Newly qualified practitioners’ perceptions of the definition and management of challenging behaviour on the paediatric caseload
Jones, Cain Eleri
Cardiff Metropolitan University
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Background: Due to the apparent comorbid relationship between speech language and communication difficulties (SLCD) and challenging behaviour (Kevan, 2003; Campbell 1995) speech and language therapists (SLTs) are very likely to encounter challenging behaviours on the paediatric caseload. However, little is known of SLTs’ attitudes and opinions about working with children who have challenging behaviour (Parrow, 2009) Aims: This small-scale study intended to explore newly qualified practitioners’ (NQPs) perceptions of challenging behaviour on the paediatric caseload. The study also aimed to identify any common themes or re-occurring opinions which would lead to the suggestions of future action, or further research directions. It was anticipated that achieving the aim and reaching an outcome would provide the speech and language therapy profession with useful information regarding dealing with challenging behaviour on the paediatric caseload. Methods & Procedures: Purposeful sampling was used to find four participants. Semi-structured interviews were used to explore the NQPs’ opinions, and thematic analysis was used to analyse the interview transcripts. Outcomes & Results: Asking the participants to define challenging behaviour generated patterned responses, as all participants discussed having to change their session plans as part of the definition. Spending time getting to know children on their caseload was considered as a factor which made making management decisions easier. Physical behaviours and non-compliance were believed to be the most challenging types of behaviour. Specific language impairment (SLI) was not considered a particularly challenging client group, while children with autistic spectrum disorder (ASD) and parents were identified as particularly challenging client groups. Management decisions were influenced by a variety of factors, the most prominent being advice from higher banded co-workers, previous experience, and a formal diagnosis. There was an identified lack of support from university, clinical placements and the workplace, and no guidelines were reportedly used by the NQPs Behavioural rewards technique was the only technique reported to be used by the NQPs. The NQPs expressed how learning is on a continuum, and the process of learning does not end once graduated, rather it continuous into qualified practice. Conclusions & Implications: A percentage of the perceived challenging behaviour displayed by paediatrics might simply be a case of ineffective management as a direct result of NQPs’ rigid session plans, therefore suggesting that session plans need to be more flexible. However these assumptions cannot be generalised to the wider speech and language therapy profession. Behavioural rewards technique is the only technique used by NQPs to manage the challenging behaviour which occurs, making room for arguing that more support and teaching/training is needed in the field of managing challenging behaviour.
B.Sc. (Hons) Speech and Language Therapy
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