Lost at School (28 page)

In fact, once people start using the CPS model with a kid, they discover that there’s an impressive, perhaps overwhelming, pile of accumulated problems that have been precipitating challenging behavior for a long time. Remember, you won’t be able to solve them all at once. Work toward solutions for one or two problems at a time, then move on to other problems once those initial problems are solved, all the while watching for whether the solutions to the initial problems are standing the test of time. After a while, you’ll have made quite a dent in the pile of problems and the kid will have the beginnings of some new skills. Keep returning to the pile as necessary.

Question:
Aren’t there some challenging kids who need meds?

Answer:
Yes, though nowhere near as many as are actually
on
meds. Overmedicating kids flows from an overemphasis on diagnoses, the ease with which medications are prescribed, a lack of awareness of the true factors underlying kids’ challenging behavior, the failure to achieve a comprehensive understanding of a kid’s challenges, and a lack of knowledge of Plan B. That said, there are some kids for whom
psychotropic medication is an indispensable component of treatment and whose participation in Plan B is impossible without medication. It’s crucial to differentiate between the things psychotropic medicine does well and the things psychotropic medicine does not do well lest, as is commonly the case, medicine be prescribed for things medicine does not do well. Medicine is effective at reducing hyperactivity and poor impulse control, improving attention span, enhancing mood, reducing obsessive-compulsive behaviors and general anxiety, reducing tics, inducing sleep, and helping volatile, aggressive kids be less reactive. Medicine does not teach skills.

Question:
What if school staff thinks a kid needs medication and the parents don’t agree?

Answer:
First, you’ll want to assume that the parents have legitimate concerns about medicating their child. You’ll want to hear as much as possible about those concerns (that would be the Empathy step). Then you’ll want to describe the specific difficulties the child is having that you feel would be well-addressed by medication (that would be the Define the Problem step). Then start brainstorming to arrive at solutions that address the concerns of both parties (the Invitation), if necessary (and with parents agreeing that it’s a good idea) bringing in additional expertise and collaborating with professionals who may already be working with the child. “Medication yes” versus “medication no” is just dueling solutions.

Question:
You said it was going to take awhile to become skilled at Plan B and solve the problems on my trigger list and teach some of the skills on the ALSUP. What do I do in the meantime while I’m waiting for Plan B to work?

Answer:
You’re
reducing your use of Plan A
because you now understand that Plan A heightens the likelihood of challenging behavior in challenging kids. Thus, you’ve eliminated many of the challenging behaviors that could have been set in motion through your use of Plan A. And because you now understand that the kid can’t handle all the expectations on his radar screen, you’ve
increased the use of Plan C,
thereby eliminating some expectations and reducing challenging behavior even further. While Plan B is the process by which you’re pursuing
the expectations that remain, teaching skills, and helping the kid solve problems, it’s not the only ingredient in the mix.

But it depends a little on what you mean by
working
. What a lot of people mean by
working
is that the problem-solving process has reached its ultimate destination: the problem has been durably solved. But there are a lot of “workings” on the way to the ultimate destination, and it’s important not to lose sight of them. At the micro level, Plan B is working if a kid is willing to stay in the room with you to talk about an unsolved problem. It’s working if the kid actually talks (if he doesn’t, then Plan B is working if you’ve started pondering why he’s not talking so that he eventually does talk); if the adults finally achieve a clear understanding of the kid’s concern or perspective; if the kid listened to your concern; if you and the kid are contemplating solutions together; if you agree on a solution and begin to enact it. And it’s working if the kid is willing to return to Plan B if the first solution doesn’t stand the test of time. At the macro level, Plan B is working if your relationship with the kid is improving. It’s all good, even though solving the problem durably is your ultimate destination.

