DEFINING REPETITIVE QUESTIONING BEHAVIOUR

Repetitive questioning behaviour is when a child asks the same question repeatedly.

REPETITIVE QUESTIONING BEHAVIOUR AS PART OF NORMAL DEVELOPMENT

As adults, we play a vital role in our child’s learning. Answering our children’s questions and providing explanations help children understand how the world works, how to make predictions and learn how to handle situations effectively, and repeating the information helps children consolidate and retain it.

Even if children have specific knowledge, it’s normal for them to still ask the same question from time to time to alleviate worry, doubt or fear. 

REPETITIVE QUESTIONING AS A BEHAVIOUR OF CONCERN

Some children ask the same questions so many times that it becomes excessive. Questioning can be repetitively asking about an activity (e.g. Do I have to go swimming?), time (e.g. When are we having lunch?), person (e.g. Is Simona coming today?), place (e.g. Can I sit in the front seat of the car?) or transport (e.g. Are we going to miss the train?).

It is important to note that repetitive questioning behaviour exists for a variety of reasons, and is particularly prominent in children with anxiety, Obsessive-compulsive disorder, traumatic brain injury, Autism spectrum disorder, Smith-Magenis syndrome, Fragile X syndrome and PraderWilli syndrome.

IMPACT OF REPETITIVE QUESTIONING BEHAVIOUR

Most children and adults try to stay as patient as possible but at times they may feel tired of answering the questions and in exasperation, snap and say something like, ‘I have already told you the answer a hundred times’, ‘We just talked about this two minutes ago’ or ‘Why do you keep asking me when you already know the answer.’ However, these responses only seem to increase the child’s stress and the situation worsens

When a child begins to persistently exhibit repetitive questioning behaviour, the climate of the context (e.g. childcare, early childhood, primary and secondary school, disability support and youth services) can change dramatically. A considerable amount of time and energy can be spent on the child showing the repetitive questioning behaviour, which can have a deleterious effect on the quality of the learning experience for all the children. Research consistently shows that managing behaviour is linked to staff experiencing high levels of stress, burnout, and job dissatisfaction.

Repetitive questioning affects everyone involved and the child who is asking questions repetitively requires necessary help to learn positive ways of behaving and managing their emotions.

POSITIVE BEHAVIOUR SUPPORT AND REPETITIVE QUESTIONING BEHAVIOUR

Positive Behaviour Support (PBS) focuses on evidence-based strategies and person-centred supports that address the needs of the individual and the underlying causes of behaviours of concern, to enhance the quality of life for both the individual and those that support them.

PBS recognises that there is no single cause for repetitive questioning behaviour. It is a complex behaviour that is a product of the interaction between multiple factors contributing to its development and persistence. 

Repetitive questioning behaviour is like the tip of the iceberg so it is essential to look beneath the surface to work out the why before we can address the problem.

There are three main setting-related factors which impact the child and their behaviour:

  • environment
  • activity, and
  • interaction

These factors place different demands on the child and when any of these demands outweigh the child’s skills to cope with them, the child engages in repetitive questioning behaviour. Repetitive questioning may be the only way the child has learnt how to respond to these demands and get their message across.

 EXAMPLE:

David is an adolescent with Autism spectrum disorder. He wants to interact but has a limited range of topics he can talk about. During break times he will often approach a child and say, ‘Hi, my name is David. What’s your name? How old are you? For breakfast I had ______________.’ He will then walk away from the child and come back and say, ‘Hi, my name is David. What’s your name? How old are you? For breakfast I had ___________.’ A few minutes later he will repeat the same interaction. Each time the other child responds, David gets excited and starts to flap his hands because he already knows the answer the child is about to give. Even though his teacher signals him to stop he can’t, it’s like he is stuck. His teacher has noticed that there is an increase in his repetitive questioning when he is feeling anxious. Some of the social situations that cause David anxiety include meeting and talking to new staff or children, especially if he is interacting with them in an unstructured activity.

