Awareness 1
Assume that _____ can happen, even if it doesn't seem likely
aggression/behavior
avoid talking about a clients ____ in front of them
behaviors
discuss out of earshot of the client (this may be a few feet away or all the way down the hall depending on the client) (ex: VV listens through the door)
whispering, pinging, gesturing can be helpful if immediately necessary
all clients, verbal or nonverbal, may be able to understand more than you think and it can be triggering to hear someone talking about you as if you are not there
always stay out of the ___ ___ near the person's mouth or where you can easily be bitten
bite zone
pay close attention to body language, tone of voice and other signals of possible escalation. These are called _____
precursors
if you are injured in any way, you must fill out a ___ ___ and notify a ____
(staff) incident report, manager
(if you notify a manager or BCBA they can direct you to the correct form)
when approaching a client, approach within their vision but do not cross the _____
midline
give an example of a potentially dangerous object
anything heavy or hard
chairs, tables, water bottles, ipads, laptops, heavy or hard toys, rocks
sharp items like pencils, scissors, etc
anything hot or chemical
coffee, cleaning supplies (anything that could be spilled on you or the client or ingested)
and more!
when sitting with a client, avoid sitting on the ____, or positioning yourself ____ the client
floor, below (or lower than)
ex: client is sitting in chair, do not sit on the floor, get a chair to sit near them in
Triggers are anything that happens before the behavior/escalation. Give an example of a trigger.
loud noises (kids crying, kids screaming, loud tv, phone alarm, etc)
demand
teasing from a peer
someone standing too close to client
not able to access a preferred item
overheard a conversation about them
unexpected schedule change
being asked to wait for something
crowded room
bored
if a client is injured in any way, you must fill out a ___ ___ and what two people need to be notified/sign?
(client) incident report, manager, parent
(if you notify a manager or BCBA they can direct you to the correct form)
what does dressing for safety look like? (give one example)
avoid items that can be easily grabbed (jewelry, scarves, make sure you have a breakaway lanyard, etc)
tie back hair
trim long nails
closed toed shoes you can run in
dont wear clothing too loose or too tight
what should you do with potentially dangerous objects when you notice a client beginning to escalate?
remove them
never turn your ___ to a client
back
Precursors are behaviors the client engages in that signal they are escalating. Give an example of a precursor behavior.
covering ears
screaming or whining
fidgeting
swiping or pushing materials away
vocalizations
closing eyes
staring at others
quick motor movements
inappropriate comments (I hate you, I want to cut your hair, dont hit cathy, etc)
laughing uncontrollably
tensing
noncompliance or ignoring demands
angry facial expression
crying
If physical management (hold) is used, what form may be required to be filled out, and who needs to be notified immediately?
de-escalation form, management/bcba
(if you notify a manager or BCBA they can direct you to the correct form)
do not take a clients behavior ____. The way a client behaves toward you is about your role, not you as a person!
personally
if you are working with a client who is known to have behaviors that require assistance, grab a ___ ___ from the front office before your session begins
walkie talkie
Avoid moving into a client's ___ space unexpectedly
personal
-if you are not sure what the personal space is, assume it is 1.5-2 of the persons arms lengths (stay out of reach), for VV that is a much bigger space than NY for ex
BIP - behavior intervention plan
-but it is important to watch for these at all times for any possible novel behavior that could occur!
in the case of more serious injury, you may be asked to go to ____ to be evaluated
a doctor/urgent care
unless otherwise explicitly stated, what should you do when transitioning with a client who has elopement as a known behavior?
hold their hand or guide them to prevent elopement attempts
(in general you should never be more than a couple feet away from your client regardless of elopement history - bx can always happen!)
Give an example of a dangerous behavior AND an example of a disruptive (not dangerous) behavior
Dangerous: hitting self or others, biting self or others, throwing objects, pulling others hair, choking self or others, kicking others, head banging etc
Disruptive: screaming, spitting, flopping, peeing on self or floor, hitting walls low intensity, etc
Avoid ____ or other positions in which the client's face is near your torso, shoulder or legs
hugs
(can be given from side if requested, bites can happen during hugs!)
ex: NY/AIR bite legs/arms when being tickled on the floor, KG bites during hugs, etc
if you notice a client is responding to a trigger or is showing precursors, intervene immediately. Increase ____ between yourself and client if safe to do so (i.e. elopement), and follow the instructions for responding to precursor behaviors in the ____
distance/space, BIP
if you decide to be evaluated by a health professional after an injury, who should you notify before you go?
management
(not all doctors are covered by workmans comp and you may be sent to a specific location, though most are)