In the Classroom: Managing Severe Behavior Challenges in the Midst of Crisis

Description of the Problem

Many students with TBI have limited ability to control their own behaviors, are often confused and frustrated by the daily requirements of school, and are simply angry about the changes that have resulted from their brain injury. Unable to understand their multiple emotions and thus unable to manage them, it is very common for students with TBI to express depression and anxiety by acting out aggressively. It is critical to remember that many of the most severe behavioral challenges demonstrated by students with brain injury are NOT willful or purposeful. Aggressive behavior, whether physical or verbal, can cause risks to the health and safety of the student and to others, and it often results in removal from the classroom or in the worst cases, alternative placement in more restrictive settings.

Causes

The parts of the brain that manage impulse control, including control of aggression, are frequently damaged in TBI. In addition, many students with challenging behaviors demonstrated some difficulties with behavioral regulation and impulse control prior to brain injury, and these behavioral tendencies can be exacerbated by brain injury.

Solution

Create intervention strategies to address common situations that result in challenges before they emerge (e.g., learning to take a break, identifying situations that cause fatigue, engaging in positive physical activities routinely). Use communication strategies to defuse an outburst, should one arise. Have a plan to address these situations before they happen.

Strategies

• Remain calm and positive. A student’s anxiety can spread to you or others and spiral out of control. If you remain calm and positive, you can interrupt the spread of anxiety and defuse the situation. It models how you want the student to behave and provides positive reinforcement for good behavior. This is hard to do, especially when students demonstrate significant behavioral challenges. It is useful to routinelypractice calm responses to emotionally charged situations with co-workers to create a series ofcommon verbal responses to use when a problem emerges (e.g., “OK, you’re not ready, I’ll wait,”“Looks like you need a break,” “No big deal,” etc.).
• Try redirection. Sometimes, you can head off a crisis by redirecting a student to an entirely unrelated task. Makesure the new task is neutral to prevent inadvertent reinforcement of the aggression; you do not want a student to think, “When I threaten to hit someone, I get to go play.”
• Keep everyone safe. It will sometimes be easier to move others out of the room into a safe space than it will be tomove an out-of-control student into isolation. Follow your institutional and state guidelines for physical restraint in extreme cases.
• Present yourself as a helper rather than an enforcer.  Ask, “what can I do to help you?” or “what do you need to get back in control of yourself?” It might create an opening for verbal intervention; at the very least, it is unlikely to escalate the situation.
• State the situation clearly and simply.  Sometimes an objective, non-judgmental statement of what has occurred can help a student regain calm (e.g., “OK, you were working on a math problem and something went wrong. When you’re ready, we can figure it out and try something else.”). In any case, limit the amount of chaos by choosing a single spokesperson and keeping all communications clear, calm, and confident.
• Choose your battles wisely.  If a student appears to challenge your authority, consider the consequences before reacting. Does it matter? Is this a big enough deal that you have to address it at this exact moment? Is there a way to reach your goal without provoking the student? Only start a battle if you’re sure it’s what’s best for the student’s success and you’re sure you can win.