‫‪-١‬مقدمة عن مفهوم التدريب في المركز‬

‫لقد أولت جمعية مؤسسة سند الطفل المعاق الكويتية ومركز الخرافي ألنشطة األطفال المعاقين أهمية‬
‫كبيرة لقطاع التدريب منذ نشأت المؤسسة عام ‪ 2005‬حيث تمحور التدريب في البداية عن أهمية اللعب‬
‫الحر والترفيه لألشخاص من ذوي اإلعاقة وذلك لألولياء األمور والمعلمين والمتخصصين في مجال‬
‫االعاقة ومدى انعكاس ذلك على تطور الطفل في حقول ومجاالت النمو المختلفة حيث تم االستعانة‬
‫بخبيرة بريطانية وهي السيدة أليسون وبالتعاون مع منظمة ‪ kids active‬ثم مع نمو العمل تم االهتمام‬
‫في تدريب المتطوعين سواء افراد او مجموعات خاصة مع برنامج لوياك‪ ،‬ومن بعد هذه المرحلة تم‬
‫التدريب واالعتناء بطلبة التدريب الميداني من طالب الجامعات والمعاهد والكليات التعليمية ‪ ،‬وأيضا‬
‫برزت الحاجة لتوجيه وارشاد أولياء األمور ‪ ،‬هذا باإلضافة للمشاركة في العديد من ورش العمل‬
‫والمحاضرات والدورات التدريبية المحلية واالقليمية والعالمية واالستعانة بخبراء محليين في مجال‬
‫االعاقة والمجاالت المختلفة‪.‬‬

‫‪ -٢‬نرجو مراجعة الدراسة االستشارية الخاصة بإنشاء مركز التدريب ( مرفق الدراسة )‬
‫‪ -٣‬ال يوجد توصيف وظيفي حتى اآلن‬
‫‪ -٤‬المحاضرات والدورات التي تم حضورها او اقيمت في المركز خالل ‪ ٦‬أشهر الماضية‬

‫• ‪ 3/15‬شارك الموظفين في دورة بورتيج المقام في جمعية رعاية المعوقين‪.‬‬

‫• ‪ 3/27‬محاضرة ألولياء األمور من تقديم د‪ /‬أسيل المجبل عن مشاكل القدم الشائعة لدى‬
‫األطفال‪.‬‬
‫• ‪ 11/3‬شارك المركز في ورشة الرعاية المتكاملة في منطقة غرناطة بعنوان ( ورشة القص‬
‫االلكتروني على الكاميو – ورشة االبداع اليدوي في النسيج ) وقد حضر الورشة األخصائية ‪/‬‬
‫نور غسان‬
‫واألخصائية ‪ /‬ايمان عبدالمنعم‪.‬‬

‫‪© Alison John & Associates and Garry West Training‬‬ ‫‪Page 1‬‬
 ‫ بعض المرفقات نبذة عن قطاع التدريب‬-٥
5 Ways

Aims:

• To offer five key strategies to enable parents and carers to empower their Disabled
Children to achieve their human rights and be fully included in the life of their
communities.
• To share experiences and develop the confidence of parents and carers in allowing
Disabled Children to take risks

Learning Outcomes:

• To understand the social and medical models of disability

• To understand the meaning and experience of inclusion
• To identify the barriers to inclusion and how they can be overcome
• To identify language and terminology which contributes to negative stereotypes
• To know about the Children’s Rights and other legislation that supports inclusion

Target Audience
Parents, Carers and families of Disabled Children. The course can be adapted for professionals who
work to support parents of Disabled Children

Number of Students
Minimum: 6
Maximum: 14

Course Requirements
A course delivered by two trainers on two consecutive days. Includes small and large group work

Resources
AJA Course Materials provided. Other recommended resources on display during the course

Courses are delivered in a fun, participative way and can be adapted to engage different
target audiences. Requirements for access, timing and training space will be specified in
advance. The timing of courses can be flexible to meet the needs of learners.

© Alison John & Associates and Garry West Training Page 2

Help I'm Being Challenged!
Aims:

To provide practitioners with an awareness of personal behaviour, environments and triggers that
can affect individual’s behaviour; and provided a skill base that enables the development and
implementation of strategies for supporting behaviour that challenges.

