Consult the 8-Ball


We work with a 26 year old woman who [has mental retardation]. She came to live in our program four months ago. She is very negative. She always talks about not feeling well or about something hurting. We do check to make sure she’s not really injured or sick but she never is. Unless she’s talking about something wrong with her body she hardly ever really says anything. When I walk into the home she’ll come up to me and say, “My stomach hurts” or “I have a temperature.”

Dental Work

We have a client who needs extensive dental work. It is believed that some challenging behaviors are related to his dental health condition. This person does not communicate through speech. Although this man was able to sit for procedures on a previous visit, during his most recent appointment he became impatient and uncooperative in the middle of the procedure, which led us to restrain him for medical purposes. Because he is on a lot of behavior meds, the dentist didn’t feel it was safe to give him a sedative.

Toileting Accidents

We have a 29-year-old woman with Down Syndrome in our center that has recently begun having toileting accidents. As far as anyone here knows she has never had this problem as an adult. Her doctor said there was nothing medically wrong with her and it was probably for attention. We have a referral in to the staff psychologist but for now, it’s hard not to give her attention when we’re having to change her when she wets.


I was very optimistic when our school adopted a positive behavior support system, especially since that meant committing to a data based decision making process, but unfortunately, it hasn’t made getting consensus any easier. For instance, last month after doing a very involved functional behavior assessment involving many people, we developed a behavior intervention plan for a student with verbal aggression.


You promote positive approaches but you teach physical restraint. Isn't that a contradiction?

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