That said, there are certainly times when you’ll need what might be called interim interventions while you’re on the way to solving a problem. For example, even though Kelvin’s teachers were aggressively trying to solve the problems that were precipitating his challenging episodes, they didn’t make enough progress early on to circumvent a lot of these episodes. Specifically, they had to find a place for him to cool off and collect himself if he became agitated and had to develop a plan for him to seek help from adults. Once they started making inroads on the problems that were setting the stage for his challenging episodes, his use of his cooling-off spot and frequency of seeking help were dramatically reduced.

Question:
In the research literature, training cognitive skills in kids with challenging behavior often hasn’t fared very well. How is CPS different?

Answer:
In the research literature (and in real life) cognitive skills training has often been conducted outside the environments in which a kid is having the greatest difficulty and by people the kid isn’t having difficulty with—for example, in the office of a guidance counselor, principal,
or mental health professional or in a researcher’s lab. Skills taught in these artificial environments often haven’t generalized to the environments in which the kid was having difficulty. In addition, the training has often been done in a rote, circumscribed fashion using skills-training modules or curriculum that were not tailored to the specific lagging skills or unsolved problems of individual kids, so the skills weren’t learned. The CPS model is designed to be applied by those who are in the environments in which a kid is having his greatest difficulties, and the artistry of the model is how it is tailored to individual kids.

Question:
I’m having trouble imagining doing Plan B with kids younger than ten years old.

Answer:
Plan B is frequently successfully implemented with kids as young as three years of age. The key variable is developmental skills, not chronological age. I’ve worked with three-year-olds who were able to participate in Plan B more readily than many of the seventeen-year-olds with whom I’ve worked.

Question:
Does CPS help with kids on the autism spectrum?

Answer:
It’s often assumed that the CPS model has no application to these kids, and that well-known applied behavior analysis methodology is really the only option. I beg to differ. “Autism spectrum” doesn’t say anything about the kid’s general cognitive functioning, and unless you’re ready to throw in the towel on teaching the kid lagging skills or helping him learn to solve problems—and hopefully you’re not—then CPS may well have a role to play. The most common obstacle is communication skills.

As described earlier in this chapter, you’ll want to focus first on helping the kid develop the skills to communicate his concerns (often through pictures or hand signals) in a very rudimentary manner, and if the kid is unable to provide much information about his concerns, then your powers of observation and intuition will be crucial. Of course, because your powers of observation and intuition aren’t infallible, you’ll need to continue observing and intuiting so you can recognize if you’ve hit the nail on the head with your hypotheses about the kid’s concerns. Then you’ll want to focus (if it’s feasible) on helping
the kid express those concerns verbally and watch closely to see if there is some mechanism for the kid to participate in generating solutions.

Question:
Are there kids Plan B won’t help? Who need to be placed in programs outside of public schools?

Answer:
There are kids who might, despite our best efforts, need to be placed in such programs. But it would be interesting to see how the numbers of those kids would change if more schools were incorporating CPS into their practices for assessing and addressing the needs of kids with behavioral challenges. In several current projects, researchers are examining the degree to which implementation of the CPS model reduces not only challenging behavior but also special ed costs and referrals, the use of suspension, detention, and expulsion, and placement of kids in programs outside of their home schools.

The Story Continues …

On the Monday morning after Joey’s run-in with the sub, Mrs. Woods, Mrs. Franco, Dr. Bridgman, and Mr. Middleton gathered in the assistant principal’s office. Joey was asked to wait outside for a few minutes.

“Mrs. Woods, how do you feel?” asked Mr. Middleton.

“Not completely up to par, but I’m here,” said Mrs. Woods.

Mrs. Franco looked sympathetically at her friend. “She should have stayed home another day.”

“Mrs. Woods, I talked with Mrs. Franco and Mr. Owens about what happened in your classroom on Friday,” said Mr. Middleton. “It seems that we didn’t do a great job of letting poor Mr. Owens know about the plan you had worked out with Joey. I’m going to apologize to Joey for that. I assume your plan had been working up until then?”

