Monday 19 August 2019

Are we ensuring we are using a carrot and not a stick? Low Arousal: a non-aversive approach to behaviour management

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“In crisis circumstances, we have to ‘ride out the storm’ and to use the sailor’s term, ‘batten down the hatches’. You are not going to be able to prevent the storm and there is no point in wishing it away!”.

Professor Andrew McDonnell’s new book, The Reflective Journey: A practitioner’s guide to the Low Arousal approach, is a fabulous ‘how to’ guide enabling families and professionals, supporting highly anxious and challenging people, to apply low arousal strategies in their everyday practises.
With child anxiety and mental health issues more prevalent than ever, families are being left significantly vulnerable from not receiving the provision they need in trying to raise a child with such challenging and individualised needs.
Working with both adults and children with extremely ‘challenging’ behaviour myself over the past 10 years, I have always had the belief that ‘all behaviour is communication’. Yet, the power of this book is that it instantly flips this narrative on its head and made me realise what Psychologist Albert Bandura had claimed: ‘all behaviour is about perception’. How the adult ‘perceives’ what the person is trying to communicate. As you may have noticed I have already referred to the term ‘challenging behaviour’ several times in this review; however, McDonnell takes a new stance and I am going to follow suit and from now on refer to it as ‘behaviours of concern’. This choice of words provides a more ‘neutral’ definition and therefore inevitably changes how we begin to observe these actions. 

As so many of the current literature in the Speech and Language Therapy and Psychology fields focuses on assessing ‘why’ a person is behaving in an aggressive or unexpected way, The Reflective Journey takes a refreshing approach by probing the reader to first look within themselves at their own actions. If we as parents and professionals are going to support the individual to adapt their behaviour, then it has to start with us!

But what is the Low Arousal Approach?

The Low Arousal philosophy advocates interaction, distraction, diffusion and physical avoidance strategies to manage, rather than change the undesirable behaviours. 
As an eternal student to my profession, I’m continually on the look-out for new therapy techniques to add to my ever expanding toolkit, but I have to be honest and admit that I am usually the person on the training workshop who is thinking, just get to the bit where you tell me the strategies, so I can ‘get going’ on the therapy side of things.
What was so thought provoking about this book, is the due to the two clear parts it has been divided into, the strategies to use with my students were not introduced until the second half and until that point had somehow, surprisingly, managed to restrain my own eagerness into first considering how essential reflecting on my own behaviour is, before trying to support the behaviours of the people I am working with.

I should have guessed that was the journey the book would take me on because the clue was in the name ‘Reflective’ and highlights the importance of ‘thinking’ before ‘doing’!.
I cannot remember a time when a work-related or ‘educational’ book as it were, kept me so engaged. By the end of the first chapter my head was already buzzing with questions about how my own actions, tiredness, tolerance levels and stress etc. over the years may have subconsciously leaked into my interactions with my students. Now, I do pride myself on my ability to ‘leave my personal issues at the door’ so to speak and to put my work face on each day – but I am only human after all! What was great about this book, is that it pulled all of those influential factors to the forefront of my Speechie brain and has since reading it, made them a lot more prominent when I am managing behaviours of concern. In my personal life, as well as my professional one!

I felt that the overall aim of The Reflective Journey was to empower any reader, regardless of experience, to be able to apply the low arousal approach by the end of reading a series of simple steps and I don’t feel it disappointed in achieving this.

Prof. Andrew McDonnell is an amazing Clinical Psychologist who has over 30 years’ experience testing low arousal techniques in countries across the world and after founding the Studio 3 organisation in 1992 is continually advocating for practitioners to move away from the more traditional ‘hands-on’ strategies towards a more humanistic and person-centred style. Low arousal is now the chosen approach in many services throughout the country.

In crisis situations our primary focus is always to ensure that everyone around is safe; though now, rather than just feeling we can merely ‘batten down the hatches’, this book has provided both parents and professionals supporting children with ‘behaviours of concern’ with easy, effective and empathic strategies to ‘ride out the storm’.

A final point to take away: Our children and students can be very hyper-vigilant, they are constantly on the look-out for any perceived threat, which inevitably increases anxiety and arousal levels. So always remember, they can sense how we feel about them! And how we ‘perceive’ them!