Learning Outcomes
By the end of the session participants will:

• Know the ecology of behaviour and the impact that change has on an individual’s behavior
• Be able to identify levels of behaviour and appropriate practitioner responses.
• To identify essential points for inclusion in an equal opportunities policy
• Recognise how their own attitudes and behaviours impact on their practice and inclusion.
• To develop confidence in managing different behaviour.
• Begin to develop a strategy around positive behaviour, to use in their workplace.

Evaluation Comments

Things that were good about the training:

• Found whole day very useful, course was made fun and interesting. Well done for no
PowerPoint.
• Enjoyed the day, greatly
• Games made information clearer
• Went well. Clear information regarding behavioural cycle
• Enjoyed the behaviour cycle
• Bravo
• Very interactive. All activities related to course content and made me think
• Games were fun – very enjoyable. Learnt lots of valuable information. Thank you !!
• The role play around the stages. Question. Vocal. Etc. calm. Worked really well
• Bananas/Apples role play. Good way to see how behaviour can escalate
• Good mix of theory and practical
• Good delivery of training
• Lots of activities practical and useful. Lots of variety. Lots of ideas to take and use with
others
• Use of ecology of behaviour circles
• Apples & Bananas. Experiencing how it feels to go through process of why we behave the
way we do
• Great group work. Sharing knowledge/experience. Fun
• Very positive. Liked the delivery. Participation as wasn’t expecting that. Very different but
in a good way
• Initial session. In touch with anxiety levels. Everything was useful especially as a parent
• Found it useful to have a mixture of staff and parents. X
• Interactive element worked well. Really encouraged you to think in detail of situations and
your responses.
• I have thoroughly enjoyed today’s session. Excellent facilitators and lots of thought
provoking discussions.
• At times felt challenged!! But that was good really

© Alison John & Associates and Garry West Training Page 3

 • Fantastic course – worn out but learnt loads. Thank You!

Target Audience
Parents and carers, staff responsible for providing childcare, supervisors and managers and
anyone working with children and young people.

Courses are delivered in a fun, participative way and can be adapted to engage different
target audiences. Requirements for access, timing and training space will be specified in
advance. The timing of courses can be flexible to meet the needs of learners.

© Alison John & Associates and Garry West Training Page 4

 Alison John & Associates

&

Garry West Training

Help! I’m being Challenged

www.alisonjohn.com

© Alison John & Associates and Garry West Training Page 5

Help! I’m being challenged.

Purpose of the course

To provide practitioners with an awareness of behaviour and
environments, effects and triggers of behaviour and provides a skill base
relating to development and implementation of strategies for supporting
behaviour that challenges.

Learning Outcomes
By the end of the session participants will:
• Know the ecology of behaviour and the impact change has on an
individual’s behaviour.
• Be able to identify levels of behaviour and appropriate practitioner
responses.
• Recognise how their own attitudes and behaviours impact on their
practice and inclusion.
• Of develop confidence in managing different behaviour.
• Began to develop a strategy around positive behaviour, to use in
their workplace.

© Alison John & Associates and Garry West Training Page 6

 Behaviour Bingo
Has hit someone Has slammed a Has sworn at Has damaged
or something. door. someone. property.

Name: Name: Name: Name:

Has fallen out Has not done Has cried over

with someone something they Has a phobia.
something.
close. should have.

Name: Name: Name: Name:

© Alison John & Associates and Garry West Training Page 7

What is behaviour?
A positive or negative physiological or psychological response to a
verbal, social or physical stimulus, including social stimulus and
communication.

What is Behaviour that Challenges?

Behaviour that challenges (sometimes known as challenging behaviour)
is a response to a type of behaviour others find difficult to manage or
deal with. Examples:
- A three year old having a tantrum for not getting things his/her
own way.
- A child who repetitively challenges authority and ignores the
rules.
- A child who self harms,
- A teenager displaying disrespectful attitude towards
parents/carers

Before we can deal with the behaviour, we are required to understand

the challenge. Children don’t have challenging behaviour; they
experience behaviours that are a response to a variety range of differing
and collective stimuli. Therefore the challenge becomes ‘ours’ and not
the child’s.
This approach compliments the social model approach, where disability
is recognised as a barrier, and not an impairment, opposed to the
medical model approach, which sees the child as the problem. Using a
social model approach enables us to consider our attitudes,
environments and organisational framework that may create a barrier,
which in turn may result in a child’s behaviour becoming challenging to
us.

