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Down’s Syndrome is a genetic condition where a child is born with 47 chromosomes in each cell instead of 46 due to a full or partial extra copy of chromosome 21 (Down’s Syndrome is also known as Trisomy 21). This additional material alters the course of a child’s development  and results in the characteristics of Down’s Syndrome. Each person with Down’s Syndrome is a unique individual who share all their parents genetic material; they will possess the features of Down’s Syndrome to varying degrees.

There are some strengths and weaknesses that can characterise the syndrome and influence behaviour:

Strengths Areas of need
  • Social Skills
  • Social Understanding
  • Visual Imitation
  • Visual Processing
  • Decreased Task Persistence
  • Early Expressive skills
  • Escape Motivated (Avoid difficult tasks)
  • Some areas of Motor Development
  • Some areas of Cognitive Ability
  • Hearing and Visual Impairment

This relative social strength, in conjunction with a propensity to avoid difficult tasks can become a barrier to learning, negatively impact on the acquisition of critical skills and influence behaviour. A negative behaviour may develop into a ‘challenging behaviour’ if it is (unwittingly) reinforced. In order to prevent negative behaviours from escalating, it is important to remember that behaviours are often learned, influenced by context and outcome i.e. antecedents and consequences.

For example

When I bang my plate on the table, my Mum takes this as a signal that I would like some more food so I am rewarded with more food, therefore I will bang my plate again when I want more food on my plate in the future.

  • Context : I am still hungry
  • Behaviour : Banging plate
  • Outcome : I get more food.

To prevent minor behaviour issues escalating therefore, it is vital to reduce inappropriate behaviour by teaching skills to get needs met through employing more appropriate behaviour.

For example

if I am taught how to sign ‘more’ I can signal to my Mum what I want more appropriately.

  • Context : I am still hungry
  • Behaviour: Signing ‘more please’.
  • Outcome : I get more food.

To promote positive behaviour:

  • Identify how the behaviour is learnt.
  • Look at ways to change the environment to reduce behaviours that challenge.
  • Provide opportunities to reinforce desired behaviour.
  • Teach new skills.

 


Strategies for Supporting Positive Behaviour

Strategies to promote positive behaviour can be categorised as :

  • Preventative
  • Proactive
  • Reactive 

Preventative Strategies

Preventative strategies are implemented to prevent inappropriate behaviours from developing.

To provide positive attention (to reduce attention seeking behaviours) :

  • Ensure time for individual teacher attention is allocated.
  • Reinforce the desired behaviour immediately with a tangible reward. Please note that cumulative rewards may have little meaning to a pupil with short-term memory problems.

https://sendsuccess.org.uk/using-personal-reward-charts/

  • Ignore attention seeking behaviour as much as it is realistically possible and reasonable to do so and re-direct
  • Praise for success.
  • Build on the pupil’s strengths.
  • Ensure the pupil with DS can work with peers who act as good role

Remember: Where attention goes, behaviour grows!

To reduce avoidance behaviours:

  • Develop a range of strategies to distract and re-direct attention. Distract rather than confront.
  • Match the child’s ability to concentrate with the length of the task.
  • Opportunities to make their own choices will help to reduce behaviours that challenge. Check out our article on Choosing Boards for some ideas.
  • Identify a ‘calm’ area where the pupil can go when they are upset.
  • Teach skills to address weak areas.

To develop comprehension skills:

Pupils with DS tend to have a very good visual memory and as such are good visual learners so the use of visual resources is very important.

  • Clear rules and expectations – symbols, pictures, keywords – an example is illustrated below using Widgit software.
  • Good behaviour prompt photos (photos of the pupil sitting on the carpet, lining up, putting hands up… ).
  • Short clear verbal instructions.
  • Consistent approach employed across all staff

 


Other strategies to support understanding

  • Communication books.

This is an example of pages in a communication book produced by the ACE centre whereby the pupil can use the symbols on the right to explain why they are feeling upset.

Photographs can also be used in the book.

Please see the communication hierarchy document for further information on the progression from photographs to symbols.

