Thank you for a great article! I have a child with Down syndrome who is quite difficult and we are still working on figuring out how to deal with his behaviors.

My grandson is 7 years old and has Down Syndrome and he has days when he is very agreeable and cooperative: other days he is terribly oppositional. When his mother asks him why he does not do something that he is told he always says, "I don't know." I am wondering if he shuts down and really cannot remember why he did not obey or if it is a defense mechanism. My daughter is at her wits end and doesn't know how to deal with him. How can we know why he is so unpredictable. He behaves similarly in school. Help!!

There is not a lot to go on here so forgive me if I cover ground you have already tread. I would rather be thorough than leave out something that may be important. The first thing to do is to be clear about what you mean by "oppositional." It is normal for 7 year olds to be non-compliant about 20% of the time. For people with communication difficulties it can be harder to negotiate (e.g., "I don't want to do this now", "can I do it later?", "I don't want to") when asked or told to do something undesirable and so "behavior" becomes the only way to communicate. Behavior also becomes the outlet for built-up frustration. The more a person with language difficulties is pressed, the more frustrated they can become and therefore "behaviors" can escalate. I would not expect your grandson (or any 7 year-old) to understand why he is feeling frustrated and to be able to articulate what is going on for him thus I would stop asking him to explain himself as this will probably only increase his frustration and your daughter's. Instead, I would advise you to keep a record of what is going on when he is behaving in an "oppositional" manner so that you can find patterns. To do this, first be clear about when he is being "oppositional." What does this look like as opposed to something else? Then every time he engages in oppositional behavior, record what happened immediately before and immediately after. Also note the time of day and any pertinent info like how did he sleep the night before, was he hot or tired, etc. Record only what you actually observe and keep it factual. For example, mom asked "do you want a turn?" before the behavior and immediately after mom said "no!". If you do this you will start to see a pattern and given that this behavior is not consistent I would expect that there is some setting event like his sleep pattern or time of day, particular activity or something of that nature that is behind it all. The other thing to look for is a sensory component to his behavior. Is there a particular sound that causes him to react (e.g., a frequency), fluorescent lights, or something of that nature? It is not as uncommon as people think. Behavior is rarely truly unpredictable, but it is often difficult to find the cause.
I hope this is helpful. Please come back to me if this is not clear.

Hi,
I have a 3 year old boy with down syndrome. He has had a number of medical comorbidities so his development is on the whole at the slower end of his down syndrome counterparts. However he is a happy, well adjusted boy who responds well to positive feedback. My current challenge is that he constanly throws his drink cup when he has finished his mouthful. This happens constantly, wether at the table, sitting outside.... the setting doesn't influence his behaviour. I have tried positive feedback when he places the cup on the table etc, combining this with disapproval when the cup gets throw, and also hold his hands and repetitively show him what is expected. I don't feel like I am winning, i feel like it is becoming a game and a habbit and his 15 month old brother is now copying this behaviour. Any suggestions or ideas you could give me would be very welcomed.
Thanks!!!

My 8yr old son who has downs is very well behaved at home but we are have a lot f trouble at school! There are several new kids in his class this year who have somE behavior issues. His teacher says he has started mimicking these kids and now hs behavior s becoming a problem! Neither she nor I know what to do about this ! We are at a loss! We are glad he s finally socializing with other kids but how can we make him understand his behavior is wrong?

Hi Tammy,

You might try writing a social narrative (i.e., a book) with him to help him understand what behaviors are OK and which are not. You can do this by taking photos or googling images of behaviors that you expect at school and explain in the book how exhibiting these behaviors benefit him (e.g., make teacher and mum happy, gets to go to recess, etc.) Use simple language and I like to talk about "good choices" and "bad choices" to let him know that behavior is a choice and use your story book to link those choices to consequences. After covering expectations, include examples of the bad behaviors of other students (no names or references to individuals) and label them a "bad choice" and explain in the book what the consequences are for those behaviors.

The other issue is that when he exhibits these behaviors other kids might be laughing and that can keep him making a "bad choice." If this is the case, the teacher needs to find a way to get him in a quick time out so that the reaction of the other kids is minimized. Sometimes I simply place my body between the child and the peers, making sure that my back is to the child and the child can not see his peers (though he can still hear them.)

I don't know the particulars of your case, but I think these strategies could go a long way to helping.

God Bless,
Ann

My daughter is 7 years old and has DS. She has been having the same difficulties at school as your son, Tammy. She is in a general education 1st grade classroom, only pulled out of the class for Reading. She is normally great at home, but, naturally, things aren't as structured at home as they are at school. She becomes fixated- sometimes downright OBSESSED- with certain things for months at a time, such as certain foods or television shows. We can handle her behavior at home if she starts to act up, but the school can't seem to get her redirected. I have gotten a call once a week since school started in August; a teacher telling me that she can't control her behavior, and "doesn't know what to do." We are at a loss as well, I think mainly because I'm not there to do the typical things that we do to redirect her, or keep the triggers away. Also, the things they are saying she's doing (climbing under tables, yelling at the teachers, downright defiant attitudes) are baffling us, because this behavior isn't present at home. Talk about embarrassing though....
My question is, what are some techniques that you would suggest for discipline/redirection? We may even be able to incorporate them at home if need be. Currently, there is a policy in which the students pull cards of different color, each card meaning a different discipline level (e.g. if the student pulls a green card, s/he will lose 5 minutes of recess.) The problem is that my daughter does not comprehend the action that caused her to pull the card. (Eliminating the cause.) She will turn the card back when the teacher isn't looking. Then when she arrives home from school, she can say "I stayed on green today, Mommy!" This policy is NOT working for her, OBVIOUSLY. I am genuinely concerned because I don't want her learning process to be hindered, nor do I want her to be disrupting the class by her behaviors. Any ideas are welcomed!

Hi,

You mention that your daughter is in first grade, so I am assuming that you live in the U.S.A. You should have a resource teacher available and most districts also have a behavior specialist. You can also ask that a behavior plan be drawn up as part of your IEP (you do NOT need to wait until the next IEP to have this added.) To make a behavior plan, someone needs to do a "functional behavioral analysis" to determine why your daughter is feeling the need to crawl under tables and yell at the teachers. In most instances, children exhibit these behaviors to escape something and not to be "defiant," although I know it looks like defiance. A behavior plan to stop the behaviors will not work unless the underlying cause is addressed. It is possible to stop behaviors like crawling under the table, but unless the cause is addressed she will simply replace it with some other inappropriate escape behavior. Here are some common triggers:
work- too hard or too easy. Is the print too small, too cluttered?
sensory- are there too many demands being placed on her without adequate sensory breaks? Sensory overload causes most of us to resort to bad behavior and many people with Down syndrome have inefficient sensory systems that get overloaded quicker. Talk to an occupational therapist if you have concerns here because a sensory diet can help.
unclear expectations - does she really understand what is expected of her at all times? Repeating rules does not mean she understands them. Simple pictures depicting expectations can really help (e.g., "walk in hall," "listen to teacher," "hands in lap.") Your school speech therapist can help you with this.
I would also recommend that you make a meeting with the school staff to share your observations and how you redirect the obsessive behavior at home. Obsessive behavior is fairly common in Down syndrome and it does need to be "nipped in the bud" where possible and your experience would be invaluable to the staff. I also think that along with behavioral strategies, it is more important that staff believe in your daughter's potential. She is only 7 and only at the beginning of her school career. I think it is great that you are taking this on board and wanting to intervene, but it will get better. Push for that functional behavioral assessment!
Ann