{"id":8216,"date":"2020-09-25T07:47:45","date_gmt":"2020-09-25T07:47:45","guid":{"rendered":"https:\/\/autismwales.org\/?page_id=8216"},"modified":"2020-09-25T13:15:02","modified_gmt":"2020-09-25T13:15:02","slug":"behaviour-that-challenges","status":"publish","type":"page","link":"https:\/\/neurodivergencewales.org\/en\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/behaviour-that-challenges\/","title":{"rendered":"Behaviour that challenges"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"8216\" class=\"elementor elementor-8216\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2cd01957 elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"2cd01957\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-173cf83a\" data-id=\"173cf83a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7fb71969 white-icon elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"7fb71969\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<i aria-hidden=\"true\" class=\"fal fa-hand-holding-heart\"><\/i>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-780702b9\" data-id=\"780702b9\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-257eee03 white-heading elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading\" data-id=\"257eee03\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"theme-post-title.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Behaviour that challenges<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-699d8755 white-breadcrumbs elementor-widget elementor-widget-breadcrumbs\" data-id=\"699d8755\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"breadcrumbs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p id=\"breadcrumbs\"><span><span><a href=\"https:\/\/neurodivergencewales.org\/en\/\">Home<\/a><\/span><\/span><\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-14996dde elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"14996dde\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-wider\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-147d75d4\" data-id=\"147d75d4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a75a0b elementor-widget elementor-widget-text-editor\" data-id=\"a75a0b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>The following advice is adapted from NICE Guideline CG170: Autism in under 19s: support and management [<a href=\"http:\/\/www.nice.org.uk\/guidance\/cg170\">http:\/\/www.nice.org.uk\/guidance\/cg170<\/a>]<\/strong><\/p><h2>Assessment of Behaviour<\/h2><p>When assessing behaviour that challenges, the practitioner should take the following potential causes into account:<\/p><ul><li>impairments in communication that may result in difficulty understanding situations or in expressing needs and wishes<\/li><li>coexisting physical disorders<\/li><li>coexisting mental health problems<\/li><li>the physical environment, such as lighting and noise levels<\/li><li>the social environment, including home, school and leisure activities<\/li><li>changes to routines or personal circumstances<\/li><li>developmental change, including puberty<\/li><li>exploitation or abuse by others<\/li><li>inadvertent reinforcement of behaviour that challenges<\/li><li>the absence of predictability and structure<\/li><\/ul><h2>Planning Care<\/h2><p>A care plan should be developed and if any of the following have been identified, the care plan should state how they will be addressed.<\/p><ul><li>treatment, for example, for coexisting physical, mental health and behavioural problems<\/li><li>support, for example, for families or carers<\/li><li>necessary adjustments, for example, by increasing structure and minimising unpredictability<\/li><\/ul><p>If this care plan is unsuccessful in addressing the behaviour, carry out a multidisciplinary review, taking into account the following:<\/p><ul><li>the nature, severity and impact of the behaviour<\/li><li>the child or young person&#8217;s physical and communication needs and capabilities<\/li><li>the environment<\/li><li>the support and training that families, carers or staff may need to implement the intervention effectively<\/li><li>the preferences of the child or young person and the family or carers<\/li><li>the child or young person&#8217;s experience of, and response to, previous interventions<\/li><\/ul><h2>Psychosocial Interventions<\/h2><p>If mental health, physical health, behavioural and environmental causes of the behaviour that challenges have been ruled out, psychosocial interventions should be the first line of treatment.<\/p><p>Complete a\u00a0<strong>functional assessment<\/strong>\u00a0of the behaviour. This should include the following.<\/p><ul><li>factors that appear to trigger the behaviour<\/li><li>patterns of behaviour<\/li><li>the needs that the child or young person is attempting to meet by performing the behaviour<\/li><li>the consequences of the behaviour (that is, the reinforcement received as a result of the behaviour)<\/li><\/ul><p><strong>Psychosocial intervention<\/strong>\u00a0should be informed by the functional assessment, and should include:<\/p><ul><li>clearly identified target behaviour<\/li><li>a focus on outcomes that are linked to quality of life<\/li><li>assessment and modification of environmental factors that may contribute to initiating or maintaining the behaviour<\/li><li>a clearly defined intervention strategy that takes into account the developmental level and coexisting problems of the child or young person<\/li><li>a specified timescale to meet intervention goals (to promote modification of intervention strategies that do not lead to change within a specified time)<\/li><li>a systematic measure of the target behaviour taken before and after the intervention to ascertain whether the agreed outcomes are being met<\/li><li>consistent application in all areas of the child or young person&#8217;s environment (for example, at home and at school)<\/li><li>agreement among parents, carers and professionals in all settings about how to implement the intervention<\/li><\/ul><h2>Pharmacological interventions for behaviour that challenges<\/h2><p>Consider antipsychotic medication for managing behaviour that challenges in children and young people with autism when psychosocial or other interventions are insufficient or could not be delivered because of the severity of the behaviour. Antipsychotic medication should be initially prescribed and monitored by a paediatrician or psychiatrist who should:<\/p><ul><li>identify the target behaviour<\/li><li>decide on an appropriate measure to monitor effectiveness, including frequency and severity of the behaviour and a measure of global impact<\/li><li>review the effectiveness and any side effects of the medication after 3\u20134\u00a0weeks<\/li><li>stop treatment if there is no indication of a clinically important response at 6\u00a0weeks.<\/li><\/ul><p>If antipsychotic medication is prescribed:<\/p><ul><li>start with a low dose<\/li><li>use the minimum effective dose needed<\/li><li>regularly review the benefits of the antipsychotic medication and any adverse events.<\/li><\/ul><p>When choosing antipsychotic medication, take into account side effects, acquisition costs, the child or young person&#8217;s preference (or that of their parent or carer where appropriate) and response to previous treatment with an antipsychotic.