Principles of Behavior Management

Written Resources to Help Understand and Redirect Behavior in Kids with Down Syndrome

Dr David Stein, PsyD's Practical Guide to Behavior Management

Apoyo para la conducta - en Espanol

National Down Syndrome Society Article on Behavior Management

Down Syndrome Education International's Article on Behavior Management

Resources for Building Visual Supports

Desensitization to Equipment

Dr Patel's Presentation on Desensitization for Glasses, Hearing aids, CPAP mask

Personalized Desensitization Plan

Picky Eating

Hand Washing

Toilet Training your Child with Down syndrome

Here is the National Down Syndrome Society handout on toilet training, as well as some other resources compiled by the DS association of the greater St Louis area

Social Stories

What are Social Stories?
Social stories involves the reading of a story that includes illustrations or pictures to teach the student appropriate behavior for a variety of social situations.

This could include: 

• Acceptable behavior in public 

• Who to confide in if you are feeling sad or scared

• Personal hygiene 

• Going to the bathroom 

While social stories were developed for people with autism, they are great for children with many other developmental challenges, and for neurotypical children too.

The Purpose & Benefits

• Provides precise and detailed information that a student with Down syndrome may find confusing 

• Many students with Down syndrome have difficulties with oral language, so a social story may be more effective than constant verbal reminders.  

• Increases the students understanding of the social situation that is being described

How to Use Them

• The story should begin by introducing the behavior. 

• Consider the student's age, interests, attention span, and level of ability of understanding 

• Consider information about the situation you have chosen: where does it occur, what people are involved

• It should then outline the outcomes if the child performs the appropriate behavior.  

• Be accurate (use words like ‘usually’ or ‘probably’ if the outcome isn’t guaranteed)    

• Use a social story before an outing to remind the child of the norms they might need to follow. Then, when you are out, refer back to the social story, with certain verbal cues or lines from the book in order to give gentle reminders to the child.

• A social story isn’t designed to be used just once or twice and be done, rather it’s the repetition that creates familiarity. With each reading the scenarios become more familiar, and trigger conversations, and layers of comprehension start to form until the child really grasps what is expected of them in social situations.

How to Make a Social Story

• You can use Power Point or Google Slides, with a picture and simple text. 

• You can also use programs and apps to develop social stories. Here are some programs that can help: 

• Your child's educational team can help you create social stories for your child. Teachers and school staff have programs they can use to create and print a story for a specific purpose

Resource for Making Sure that the Language is at an Appropriate Reading Level

https://hemingwayapp.com/

Social Stories to Get Ready for Procedures

Dental desensitization program at UCSF

This is a new program that we have started at pediatric dentistry at Parnassus in conjunction with UCSF center for ASD. 

Patient’s with Denti-cal are welcome, as are those with private dental insurance. 

They do not have an out of pocket additional cost for behavioral services. 

However, if patients usually have a dental copay for exam/treatment they are responsible for that. 

They are grant funded and not have to charge patients at this time for BCBA support.

They do dental visits with a BCBA and focus on behavioral interventions (desensitization, distraction, positive reinforcement) to help children with ASD and other Neurodevelopmental disorders go to the dentist w/o restraint/sedation/GA. 

They do not have to be patients of the STAR clinic. Anyone under 18 is welcome. We do a mix of telehealth and in-person visits.

No county restriction.

They have a few providers who speak spanish/mandarin/cantonese but also can use interpreter services as needed. Interpreter is not ideal, but its better than nothing. 

Patients can self refer. They do an initial consult with caregiver usually on ZOOM so we can learn patient specific needs then go from there with plans to work with kids in-person or telehealth depending on goals (such as trying to work on home oral hygiene or working on in clinic behavior).

They are a small clinic (only 2 afternoons a month for now). 

Contact: 

Jean Marie Calvo, DDS, MPH 

Health Sciences Assistant Clinical Professor, Division of Pediatric Dentistry - University of California, San Francisco

Jean.Calvo@ucsf.edu

Video Modeling

Video modeling is another very helpful method for supporting independence and increasing tolerance for a number of things - glasses, CPAP machine, toothbrushing, you name it!

Individuals with Down syndrome are visual learners, and watching themselves being successful with a task can (1) increase enthusiasm about the task and (2) desensitize the child

Learn more in this presentation:

Videos from the Chicago Adult DS clinic

Mental and Behavioral Health and Psychotropic Medications