Neurologically-Based Neurologically-Based Behaviour: Chapter 3 Behaviour: Chapter 3

ExplainedExplained

Prepared by Ellen Young, Prepared by Ellen Young, Krista Heisinger Frost, and Krista Heisinger Frost, and

Michelle HancockMichelle Hancock

What is Neurologically-What is Neurologically-Based Behaviour (NBB)?Based Behaviour (NBB)?

• NBB is behaviour that results from NBB is behaviour that results from cerebral processes occurring in an cerebral processes occurring in an abnormal manner that results in abnormal manner that results in information not being processed correctly information not being processed correctly in the brain. The resulting behaviour is in the brain. The resulting behaviour is challenging, unpredictable, inconsistent challenging, unpredictable, inconsistent and unresponsive to ordinary discipline.and unresponsive to ordinary discipline.

3 Indicators of NBB3 Indicators of NBB

1. Behaviour difficulties - atypical, 1. Behaviour difficulties - atypical, inconsistent, compulsive or immune to inconsistent, compulsive or immune to normal behaviour managementnormal behaviour management

2. Language Difficulties – problems 2. Language Difficulties – problems understanding, processing, and understanding, processing, and expressing information verballyexpressing information verbally

3. Academic Difficulties – memory, fine 3. Academic Difficulties – memory, fine and gross motor skills, comprehension, and gross motor skills, comprehension, language and math skills deficitslanguage and math skills deficits

Common Behaviour Common Behaviour IssuesIssues• High degrees of:High degrees of:

– InattentionInattention– HyperactivityHyperactivity– ImpulsivityImpulsivity– Excess emotionalityExcess emotionality– AnxietyAnxiety– Inconsistent emotional responsesInconsistent emotional responses– Unpredictable intense mood swingsUnpredictable intense mood swings– WithdrawalWithdrawal– Episodes of rageEpisodes of rage

Common Diagnoses Common Diagnoses within NBB:within NBB:

• Brain injuriesBrain injuries• Attention-Deficit Attention-Deficit

Hyperactivity Hyperactivity Disorder Disorder

• Oppositional Oppositional Defiant DisorderDefiant Disorder

• Bipolar DisorderBipolar Disorder

• Anxiety DisordersAnxiety Disorders• Fetal Alcohol Fetal Alcohol

Spectrum DisorderSpectrum Disorder• Sensory Integration Sensory Integration

DysfunctionDysfunction• Autism Spectrum Autism Spectrum

DisorderDisorder• Learning Learning

DisabilitiesDisabilities

Misguided AssumptionsMisguided Assumptions• Discipline and classroom management models Discipline and classroom management models

typically “rely on the assumption that students typically “rely on the assumption that students are cognitively, neurologically, and socially are cognitively, neurologically, and socially capable, equal, and motivated to do well” capable, equal, and motivated to do well”

• This may not be the case for students with NBB This may not be the case for students with NBB due to possible:due to possible:– organic neurological differences and organic neurological differences and

executive functioning deficits that affect their executive functioning deficits that affect their ability to recognize cause and effectability to recognize cause and effect

– Learning disabilities that have impacted Learning disabilities that have impacted academic and social skill developmentacademic and social skill development

– Differing values and life experiencesDiffering values and life experiences

Sensory Overload and Sensory Overload and NBB BehaviourNBB Behaviour

• In classrooms that are exciting and In classrooms that are exciting and stimulating, students with NBB can stimulating, students with NBB can experience sensory overload, resulting experience sensory overload, resulting in unusual behaviours.in unusual behaviours.

• The student with NBB sees his/her The student with NBB sees his/her behaviour as completely behaviour as completely appropriate/logical at the time it occurs appropriate/logical at the time it occurs due to their misperceptions of internal due to their misperceptions of internal and external environmental influences.and external environmental influences.

