What are the Causes of Behaviour that Challenges?

Practitioners in different settings, such as nurseries, schools, care homes, GP surgeries, after school clubs and child care will all experience behaviour that challenges in children. It is important to have good knowledge on what managing behaviour that challenges is, how to support children with behaviour that challenges, as well as others around them including parents and siblings. Living and working with children who experience behaviour that challenges can be difficult.

Throughout this blog you will gain an in-depth knowledge into the causes of behaviour that challenges and how to manage it in different settings.

What is behaviour that challenges?

In previous years, behaviour that challenges was known as many different things, such as:

• Socially unacceptable behaviour.
• Problem behaviour.
• Challenging behaviour.

Now, all of the terms noted above are considered unacceptable because they place a negative label on the child rather than on the behaviour and so they should be avoided.

It is now understood that behaviour that challenges is not seen as a diagnosis but is regarded as something which sets out to serve a purpose, usually that the child has a need that is unmet.

Behaviour is identified as challenging if it poses a risk of harm to the child or to others and/or if it leads to the child’s quality of life being reduced.

Some examples of behaviour that challenges include:

• The child being unable to attend school because they are aggressive towards other children or towards staff.
• The child cannot be left alone at any time or they may wander off, including at times when they are at school.
• The child cannot visit other people’s homes or places such as restaurants or supermarkets as they would be at risk of destroying property or behaving aggressively towards strangers.

It is important to keep in mind that everyone’s definition of behaviour that challenges will not be the same. For example if parents of a child who lives with autism were to witness them biting their clothing, this would simply indicate to the parents that the child needed something. If this behaviour were to be experienced whilst in a social setting where strangers were present then it would likely be seen as challenging by those who witnessed it.

Positive behaviour – Positive behaviour involves positive words and actions that ensure that a child’s needs are met in all aspects of their life (i.e. their needs are met holistically) such as:

• Emotionally.
• Socially.
• Physically.
• Intellectually.
• Spiritually.

Positive behaviour comes about when a child’s needs are met in a way that is meaningful to them and not just met in a way that is most convenient for the person who is meeting the need.

Developing positive behaviour

As part of enabling parents, carers and others to help children behave in a more positive way, a strategy known as ‘positive behaviour support’ is now utilised in an attempt to understand why children experience certain behaviours and what the triggers to them might be. This support is based on the fact that all children are unique and that behaviour that challenges comes about to serve a purpose and to enable children to live in a way that is best for them.

Some examples of supporting positive behaviour include:

• Using positive risk assessments so that children can make choices but are not put at the risk of harm.
• Enabling children to participate in social activities.
• Showing compassion and empathy.
• Enabling independence to empower children.

The basic needs of children and how these can be met

The needs of children, in their most basic sense are no different to those of adults. One of the most effective ways of considering the needs of children is to firstly look at what their most basic needs are.

Maslow’s hierarchy of needs – Basic needs were identified by Abraham Maslow as being crucial in enabling both adults and children to fulfil their potential by what he termed ‘self-actualisation’.

Maslow’s theory states that in order for people to become accomplished and to ‘self-actualise’ where they become everything that they can possibly be, they need to have certain needs met. These needs have to be met in a certain order and people cannot move onto the next level of needs before accomplishing the one before it.

The needs that Maslow proposes are usually presented in a pyramid, or hierarchy, which represents the order in which they must be met:

Needs at the lower level include basic things that are needed for survival such as rest, food and water. Children who live in poverty, for example, struggle to have these basic needs met, which means that moving up within the hierarchy becomes more difficult.

For children who do have their basic needs met, they then move on to safety needs which means that children need to feel secure in their own home and be with people who they can trust.

Once safety needs have been met then children can move onto the next level which is love and belongingness, which may mean that they develop a friendship network and, as they get older, they develop a relationship with a partner which is positive and meaningful.

Closer to the top of the hierarchy are esteem needs, which mean that children must be able to retain a good sense of self-esteem by being praised for their accomplishments and being given the confidence to try new things and make mistakes.

Finally, once all other needs have been met, Maslow theorised that children could fulfil their potential. He did however state that self-actualisation was very difficult to achieve because people, children included, are always looking for ways to develop and improve themselves and so are never quite as proficient as they would like to be.

How children respond if their needs are not met

It is difficult to definitively state how children will respond if their needs are not met because each child is a unique individual. Some children will be able to respond positively because they have a level of self-awareness and they know that if they act in a way that others perceive as ‘naughty’ or which they know will get them into trouble, they will find an alternative way of having their needs met.