© Alison John & Associates and Garry West Training Page 8

In retrospect, impairments and medical conditions such as Attention
Deficit Hyperactivity Disorder and Autism Spectrum Disorder do not
directly cause behaviour that challenges, instead a lack of effective and
appropriate communication methods, techniques and resources, lack of
appropriate equality/inclusion training, labelling and stereotypical
attitudes and inflexibility, lack of awareness and ignorance in policy and
procedures caused the behaviour to become challenging to others.
Understanding the ecology of behaviour, stages of behaviour and our
approach to managing behaviour more effectively, by using
individualised behaviour plans and strategies, will result in the behaviour
becoming less challenging, and will enable the development of effective
communication, required to build rapport and trust whilst establishing
respectful relationships.

© Alison John & Associates and Garry West Training Page 9

Ecology of Behaviour (Bronfenbrenner / Manchester Circles)
Focus Area 1 – The Individual
- Normal day-to-day behaviour, Individual Requirements
and communication preference.

Focus Area 2 – The Environment

- Personal space, body language facial expressions and
effective communication of workers. workers,
- Auditory, Visual, Social and Emotional & Sensory
Stimulation

Focus Area 3 – The Organisational Framework

- Policy, procedure & Practice including individual
behaviour strategies and play plans.
- Management of space, time and resources.

Focus Area 4 – The Wider Context

- Legislation including Children’s Rights, Children’s Act
1989 and Every Child Matters and Good Practice
Guidance e.g. Department of Health and BILD Guidance.
- Social, Cultural and family influences and factors.

© Alison John & Associates and Garry West Training Page 10

HELP!
H – How? (Assessment)
- How do I Look, Feel and Sound?
- How do they Look, Feel and Sound?
- Have I got a plan?

E – Environment
- Environmental Factors
o Physical Space
o Emotional Space
o Dynamic Space (Children, Workers & Others)
- How does the environment Look, Feel and Sound?

L – Listen
- Active Listening Skills
- Listening for ‘Facts’ as well as ‘Feelings’

P - PLAN

A, B, C’s
A – Antecedent
B – Behaviour
C – Choices & consequences
S – Strategy’s

© Alison John & Associates and Garry West Training Page 11

 Five-Stage Behaviour Cycle

Stage 5 - Calming

Stage 4 - Physical

De-escalating Behaviour
Escalating Behaviour

Stage 3 - Verbal

Stage 2 - Apprehensive

Stage 1 -
Individual

© Alison John & Associates and Garry West Training Page 12

5-Stage Behaviour Cycle
Stage 1 - Individual
What is ‘natural’ behaviour for the individual?

Who would you need to gather information from to establish an

individual’s natural behaviour?

What information would you need to gather?

What might you need to consider when gathering information from the
individual?

How would you share this information with people who need to know?

© Alison John & Associates and Garry West Training Page 13

5-Stage Behaviour Cycle
Stage 2 – Apprehensive
Personal Space
What can affect personal space?

Why is should personal space be respected?

© Alison John & Associates and Garry West Training Page 14

Body Language
What is body language?

Why is it important to recognise body language?

Why is it important to be aware of our own body language?

Why is it important to acknowledge the impact of conditions and

impairments on body language?

Active Listening
I – Individual Requirements

L – Look out for Facts and Feelings

I – Interested
S – Silence
T – Time
E – Empathy
N – Non-Judgemental

© Alison John & Associates and Garry West Training Page 15

5-Stage Behaviour Cycle
Stage 3 – Verbal Escalation
Questions: Individual seeks answers or information, usually
in unfamiliar.
Examples:

Challenges: Individual challenges authority, unreasonable

response to reasonable requests.
Examples:

Refusal: Individual refuses to engage tasks or verbal

communication.
Examples:

Venting: Individual lets off steam, temper tantrums,

verbally and physically and environmentally.
Examples:

Threats: Individual makes threats and/or becomes

threatening and intimidating.
Examples:
Calming: Individual shows signs of returning to natural
behaviour. Levels of verbal & physical behaviour
returns to natural comfort zone.
Examples:

© Alison John & Associates and Garry West Training Page 16

An individual’s behaviour fluctuates according to different environmental,
physical and psychological situations. It is important to remember that
behaviours of both the individual and the parent or practitioner can
influence a positive or negative outcome.