Behaviour ResponsesBehaviour Responses

• Processes in the brain (varying from Processes in the brain (varying from chemical imbalance, congenital brain chemical imbalance, congenital brain differences, brain injuries or diseases, or differences, brain injuries or diseases, or undiagnosed brain differences) activate the undiagnosed brain differences) activate the brain’s brain’s fight/flight/freeze responsefight/flight/freeze response. .

• This response is designed to ensure This response is designed to ensure survivalsurvival

• ““Extreme behaviour is self-protective… not Extreme behaviour is self-protective… not always wilful or planned,” (31)always wilful or planned,” (31)

• videovideo

To Understand how To Understand how to Approach NBB to Approach NBB

You have to You have to Understand the Understand the

Brain Brain

The Brain: 3 layersThe Brain: 3 layers

• Survival brain Survival brain (reptilian brain): (reptilian brain): bottombottom

• Function: ensure Function: ensure survival, controls survival, controls heart rate, blood heart rate, blood pressure, and other pressure, and other bodily functionsbodily functions

• Governs fight or Governs fight or flight responseflight response

Emotional brain (limbic Emotional brain (limbic system)system)

• Midbrain believed Midbrain believed to be the area of to be the area of emotional arousalemotional arousal

• Includes Includes hippocampus hippocampus (which stores (which stores painful/emotional painful/emotional memories) and memories) and amygdala (senses amygdala (senses danger/threats to danger/threats to survival)survival)

The AmygdalaThe Amygdala

• Reads the Reads the environment environment (including visual (including visual facial cues of others facial cues of others and auditory cues and auditory cues such as tone of such as tone of voice), then acts to voice), then acts to protect the organism protect the organism by triggering the by triggering the fight/flight response. fight/flight response.

Amygdala Hijack - it can happen to everyone

The Logical BrainThe Logical Brain

• Neocortex:Neocortex: does not fully develop does not fully develop until late teens/early 20’suntil late teens/early 20’s

• Governs language, decision-makingGoverns language, decision-making

What does this mean for What does this mean for educators?educators?

• Paula Cook believes the reason that Paula Cook believes the reason that behaviour management strategies such behaviour management strategies such as token economies, restitution, and as token economies, restitution, and behaviour modification don’t work for behaviour modification don’t work for students with NBB is that they work students with NBB is that they work from the “top down”from the “top down”

• → → start with the logical area of the start with the logical area of the brain (neocortex) which can’t be brain (neocortex) which can’t be engaged until the mid-brain (limbic engaged until the mid-brain (limbic system) calms down system) calms down

NBB Model of SupportNBB Model of Support• Attempts to provide behaviour support from Attempts to provide behaviour support from

the bottom and mid-brain, working up to the the bottom and mid-brain, working up to the logical brain, by adding language, social logical brain, by adding language, social skills and socially appropriate behaviourskills and socially appropriate behaviour

• Approach involves: environmental Approach involves: environmental modification, body awareness, somatic modification, body awareness, somatic understanding, calming techniques, and understanding, calming techniques, and meditation to calm the mid-brainmeditation to calm the mid-brain

• Once calmed: cognitive behaviour therapy, Once calmed: cognitive behaviour therapy, conflict resolution, mediation can be used to conflict resolution, mediation can be used to help students process information correctlyhelp students process information correctly

Somatic UnderstandingSomatic Understanding

• Somatic understanding relates to the Somatic understanding relates to the way in which we can know the world way in which we can know the world through our physical senses. The through our physical senses. The emphasis is on how our body frames emphasis is on how our body frames our engagement with and our engagement with and understanding of the world, starting understanding of the world, starting in our pre-language-using stage of in our pre-language-using stage of childhood, but extending throughout childhood, but extending throughout our lives. our lives.

