Caregiving for Children with Physically Aggressive Behavior Concerns

95 Pages·2015·4.44 MB·English

Caregiving for Children with
Physically Aggressive Behavior Concerns
Time: 6 hours

Developmental Competencies

CCW201-03 Understands the need to develop plans and procedures to avoid DLR/CPS
involvement; knows how to identify and seek services and supports available in the event of
a CPS allegation.
CCW201-05 Has the knowledge to distinguish between urgent questions or needs, critical
incidents and emergencies and seek appropriate assistance (CA, police, fire, ambulance).
CCW202-02 Understand the value of effective communication and engagement with the
child welfare team.
CCW204-03 Knows to listen and validate when a child discloses information related to
CA/N; understands the need to report information to intake and social worker; knows to
not conduct child interviews.
CFAM231-03 Understands and recognizes effects of poverty, trauma, and maltreatment and
to identify resultant developmental delays.
CFAM232-01 Understands the need to identify and seek services, supports or training
available to develop the skills needed to support and help to heal the emotional trauma of
children in care.
CFAM234-01 Knows how to encourage everyone in the home be respectful; how to provide
appropriate nurturing and empathy to children.
CFAM234-02 Understands how to provide structure and predictability for a child who has
been maltreated.
CFAM234-05 Understands when children are emotionally distressed and knows to respond
with a focus of care, attention and skill building.
CFAM234-07 Understands the importance of and need for a high level of supervision in the
caregiving home.
CFAM234-08 Understands the need to: teach children to manage and deescalate anger;
teach skills to express emotions in ways that are respectful and healthy.
CFAM234-09 Understands the skills necessary to address crisis/severe behavior problems in
the home: knows ways to de-escalate dangerous situations and keep everyone in the home
safe; follows agency policy on nonphysical restraint of children in care.
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CFAM234-10 Knows and understands the influences/triggers on a child’s behavior including:
developmental challenges, behavioral emotional challenges, past abuse, neglect,
separation, and placement.
CFAM235-01 Understands the effect on the family of being a care provider.
CFAM239-02 Understands the skills necessary to provide care to children who have special
needs: developmentally delayed, or emotional and/or behavioral issues.
CFAM239-07 Understands the need to teach children to manage and de-escalate anger;
teach skills to express emotions in ways that are respectful and healthy.
CSELF281-01 Understands the need to seek, receive and understand all relevant placement
information prior to accepting placement of a child in the caregivers home.

Tal king about Competencies
Thi s 6 hour in-service training for caregivers provides a foundation for caregiving and behavior
man agement for children in out-of-home care who struggle with physically aggressive behaviors.
Participants will explore the potential impacts of trauma and maltreatment on attachment, behavior and

development as well as the risk factors for violent behavior in children. Participants will closely

review the newest Washington Administrative Code (WAC) related to discipline and will contrast

principles of positive discipline and punishment. Skill building will focus on creating a plan to prevent

a crisis; the various forms aggression may take and how to look for signs of when a child is agitated or

escalating; how to intervene during a crisis; and how to manage ongoing or explosive aggressive
beh aviors via teaching coping skills and Collaborative Problem Solving. Local resources and supports
for the youth as well as the caregiver are discussed.

Materials and Preparation

• Computer with Internet connection
• Projector
• Flip chart paper or dry erase board

Handouts and Resources

• Handout – Discipline in Foster Care - WAC 388-148-1615
• Handout – Characteristics of Positive Discipline vs Punishment
• Handout – The Four Levels of Agitation

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Session Flow

Step Delivery Method Time
1 Welcome and Introductions Group Discussion 10 mins
Part 1: Laying the Foundation – Review/Refresher of Lecture, Group Discussion,
2 40 mins
Fundamental Information Handouts, Activities
Lecture, Group Discussion,
3 Part 2: Understanding Anger and Aggression 40 mins
Handouts, Activities
Lecture, Group Discussion, 3 hour
4 Part 3: Managing Physically Aggressive Behavior
Handouts, Activities 15 mins
Lecture, Group Discussion,
5 Part 4: Resources: You Are Not In This Alone 30 mins
Handouts, Activities
Lecture, Group Discussion,
6 Part 5: Self Care 30 mins
Handouts, Activities
7 Closing Group Discussion 15 mins

Classroom Training
Slide 1

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Slide 2
Slide 3
Parts of this training were used with permission and in collaboration with the Child Welfare
Training Institute at the University of Southern Maine based in part on the training Parenting
Physically Aggressive Children and Youth.
Thank you! to the many Social Workers and Child Welfare Professionals for their contributions.
For more information, please contact:
University of Southern Maine
Muskie School of Public Service
Child Welfare Training Institute
295 Water Street, Augusta, Maine 04330
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Slides 4, 5 and 6

The Alliance’s trainings are competency based. Please take a moment to review the
competencies associated with this training.

You can also review the full list of training competencies at the Alliance website:
http://allianceforchildwelfare.org
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Slide 7

Read the slide. Stress that they will leave today with skills, ideas, and principles that will help
them to manage Physically Aggressive Behavior.

