There are times when individuals with intellectual and developmental disabilities express themselves in ways which neurotypical people– family, staff, and strangers– cannot understand. For instance, if a person is typically calm and easy-going, but he comes to the Day Program for several days with his eyes wide and his frown permanently plastered on, and if he responds to every request with a, “F*** You!” we have to ask what’s really going on “behind the scenes”? Because it may be more than we initially assume.
Most often, if an individual has a Behavior Support Plan (BSP), the standard guidance for maladaptive behavior (basically anything that is socially inappropriate) is to ignore the behavior and redirect the individual. However, in instances where this maladaptive behavior is so foreign to this individual’s spectrum of predictable behaviors, it is incumbent upon us– as the staff– to “dig deeper.”
There is a concept in therapeutic intervention called Trauma Informed Care (T.I.C. for short). T.I.C. argues that vulnerable populations have, more than likely, experienced something traumatic in their lives and T.I.C., therefore, suggests to anyone serving these populations that we approach care and support in a trauma-informed way (i.e. assume trauma before it has been disclosed).
When a person has suffered trauma, he or she exhibits reactions that look a lot like Post-Traumatic Stress Disorder (PTSD) such as irritability or a “short fuse,” pained facial expressions, the sudden onset of cursing or other aggressive behaviors; or, alternatively, the person may be acting shy and withdrawn and showing less interest in previously-engaging activities. Diagnosis PTSD in individuals with intellectual and developmental disabilities is, clinically, very challenging because of limited expressive communication; so, the T.I.C. approach– assuming the person has experienced trauma and acting accordingly– can be a great panacea.
As a Human Services professional, you should not try to fix or alleviate this event with cliches like, “Everything will be all right” because everyone is entitled to feel pain over trauma. If a person whom you’ve been working with is suddenly acting differently, it is safe to assume he or she is responding to some unknown (to you) traumatic event.
Instead of ignoring and redirecting, try, instead, to validate the person’s feelings, explain that is it okay to feel a certain way, and invite the person to focus on the task at hand. By saying, “I can see you’re feeling upset, and that’s totally fine. You can feel however you want to feel. It might help to focus on ________,” we’ve validated the person’s pain– not minimized it– and fostered a connection that will help us both move forward.
Our goal should always be to put the person’s needs first; a trauma-informed approach lets us do that.
#traumainformedcare #disabilities #PTSD #behavioralsupport #TIC #therapeuticintervention