© Alison John & Associates and Garry West Training Page 17

 Stages of Level Level Level Level Level De-escalation
Behaviour 1 2 3 4 5

Physical

Threats

Venting
Verbal Calming
Refusal

Challenging

Questions
Apprehensive

Individual
© Alison John & Associates and Garry West Training Page 18
5-Stage Behaviour Cycle
Stage 4 – Physical
It is important to realise that whilst the ‘HELP! I’m being challenged’
programme does not provide training on Physical Intervention
Techniques, that these techniques if not attempted competently can
pose a significant risk of physical and emotional injury including death.
Participants are therefore encouraged to undertake accredited Personal
Safety and Physical Intervention Training as part of their professional
development. This will ensure they meet the legal, professional, and
welfare requirements of engaging in physical interventions as stipulated
under the Department of Health Guidance to Restrictive Intervention.
In addition, particular attention should be given to the British Institute of
Learning Difficulties (BILD) guidance, if workers are engaging with
children and young people that experience Learning difficulties e.g.
ADHD, Autism Spectrum Disorder etc.

For more information on Personal Safety and provision of safe, non-

harmful Physical Intervention Training contact BILD, and familiarise
yourself with:
The Department of Health Guidance on Physical intervention:
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@
dh/@en/documents/digitalasset/dh_4068461.pdf
or The British Institute of Learning Difficulties:
http://www.bild.org.uk/pdfs/05faqs/pi.pdf
A summary factsheet of the BILD Guidance can be found on the next
page.

© Alison John & Associates and Garry West Training Page 19

Appendix 1: Factsheet on Physical Interventions Source:
Taken fromhttp://www.bild.org.uk/pdfs/05faqs/pi.pdf
Summary
50% of people with intellectual disabilities and challenging behaviour will
have physical interventions used on them at some point in their life.
Physical Interventions should be used in the light of clear policies and
procedures, in the context of other strategies for the individual.
Staff training and support is essential to ensure good practice in the use
of physical interventions
The BILD Physical Interventions project is working to develop an
Accreditation Scheme for trainers in Physical Interventions with funding
made available by the Department of Health and the Department for
Education and Science Skills DoH / DfES Guidance on restrictive
physical intervention now published.

1. General Introduction
The behavioural challenges presented by a small number of adults and
children with learning disabilities and/or autism, special educational
needs or emotional and behavioural difficulties mean that the use of
some form of physical intervention may be unavoidable.
There is a need to ensure that such interventions are carried out within a
legal and ethical framework that sets out explicit safeguards for the
person with a learning disability and for staff.
It has also been identified that training in physical interventions must be
commissioned, delivered and planned within a strategic approach and to
a set of desired standards.
The inappropriate use of Physical Interventions increases the risk of
injury to both staff and service users.

2. Numbers
Challenging behaviour is very common in people with learning disability,
estimates suggesting about 20% of children and 15% of adults exhibit
some form of challenging behaviour. (Harris 1993).
There is currently no systematically recorded evidence of the extent to
which physical interventions are used in services for people with learning
disability and/or autism. Recent research has suggested that 50% of
people with intellectual disabilities and challenging behaviour will have
physical interventions used on them at some point in their life.

© Alison John & Associates and Garry West Training Page 20

3. The Issues

What are Physical Interventions?

Physical interventions have been defined in the BILD guidance as:
"A method of responding to the challenging behaviour of people with
learning disability and/or autism which involves some degree of direct
physical force which limits or restricts the movement or mobility of the
person concerned."

Categories of Physical Intervention

The BILD policy framework for physical interventions sets out three
broad categories of physical intervention
• Direct physical contact between a member of staff and a service
user e.g. holding a person's arms and legs to stop them attacking
someone
• The use of barriers, such as locked doors, to limit freedom of
movement e.g. placing door catches or bolts beyond the reach of
service users
• Materials or equipment which restricts or prevent movement e.g.
placing splints on a person's arms to restrict movement

The Legal Framework

This brief factsheet cannot set out the full extent of the legal framework,
however, some brief points can be made.

Professionals working with vulnerable people have a duty of care to

ensure that in this context means a need to avoid actions that may harm
others, and that the agencies they work for act always in the best
interest of the service user.

Also, the framework provided by criminal and civil law should ensure that
people can live without 'interference from others' including for example
assault or false imprisonment.

There is further discussion and clear guidance about the legal

framework to be found in BILD Physical Interventions Policy Framework.

