Hyperactivity involves the child engaging in excessive motor activity.
HYPERACTIVITY AS PART OF NORMAL DEVELOPMENT
It is normal for children to be active and some children are more active than others. As children mature, they develop a range of skills and abilities supported by adult guidance which help them develop how to better control their body.
WHEN HYPERACTIVITY BECOMES OF CONCERN
Whilst most children over time learn how to calm their body when instructed to, or are required to stop so that they can engage in an activity, children with hyperactivity struggle.
For example, during a floor time activity a child will roll around on the carpet, or roam around the room aimlessly touching everything in sight. They may make sudden noises when everyone is expected to quietly listen to the book being read; or grab toys from the toy basket in a haphazard manner without playing with any of them properly; or climb on furniture. Whereas, during lunch time, an adolescent who is sitting with peers will fidget with something (e.g. cutlery, condiment shakers) or squirm and reposition constantly in their seat and experience excessive mind-wandering which affects their ability to partake in the conversations as they often interrupt others and take over the conversation.
Hyperactivity may present on its own or co-occur with conditions such as Attention Deficit Hyperactivity Disorder, Sensory Processing Disorder, Hyperthyroidism, Anxiety Disorder and Fragile-X disorder.
IMPACT OF HYPERACTIVITY
Having to constantly guide a child’s hyperactivity is stressful and wearing. Continually having to say ‘Could you please stop tapping?’, ‘What are you throwing? Should you be touching that?’, ‘For the fifth time could you please stop talking’ or ‘How many times do I need to tell you to stop running?’ tests everyone’s patience. It often results in people feeling frustrated, annoyed and stressed as the child does not appear to listen. The climate of the context (e.g. childcare, preschool, kindergarten, school, disability support and youth service) can change dramatically. A considerable amount of time and energy can be spent on the child showing the hyperactive behaviour, which can have a deleterious effect on the quality of the educational experience for all children. Research consistently shows that managing behaviour is linked to staff experiencing high levels of stress, burnout, and job dissatisfaction.
Hence, hyperactive behaviour affects everyone involved and the child who is hyperactive requires necessary help to learn positive ways of behaving and managing their emotions.
POSITIVE BEHAVIOUR SUPPORT AND HYPERACTIVITY
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 hyperactive behaviour.
Hyperactive behaviour does not occur in a vacuum, but within a context.
There are three main setting-related factors which impact the child and their behaviour:
- activity, and
These factors place different demands on the child and when any of these demands outweigh the child’s skills to cope with them, it can contribute to the occurrence of behaviours of concern.
Harry is a seven-year-old boy with ADHD and Sensory Processing Disorder (SPD). To get to school he needs to sit on the bus for an hour. When he arrives at school he needs to unpack his backpack, engage in a free time activity for about 10 minutes – either read a book or make a puzzle – then take part in a twenty minute morning circle. During morning circle, within a couple of minutes he will start wriggling and fidgeting. He will then start touching the children next to him. As the other children move away from him he then will often stand up and start running around the room. As he is running he may jump on chairs, bump into people and vocalise loudly. When his teacher and the other children call out to him to stop, it’s as if he can’t hear what they are saying, and he does not stop. Despite repeated reminders to remain seated he doesn’t.
- Communication skills – Does Harry understand the educator’s instructions? Does Harry have a way of expressing his sensory needs? Does Harry have the skills to express his feelings (e.g. I’m feeling bored of sitting here for a long time) and his needs (e.g. I need a movement break).
- Self-regulation skills – Is Harry aware of his needs and behaviours?
- Sensory needs – Can Harry engage in passive/low movement activities (e.g. sitting on bus, free time activity) for long periods of time without engaging in active/high movement activities? Does Harry have a sensory diet so that throughout the day he gets the necessary movement input, i.e. active movement/passive movement/active movement/passive movement, at frequent intervals to prevent him from becoming dysregulated in passive activities?
As Harry does not have the skills and supports needed to cope with the demands, he resorts to exhibiting a range of challenging behaviours.
The example highlights that hyperactive behaviour is not without purpose. It is important to investigate the triggers that could be contributing to the occurrence of hyperactive behaviour. It is never too late to address hyperactive behaviour, even if it has been occurring for a while.
Developing a comprehensive and individualised PBS plan to address the hyperactive behaviour involves three stages: Assess-Manage-Prevent.
- ASSESS: How to identify the reasons that contribute to the hyperactive behaviour,
- MANAGE: How to respond when hyperactivity occurs, and
- PREVENT: How to help the child learn positive ways of behaving and managing their emotions.
Assess Stage Aims
The Assess stage helps to identity:
- Activities during which the hyperactive behaviour occurs,
- Environments in which the hyperactive behaviour occurs, and
- People dealing with the hyperactive 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 hyperactive behaviour.
- Functional Behaviour Analysis (FBA)- Systematically reflect on an incident by analysing the antecedents (what preceded the hyperactive behaviour), describing the hyperactive behaviour, consequences (what happened after the hyperactive behaviour).
- Hypothesis – Determine the purpose (function) that the hyperactive behaviour served.
Manage Stage Aims
The Manage Stage outlines how to effectively respond to the behaviours that occur before the hyperactive behaviour 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 hyperactive 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 Aims
This stage aims to minimise the occurrence of the hyperactive behaviour 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 hyperactive behaviours by providing the child with:
- Supportive environments – Tailoring environment related aspects to minimise or avoid triggers that contribute to the occurrence of hyperactive behaviour.
- Supportive activities – Tailoring activity related aspects to minimise or avoid triggers that contribute to the occurrence of hyperactive behaviour.
- Supportive interactions – Tailoring interaction aspects to minimise or avoid triggers that contribute to the occurrence of hyperactive behaviour, and
- Teaching the child – Teaching the student positive ways of communicating their messages and managing their emotions and behaviours.
H FOR HYPERACTIVITY: POSITIVE BEHAVIOUR SUPPORT GUIDE
Use the practical tools (checklists, forms, and strategies) in H for Hyperactivity: 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.