“Joey and I have been meeting some days before school to go over assignments that I think might be confusing for him,” said Mrs. Woods. “He’s been very good so far about coming to school early to meet with me, and he’s been using a signal we’ve developed to let me know if I’ve missed any.”

“Good,” said Mr. Middleton. “But walking out of the classroom and pounding his fist into a locker is not acceptable behavior around here, and Joey needs to know that. Now, I thought we should meet because I wanted to respect the fact that you all have been working together to help Joey control himself. And I wanted to involve you in the discussion about what we’re going to do about what happened on Friday. I know that Mrs. Franco feels Joey handled himself reasonably well on Friday—I can’t say that’s my perspective exactly, but I wanted to get everyone’s input.”

“Well, whether what happened on Friday was an improvement or not, it tells us we have more work to do, especially in the communicating department,” said Dr. Bridgman. “And I also think that we should probably start talking with Joey about why he gets embarrassed so easily in front of the other kids and about what we can do to keep that from happening.”

Mr. Middleton considered this perspective. “OK, of course, we still have the matter of our school discipline code to consider. And what our school discipline code says is that Joey should be receiving one detention for leaving the classroom without permission and in-school suspension for destruction of property.”

“It says that, does it?” asked Mrs. Franco.

“Yes, it does,” said Mr. Middleton. “Why?”

“You want my honest opinion?” asked Mrs. Franco.

Mr. Middleton smiled. “Mrs. Franco, I’ve learned that under most circumstances you’re going to give me your honest opinion whether I want it or not.”

Mrs. Franco returned the smile. “Well, no offense, but I don’t think much of our school discipline code. I’m the one who ran after him when he left the classroom and I’m the one who was out in the hall with him. And I’ll admit I was scared when he hit that locker. But I could see how hard he was trying to hold it together, and I think punishing him for trying hard is not the message we want to be sending him.”

“Of course, telling him it’s OK to leave the classroom and slam lockers is not the message we want to be sending, either,” said Mr. Middleton.

Dr. Bridgman cleared his throat. “We have other options besides Plan C—where we’re doing nothing about what happened and maybe giving Joey the impression that what he did was OK—and Plan A, where we’re punishing Joey for what happened. Don’t forget about Plan B.”

Mr. Middleton leaned forward in his chair. “Tell me more.”

“Joey knows that leaving the classroom and punching a locker aren’t OK,” said Dr. Bridgman. “But he still doesn’t know what to do when he’s embarrassed in front of the other kids, and he didn’t know what to do when Mr. Owens didn’t know the plan. But detentions aren’t going to teach him those things. If we do Plan B with Joey, we’ll work on solving those problems, especially the embarrassment one, because it comes up a lot.”

“And what message are we sending the other kids if we don’t do what the school discipline code says we’re supposed to do?” asked Mr. Middleton.

“What message are we sending the other kids if we continue to apply an intervention that isn’t working?” asked Dr. Bridgman.

Mr. Middleton smiled slowly. “Dr. Bridgman, that’s a good question. Mrs. Woods, Joey spends most of his time with you. What do you think?”

“For one thing, I think I wish I hadn’t gotten sick,” said Mrs. Woods. “But I’m torn. I don’t think giving him a detention is going to accomplish anything, but I also understand that we can’t send the wrong message to the other kids.”

“I think we need to do what’s best for Joey,” said Dr. Bridgman. “I don’t think the other kids care whether we follow the school discipline code. I think they want us to do whatever it takes for Joey to have better control of himself.”

“But if we don’t stick to the discipline code, what’s to stop the other kids from just walking out of class and hitting a locker?” asked Mr. Middleton.

“The other kids aren’t behaving themselves because of the discipline code,” said Dr. Bridgman. “They’re behaving themselves because they
can.
They’ve been watching Joey get punished for a long time. What they want us to do is
help
him. We don’t teach every kid academics the exact same way, especially if they’re struggling. I don’t think we should apply a rigid algorithm of punishments to a kid if he’s struggling, either.”