Severe Dysfunctional Behaviour

I have been away for the last couple of weeks and during this time I have been involved with a difference of opinion in the public policy journal, Pearls and Irritations regarding what constitutes students with dysfunctional behaviour.  The dispute was about whether or not children with dysfunctional and severely disruptive behaviours attended private schools.  I’m sure you know me well enough to understand my opinion on this issue.  However, it has caused me to reflect on expressions of behaviour and I want to share my thoughts with you.

 

Dysfunctional behaviour is recently been considered a disability and using the old NSW Education Department’s classification it could be considered as mild, moderate or severe.  This assumes that behaviour is on a continuum.  This is a thought-provoking characteristic of behaviour and something I am not yet comfortable with but I have no alternative that satisfies any definition I would use.

 

Most commonly, behaviour is categorised by its expression against an expected norm.  In a classroom we expect a student to pay attention, follow teacher’s instructions and do their best cooperating with their peers.  If they are a little inattentive, talk out of turn, etc. we might describe them as mildly dysfunctional.  If they scream obscenities, throw chairs and hit other students we could consider them severely dysfunctional and, yes, these students exist!  I accept that this appears to be a continuum.

 

To consider if behaviour is on a continuum we must examine its purpose.  I hold that the reason we behave, from functional to extremely dysfunctional is to address the deficits in our homeostatic equilibrium. Below is a quick reminder of the philosophy that underpins my work:

• We are driven to survive and reproduce, we are just like every other living species. 
• When we are in an environment that satisfies all our needs we are in equilibrium.
• When we are not in equilibrium we become stressed and this drives the behaviour for change.

In simple terms how we behave predominantly depends on:

• Early childhood learning.
• The health of our brain.

It is these last two factors that determines the severity of the child’s dysfunction.

 

There are plenty of previous Newsletters that discuss abuse, trauma and neglect and the impact these have on children (there is a sample of references at the end of this Newsletter) and, to summarise these result in:

• A clash of environments, that is a child is raised in a dysfunctional household, relative to society norms and develops behaviours that are functional in the home but clash at school.
• They are so neglected their brain misses normal developmental opportunities and have a deficit.
• They are continually abused to a level that the constant elevated stress levels inflicts permanent brain damage.

You have seen the illustration of an extremely neglected and abused child below many times but it is worth repeating.

These changes in their brain are real and not present in ‘normal’ children.  The question I struggle with is does everyone’s brain have a continuum of damage or is there a critical point where cognitive control is lost?

 

In any case, how we intervene as teachers will differ.  Children even if they have mild behaviour disability have access to reasoning and are reasonably resilient when they are somewhat challenged.  This is why the existing interventions based on cognitive restructuring or the positive behaviour interventions used in schools and elsewhere are reasonably effective.  These kids have enough control of their internal environment.

 

However, children with a cognitive structure as outlined above have a very different relationship with their internal world particularly how it relates to the external environment.  The use of cognitive interventions, etc. is ineffective and teachers of these children need other approaches to manage their behaviour.

 

To deal with these students we need to accept that they have become that way because of the environment they were exposed to in early childhood.  The only way to get them to make any real change is to present an environment that lets them develop new pathways between what they do and what happens to them.  Over a period of time they can develop new neurological pathways that generate functional pathways, of course depending on the environment the school presents. 

 

The illustration above shows the interaction between a child’s internal and external environment.  Mental health professionals are trained to deal with their internal world, teachers are most definitely not.  The emergence of trauma-based interventions are risky in the hands of non-professionals and they can be damaging.

 

What the environment requires is:

• Structure – when a child behaves in an appropriate way they get an appropriate consequence.  Conversely, if they act inappropriately they get an undesired consequence.  This does not need to be severe but consistent and persistent so new behaviours can be learned.
• Expectations – It is wrong to assume the students know what to do.  Students need to know how to behave to get their needs met.  For severely dysfunctional kids this is not easy and expectations should be explicit.  There a good social skill training programs available that can be used for this.
• Relationships – This is the key and, as the only professional adult in the room this is the teachers responsibly.  Creating a relationship with some of these students is an extreme challenge but it can be done.  The key is to have a 100% acceptance of the child understanding that their behaviour is a result of some adult abusing them and 100% rejection of inappropriate behaviour.

These three qualities may sound simple but they require a special, courageous person that will consistently hang-in for the time required.

 

So, I have to conclude that I am no wiser in regards to whether or not the functioning of behaviour is on a continuum but I’m confident that the types of interventions are not.  However, what I do know is any school or teacher who presents the type of environment outlined above will provide all their students with a sense of security and belonging.

 

Newsletters dealing with neglect and abuse:

• Newsletter 24. The Impact of Neglect                                                - 09/12/2017
• Newsletter 26 - Characteristics of the Abused Child                          - 09/26/2017
• Newsletter 28 - Physical Damage from Early Childhood Abuse          - 11/06/2017
• Newsletter 53 - Dysfunctional Behaviour to Deal with Stress            - 07/02/2018
• Newsletter 59 - The Impact of Poverty and Neglect                           - 08/20/2018
• Newsletter 121 – Trauma and the Environment                                 - 11/05/2020
• Newsletter 129.  Damage to the Brain                                                - 07/13/2020
• Newsletter 133.  Physical Damage from Early Childhood Abuse        - 08/10/2020
• Newsletter 165. Hidden Types of Abuse                                             - 06/16/2021
• Newsletter 189.  The Early Years and Dysfunctional Behaviour         - 02/15/2022
• Newsletter 192. Early Childhood Trauma                                           - 03/08/2022