DEFINING BITING BEHAVIOUR
Biting is a behaviour that involves the use of the teeth or jaw to seize, tear or chew into an object, the self, or another person. Biting can cause injuries that range in severity from a bitemark that barely breaks the skin to broken skin with bleeding, heavy bruising and wounding. The bite may leave a mark or lead to scarring or something serious such as an infection needing medical intervention.
BITING AS PART OF NORMAL DEVELOPMENT
In normal development, many children go through a stage of biting at one time or another, especially in the early years (up to age 3). A child may bite to ease the pain caused by teething. They may explore the world with their mouth or have difficulty expressing their feelings, needs and wants.
When children mature, they develop appropriate ways of communicating their needs, interacting with others, problem-solving, coping with their emotions and controlling their behaviours, which helps them outgrow the biting behaviour.
BITING BEHAVIOUR OF CONCERN
Some children, however, continue to bite. Biting behaviour becomes a concern when the following occurs:
- the frequency (i.e. how often a child exhibits biting behaviour) is of concern,
- the duration (i.e. how long each incident of the biting behaviour lasts) is of concern,
- the intensity (i.e. the strength of the biting behaviour) is of concern, and
- the biting behaviour negatively impacts the child’s participation in activities, interaction with others, their day-to-day functioning and development.
IMPACT OF BITING BEHAVIOUR
The person who gets bitten has a painful experience that can leave them feeling worried that it might happen again, while the parents of the bitten child can be angry that their child was bitten and be anxious about their child’s safety. The parents of the child who bites may feel annoyed at their child and anxious about how others will treat their child. The child may get labelled as ‘the biter’ and others may become wary of the child.
The climate of the setting (e.g. childcare, preschool, kindergarten, school, disability support and youth services) can also change dramatically. A considerable amount of time and energy can be spent on the child showing the biting 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.
Hence, biting behaviour affects everyone involved and the child who is biting requires necessary help to learn positive ways of behaving and managing their emotions.
POSITIVE BEHAVIOUR SUPPORT AND BITING BEHAVIOUR
Positive Behaviour Support (PBS) is an evidence-based approach that is used to eliminate or minimise the occurrence of challenging behaviours.
PBS recognises that there is no single cause for biting behaviour. It is a complex behaviour that is a product of the interaction between multiple factors contributing to its development and persistence.
Biting 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:
- activity, and
These factors place varying demands on the child, and when any of these demands outweigh the skills to cope, the child engages in biting behaviour.
Zac is a four-year-old and is playing with his red car. Zac does not notice Kelly asking to play too. When Zac puts the car in the garage and reaches for a truck, Kelly takes the car.
Some of the skills needed to cope with this interaction include:
- Communication – Can Zac communicate to Kelly that he wants his toy back?
- Emotional regulation – Can Zac regulate his emotions and stay calm?
- Flexibility – Can Zac be flexible and play with the truck if the other Kelly does not return the car?
- Patience – Can Zac wait for the toy to be returned?
- Cooperation – Can Zac play with Kelly and take turns with the car and truck?
As Zac does not have the skills needed to cope, he resorts to biting Kelly, who drops the toy and runs away crying.
Keira is a ten-year-old with a Autism Spectrum Disorder (ASD) and a Sensory Processing Disorder (SPD) so that she is hypersensitive to visual, auditory (noise) and temperature sensory input.
Keira sits at the back of the classroom, next to the heater, which often causes her body to overheat. From her seat, she notices all the activity: using posters, the smart board and computers. It is a busy, noisy environment, and Keira’s senses are often overloaded.
Some of the skills needed to cope with her environment include:
- Self-awareness: Can Keira identify how she is feeling? Can she identify what aspects of the environment are causing the overload?
- Emotional regulation: Does Keira know what strategies to use to manage her emotions?
As Keira does not have these skills, she bites her wrists in frustration. She has learned through previous experiences that when she bites, the oral, touch and deep pressure sensory input helps calm, soothe or organise and regulate her brain.
Maddi is a fifteen-year-old who has test anxiety, which means that her fear, worry and unease about doing a test is so high and intense that it can prevent her from doing her best.
Some of the skills she needs to cope with the activity include:
- Healthy thinking patterns – Can Maddi think in a way that will help her progress to complete the test?
- Relaxation – Can Maddi use any strategies to calm her body and ease her anxiety?
- Resilience – Does Maddi have the skills to keep persisting and persevering in the face of difficulty?
As Maddi does not have these skills, she bites her pencil.
These examples highlight that biting behaviour is not without purpose. Developing a comprehensive and individualised PBS plan to address the biting behaviour involves three stages: Assess-Manage-Prevent.
- Work out why your child is biting (assess stage),
- How to respond when your child bites (manage stage), and
- How to prevent them from biting (prevent stage).
Assess Stage Aims
The Assess stage aims to identity:
- Activities during which the biting behaviour occurs,
- Environments in which the biting behaviour occurs, and
- People dealing with the biting 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 biting behaviour.
- Functional Behaviour Analysis (FBA)- Systematically reflect on an incident by analysing the antecedents (what preceded the biting behaviour), describing the biting behaviour, consequences (what happened after the biting behaviour).
- Hypothesis – Determine the purpose (function) that the biting behaviour served.
Manage Stage Aims
The Manage Stage outlines how to effectively respond to the behaviours that occur before the biting 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 biting 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 prevent the occurrence of the biting behaviours by minimising 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 biting behaviours by providing the child with:
- Supportive environments – Tailoring environment related aspects to minimise or avoid triggers that set off biting behaviour.
- Supportive activities – Tailoring activity related aspects to minimise or avoid triggers that set off biting behaviour.
- Supportive interactions – Tailoring interaction aspects to minimise or avoid triggers that set off biting behaviour, and
- Teaching the child – Teaching the student positive ways of communicating their messages and managing their emotions and behaviours.
B FOR BITING: POSITIVE BEHAVIOUR SUPPORT
Use the practical tools (checklists, forms, and strategies) in B for Biting: Positive Behaviour Support to develop comprehensive PBS plans that can be used to support children of all ages consistently in all settings.
This invaluable resource is useful for educators in childcare, early childhood, primary and secondary schools, disability, mental health, allied health, and supervisory professionals.