<\/p><p>When prescribing is transferred to primary or community care, the specialist should give clear guidance to the practitioner who will be responsible for continued prescribing about:<\/p><ul><li>the selection of target behaviours<\/li><li>monitoring of beneficial and side effects<\/li><li>the potential for minimally effective dosing<\/li><li>the proposed duration of treatment<\/li><li>plans for stopping treatment<\/li><\/ul><p>NB At the time of publication of NICE guidelines (August 2013), no antipsychotic medication had a UK marketing authorisation for use in children for this indication. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the General Medical Council&#8217;s\u00a0<a href=\"http:\/\/www.gmc-uk.org\/guidance\/ethical_guidance\/14316.asp\" target=\"_top\">Good practice in prescribing and managing medicines and devices<\/a>\u00a0for further information.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-b985974\" data-id=\"b985974\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-3dd28b78 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3dd28b78\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container 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href=\"https:\/\/neurodivergencewales.org\/en\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/general-principles-of-care\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">General principles of care<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6379342 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"6379342\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/supporting-family-and-carers\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Supporting family and carers<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d115661 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"d115661\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/interventions-for-the-core-symptoms-of-autism\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Interventions for the core symptoms of autism<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9871fe5 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"9871fe5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/behaviour-that-challenges\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Behaviour that challenges<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-de1f192 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"de1f192\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/development-of-life-skills\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Development of life skills<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e765694 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"e765694\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/interventions-that-should-not-be-used\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Interventions that should not be used<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bcd7f30 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"bcd7f30\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/interventions-for-co-existing-problems\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Interventions for co-existing problems<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3d6bd4c elementor-align-center elementor-widget elementor-widget-button\" data-id=\"3d6bd4c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/sleep-issues\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Sleep issues<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fe55a4f elementor-align-center elementor-widget elementor-widget-button\" data-id=\"fe55a4f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/transition-to-adult-services\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Transition to adult services<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2a31cd92 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2a31cd92\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d535fb8\" data-id=\"d535fb8\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-10c8b89b elementor-widget elementor-widget-heading\" data-id=\"10c8b89b\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"downloads\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Downloads<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-5387debe elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5387debe\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-63c870a6\" data-id=\"63c870a6\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3a64ba49 btchead elementor-widget elementor-widget-heading\" data-id=\"3a64ba49\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">ABC Chart <\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5e4e0e25 elementor-widget elementor-widget-image\" data-id=\"5e4e0e25\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"493\" src=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-ABC-chart-1600x985.jpg\" class=\"attachment-large size-large wp-image-5990\" alt=\"\" srcset=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-ABC-chart-1600x985.jpg 1600w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-ABC-chart-800x492.jpg 800w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-ABC-chart-768x473.jpg 768w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-ABC-chart-1536x945.jpg 1536w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-ABC-chart-2048x1261.jpg 2048w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-360cd23 elementor-align-right elementor-widget__width-inherit elementor-widget elementor-widget-button\" data-id=\"360cd23\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-ABC-chart.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download PDF<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-489b9d3f\" data-id=\"489b9d3f\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-357d268 btchead elementor-widget elementor-widget-heading\" data-id=\"357d268\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">How to use an ABC Chart...<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2b70b28b elementor-widget elementor-widget-image\" data-id=\"2b70b28b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"800\" height=\"493\" src=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-Using-an-ABC-Chart-to-Identify-Triggers-of-Challenging-Behaviours-in-Children-with-Autismpdf-1600x985.jpg\" class=\"attachment-large size-large wp-image-5996\" alt=\"\" srcset=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-Using-an-ABC-Chart-to-Identify-Triggers-of-Challenging-Behaviours-in-Children-with-Autismpdf-1600x985.jpg 1600w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-Using-an-ABC-Chart-to-Identify-Triggers-of-Challenging-Behaviours-in-Children-with-Autismpdf-800x492.jpg 800w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-Using-an-ABC-Chart-to-Identify-Triggers-of-Challenging-Behaviours-in-Children-with-Autismpdf-768x473.jpg 768w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-Using-an-ABC-Chart-to-Identify-Triggers-of-Challenging-Behaviours-in-Children-with-Autismpdf-1536x945.jpg 1536w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-Using-an-ABC-Chart-to-Identify-Triggers-of-Challenging-Behaviours-in-Children-with-Autismpdf-2048x1261.jpg 2048w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-364f8ce6 elementor-align-right elementor-widget__width-inherit elementor-widget elementor-widget-button\" data-id=\"364f8ce6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-Using-an-ABC-Chart-to-Identify-Triggers-of-Challenging-Behaviours-in-Children-with-Autismpdf.