Understanding “Leaky Brakes” - Edmonton Chapter · 2020-03-22 · Child Concern: You tell your...
Transcript of Understanding “Leaky Brakes” - Edmonton Chapter · 2020-03-22 · Child Concern: You tell your...
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CHILD & PARENT
RESOURCE INSTITUTE CPRI MINISTRY OF CHILDREN
AND YOUTH SERVICES
Understanding “Leaky Brakes”: Navigating Neurological Storms Becky Richards, Community Behaviour Consultant (CPRI)
Jenna Koning, Community Behaviour Consultant (CPRI) 1
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Who are we? Services
We provide highly specialized,
trauma-informed mental health
and developmental services:
Assessment
Consultation
Treatment
Research
Education
Our services are:
Accessible
Inclusive
Culturally-sensitive
Individualized
Evidence-informed
Our mission is to support
children and youth with complex
mental health or developmental
challenges in reaching their full
potential and enhancing their
quality of life.
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
A Multidiscipline Team including;
Becky
Richards Community Behaviour
Consultant
Jenna Koning Community
Behaviour
Consultant
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Road Trip!!
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Road Trip!!
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Road Trip!!
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Road Trip!!
UH –OH!!!!
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You’re careless
You should have stopped
You don’t care about anyone but yourself
You’re a reckless driver.
You don’t abide by the rules of the road.
I’m a good person
I tried really hard to stop
My brakes didn’t work
I’m not reckless
I’m a good driver.
I’m smart, I know the rules .
I S
AY
, BU
T …
.. TH
EY S
AY
……
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Now imagine you had to drive around in a car that had leaky brakes ALL
the time.
Wouldn’t YOU be frustrated?
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CHILD & PARENT
RESOURCE INSTITUTE CPRI ‘Leaky Brakes’
Leaky Brake over attention +/or impulsivity (ADHD)
Leaky Brakes over thoughts (OCD)
Leaky Brakes over movements & sounds (TICS)
Leaky Brakes over behaviour (ODD, CD, Rage)
Leaky Brakes over senses (Sensory Integration Disorder)
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
11
Notes on Tics & Other Leaky Brakes
Tics
•relatively common
•tend to be at their worst between ages 10-12
•It’s hard (if not impossible) to “hold in” tics
What is sometimes more disruptive
•ADHD – 50%,
•OCD – 30 to 40%
•Sensory Difficulties, Disruptive Behaviours, Rage, Learning Disabilities, Mood, Anxiety
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
• Cries
• Swears
• Throws Things
• Out of Control
• Bad Kid
• Unmotivated
• Not Liked
• A huge PAIN!
Meet Johnny *
*fictional representation for illustrative purposes
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Why would a
child do poorly
if they had the
skills to do
well?
Lazy Child
Poor
Parenting
“If he just tried harder, things would get better…
He could do well if he wanted to”
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Conventional View
Could there be another explanation?
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Is it because of poor parenting, lazy child behaviour
or
Could there be another explanation? Kids do well if they can
(NOT if they want to!)
Your explanation
of the behaviour
guides your
intervention
A Different View
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Be A Detective : Figure out why your child is not
doing well…
WHY WOULD A KID HANDLE A SITUATION POORLY IF
THEY HAD THE SKILLS TO HANDLE IT WELL?
Understand and Learn about your child’s:
‘Leaky Brakes’ - described by Dr. B. Duncan McKinlay
‘Pathways & Triggers’ - described by Dr. Ross Greene
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
Skill Deficit Model - Dr. Ross Greene, PhD.
Another explanation?
Flexibility/Adaptability
Change in routine
Difficulty shifting
Meeting new people
Trying new food
Frustration Tolerance
Accepting change
Having to wait
Sharing
Surprises
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Lagging Skills
Solve the equation:
2cos2(x + π/6) – 3 sin (π /3- x) + 1 = 0
I’ll give you $100.00
I’ll take away your car
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CHILD & PARENT
RESOURCE INSTITUTE CPRI ‘Leaky Brakes’
Leaky Brake over attention +/or impulsivity (ADHD)
Leaky Brakes over thoughts (OCD)
Leaky Brakes over movements & sounds (TICS)
Leaky Brakes over behaviour (ODD, CD, Rage)
Leaky Brakes over senses (Sensory Integration Disorder)
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CHILD & PARENT
RESOURCE INSTITUTE CPRI ‘Pathways’
Executive Functioning Skills
Cognitive Functioning Skills
Language Processing Skills
Emotion Regulation Skills
Social Skills
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Why focus on Leaky Brakes and Pathways?
