Connection Blog 

Book Review: Supporting Positive Behavior in Children and Teens With Down Syndrome

Cathleen Small

A book review from Cathleen Small on Supporting Positive Behavior in Children and Teens With Down Syndrome: The Respond but Don't React Method. This book is available in our Lending Library.

My sweet little Sam, apple of my eye, is due to start kindergarten in the fall. And while he’s mostly an agreeable, easygoing child, he definitely has his moments of being stubborn and strong-willed. Which, in the long run, is probably a good trait (or at least, that’s what I tell myself with both of my kids!). However, particularly when your child is delayed in expressive communication skills, any sorts of challenging behaviors can get to a point where they’re difficult to redirect. And while I don’t expect Sam to be perfectly behaved (what child is?!), I also would like to address any particularly challenging behaviors before he starts kindergarten, so he can be as successful as possible in his new classroom.

That’s where Supporting Positive Behavior in Children and Teens with Down Syndrome: The Respond but Don’t React Method comes in. I had heard really good things about this book, and it’s an easy read so I was interested to try it.

After finishing it, I can definitely say that this book will remain on my bookshelf for years to come. Reading it one time through was really useful because it gives an overview of why children with Down syndrome tend to react in certain ways to challenging situations. It talks about brain structure and how certain things are processed in the brain and why that’s different in a person with Down syndrome, and also about learning and processing styles of people with Down syndrome. Really, I can sum it up like this:

Delays in processing (particularly auditory processing) + difficulty with short-term memory + visual learning style = children who learn best with many visual supports and much repetition, plus manageable bites of information

But the book is a keeper long term because it covers in detail some behaviors that are typical in children with Down syndrome. For example, bolting. This is not a huge problem with Sam, but it is something he’ll do. For example, he ran away from us today in Target. No harm done, as he was in a store and we were right behind him. But what if that were a parking lot? Or a busy street?

The book explains the best way to handle that specific behavior. (Spoiler alert: Do not react strongly! Remain calm and do not show your fear or upset.)

Another common behavior in the DS word: everyone’s favorite Flop and Drop! You know, when your kid goes all dead weight and flops to the ground? It’s not so bad when you’re talking about a little two-year-old who can easily be picked up and tossed over your shoulder like a sack of potatoes. But what about a fifty-pound seven-year-old? Much more challenging! The book explains the best way to handle that one, too.

Other common behaviors are covered, too, though I won’t detail them all here. Suffice it to say, for the most common challenging behaviors for kids with DS, the book talks about specifically how to handle them. I can see myself referring to this book again and again over the years, as we move through different phases with Sam.

By the way, in case you’re curious: The “respond but don’t react” part comes from the processing delays in people (especially kids) with Down syndrome. Because auditory processing is difficult for many, many people with DS (who are notoriously visual learners–obviously this is not true for everyone with DS, but many studies have shown that most people with DS are visual learners; I’m taking an online education course about teaching children with DS right now, and it emphasizes the same thing), if you react with emotion and tell them something, they may not understand what you’re telling them–all they know is that you’re responding with emotion, and emotion is fun! It doesn’t matter what words you’re saying, because they may not be processing all of them anyway—but they know you’re emotional! So instead, a better approach is to simply respond with no emotion and redirect.

This is kind of an interesting shift for Chris and me, since we had to parent Theo with exaggerated emotion. He struggled to read emotions and body language for a long time, and we eventually learned that the best way to make him understand was to exaggerate whatever emotion (fear, hurt, anger) his behavior prompted. Which isn’t to say we flew into a rage when we wanted to show him we were angry because he chose to misbehave—but we had to make it very clear that we were angry and not amused. With Sam, apparently, we should do the exact opposite—downplay our emotional response pretty much entirely.

Anyway, I’ve been playing around with it and trying the strategies in the book–both the responding without reacting, and the suggestions for many, many visual supports–and I’m pleased to say it’s working well! Sam had been really fighting the morning routine, and I’ve now started using a visual support for each step, and he is much more amenable to it. That’s not to say there’s no protest, but it’s much less than it was. Hallelujah! (In case you’re curious, the visual support I’m using is one the book’s author recommended: an app called First-Then. It allows you to create step-by-step routines of picture cards on your phone or iPad that your child can swipe through as they complete them. So for the morning routine, we have: Take PJs off, put pants on, put shirt on, take medicine, eat breakfast, put on socks and shoes. Seeing the picture cards for each step on my phone seems to motivate Sam and lessen his resistance, just as the book’s author predicted.)

Anyway, definitely a recommended addition to your library if you have a child with Down syndrome! The strategies are simple to implement and very common-sense.

Read more of Cathleen's writings on her blog: foursmalls.com.