The skills David needs to have to minimise or avoid the use of repetitive questioning include:

  • Conversational skills – Does David know any different questions he can ask to start and maintain a conversation?
  • Non-verbal communication skills – Can David recognise if the listener is getting bored?
  • Control and competence – Does David like to demonstrate his knowledge and competence by controlling the questions that are asked in the conversation?
  • Emotional regulation – Does David know how to manage his anxiety?
  • Perseveration – Does David know how to break out of being stuck in a repetitive loop of asking the same question over and over again?

As David does not have these skills, he engages in repetitive questioning. The example highlights that repetitive questioning behaviour is not without purpose.

It is never too late to address repetitive questioning behaviour, even if it has been occurring for a while. PBS provides a road map to address repetitive questioning behaviour by using a holistic approach to develop a comprehensive and individualised PBS plan in three stages: Assess-Manage-Prevent.

Developing a comprehensive and individualised PBS plan to address the repetitive questioning behaviour involves three stages: Assess-Manage-Prevent.

  • ASSESS: How to identify the reasons that contribute to the repetitive questioning behaviour,
  • MANAGE: How to respond when repetitive questioning behaviour occurs, and
  • PREVENT: How to minimise or eliminate the occurrence of repetitive questioning behaviour.

ASSESS STAGE

Assess Stage Aims

The Assess stage helps to identity:

  • Activities during which the repetitive questioning behaviour occurs,
  • Environments in which the repetitive questioning behaviour occurs, and
  • People dealing with the repetitive questioning behaviour.

Assess Stage Checklist:

  • Child’s profile – Gather information about the child to create a comprehensive picture of the child, their abilities and needs.
  • Behaviour data collection forms – Record measurable details (e.g. frequency, intensity, duration) about the child’s repetitive questioning
  • Functional Behaviour Analysis (FBA)- Systematically reflect on an incident by analysing the antecedents (what preceded the repetitive questioning behaviour), describing the repetitive questioning behaviour, consequences (what happened after the repetitive questioning behaviour).
  • Hypothesis – Determine the purpose (function) that the repetitive questioning behaviour served.

MANAGE STAGE

Manage Stage Aims

The Manage Stage outlines how to effectively respond to the behaviours that occur before the repetitive questioning and after. Appropriate responses can help to safely defuse, redirect, and de-escalate the situation in the least disruptive manner.

Manage Stage Checklist:

  • Escalation stages – Help those supporting the child to recognise the number of stages the child exhibits as their emotion rises (i.e. mild escalation, moderate escalation, extreme escalation, and recovery stage).
  • Escalation profile– Help those supporting the child to recognise what non-verbal and/or verbal behaviours are exhibited in the different escalation stages, where the repetitive questioning behaviour occurs in the escalation and how long it can last.
  • De-escalation plan – Help those supporting the child with guidelines on how to immediately respond when the behaviour occurs, safely defuse, and de-escalate the situation in the least disruptive manner.

PREVENT STAGE

Prevent Stage Aims

This stage aims to minimise the occurrence of the repetitive questioning by reducing or avoiding the triggers that cause it and teach the child alternative behaviours.

Prevent Stage plan

The plan details strategies to minimise or avoid the triggers that contribute to the repetitive questioning behaviour by providing the child with:

  • Supportive environments – Tailoring environment related aspects to minimise or avoid triggers that contribute to the occurrence of repetitive questioning
  • Supportive activities – Tailoring activity related aspects to minimise or avoid triggers that contribute to the occurrence of repetitive questioning
  • Supportive interactions – Tailoring interaction aspects to minimise or avoid triggers that contribute to the occurrence of repetitive questioning behaviour, and
  • Teaching the child – Teaching the student positive ways of communicating their messages and managing their emotions and behaviours.

R FOR REPETITIVE QUESTIONING: POSITIVE BEHAVIOUR SUPPORT GUIDE

Use the practical tools (checklists, forms, and strategies) in R for Repetitive questioning: Positive Behaviour Support guide to develop comprehensive PBS plans that can be used to support children of all ages consistently in all settings.

This invaluable guide is useful for parents, caregivers, educators in childcare, early childhood, primary and secondary schools, disability, mental health, allied health, and supervisory professionals.