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““Problem” Problem” behaviourbehaviour

In relation with autism

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Topics:Topics:

Problem behaviorProblem behavior

Team processes/conflictsTeam processes/conflicts

Elderly peopleElderly people

Efficiency in the healthcareEfficiency in the healthcare

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Rini BlankersRini Blankers:: nurse, manager, trainer, coachnurse, manager, trainer, coach

Blankers-Hage Blankers-Hage v.o.f.v.o.f.The NetherlandsThe Netherlands

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What is problem What is problem behavior?behavior?

In a general wayIn a general way

We talk about problem behavior when the behaviour of one person or a group persons disturb an activity, and the behavior is difficult to change

But there is more…

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Trias of Wing in Trias of Wing in combination with problem combination with problem behaviourbehaviour

We can talk about 3 groups:We can talk about 3 groups:

• AloofAloof

• PassivePassive

• Active-but-oddActive-but-odd

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Individual differencesIndividual differences

• IntellectIntellect

• SpeakingSpeaking

• Level of being active (passive of Level of being active (passive of active)active)

• Personality and temperament Personality and temperament

• Age Age

• Fluctuation of autismFluctuation of autism

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Courses of problem Courses of problem behaviourbehaviour

• FearFear

• Physical painPhysical pain

• Overestimating (of themselves) Overestimating (of themselves)

• Unexpected changes Unexpected changes

• BoredomBoredom

• ThreateningThreatening

• Hypersensitive (hearing/feeling) Hypersensitive (hearing/feeling)

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Visible behaviourVisible behaviour

• Compulsive Compulsive • AggressionAggression -To other ones-To other ones -To themselves (automutilation) -To themselves (automutilation) • Doing the same thing (stereotype)Doing the same thing (stereotype)• Withdrawn (aloof)Withdrawn (aloof)

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Non visual behaviourNon visual behaviour

• Don’t understand the Don’t understand the surrounding/environment surrounding/environment

• Problems with communicationProblems with communication

• Problems with social contactsProblems with social contacts

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Why?Why?

• Contact and communication problemsContact and communication problems

• Fears because of changes in the Fears because of changes in the surrounding surrounding

• Context blindnessContext blindness

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Problem behaviour is Problem behaviour is used for: used for:

• Making something clear Making something clear (communication) (communication)

• Showing the feelings of Showing the feelings of

-fear -fear

-Angriness-Angriness

-Panic-Panic• Showing the feelings of autismShowing the feelings of autism

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Autistic clients have problems Autistic clients have problems with sense information with sense information Making combinations is difficult, Making combinations is difficult, and sometimes they make wrong and sometimes they make wrong combinationscombinations

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Context Context blindnessblindness

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Specific and non specific Specific and non specific problem behaviourproblem behaviour• Specific: (in the autist)Specific: (in the autist) Direct related to autism for example:Direct related to autism for example: Resistance of changes and close Resistance of changes and close

themselves for stimuli themselves for stimuli

• Non specific (surrounding) Non specific (surrounding) not direct related to autism but related not direct related to autism but related

to how an autistic is standing in life. to how an autistic is standing in life.

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Attitude guider/parentAttitude guider/parent

• ConsequentConsequent

• Prepare (pro-active)Prepare (pro-active)

• Prevent problem behavior: use Prevent problem behavior: use simple languishsimple languish

• Don’t think its manipulative behaviorDon’t think its manipulative behavior

• Don’t go to far into the situation Don’t go to far into the situation (carry away)(carry away)

• Be creative in the structure!Be creative in the structure!www.blankers-hage.nl

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TreatmentTreatment• Look to the surrounding: is there Look to the surrounding: is there

structure, good communication?structure, good communication?

• Is there specific problem behavior?Is there specific problem behavior?

• Obsessive compulsive behavior:Obsessive compulsive behavior:

-Rules -Rules

-Alternatives-Alternatives

-Use as a reward -Use as a reward

-give them borders-give them borders

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StructureStructure

• Stimuli Stimuli reduction reduction (protection of stimuli)(protection of stimuli)• StimuliStimuli selection selection (witch stimuli you give (witch stimuli you give

and witch not)and witch not)• Stimuli Stimuli regulationregulation (making the stimuli (making the stimuli

predictable: a drill makes a lot of noise) predictable: a drill makes a lot of noise) • StimuliStimuli intensity intensity (bigger photo’s, (bigger photo’s,

visualization)visualization)• StimuliStimuli expand expand (to learn new things in a (to learn new things in a

right way) right way)

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The best long term effect The best long term effect you can have, is when you can have, is when you have investigate the you have investigate the function of problem function of problem behavior!behavior!

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QuestionsQuestions??

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Thank you very much for your Thank you very much for your attention!attention!

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