Some children, however, are less able to regulate their own behaviour and reasons for this will be discussed in the final section of this unit. They may resort to behaviour that challenges as a way of getting the attention of someone who can fulfil their need. For example, if a young child who has experienced neglect by one or both parents, does not get the attention they need in school so that they can develop academically, they may behave in way that challenges to try and ensure that they are able to get the attention they need to progress in school.

The difference between anger and aggression

Although these are two terms that are used interchangeably to mean the same thing, they are actually two different things and should be referred to as such.

Anger – Anger is a normal human emotion that comes about when a person feels as though they have been wronged and because they feel that they are out of control of a situation. It is not always negative; individuals can feel angry about something and do something positive in response, for example becoming angry about discrimination and then starting a campaign to end it.

Anger may also come about in response to feeling frustrated, sad or lonely and so enabling children to express other emotions is key in preventing anger becoming negative and possibly leading to aggression.

Aggression – Unlike anger, aggression does not have a positive element. It is a response that comes about when a person loses control of their anger and can no longer regulate their own behaviour.

Aggression is deliberate; it serves the purpose of inflicting damage and is characterised by a range of behaviours that can result in physical or psychological harm to the person who is being aggressive or to other people or to objects that are present in the environment when aggression is taking place.

Behaviour that challenges is an example of aggression, it comes about because of the anger and frustration that is experienced when a need is not met.

Examples of behaviour that challenges

Behaviour that challenges will usually be one of the following three or a combination them:

• Verbal.
• Non-verbal.
• Physical.

Parents, carers and those people who work with children who may experience behaviour that challenges may notice patterns of behaviours that come about when needs are not met but this is not always the case. Some children will experience different behaviours all the time, which can make it more difficult to identify triggers and to employ strategies that reduce or eliminate behaviours that challenge, although this is not impossible.

Verbal behaviour that challenges – Some examples of verbal behaviour that challenges include:

• Shouting.
• Arguing.
• Screaming.
• Abuse including use of offensive language.
• Threatening.
• Using inappropriate language such as that which is sexist, racist or homophobic.
• Name-calling.

Non-verbal behaviour that challenges – Examples of non-verbal behaviour that challenges include:

• Using intimidating facial expressions.
• Being deliberately silent.
• Walking away during an interaction.
• Clenching fists.
• Moving into someone’s personal space.
• Pointing directly in someone’s face.
• Standing in an aggressive posture.

Physical behaviour that challenges – Examples of physical behaviour that challenges are vast and it is easier to sub-categorise them so that the extent of them can be seen:

Self-injurious (self-harming)

• Eating non-food items including substances, which are poisonous.
• Eye poking or gouging.
• Scratching and cutting.
• Biting.
• Pinching.
• Teeth grinding.
• Head banging.
• Burning.
• Pulling hair out.
• Over eating or under eating.

Directly aggressive

• Hitting and punching.
• Physical intimidation such as standing over someone.
• Biting.
• Pinching.
• Grabbing and holding.
• Hair pulling.
• Spitting.
• Throwing objects.
• Kicking.
• Using an object to inflict injury.
• Cornering (where someone is forced against their will into a situation from which it is difficult to escape).
• Scratching.

Non-person directed

• Damage to property and possessions.
• Stealing.
• Inappropriate sexual behaviour.
• Withdrawal.
• Lack of, or poor awareness of danger.

It is important for others to try and learn what some behaviours may mean if this is possible. This will enable them to reduce incidents of behaviour that challenges by preventing them from happening in the first place or stopping them from escalating if it is not possible to prevent them.

What causes a child to experience behaviour that challenges?

Although any child can experience behaviour that challenges, it is most likely to come about consistently with children who fall into one or more of the categories below:

• Children who live with autism.
• Children who live with learning disabilities.
• Children who have mental health difficulties.
• Children who have specific conditions such as ADHD.

Within each of these categories, there are many different reasons that a child may behave in a way that challenges and these will very much depend on the individual child, including their genetics, their environment and their mental and physical health.

Biological and physical causes of behaviour that challenges

• Specific health conditions – There are some health conditions that make it difficult for children to regulate their behaviour because the hormones that control behaviour are imbalanced. An example of this is Lesch-Nyhmam syndrome which increases self-injurious behaviours.
• Genetics – There is no known gene that may cause behaviour that challenges but it may be possible that a parent who was prone to behaviour that challenges as a child may then have a child who has the same types of behaviour.
• Hunger and thirst – Something as simple as needing something to eat or drink may cause behaviour that challenges if this need is not met. As a most basic need, children will not be able to move on if they are hungry or thirsty as this will impact their ability to carry out other tasks, such as concentrating in school.
• Needing the toilet – Children who have difficulties in communicating needs may use behaviour that challenges to bring attention to the fact that they need to use the toilet and are becoming distressed.
• Sensory impairments – Children who have impairments with hearing and/or sight can experience barriers to communication that may mean that needs are unmet and that they behave in a way that may challenge to bring attention to their needs.