Where services have concerns about the legal status of procedures

employed to respond to behaviour that challenges, they are
advised to consult a lawyer with relevant experience.

When to Use Physical Interventions?

© Alison John & Associates and Garry West Training Page 21
The guidance on the use of physical interventions sets out the
circumstances in which they can be used. Some key principles are that
physical interventions should be used in the context of other strategies
for the individual, after other less intrusive methods have been tried and
found to be ineffective, and as a part of individual support plans.

The Role of Management in Policy and Procedure Service Managers

have a number of responsibilities around the appropriate use of Physical
Interventions:
• Ensuring that Care staff always work in ways that are consistent
with the law.
• Ensuring the needs of service users are properly met.
• Discharging responsibility for health and safety in the workplace.
• Developing Policy

Managers in services have a responsibility for the development of

policies on the use of physical interventions, and for ensuring that staff
are appropriately trained.

There is further guidance on the development of policy and procedure in

the BILD guidance.
Some key points about policy development are that:
• Staff record the use of physical interventions fully and honestly,
• Emergency responses to behaviours and follow up process
required are clearly laid out,
• Service users as fully involved as possible in developing the
Physical Interventions policy.

Training must make explicit reference to the values that underpin the
use of Physical Interventions. Training in the use of Physical
Interventions is not a one off event. In successful services, where good
strategies for prevention of challenging behaviour are used, it could be
that PI is used minimally, or that incidences of its use are few and far
between. Because of this staff skills and competences in this area will
need to be regularly updated.

© Alison John & Associates and Garry West Training Page 22

The BILD Physical Interventions project is working to develop an
Accreditation Scheme for trainers in Physical Interventions with funding
made available by the Department of Health and the Department for
Education and Science Skills.

For Reference list and more information can be found 0n BILD’s

website www.bild.org.uk

Authors: Sharon Powell and John Northfield, Date: 20 February 2002

BILD has made every effort to ensure the accuracy of the information
contained within it’s factsheets, but cannot be held liable for any actions
taken based on the information provided.

British Institute of Learning Disabilities

Campion House
Green Street
Kidderminster DY10 1JL
Telephone 01562 723010
enquiries@bild.org.uk
www.bild.org.uk

© Alison John & Associates and Garry West Training Page 23

5-Stage Behaviour Cycle
Stage 5 – Calming
During
Acknowledge the individual’s present stage of behaviour for all involved.
Remember that it’s the behaviour that your experiencing that is
challenge and not the individual.
Assess the current physical, emotional, social and intellectual risks and
make provision accordingly, including the environment.
Recognise and work to reduce the level of unproductive physical and
psychological behaviours.
Remember to use effective communication that enables the individual to
reduce their unproductive behaviours.
Be aware of how you look, sound and your present stage of behaviour.
i.e. emotions
Don’t be afraid to acknowledge that you may not be the right person to
de-escalate the situation.
Congratulate yourself.

© Alison John & Associates and Garry West Training Page 24

After
Reflect on what has happened to establish if there are any patterns of
behaviour, factors that may affect behaviour and preventative actions
that could be taken.
Report and record productive and unproductive information, including
what was said and what was done.
Where possible engage and negotiate with the individual to empower
them to self-manage re-occurring behaviours.
Communicate what worked productively with parents and/or other
professionals.
Where possible work collaboratively with the individual to agree future
strategies.
Remember to detach yourself from what has happened and reward
yourself for managing a difficult and perhaps scary situation.

© Alison John & Associates and Garry West Training Page 25

Before re-occurrence
Complete a list of things you need to consider and acknowledge before
the behaviour re-occurs.

•
•
•
•
•
•

© Alison John & Associates and Garry West Training Page 26

Suggested Individual Support Plan for ______________________________________________________

Stages of Behaviour’s Identified ‘Calming’ Approach

Behaviour
Physical Productive Unproductive

Verbal
Threats:

Venting:

Refusal:

Challenging:

Anxiety
Questions:
Individual (Requirements / Observations):
Suggested Individual Support Plan for ___________________________

Stages of Behaviour’s ‘Calming’ Approach

Behaviour Identified
Productive Unproductive
Physical

Verbal Threats:

Venting:

Refusal:

Challenging:

Anxiety Questions:

Personal Space:

Body Language:

Environment:

Individual (Requirements /
Observations):
Notes

© Alison John & Associates and Garry West Training Page 29