Foreword Review — Sept / Oct 2010
One of the major challenges in providing care to a person with developmental disabilities—such as autism or ADHD—is the management of bad behavior, which can include throwing furniture, hitting, biting, and screaming. According to Swedish psychologist Bo Hejlskov Elvén, however, anyone who can behave, will behave. People who are behaving badly may not have any other choice at that moment, in that situation, and it’s up to the caregivers to change the environment to allow for the good behavior that people with developmental disabilities want to accomplish.
Elvén spends much of his book exploring the possible reasons behind bad behavior. He encourages caretakers and teachers to analyze their own attitudes to see if perhaps their expectations are too great, or if they are unconsciously expressing anger. He also points out that behaviors that are classified as bad are often coping mechanisms that keep the service-user (a person with developmental disabilities) from experiencing a worse chaos. Parents and teachers should examine their own reactions to these “bad” behaviors and determine for whose sake the behaviors are being eliminated.
Service-users may be greatly influenced by stress. Pain, sensory overload, change, lack of sleep—all these things can adversely affect a person’s ability to cope. Elvén asks his readers to consider their own reactions to stress and to realize that a service-user may experience the same frustration, only magnified. If surroundings and routine are changed, service-users may have a better chance at behaving well, which is what they really want to do.
Elvén also recognizes that bad behavior cannot always be avoided and offers tactics for solving problems when they do arise, using diversionary tactics, rewards, and other techniques.
Elvén writes with the compassion and clarity that come from years of working with service-users and their caregivers. He knows his subject very well and can communicate both the theory behind his ideas and their practical application.
Examples are plentiful, and include not only stories about service-users but more subtle ones that center on people without developmental difficulties. Elvén often uses himself as an example of how healthy people can still react badly to adverse conditions. We all have ways in which we struggle, and when the parallels are pointed out between people who do and who do not have developmental disabilities, it’s easier to reach understanding and to maintain professional compassion.
Life with a service-user sometimes seems like an endless confrontation. Elvén shows that with a few changes and a different way of understanding, a better quality of life may be obtained for all.