www.dimagine.<strong>com</strong>It’s almost too obviousto state: spend time withthe personothers know that they understand.The important point, always, is to askthe person for permission to stick yournose into their business, even at therisk of seeming silly in front of peoplewho think the person cannotunderstand up from down (they’reusually wrong).2. Remember that allbehavior is meaningfull.Difficult behaviors are "messages"which can tell us important thingsabout a person and the quality of herlife. In the most basic terms: difficultbehaviors result from unmet needs. The verypresence of a difficult behavior can bea signal that something important thatthe person needs is missing. Here aresome examples of the kinds of thekinds of messages a person may beconveying with his or her behavior:“I’m lonely.”Michael’s older brother was invitedover to a friend's house for a sleepover. Michael is never invited to thehomes of children because he goes toa "special" school 35 miles from hisneighborhood. Michael has no friendsto play with."I'm bored."Roberta's sister is a doctor at the localhospital. She has her own house and isher parent's pride and joy. Robertaworks all day at a sheltered workshopwhere she packages plastic forks andknives. She lives at home and is tiredof packaging. She wants to get a realjob. Roberta's case manager says sheday dreams too much."I have no power."John likes to sit down on the sidewalkwhen the bus arrives to take him toschool. His mother be<strong>com</strong>es veryangry and tells him that there will beno dessert when he gets home. Johnlaughs when the bus driver threatenshim with time out."I don't feel safe."Conrad uses a wheelchair and is notable to defend himself adequately fromattacks by another man. Conradworries that he will be hurt and oftencries when left alone. Staff think hehas a psychiatric illness."<strong>You</strong> don't value me."Gloria has a "severe reputation."People from all over the state haveheard stories about her terribletantrums. No one knows that she is avery caring person who worries aboutenvironmental issues. The only part ofGloria people pay attention to is herproblem behaviors.Version 20 January 2002David Pitonyak—2
"I don't know how to tell youwhat I need."June does not know how to usewords or sign to let other peopleknow what she was thinking. Shelives in an institution where shelearned that the best way to getpeople's attention was to biteyour arms. It hurts, but it is theonly thing that "works.""My ears hurt."Walter hits his ears withhis fists. His job coachwants to stop and wrote abehavior plan for "nothitting." Weeks later, at ascheduled doctor'sappointment, it was learned thatWalter had a low-grade earinfection. Anti-biotics cleared upthe infection and Walter hasstopped hitting his ears.Obviously there are many needsthat a person may be conveyingwith her behaviors. A singlebehavior can "mean" manythings. The important point isthat difficult behaviors do notoccur without reason. Allbehavior, even if it is selfdestructive,is "meaning-full."Ask the person (and/or theperson’s supporters) what he orshe needs to be happy. Find outwho he or she counts on in apinch. How o ften does he or shesee loved ones and friends?What are his or her favoriteactivities? Where does he or shelike to go? Ask the person whatleads to unhappiness. Who arethe people who the person doesnot like? How often does he orshe see them? What are theperson’s least favorite activities?Since many people areexperiencing physical and/orpsychiatric distress, it’s alsoimportant to know somethingabout the person’s physical andemotional health. <strong>Do</strong>es theperson have a way to let othersknow what he or she needs andfeels? Is the person experiencingphysiological or psychologicaldistress? What kinds ofmedications is he or she taking?<strong>Do</strong> they help?Finally, if you’re stumped, ask,“Are there times when theperson exhibits this behaviorfrequently?” and “Are there timeswhen person exhibits thisbehavior infrequently or not atall?” Answering these twoquestions can tell you a great dealabout the meaning of theperson’s behavior. With time,you should be able to see adiscernable pattern.For example, you might find thatthe person engages in thedifficult behavior in the morninghours, but rarely in the afternoon.Ask, “What happens in themorning that might cause theperson to behave this way?” or,conversely, “What is happeningin the afternoon that causes theperson not to behave thisway?” (Hint: it often hassomething to do with the things aperson is being asked to do, and/or who is asking the person to doit).3. Help the personto develop a supportplan.People who exhibit difficultbehaviors are usually subjected toa behavior plan at some point intheir lives. It is rare that they areasked if they want a plan, letalone invited to the meetingswhere one is developed. Instead,a plan is developed by strangers(e.g., the agency behaviorist whohas spent less than two hours"observing" the person).Think about how difficult itwould be to stop a behavior thatwww.dimagine.<strong>com</strong>a stranger thinks you should stop.It can be difficult enough to stopbehaviors we choose to stop (e.g,smoking, excessive eating)!Instead of a behavior plan to"fix" the person, help the personand the person's supporters todevelop a support plan thatreflects a real and authentic life.John and Connie Lyle O'Briensuggest the following questionsfor building a support plan. Notehow different these questions arefrom those we typically ask, suchas "How can we reduce thisperson's problem behaviors?" or"How can we manage thisbehavior?"1. How can we help the person toachieve health and wellbeing?2. How can we help the person tomaintain his or her relationships andmake new ones?3. How can we help the person toincrease his or her presence andparticipation in everyday <strong>com</strong>munitylife?4. How can we help the person to havemore choices in life?5. How can we help the person tolearn skills that enhance his or herparticipation in <strong>com</strong>munity life?6. How can we help the person to makea contribution to others?The team can ask, "Is our visionfor the person similar to thevision we hold for ourselves andeach other? When we thinkabout what the person needs, dowe focus on "fixing" deficits ordo we think about supporting theperson in achieving a real life?"4. Develop a supportplan for the person'ssupportersJust as it is simplistic to treat aperson's behavior withoutunderstanding something aboutVersion 20 January 2002David Pitonyak—3