Slide 8

A few housekeeping items before we begin:
• RESPECT – today’s training is going to cover a sensitive topic: children struggling with
physically aggressive behaviors.
• In today’s training, we will commonly refer to “children who struggle with Physically
Aggressive Behaviors” rather than “Physically Aggressive Youth” or “Physically
Assaultive Youth” or the combined term of “Physically Aggressive/Assaultive Youth”.
• It is important to know the majority of children who struggle with physically
aggressive behaviors do not receive the full assessment as being “Physically
Aggressive/Assaultive Youth”
• ***Unless you have confirmed your child has this assessment, it is best to
avoid using the PAY/PAAY term***
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• While “Physically Aggressive Youth” is an official assessment and term, we want
to be careful not to encourage caregivers to treat children as if their assessment,
diagnosis, or behavior is all that they are.
• It is important to respect the child, youth, or person is struggling to manage their
behaviors
• The purpose of todays training is to help educate caregivers to support the children and
youth in their care, while also meeting their specialized needs
A few OTHER housekeeping items:
• Restrooms are here
• We will take breaks
• If you are interested in taking more training on Child Caregiving for Children with
Physically Aggressive Behaviors, and many other topics, check out the Alliance website
at http://allianceforchildwelfare.org

Slide 9

• Confidentiality is important. Information shared today which relates to a participant,
his/her family, or specific children in care needs to stay in this room. The one exception
to confidentiality relates to information about child abuse or neglect which has not yet
been reported to Child Protective Services.
• Instructor and participants share responsibility for a positive learning experience.
• We try to adapt the training to the learning goals of each audience, so let us know how
we can best meet your needs.
• Active participation is encouraged, and will make the day much more enjoyable.
Extraverts are encouraged to share “air time” with those who are quieter.
• We try to stay on task. Discussion is highly valued in our trainings. However, questions
and comments that fall outside of the training topic may be deferred to later part of the
training, the expertise of other participants, or to another resource.
• We respect the diverse opinions and experiences of people in the room.
• Participants should feel comfortable to take care of their physical and emotional needs.

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Cautions/Assumptions: Some kids need more
This curriculum is intended for caregivers of children and youth who have the cognitive skills to
engage in some problem solving and interaction with adults. We have included some resources
for those working with younger children and children who have not yet developed the cognitive
skills to engage in some of the problem-solving techniques we will be discussing.

Slide 10

Part 1 - Before we begin to look at physically aggressive children and youth, we’ll review some
fundamental concepts – trauma, development, attachment – as they impact behavior.

We will also consider Washington State’s Policy on discipline, and compare Positive Discipline
and Punishment.

Finally, we will review what to do if by chance you ever respond inappropriately to your child’s
behavior.

Slide 11

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For today’s training, we will define trauma as: “an intensely distressing event in which a child
believes that he/she or a loved one is in imminent danger of death of serious bodily harm.
During the event, the child experiences intense fear, terror, and helplessness.”

Ask the group: How might the experience of trauma be different for children versus adults?

Probe/listen for:
• Children have less ability to make sense of the experience.
• Children are less able to physically defend themselves or escape from the situation.
• Children lack adult coping skills.
• Children are highly impressionable – emotionally and mentally.
• Abuse is all the children know, so they aren’t aware that they deserve better treatment.
• Children tend to blame themselves.

Slide 12

Let’s consider the specific impacts of these traumatizing experiences. Much of the following
material is from the work of Dr. Bruce Perry, one of the leading researchers in the area of
childhood trauma and brain development.
Perry found that, as with adults, trauma elicits two primary types of immediate responses in
children:
• Hyperarousal: The child becomes hypervigilent and fearful, ready to scope out and
defend against other threats in the environment. Heart and respiratory rates increase
dramatically. Behavior is extremely reactive and anxious. Both “flight” and “fight”
responses are possible.
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• Dissociation: The child mentally withdraws from the outside world, and appears to be in
a daydreaming type of state. Heart and respiratory rates slow down. The child is
compliant when instructed by adults. In some instances, the child will faint. The child
loses track of time and has little or no memory of what has occurred.
Perry did find some gender and personality factors that are associated with one response type
or the other. However, he was careful to say that most people react with a mixture of
hyperarousal and dissociation, usually first displaying the symptoms of hyperarousal, and then
with increased threat, moving higher along the hyperarousal continuum until dissociation kicks
in, providing an escape from the intensity of the situation.
Slide 13

In addition to our immediate reactions to traumatic events, most people experience symptoms
after the event and they are out of harm’s way. These symptoms are what we call “post-
traumatic stress”. In children, symptoms of post-traumatic stress include:
Re-experiencing
• The child appears to be re-experiencing past traumatic events, both during waking
hours and while asleep
• The child engages in repetitive play that mimics a traumatic event
• The child expresses that he can’t get a thought or image out of his/her mind
• The child’s drawings are full of violent images, monsters, images of the child holding a
weapon, wearing protective gear, etc.
Arousal
• Chronic nervousness about everything and everyone around him/her
• Irritability
• Startles easily
• Disorganized and agitated behavior
• Phobias
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