At Home #14: hits or pushes
Problem: The student hits, shoves or pushed peers and/or adults, or uses aggressive or threatening language.
I. GENERAL MEDICAL POSSIBILITIES
1.Selective Brain Damage: In rare cases, aggression can be a direct result of certain kinds of brain damage or unusual activation of certain parts of the brain. For example, stimulation of a part of the amygdala or of the hypothalamus in the limbic system can produce aggressive responses in otherwise non-aggressive people. When students with TBI act aggressively, especially if the aggression appears not to have a normal explanation, consultation with a physician or neuropsychologist may help staff understand the source of the aggression. Aggression that is neurologically based should be managed with a comprehensive environmental effort to prevent the aggressive behavior, possibly combined with medication. (See Tutorial on Behavior Management: Prevention Strategies)
2. Chronic Pain: Some students may act in an aggressive manner as a result of being in chronic pain.
3.Fatigue/Hunger/General Nutrition: Some students may act in an aggressive manner as a result of fatigue or hunger. (See Tutorial on Fatigue)
4.Seizures: In rare cases, aggression may be a result of temporal lobe seizures that may or may not be diagnosed. If temporal lobe seizures have been diagnosed, staff should ask the physician if aggression is a likely or possible consequence of the seizures. If seizures have not been diagnosed, but are suspected, a seizure evaluation should be recommended. When students with TBI engage in aggressive acts that are unpredictable and incompatible with the student’s normal behavior, consultation with a physician or neuropsychologist may help staff understand the source of the aggression. Aggression that is neurologically based should be managed with a comprehensive environmental effort to prevent the aggressive behavior. (See Tutorial on Behavior Management: Prevention Strategies) If seizures are diagnosed, the prescribed medication regimen should be followed along with environmental management. (See Tutorial on Seizures)
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II. COGNITIVE/SELF-REGULATORY POSSIBILITIES
1.Self-Regulation Impairment: Some students may be aggressive as a result of general difficulty with self-regulation (e.g., impulse-control problems). (See Tutorials on Self-Regulation; Self-Monitoring and Self-Evaluating; Organization; Impulsiveness/Disinhibition; Initiation; Problem Solving)
2.Inflexibility: Some students may be aggressive as a result of difficulty with change; they may be rigid and inflexible; they may have particular difficulty with novel versus routine tasks. (See Tutorial on Flexibility)
3.Generally Weak Cognitive Functioning: Some students may be aggressive as a result of excessive demands placed on their memory, organizational ability, academic skill, or other cognitive ability. (See Tutorials on Cognition; Memory; Organization)
4.Weak Orientation to Task: Some students may be aggressive as a result of uncertainty regarding what is required of them. (See Tutorials on Language Comprehension; Organization)
5. Weak Understanding of and Perception of Others’ Responses to Aggressive Behavior: Some students may be aggressive as a result of uncertainty regarding what behaviors are socially acceptable and how others react to their behavior. They may not understand that peers become upset in response to their aggressive behavior and that such behavior reduces their chances for peer acceptance and friendship. They may “misread” peers’ responses to their behavior. (See Tutorials on Social Competence; Social Perception; Friendship and Peer Acceptance)
6. Severely Impaired Impulse Control: Some students may be aggressive as a result of serious impulse control problems. They may understand intellectually that aggressive behavior is unacceptable and jeopardizes peer acceptance and friendship, but nevertheless they act on impulse which leads to occasional aggression. (See Tutorial on Impulsiveness/Disinhibition)
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III. BEHAVIORAL POSSIBILITIES
1.Functional Behavior Assessment: Negative behaviors can serve a variety of possible purposes, including (1) to escape something (e.g., escape a person, place, activity, demand, sensory environment), (2) to gain access to or acquire something (e.g., gain access to a person, place, activity, thing, attention), (3) to gain control or power, (4) to gain peer attention, approval, or admiration, (5) other. Each of these possibilities can be explored experimentally in a way that is similar to the other experimental explorations outlined on this web site. In the case of negative behaviors, this exploration is called functional behavior assessment.
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IV. SOCIAL-EMOTIONAL POSSIBILITIES
1. Depression: Some students may be aggressive because they are upset, depressed, and/or lack positive relationships with peers and/or adults. (See Tutorials on Depression; Peer Relationships) Young children often manifest depression by acting out.
2. Anxiety: Some students may be aggressive as a result of anxiety. (See Tutorial on Anxiety)
3. Frustration: Some students may be aggressive as a result of feeling frustrated. (See Tutorials on Self Regulation/Executive Function Routines after TBI; Teaching Positive Communication Alternatives to Negative Behavior)
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