Social causes of behaviour that challenges –

• Sensory overload – For children who live with autism in particular, any environment that is excessive can cause behaviour that challenges. For example, being too hot, cold, bright, dark or crowded can cause difficulties that children may draw attention to by behaving in a way that challenges.
• Poor social skills – Children may feel as though they have been picked on if they have to speak in front of others and some may struggle to have a one-to-one conversation if they have a condition that causes social interaction problems or social anxiety. Behaviour that challenges comes about as a means of escaping such a situation.
• Feeling out of control of decision making – If children have plans made about them without their involvement they may behave in a way that challenges not only to bring attention to this but to also try and regain some form of control over their own life.
• Feeling out of control of decision making – If children have plans made about them without their involvement they may behave in a way that challenges not only to bring attention to this but to also try and regain some form of control over their own life.
• Being bullied – Some children who are being bullied may not feel able to speak up about this or they may have a communication difficult that makes this more difficult. It may then be the case that behaving in a way that challenges feels like the only way that the child can bring attention to the fact that something is not right.

Other potential causes of behaviour that challenges

• Transitions – Whether big or small, transitions can cause many difficulties for some children, which may cause them to behave in a way that challenges. For example, divorce can change a child’s behaviour as they try to understand what is happening. For children who live with autism, the small change of having a different classroom, which breaks a routine can be very difficult for them to manage.
• Mental health difficulties – Mental health difficulties can cause problems with communication, such as when a person is living with depression and cannot summon the energy or motivation to speak with others. In cases of serious mental illness, psychosis may mean that a child believes that they are being followed or attacked, which can prompt significant experiences of behaviour that challenges.
• Learned behaviour – In some instances, there may be no other explanation for behaviour that challenges other than the child has observed it in a role model, such as a parent, sibling or friend and repeats the behaviour that they have seen if they believe that they are going to get rewarded for it. For example, if a child sees an older brother scream and shout and get out of going to the dentist, the younger child may do the same if they believe they can get the same outcome.
• Difficulties in processing information – Some learning difficulties such as dyslexia can cause a slowing down of processing information. This can cause behaviour that challenges if a child is struggling to keep up in class or they cannot communicate the difficulty they are having such as if they have a communication difficulty or if they are too embarrassed to speak up about it.

The importance of building an effective relationship to help manage behaviour that challenges

Arguably, the most successful way of ensuring that children learn positive behaviours and ways of self-regulation in terms of their own behaviour is to make sure that significant others such as family members, teachers and health and social care professionals build effective relationships with them and this should start from as young an age as possible.

When considering an effective relationship in the context of behaviour, it is important to keep in mind that ‘behaviour management’ does not have to be about controlling children. Instead, key factors such as what follows are thought to be the most important way to ensure successful relationships and positive behaviour:

• The creation and maintenance of safe boundaries.
• Understanding the needs of children.
• Showing an interest in a child’s family, talents, goals, likes and dislikes.
• Observing for triggers for behaviour that challenges.
• Enabling children to learn self-management strategies.
• Enabling children to communicate effectively with significant others.

When a successful relationship is built with a child, it is then more likely that they will feel safe, listened to and respected as well as feeling as though they have some control over what is happening in their life.

The importance of trust

The need to be able to trust other people is vital for children as it enables them to build positive relationships not just in childhood but throughout the rest of their lives as well. Without trust, children may feel as though they have no one to turn to in a time of difficulty or crisis and this can then lead to isolation, which is a known factor in mental health difficulties and an increase in the possibility for behaviour that challenges.

Children learn to trust adults from the minute that they are born; they are entirely reliant on others to meet their needs and children who grow up with what is referred to as a ‘secure attachment’ are better equipped to build positive relationships because they have had their trust in adults justified. For example, securely attached children know that adults will meet their needs, they know that when they leave, that they will always come back and they know that in times of distress that an adult will be there to comfort them.

Children who have grown up without a secure attachment may find trusting adults more difficult. This is because they have learned that sometimes, their needs will not be adequately met and that they have been forced to fend for themselves in times of need. This is often particularly the case for children who have grown up in a difficult environment such as one where there is one or more of the following factors:

• Poverty.
• Mental health difficulties.
• Substance misuse.
• Abuse and domestic violence.
• Chronic long-term health problems.
• Acting as a young carer.

The lack of initial trust or the loss of trust can mean that children not only have problems in trusting those who have let them down but difficulties trusting others as well because of the fear that they too will not meet their needs.