The Reflective Journey: A practitioner’s guide to the Low Arousal approach can be purchased from the Studio3 website for £17.99

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Other products related to the Low Arousal approach and managing behaviours of concern that I would highly recommend include:

-          Managing Family Meltdowns: the Low Arousal approach and Autism (Woodcock and Page 2009) £12.99

-          No Fighting, No Biting, No Screaming: how to make behaving positively possible for people with Autism and other Developmental Disabilities (Hejlskov Elvén 2010) £14.99

-          Managing aggressive behaviours in care settings: understanding and applying low arousal approaches (McDonnell 2010) £30.99

and don’t forget to check out Bo Hejlskov Elvén’s amazing Youtube series on implementing Low Arousal strategies

Highly Specialist Speech and Language Therapist
Small Talk Speech and Language Therapy

Thursday 15 August 2019

Carer or career?

Guest blog from Jodie Isitt

It started late on night, you know those nights when everyone is asleep but you daren't close your eyes because as soon as you do someone WILL wake up screaming. Life as a carer for three autistic children was busy and oh so tiring, but in those days I was surviving on a couple of hours sleep a night and pushing my body daily to meet the caring needs of my children whilst attending hundreds of appointments a year! Was this it? Was I destined to be a carer for my children all of my life? Would I spend my days researching new conditions, learning sen law and attending umpteen IEP meetings a month? I loved working, I have been a career girl all my life, starting out in catering and following the birth of my children becoming the accounts manager in my family building business. I was good at it. I enjoyed it. I love learning new things. Unfortunately due to the extensive health needs of my family and becoming increasingly unwell myself through exhaustion and stress I had to stop working. It was too much. It consumed me. To be honest if I had been employed by anyone other than my own family business I wouldn’t have lasted that long at all. Pretty sure I had become unemployable due to the time I needed to take off work just to simply attend meetings and see the children’s psychologists. It was a full time job and one that paid lousy! Carers allowance was something like £62.00 and I was working over 300 hours per week! Okay okay there aren’t 300 hours in a week, but when you’re a parent of three autistic children and a disabled fiancée there sure as hell needs to be because I was fitting in 300 hours of stuff in a week that only has 168 hours. Parents like myself are saving the government thousands with their caring - but alas that’s another post for another day way in the future. So there I was, tossing and turning unable to switch off and in that instant when everything was quiet just the soft sound of the trees blowing in the wind, my daughters 18 bubble lamps and youtube ocean music playing on repeat I had a brainwave. For months I had been on-line actively advocating for people to learn more about autism, speaking to adults, trying to make them understand, hell even some family members didn’t quite ‘get-it’ Advocating for understanding and acceptance and I realised that when I was a child I was NEVER taught about disabilities. Disabled people scared me, unnerved me, and made me anxious. I didn’t know what they were thinking, were they violent, why were they behaving in this unsociable manner? What was wrong with them? It wasn’t until I had my children that I fully understood disabilities as a whole and teaching myself everything I needed to know about them I could finally accept them for who they were. We don’t need to teach adults about autism, or disabilities or neurological conditions. We NEED to start teaching children. Thats where it will count. Incorporating awareness into their daily routine would be invaluable for generations to come. Creating the most understanding, diverse, accepting and kind individuals of the future would change the lives of millions of disabled people and what better way to do that than through storytelling using the most cutest and relatable of characters. A journey through mainstream school, using my daughter Lola as inspiration I developed the next children’s book series designed to help children understand and accept differences in the classroom. Drawing on her own experiences and her own difficulties I have written four children books using a Badger as one of Lola’s trusted friends to give the children the tools they need in order to be a kind and helpful friend to someone less like themselves without compromising their own wellbeing in the process. The books were primarily designed and written for children who don’t have neurological condition, a social story for the ‘normal’ child some might say, however following the amazing reviews and feedback from hundreds of customers its clear to me that they are more than that. They are a double whammy! They are not only helping children understand and accept other children. They are helping children understand and accept themselves. One child’s mum reports that she wore her ear defenders to school for the first time in months and was proud to be like Lola Rabbit. Another describes her child wanting to dress up, spending ages choosing an outfit complete with hair bow to look exactly like her. Some children have opened to their parents and admitted they felt like Lola, lonely and scared of the noise. Giving parents the opportunity to finally realise what kinds of things they were struggling with in the school environment. I am so excited about this project, and I cannot wait to release the second book - Lola’s wobbly lunch time where Lola gets very stressed out during lunch time and has a breakdown in the lunch hall describing the smells and sounds and the extreme busyness of the lunch hall dev

Additionally and because I'm not 'professional' I asked expert speech pathologist Molly Dresner and Occupational Therapist Lucy Bates to contribute in the book and they have done amazing job at explaining the difficulties and giving teachers and parents ideas on how to help children should they present like Lola Rabbit. This is a very unique addition to children's books and I am super proud and honoured to be able to bring these books to schools and homes near you!

Jodie x
Autism with love publishing