Skill deficits drive explosive
behaviours
Accommodation and training
required
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
Meet Your
Frustration Beaker
• Everyone has one
• They are all the same size
• Everyone reacts poorly when it is full
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© B. Duncan McKinlay, 1998-2001
+ blame and
shame + more stress
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
Beaker Check-In
• Show how full your
beaker is
• How are you doing right
now?
Key chain
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
What fills your Beaker?
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CHILD & PARENT
RESOURCE INSTITUTE CPRI How do you know your beaker is filling?
Early Warning Signs
Eyebrows pull together Face turns red
Feel tense Start sweating
Talk fast Cry
Funny feeling in stomach Raise voice
Break things
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
What empties your beaker?
Plus Many More Examples
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
What happens if my beaker looks like this?
Detour Pass
• Learning a new skill
• NOT a consequence
• Create a detour room/space
What empties your beaker?
Detours
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
CPRI Brake Shop
SENSORY ITEMS
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
Relaxation Strategies
Some New Things about an Old Approach
• Why is this strategy useful for youth with TS? (Tics, OCD,
Rage)
• Why is this strategy useful for cheerleaders? (Lower your
beaker, decrease your stress, modelling)
• How would I use this strategy? (Scripts, CD’s, breathing
triangle, creating the right environment)
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
Beaker check-ins, beaker key chains
Sensory Items
Detours
Relaxation Strategies
Individualized Education Plan
But WAIT…….
Teacher Concerns:
•We don’t have unlimited resources
• It’s Not fair to others
• They’ll rely too heavily on these resources
• Reward non-compliance?
This SOUNDS RIDCULOUS!!!!”
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Learning Disability (Skill Deficit) Philosophy?
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
Frustration Beaker Related Resources
• http://www.leakybrakes.ca
• Leaky Brake Tool Box
• Membership Cards
• Relaxation
• ‘Give Em a Brake Cards’
• Stickers
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36
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Collaborative & Proactive Solutions (CPS)
An approach to helping children/youth with behavioural
challenges developed by Dr. Ross Greene, Psychologist.
Our work in Brake Shop has been influenced by the CPS
model and the following information should be considered
an overview. To gain understanding, support, proficiency
in using this model, please refer to the resources
attached to this document for further information.
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Does CPS actually work?
Outcomes
Reduction
• Teacher Stress
• Discipline referrals
• Restraints, suspensions
• ADHD and ODD symptoms (6-10 weeks, outpatient family therapy, Sweden ,Ollendick, 2011)
Increased
•Perception of Control
•Management of Behaviour
• Improvement for CPS vs. Parent Management (Greene et al., 2004)
•Teacher confidence
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
PROBLEM SOLVING -
There have always been ways of approaching a problem or an
unmet expectation…
1. Solving the problem, “MY WAY”
2. Working it out WITH the other person
3. DROPPING IT for now
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Problem Solving Style A = ADULT
A =ADULT WAY Approach
• Authoritarianism: Adult imposes will
• Can sound like “No”, “Because I said so”….
• Use for extreme safety concerns
Whose beaker does this approach fill?
Does this approach teach children the skills they are
having difficulty with (e.g., frustration tolerance)?
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Problem Solving Style C = CHILD
C = The Drop it Approach • Permissiveness: • Adult removes/reduces expectations (even temporarily)
• Adult giving in to try and prevent a rage
Whose beaker does this approach fill?
Does this approach teach children the skills they are
having difficulty with (e.g., frustration tolerance)?
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
The Flip Flopper
Back and forth between A and C approaches Inconsistent Not predictable to TS+ children/youth
BUT …
Our Kids STRIVE on Predictability & Structure
• Helps make transitions easier • Puts fewer demands on working memory • They don’t HAVE to remember anymore –
the consequences become automatic
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
Basket A & C
in Action
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
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CHILD & PARENT
RESOURCE INSTITUTE CPRI Problem Solving Style B = BOTH
B = Solve Together Approach • Adult & Child problem solve together
• Adult & Child concerns are discussed
• Solution meets both needs
Whose beaker does this approach fill?
Does this approach teach children the skills they are
having difficulty with (e.g., frustration tolerance)?
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Collaborative & Proactive Solutions – CPS
A (ADULT)
Make child do it (“because I said so”)
Doesn’t teach thinking skills
Fills Child’s Beaker
B (BOTH)
Solve the problem together
Helps teach thinking skills
Decreases Beaker Levels for Everyone
C (CHILD)
Make parent do it (“I don’t want to”)
Doesn’t build thinking skills
Fills Adult’s Beaker
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
The Basket B Steps (EPI)
Empathy • I’ve noticed that…. • “What’s up?” – Get Child’s concern on table • Reflective listening… “I hear that …” • IMPORTANT: Solution Free Zone!
Problem Definition • Adult’s Concern: “The thing is….” • IMPORTANT: Solution Free Zone!