  • Social story/Visual Guide

Social Stories were developed by Carol Gray, for pupils with Autistic Spectrum Disorders however they can be used with a wide range of individuals with learning difficulties.

A Social Story provides accurate social information in a reassuring way, which can be easily understood by the person it is written for. The aim is to improve their understanding of an event or expectation, therefore leading to a more effective response to it.

Social Stories can reduce anxiety because they provide information about what might happen or provide guidelines on how to behave.

  • Communication Passport

A sample of a communications passport

A sample of a communications passport (see www.integratedtreatmentservices.co.uk)

A communication passport provides information on how that young person communicates and other personal details that are important for staff to know to support expressive and receptive understanding.

An index page that could be found in a communications passport

  • Feelings cards

Cards which show a range of expressions are useful to support a young person’s ability to label an emotion. This may help to support the student to identify how they are feeling to prevent an escalation of behaviour.

A feeling card produced using Widgit Software

A feeling card produced using Widgit Software

 

 

 


Functional Behavioural Assessment

If a pupil is still displaying behaviour that continues to be challenging despite implementing proactive measures, it is really important to understand why a pupil may be behaving in this way and what the function of the behaviour is.

To be able to analyse this behaviour and to build a better understanding of why the behaviour may be occurring, there are a variety of tools that help:

Frequency Charts

When a behaviour occurs frequently it may be helpful to record incidents using a frequency chart. This will enable you to identify patterns e.g. time of day, subject area, seating plan.

ABC charts

Choose one behaviour to monitor.

Collect data in the following way for 2-4 weeks.

  • Setting’ – factors that may increase the likelihood of the behaviour occurring such as: sleep, hunger, illness, allergies, bowel discomfort etc.
  • Record what happened immediately before the incident in the ‘Antecedent’ column – do not make the mistake of trying to establish what the ‘trigger’ might be; if there is a trigger, this should become apparent in time.
  • Record the exact behaviour in the ‘Behaviour’ column. It is important that only the person/ people immediately observing the behavioural incident should complete the record.
  • Record what happened following the behaviour in the ‘Consequence’ column – what you did and what the student did.

When you have collected data meet with staff involved to analyse the ABC charts.

See the pupil’s behaviour as communication – what are they trying to tell you? – a pattern may emerge in either the ‘antecedent’ column (something causing the behaviour) or the ‘consequences’ column (pupil getting something as a result of the behaviour).

Once it has been established why a pupil may be behaving in this way, it is important to teach alternative behaviours to meet the same need appropriately.

The functions of behaviours can be summarised as falling into one or more of the following categories :

  • Sensory Stimulation
  • Attention or Interaction
  • Escape from Demands
  • Social
  • Reduce experiences of pain or relief from ‘internal’ discomfort.
  • Tangible reasons.

 

If after completing a number of ABC charts over a period of time, the function of the behaviour is still not evident, completing a Functional Behavioural Assessment (FBA) will help to gain further insight and inform an evidence based behavioural intervention.

An example of a FBA : La Vigna & Willis “Aide to Functional Analysis”.

Behaviour Support Plan

If a pupil needs additional support to manage their behaviour, a Behaviour Support Plan is written; the SENDsuccess teachers can support you with developing this if required. Please see the following proforma.

 

In Summary

Many of the behaviours that are encountered with pupils with DS are not unique to Down’s Syndrome and will mostly arise out of frustration due to a limited ability to communicate their needs and feelings clearly and wanting to exert some control over their lives.

Due to additional difficulties with short-term memory problems,  shorter concentration span, motor co-ordination and learning difficulties,  it can be much harder to accomplish what a student with Down’s Syndrome is expected to do and hence more vulnerable to developing behaviours that may be inappropriate.

Challenging behaviours are less likely to emerge if the pupil with Down’s Syndrome :

  • Feels secure in knowing that s/he can do what is being asked
  • Follows a differentiated curriculum which is well matched to their needs : the task is not too easy or too hard;
  • Knows that there is a reward for completing the task and it is clear what the reward is.
  • Their preferences, wants and needs are respected.