11/07/2012

Problem behavior is more than just behavior: learning to see it from a disabled person's point of view

While reading a handbook on traumatic brain injury by the National Association of State Head Injury Administrators (NASHIA), I came across the following quote (all italics are mine).

Considering that a problem behavior may be the result of not understanding a situation can change the helper’s role from one of behavior manager to interpreter. It can also help protect against the cruel use of unnecessary restrictiveness or isolation as a means of creating a distraction free or low-stimulation environment.

Physical difficulties (e.g., limited mobility, pain, spasticity, etc.) and the emotional impact of these difficulties can also be at the root of behavioral disturbances after brain injury. For example, it should be no surprise that behavioral issues after brain injury often show up first during physical rehabilitation. Sometimes, this can be the result of an individual experiencing pain without having any other means to communicate their dissatisfaction with the person producing it. Many physical therapists have learned that, rather than discharging persons from therapy due to behavioral resistance, part of their work needs to be geared toward teaching communicative alternatives to the problem behavior. In fact, their attention to the physical, communicative, and behavioral aspects of the injury is a very good example of what we call “transdisciplinary” rehabilitation.
Finally, perceptual difficulties that result from brain injury can contribute to the emergence of all sorts of unwanted behaviors. If a person has difficulty processing visual or spoken information, they may behave in a way that says they do not care, that they are not motivated, or that they are resistant to help. If a person does not perceive the impact of his or her behavior on others, then he or she may experience difficulties developing and maintaining relationships. If a person has difficulty interpreting verbal input, then it should be expected that they would fail to initiate, miss appointments, or have trouble in social exchange.

Keep in mind, the same may be true of people with inborn physical, perceptual, language, and communication disabilities, too. 

As Ibby Grace puts it, speaking to the mother of a severely disabled autistic child:

Another way of thinking about this that helps some people is, what would it take for me to do that? 
It seems to me, the most revolutionary thing we can do for a disabled person is learn to see their behavior as communication or as a response to a bad situation, not as designed to annoy us--and then find more positive ways for them to communicate.