Be Proactive to Reduce Be Proactive to Reduce NBBNBB

• Establish a positive and nurturing rapportEstablish a positive and nurturing rapport• Make classroom environment sensory Make classroom environment sensory

friendly-reduce clutter, visually pleasingfriendly-reduce clutter, visually pleasing• All time periods should be structured All time periods should be structured

(recess and lunch)(recess and lunch)• Use and teach humourUse and teach humour• Be careful of eye contact and stern voice Be careful of eye contact and stern voice

→ seen as a threat→ seen as a threat• Provide students choices you can live withProvide students choices you can live with

Rage Cycle - Rage Cycle - NotNot Goal Goal OrientedOriented

What to Do when Rage Cycle has What to Do when Rage Cycle has been Triggeredbeen Triggered

• Recognize that you may not be able to stop the Recognize that you may not be able to stop the processprocess

• Look for physiological responses (flushing, Look for physiological responses (flushing, body language)body language)

• Stay Calm: Use non-emotional, direct, and Stay Calm: Use non-emotional, direct, and simple languagesimple language

• Maintain a non-confrontational stance – make Maintain a non-confrontational stance – make sure s/he can see your handssure s/he can see your hands

• Deflect control elsewhere and suggest an Deflect control elsewhere and suggest an alternative behaviour, “Clock says it’s time to alternative behaviour, “Clock says it’s time to clean-up”clean-up”

Escalation: Separate and Escalation: Separate and SuperviseSupervise

• Stay calm – ensure safety of other Stay calm – ensure safety of other students: room clear or move student students: room clear or move student to a quiet space to calm downto a quiet space to calm down

• If student threatens you – walk awayIf student threatens you – walk away• Use short, non-emotional phrasesUse short, non-emotional phrases• Use supportive empathy to Use supportive empathy to

acknowledge student’s feelingsacknowledge student’s feelings• Use logical persuasion to provide an Use logical persuasion to provide an

alternativealternative

Rage/MeltdownRage/Meltdown

• Allow physical manifestationsAllow physical manifestations• Restrain only if safety is an issueRestrain only if safety is an issue• Do not question or talk student out Do not question or talk student out

of rageof rage• Support others in the room to Support others in the room to

understand what is happening or understand what is happening or room clearroom clear

Post-RagePost-Rage

• Reassure the student that s/he will be all-Reassure the student that s/he will be all-rightright

• Once calm, put language to the eventOnce calm, put language to the event• Strategize with student to find a better Strategize with student to find a better

way to cope for next time → go to sensory way to cope for next time → go to sensory refuge and remain until calm, using words refuge and remain until calm, using words to get what you wantto get what you want

• Take care of yourself, document Take care of yourself, document (especially possible triggers), debrief with (especially possible triggers), debrief with othersothers

Paula Cook’s NBB Model Paula Cook’s NBB Model of Supportof Support

ATTITUDEATTITUDE

• Begin with your Begin with your attitudeattitude

• Continuously reflect Continuously reflect on your service on your service delivery and delivery and professional roleprofessional role

SENSORY SENSORY INTEGRATIONINTEGRATION

• Be aware, plan, and Be aware, plan, and teach strategies to teach strategies to address implications address implications of possible skewed of possible skewed sensory systemssensory systems

ENVIRONMENTENVIRONMENT

• Behaviour is Behaviour is reciprocalreciprocal

• Be aware of and Be aware of and consider home, school, consider home, school, community, work, and community, work, and social environmentssocial environments

LANGUAGELANGUAGE

• Remember: Language Remember: Language is often perceived, is often perceived, interpreted, interpreted, comprehended, used, comprehended, used, and understood and understood differently with differently with students with NBBstudents with NBB

DiscussionDiscussion

• Do you think students with NBB Do you think students with NBB choose to rage (Glasser would choose to rage (Glasser would suggest student behaviour is a suggest student behaviour is a choice) and have the capacity to choice) and have the capacity to change their behaviour? Does change their behaviour? Does biology determine our destiny?biology determine our destiny?

DiscussionDiscussion

• Would the most effective approach to Would the most effective approach to reduce episodes of rage look at changing reduce episodes of rage look at changing students’ perceptions of reality in order students’ perceptions of reality in order to reduce their frustration and improve to reduce their frustration and improve their ability to make better choices and their ability to make better choices and increase their self-awareness?increase their self-awareness?

