Managing Severe Challenging Behavior in the Home during the COVID-19 Crisis
April 10, 2020
Children and adults who routinely engage in severe challenging behavior typically require treatment and care from a team of professionals and trained caregivers. During this time, as we are mandated to socially distance to prevent the spread of COVID-19, the teams that support families are not as easily available to provide in-person services and the level of support and safety that is needed. Due to these restrictions, many families are on their own with little or no day-to-day assistance or guidance.
The focus for these families right now should be to maintain the safety of their children and everyone else in the family while trying to minimize the chances of inadvertently reinforcing the challenging behavior. If your child has an effective behavior plan that can be successfully used in the home setting, then families should continue to implement the plan as written. If there are concerns with the plan or the plan needs to ultimately be improved, consult with your behavior analyst about ways to create a safer environment during this time while avoiding additional assessments or plan revisions that could evoke existing or new challenging behaviors.
To aid in the discussion with your behavior analyst, here are some proactive strategies that can be used to prevent challenging behavior from occurring:
- Reinforcers – Make sure that you have enough of your child’s reinforcers to last through the coming weeks. You may also want to consider increasing the frequency of the current reinforcement schedule or just delivering the reinforcers non-contingently throughout the day at a higher frequency.
- Preferred activities – This is not a time to add additional or unfamiliar demands to your child’s schedule. Consider modifying your child’s schedule to increase the number of preferred activities throughout the day while maintaining variation.
- Home modifications – Consider making some modifications within your home to create more space in existing rooms, removing or taking down items that can easily break, and situating furniture in front of windows. These temporary changes can easily prevent a behavioral outburst from becoming a medical incident.
- Create a safe/calm space – Designating a room or a space within a room for your child to deescalate can prevent an outburst from becoming a full-blown crisis. Design this space so that your child can be there without the need of someone right by their side while also decreasing the chance of them hurting themselves.
Here are some additional safety strategies to consider in case the challenging behavior does occur:
- Protective equipment – Protective equipment is a key component to increase the odds of keeping everyone safe during a behavioral outburst or crisis. Martial arts blocking pads and body protection are probably the best equipment that you can have but couch cushions, pillows, gardening kneeling pads, and other soft, cushiony items will also work well. Whatever protective equipment you do have, make sure that you spread it out across the house so that it is always readily available, and you don’t have to leave the area to go get it.
- Personal apparel – Give some thought to the clothes and accessories that you and your family members wear each day. Avoid wearing jewelry, clothing, or any accessories that have loose and hanging pieces that can easily be grabbed. If you have long hair, you may want to consider wearing it up or having a hair band easily accessible. Durable and comfortable clothing like sweatpants, sweatshirts, and denim are good options along with having hats available to protect against hair pulling.
- Safety plan – Your family should create a safety plan that outlines some steps that everyone can follow in the case of a behavioral crisis. This plan should incorporate many of the items listed above along with trying to ensure that there are always at least two family members in the home to support each other if a crisis occurs along with consideration given to keeping younger and older family members safe.
- Coronavirus Share and Care Forum (National Council for Severe Autism)
- WEBINAR: Temporary Strategies for Avoiding or Reducing Problem Behavior in the Home Setting (Garden Academy)
We are experiencing an unprecedented moment in history and for a family with a child with severe challenging behavior, the circumstances are that much more difficult and dangerous. The primary goal for families is to keep everyone as safe as possible and to avoid any need for medical attention, considering the current situation in our hospitals. Of course, if 911 needs to be called, do not hesitate. Hopefully, the suggestions above can help families prepare for and potentially avoid a behavioral crisis and allow everyone to feel safe during this time.
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