All children engage in challenging behaviour from time to time which may or may not persist or be of concern. Behaviour is often a child’s way of communicating their wants and needs and in some cases may be their only method of communication. A child makes their needs known through observable actions. For example a child may indicate with gestures that they want a certain item or don’t want something they’ve been given, that they want more or less of your attention or that of a peer, that they don’t want to do a certain task or to go to a particular place, or that they don’t want to stop doing an activity that they are enjoying.

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Behaviour is also a child’s way of telling their caregiver that he or she is in physical pain or discomfort, tired, hungry or ill.

Generally, a child demonstrates certain behaviour in the presence of certain people and not others, in specific situations or environments, and under some conditions while not in others.

When determining if a behaviour is of concern, it is important to keep in mind the context, the age and stage of the child, as well as to ascertain if there is an explanation for the behaviour.

When challenging behaviour happens many times each day, for long periods of time, or presents an immediate risk to the child or others it may require assessment and intervention from a professional.

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If a child presents  any type of the following behaviours, consider this a red flag:

 

Self-Injurious Behaviour

► Bites self, slaps self, grabs at self

► Picks at skin, sucks excessively on skin/ bangs head on surfaces

► Eats/ingests inedible items

► Vomiting (when not obvious illness)

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Aggression towards others

► Hits; kicks; scratches; bites; pulls hair; pushes; shoves

► Cruelty to animals
► Throws objects at a person

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Property Distruction

► Bangs, throws, slams, breaks objects

► Sets fires

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Difficulties with Social Behaviour

► Unable to remain on task for specified length of time

► Excessively energetic or physically over active

► Restless; unable to sit still; continuously standing up, sitting down, or moving

► Screams; cries excessively; swearing and/or verbal threats

► Name-calling

► Hoards; steals; lies

► Has no friends; socially isolated; will not make eye or other contact; withdrawn

► Anxious; fearful/extreme shyness; agitated

► Sudden mood changes; laughing, crying and/or screaming for no obvious reason

► Compulsive behaviour; obsessive thoughts; bizarre talk

► Undresses in public

► Touches self or others in inappropriate ways

► Advanced/inappropriate knowledge/behaviour of a sexual nature for developmental age appropriateness

► Flat affect, inappropriate emotions, unpredictable angry outbursts

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Cooperation
► Refusal to follow instructions; needs several verbal prompts to complete a task
► Difficulty following multiple step instructions
► Runs away

► Resists any form of physical contact including when provided assistance

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Life Skills

► Deficits in age appropriate skills e.g. eating, toileting, dressing, play, etc.

► Loss of skill previously mastered

► Change in typical habits e.g. eating, sleeping, toileting, etc.14Difficulty managing transitions/routine changes

► Often needs physical prompting to move or to do things; consistently tired or sleepy

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Sleep

► Excessive tiredness e.g. yawning, falling asleep
► Reports nightmares, frequent awakenings
► Late/early bedtimes and awakenings

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Repetitive behaviour (in excess, or in the absence of functional play skills)

► Hand-flapping; hand wringing; rocking; swaying
► Taps surfaces
► Twirling; object manipulation i.e. lining up toys, spinning wheels, etc.

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Communication

Limited or no means of communication through:

► Verbal i.e. words

► Augmentative or alternative communicative system e.g. Picture Exchange Communication System, American Sign Language, Proloquo2Go, etc.
► Engages in any of the above behaviours in order to gain access to items or to avoid or leave a situation

If you identify any of the above Red Flags, please also refer to the following domains in this guide for other possible referrals:

• Autism

• Nutrition

• Sleep

• Speech and language

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