presented by Deborah Boroughs
This course provides students with an overview of managing challenging behaviors of children with special health care needs in pediatric home care. The importance for the home care nurse to recognize that behavior is a form of communication is emphasized. Improper response by the nurse to challenging behavior can result in negative outcomes for the child and family. Home care nurses have a unique opportunity to provide behavior support to the child and family. This course will identify the (1) common causes of challenging behavior in children with special needs, (2) examples of challenging behaviors in these children with disabilities, and (3) core components of positive behavior support and communication for home care nurses.
Deborah Boroughs, RN, MSN, has extensive professional and personal experience in the management of medically complex children. As an advanced practice nurse, she led a professional team of nurses and social workers as the director of the Pennsylvania Ventilator Assisted Children’s Home Program (VACHP), a Pennsylvania Department of Health program with offices at Children’s Hospital of Philadelphia and Pittsburgh Children’s Hospital. She is a much-published author of professional journal articles and textbook chapters, and a lecturer about care of the complex pediatric patient. She has taught pediatric and community health nursing at two universities. She currently serves as a consultant to home care agencies, an expert witness for legal cases, and a nurse educator of home care nurses. Personally, she is the mother of eight children, six of whom are adopted and have complex health care needs, including two ventilator-dependent children.
In this chapter, challenging behavior is defined. Challenging behavior can have an impact on the child’s general health and well-being. Children with cognitive impairments or speech deficits often use challenging behaviors to express their needs. It is common for children who display negative behaviors to receive personal attention. The pediatric home care nurse must endeavor to understand this form of communication to offer and implement successful interventions that minimize the behaviors and meet the needs of the child.
This chapter presents an interview of a father who is a trauma nurse and an adoptive father of several children with special health care needs who also have behavioral disorders. At the time of adoption, he was unaware that several of the children had behavior disorders in addition to significant medical needs. His perspective for successful management of challenging behaviors is highlighted.
Strategies for behavioral management of pediatric patients with special health care needs for home care nurses is offered in this chapter. Scenarios are used to illustrate successful interventions of behavioral support by pediatric home care nurses.