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download PDF<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-1ce12e35\" data-id=\"1ce12e35\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2c0565be btchead elementor-widget elementor-widget-heading\" data-id=\"2c0565be\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Understanding Challenging Behaviours in Children with Autism<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2e9d5828 elementor-widget elementor-widget-image\" data-id=\"2e9d5828\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"800\" height=\"493\" src=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-understanding-the-cause-of-challenging-behaviour-child-1-1600x985.jpg\" class=\"attachment-large size-large wp-image-5994\" alt=\"\" srcset=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-understanding-the-cause-of-challenging-behaviour-child-1-1600x985.jpg 1600w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-understanding-the-cause-of-challenging-behaviour-child-1-800x492.jpg 800w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-understanding-the-cause-of-challenging-behaviour-child-1-768x473.jpg 768w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-understanding-the-cause-of-challenging-behaviour-child-1-1536x945.jpg 1536w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-understanding-the-cause-of-challenging-behaviour-child-1-2048x1261.jpg 2048w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2cef9ab7 elementor-align-right elementor-widget__width-inherit elementor-widget elementor-widget-button\" data-id=\"2cef9ab7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-understanding-the-cause-of-challenging-behaviour-child.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download PDF<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-1dfcd030\" data-id=\"1dfcd030\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-153aa187 btchead elementor-widget elementor-widget-heading\" data-id=\"153aa187\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Identifying cause of challenging behaviour using an ABC chart<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-72288ed0 elementor-widget elementor-widget-image\" data-id=\"72288ed0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"493\" src=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-identifying-triggers-of-challenging-behaviours-1-1600x985.jpg\" class=\"attachment-large size-large wp-image-6002\" alt=\"\" srcset=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-identifying-triggers-of-challenging-behaviours-1-1600x985.jpg 1600w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-identifying-triggers-of-challenging-behaviours-1-800x492.jpg 800w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-identifying-triggers-of-challenging-behaviours-1-768x473.jpg 768w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-identifying-triggers-of-challenging-behaviours-1-1536x945.jpg 1536w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-identifying-triggers-of-challenging-behaviours-1-2048x1261.jpg 2048w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7eee974d elementor-align-right elementor-widget__width-inherit elementor-widget elementor-widget-button\" data-id=\"7eee974d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/advice-sheet-identifying-triggers-of-challenging-behaviours.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download PDF<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-40396ed elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"40396ed\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-e5640a3\" data-id=\"e5640a3\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4fe7b1d btchead elementor-widget elementor-widget-heading\" data-id=\"4fe7b1d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Developing Behaviour Programmes for Children with Autism <\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-36f0e13 elementor-widget elementor-widget-image\" data-id=\"36f0e13\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"493\" src=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-behaviour-programmes-for-a-child-with-an-ASD-1-1600x985.jpg\" class=\"attachment-large size-large wp-image-6012\" alt=\"\" srcset=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-behaviour-programmes-for-a-child-with-an-ASD-1-1600x985.jpg 1600w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-behaviour-programmes-for-a-child-with-an-ASD-1-800x492.jpg 800w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-behaviour-programmes-for-a-child-with-an-ASD-1-768x473.jpg 768w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-behaviour-programmes-for-a-child-with-an-ASD-1-1536x945.jpg 1536w, https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-behaviour-programmes-for-a-child-with-an-ASD-1-2048x1261.jpg 2048w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3bb0228 elementor-align-right elementor-widget__width-inherit elementor-widget elementor-widget-button\" data-id=\"3bb0228\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/neurodivergencewales.org\/wp-content\/uploads\/2020\/09\/Advice-sheet-behaviour-programmes-for-a-child-with-an-ASD.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-chevron-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download PDF<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-bce34e1\" data-id=\"bce34e1\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-b5909bf\" data-id=\"b5909bf\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-b5f6463\" data-id=\"b5f6463\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>The following advice is adapted from NICE Guideline CG170: Autism in under 19s: support and management [http:\/\/www.nice.org.uk\/guidance\/cg170] Assessment of Behaviour When assessing behaviour that challenges, the practitioner should take the following potential causes into account: impairments in communication that may result in difficulty understanding situations or in expressing needs and wishes coexisting physical disorders coexisting [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":1276,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-8216","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Behaviour that challenges - Niwrowahaniaeth Cymru | Neurodivergence Wales | National Neurodivergence Team<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/neurodivergencewales.org\/en\/community-services\/i-work-with-children-in-health-social-care\/practitioner-toolkit-support-and-interventions-for-children-with-asd\/behaviour-that-challenges\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" 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