• We would argue that until the student’s We would argue that until the student’s “Internal Distractions” have been dealt “Internal Distractions” have been dealt with, it is very difficult for students to with, it is very difficult for students to succeed at school!succeed at school!

DiscussionDiscussion

• Do you feel adequately trained to Do you feel adequately trained to deal with students with NBB deal with students with NBB behaviour? Do you think your level behaviour? Do you think your level of training affects your of training affects your Attitude?Attitude?

DiscussionDiscussion

• What do you do when a student’s What do you do when a student’s behaviour is extremely disruptive to the behaviour is extremely disruptive to the daily functioning of your classroom? Is daily functioning of your classroom? Is inclusion in the best interests of all inclusion in the best interests of all students with NBB? Are our schools students with NBB? Are our schools meeting their needs?meeting their needs?

• We would argue that students that have We would argue that students that have NBB are the least likely to experience NBB are the least likely to experience academic success and that more support academic success and that more support is required for teachers and students.is required for teachers and students.

Critical FriendCritical FriendYou Can’t Do This Alone!You Can’t Do This Alone!

• Model of support is not a team approach Model of support is not a team approach and doesn’t consider transferring of skills and doesn’t consider transferring of skills from school environment to the from school environment to the Community: Community:

• Circle of Care:Circle of Care:– Where is the support from the clinicians Where is the support from the clinicians

(psychologists, social workers, OT, speech and (psychologists, social workers, OT, speech and language pathologists, reading clinicians), language pathologists, reading clinicians), administration, outside agencies (CFS, Justice, administration, outside agencies (CFS, Justice, Community Mental Health Professionals), Community Mental Health Professionals), familiesfamilies

Critical FriendCritical FriendRole of Child’s Internal EnvironmentRole of Child’s Internal Environment

• Role of Medication: Barkley would argue Role of Medication: Barkley would argue that medication is the most effective way that medication is the most effective way to deal with ADHDto deal with ADHD

• Physical activity to increase the Physical activity to increase the production of endorphins (natural feel-production of endorphins (natural feel-good chemicals)good chemicals)

• Empathetic Listening and Psychological Empathetic Listening and Psychological support – CBT – to learn how support – CBT – to learn how misperceptions affect our thinking and misperceptions affect our thinking and behavingbehaving

Critical FriendCritical FriendLearning New Ways Learning New Ways

• You have to believe the underlying You have to believe the underlying assumption that kids can learn to assumption that kids can learn to change their behaviour, and change their behaviour, and acknowledge that it may take a lot of acknowledge that it may take a lot of time and energy, or else you will time and energy, or else you will likely give up on these kids!likely give up on these kids!

Resources on the WikiResources on the Wiki

• Using Sensory ToolsUsing Sensory Tools• Mental Health GuideMental Health Guide• Disorder Websites ListDisorder Websites List

ReferencesReferences

Cook, P. (2011). How do I recognize and deal with Cook, P. (2011). How do I recognize and deal with atypical behavior that is neurological-based? Charles, atypical behavior that is neurological-based? Charles, C.M. Building classroom discipline. (10th ed.). pp 41-60 C.M. Building classroom discipline. (10th ed.). pp 41-60 . Boston, MA . Pearson Education Inc.. Boston, MA . Pearson Education Inc.

Cook, P. (2009).  An investigation of the sustainability and Cook, P. (2009).  An investigation of the sustainability and practicality of a neurologically based behaviour model practicality of a neurologically based behaviour model of support.. Winnipeg, MB: University of Manitoba.of support.. Winnipeg, MB: University of Manitoba.

Glasser, W. (2011). How does William Glasser Use Choice Glasser, W. (2011). How does William Glasser Use Choice Theory and Quality Education to Establish Class Theory and Quality Education to Establish Class Discipline? Charles, C.M. Building classroom discipline. Discipline? Charles, C.M. Building classroom discipline. (10th ed.). pp. 138-155. Boston, MA: Pearson Education (10th ed.). pp. 138-155. Boston, MA: Pearson Education Inc.Inc.