Invitation • Summarize concerns • Brainstorm solutions (encourage youth ideas) • Choose a solution that is WIN/WIN: doable, realistic,
mutually satisfying
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Step 1: Empathy
IMPORTANT: Solution Free Zone!
Purpose: Gather info. about youth concern & perspective
How to begin: “I’ve noticed that”.. , Or “It look’s like..” , “what sucks about..” (Focus: problem to be solved!!!)
“What’s up?” – Get Child’s concern on table
Are these good examples of ways to begin CPS? A. I’ve noticed you swear to staff and are disrespectful. B. I’ve noticed you want food lots when it is not mealtime. C. I’ve noticed you don’t want to take your medications lately.
BUT….
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Step 1 : Empathy (Continued)
…What happens if you get stuck
(“I dunno”, “Nothing”, or the dreaded silence, etc.)
How to continue (detective work for getting unstuck):
Fishing Strategies – attempts for further details/explanation
Clarifying Questions (e.g., Why? I don’t understand)
Educated Guessing (e.g., Mind if I take a guess)
Reflective Listening (e.g., I hear you saying…)
Reassurance (e.g., You are not in trouble)
IMPORTANT: Solution Free Zone!
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Empathy: Fishing Strategies CLARIFYING QUESTIONS EDUCATED GUESSING
REFLECTIVE LISTENING REASSURANCE
Why ? Play 20
?’s
Can you
tell me
more
about this?
Mind if I
take a
guess?
Let me
know if I’m
getting
warm Am I right
that….?
You are not
in trouble
I’m not
saying you
can’t.
Your idea
is
important.
Mmm, that
sounds
frustrating
Sounds
like you
are saying
Let’s see if
I have this
straight…
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52
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Step 2: Problem Definition
Purpose: Clarify Cheerleader concern or perspective
How to begin: • “The thing is” or “My concern is”
• “What’s important to me is”
IMPORTANT: Solution Free Zone!
Move on when you have both (yours & youth) CONCERNS on the table
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Step 3: Invitation
Purpose: Brainstorm solutions together
How to begin: • Recap concerns
• “I wonder if there is a way….”
How to continue: • Give youth first chance to generate solutions (“Any ideas”)
• Encourage creativity, Don’t judge, if no ideas – try to work together
• Once potential list, review to find 1 solution that is a WIN-WIN, Realistic, and Do-able Solution for both parties
End Product Goal: Mutually Satisfactory Solution
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WHAT “B” YOUR CONCERN
*
Activity
Purpose: Recognize that the same situation can elicit
very different solutions. This is why it is so important to
spend time on the empathy step fishing for the concern.
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What “B” Your Concern ?
Situation: On the way to SMG last week you said, “I want pizza”.
Parent Invitation: Discussing it later, your cheerleader says, “What’s Up?”
Child Concern: You tell your Cheerleader, _________________________________
A B C
“We don’t have time, we’re
going to SMG”.
Cheerleader drives to Pizza,
Pizza and buys a pizza right
away.
Cheerleader ignores
comment.
Cheerleader sure, whatever
you want, honey!
Cheerleader says No. Your wish is my command,
whatever you want my little
angel.
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
A Few More Important Points …
Proactive vs. Emergency Plan B
• This can be tough! • Don’t have to do all 3 steps in 1 session
• Breaks can help
• Worksheet can help
• Use other strategies to problem solve (e.g. hot/cold for concern)
• Skills Training (Individualized Education Plan) • Expressing concerns
• Taking other people’s perspectives
• Generating Ideas, Problem Solving
• Flexible Thinking
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
58
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
59
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What is a detour pass and how do you use it?
What does EPI stand for?
What does basket A stand for? Whose beaker fills?
Which basket teaches skills?
What 3 things are we learning about our beaker?
What does basket C stand for? Whose beaker fills?
1
2
3
5
6
4
Empty My Beaker Game
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
Collaborative & Proactive Solutions (CPS)
Resources http://www.leakybrakes.ca – Go to Self Management Group Page http://www.livesinthebalance.org http://www.thinkkids.org The Explosive Child, Understanding and Helping Easily Frustrated, “Chronically Inflexible" Children, author Ross W. Greene, PhD., 2005 Treating Explosive Kids, authors Ross W. Greene, PhD., Stuart Ablon, PhD., 2006 Lost At School, author Ross W. Greene, PhD., 2008
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CHILD & PARENT
RESOURCE INSTITUTE CPRI
Your New Toolbox of Resources
• Beaker Check-ins (How full is it?)
• Noticing when your beaker is filling
• Ways to empty your beaker
(Detours, Relaxation)
• Different problem solving approach
(Basket B Approach)
* All material in this presentation is used in accordance with Fair Dealing for educational purposes. All copyrighted material is property of the copyright holder