers often feel overwhelmed by the myriad of information that they get regarding their student’s mental and emotional state. Miller, et al, suggested that when the child manifest multiple psychological problems during the FBA, it is important to conduct a separate assessment on each of the perceived behavioural disorders. Since different types of disorders may need to be address differently, it is advisable to delve into the very nature and cause of such behaviour. Since one child may manifest more than one type of behavioural disorder, teacher and the people involved in the care and education of the child, will need to address these disorders separately. To help the child with disabilities, teachers handling special education classes must be properly trained to deal with different situations. In the United States, most if not all the teachers handling special education classes in the country are well trained. Unfortunately, since the FBA often yields very complex and often multiple behavioural problems which are caused by equally complex situations and factors. Often times, the magnitude of the emotional and psychological problem “exceeds the bounds of deductive abilities for most professionals” (Haynes, p. 13 also cited in Miller, J. A., Tansy, M., & Hughes, T. L.). Since teachers are forced to confront a number of situations at the same time, there is a possibility that the teacher handing special education classes will become overwhelmed by all the information. The issue of information overload is something that we should take lightly. We must always bear in mind that dealing with children with disabilities can be very challenging. The institution of problem-solving teams or multi-disciplinary teams can help solve the problem of SIB. In schools, the collective effort of the teachers, the school administrators, the social workers, the school psychologists and the parents is essential to help prevent self-injurious behaviour among school children. The creation of problem solving teams is very important and is considered by the National Association of School Psychologists as one of the best ways to deal with complex situations. By conducting child study meetings, the problem solving teams may be able to take a closer look into the underlying problems of the child and seek specific solutions to that problem. The major challenge of these problem-solving teams now is to create a system that they can use to implement the best alternative treatments for children with SIB. Having a road map that could serve, as a guide to the teams on how to make an assessment of the problem and select the best alternative options can be very helpful is address child behaviour issues in special education classes. References: 1. Boring, E. G. (1957). A history of experimental psychology (2nd ed.). New York: Appleton-Century-Crofts. 2. Fee, V.E. & Matson, J.L. (1992) Definition, classification and taxonomy. In. J.K. Luiselli, J.L. Matson and N.N. Singh (eds), Self-Injurious Behaviour: Analysis, assessment and Treatment (pp. 3-20) New York: Springer-Verlag. 3. Fox, C & Hawton, K (2004) Deliberate Self-Harm in Adolescence, London: Jessica Kingsley Sometimes its nice to see that it is me hurting, instead of somebody else". Jonathan Weiss Self- 4. Haynes, S. N. (1998). The changing nature of behavioural assessment. In A. S. Bellack & M. Hersen (Eds.), Behavioural assessment: A practical handbook (4th ed., pp. 1-21). Boston: Allyn & Bacon. 5. Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1982). Toward a functional analysis of self-injury. Analysis and Intervention in Developmental Disabilities, 2, 3-20. 6. Jonathan Weiss. Injurious Behaviour in Autism: A Literature Review http://www.oadd.org/publications/journal/issues/vol9no2/v9n2download/art12Weiss.pdf 7. Mace, F.C., Lalli, J.S. & Shea, M.C. (1994) Functional analysis and treatment of self-injury. In J.K. Luiselle, J.L. Matson, & N.N. Singh (eds) Self-injurious behaviour: Analysis, assessment and treatment (pp. 122-152) New York: Springer-Verlag 8. Poustka, F. & Lisch, S. (1993) Autistic behaviour domains and their relation to self-injurious behaviour. Acta Paedopsyciatrica , 56, 69-73 9. Quinn, M. M., Gable, R. A., Rutherford, R. B., Nelson, C. M., & Howell, K. W. (1998). Addressing student problem behaviour: An IEP teams introduction to functional behavioural assessment and behaviour intervention plans (2nd ed.). Washington, DC: The Center for Effective Collaboration and Practice. 10. Schoeder, Mulich and Rojahn (1980) Social and Non-Social Self-Injurious Behaviour Classification 11. Skiba, R., Waldron, N., Bahamonde, C., & Michalek, D. (1998). A four-step model for functional behavioural assessment. Communique, 26, 24-25. 12. Smith, Carolyn (2006). Cutting it Out: a journey through psychotherapy and self-harm. Jessica Kingsley Publishers 13. Thomas, A. (1997). Functional assessment--not something new. Communique, 26, 5. 14. Turner M. (1999) Annotation: Repetitive behaviour in autism: A review of psychological research. Journal of Child Psychology and Psychiatry, 40960, 839-849 15. U.S. Department of Education, (2002) Twenty-fourth Annual Report to Congress,). 16. Whitlock, J.L., Eckenrode, J.E. & Silverman, D. (2006). The epidemiology of self-injurious behavior in a college population. Pediatrics, 117(6). Read More