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Violence—Behavioral Issues in Child Care and Schools

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ICD10

  • F91

  • R45.4

  • R45.6

  • Z55

How can children with violent behaviors be identified?

Violence is an extreme type of aggression in which an individual intentionally seeks to cause severe or extreme harm to someone else.

How common is it?

While it is typical for preschool-aged children to display some aggressive behaviors, especially in group care settings, violent behavior is rare. If it happens, however, caregivers should immediately act to keep everyone involved safe.

What are the behaviors usually seen?

Violent behaviors can include extreme tantrums, damage to property, and aggression that results in harm to oneself or others.

When should a more concerning issue be suspected?

Warning signs

Violent behavior is always concerning. There are several warning signs that child care and early education professionals should be aware of to help respond to a child in need before violent behavior occurs, including

  • Intense anger

  • Frequent loss of temper

  • Extreme irritability

  • Extreme impulsivity

  • Becoming overly frustrated very easily

In general, adults should take note of a child whose response to a situation appears to be stronger or more intense than would be expected.

Risk factors

There are factors and situations that put a child at greater risk of demonstrating violent behavior, including

  • Exposure to violence at home, including the use of corporal punishment

  • Exposure to violence in the community

  • Experiencing physical or sexual abuse

  • Previous violent behavior

  • Presence of firearms in the home

  • Exposure and/or use of violent media (eg, video games, television shows, movies)

  • Having a clinical-level emotional or behavioral condition, including attention-deficit/hyperactivity disorder, disruptive behavior disorders, depression, anxiety, and autism spectrum disorder

  • Rarely, medications such as steroids that are used for severe asthma or children with other serious chronic conditions

While having one or more of these risk factors does not mean that a child will become violent, it is important for child care and early education professionals to be aware of risk factors and warning signs to be able to identify children who may become violent.

What are typical management strategies in the behavioral support plan?

While violent incidents are rare, the early education site should have a specific plan that teachers can follow if an incident of violent behavior occurs. It should include the following basic steps and other steps specific to the site:

  • Teachers should call for help from the front office or have other staff who are not currently providing care to children make the call. If there are mental health professionals on-site, they should also be called immediately.

  • Teachers should quickly move other children away from the child who is displaying violent actions and ensure that the children can be appropriately supervised in an alternate area while also maintaining constant supervision of the child who is displaying violent actions.

  • All adults who interact with the child who is displaying violent actions should remain calm and tell the child that they want to keep the child and everyone else safe.

  • Unless staff members are specifically trained in holding techniques, they should refrain from physically restraining the child, unless it is necessary to keep the child or another individual safe.

  • Staff members may try to redirect the child to a preferred activity or guide the child to a soft space where he or she is less likely to become injured or to injure someone else. The child should be invited to join the staff member in a preferred activity when he or she is ready.

  • If the center is using any curriculum that includes calm-down techniques, such as deep breathing exercises, a staff member may begin to use them. For example, the teacher may use the deep breathing exercise that involves pretending to blow up a balloon. To use this technique, the teacher sits with the child and holds a pretend balloon in front of his or her mouth, while encouraging the child to do the same. The teacher takes a deep breath and then blows the breath into the fake balloon. This can be repeated as many times as needed to simulate several deep breaths.

  • After the child has calmed down, staff members should refrain from lecturing the child about the behavior or instituting immediate consequences. Instead, staff members should briefly say that they always want to keep the child and others safe. Let a mental health professional process the situation with the child and direct the caregivers on any consequences.

  • Parents and/or primary caregivers should be contacted per center guidelines, and support from the child’s pediatrician or mental health professional should immediately be sought. A pediatrician or mental health professional will review the child’s symptoms, assess possible contributors such as exposure to violence or genetic risks, and consider the child’s safety. If a child has a diagnosable clinical condition, the pediatrician will make treatment recommendations. For nearly every condition in early childhood, the first-line treatment is therapy, which generally involves caregivers as active participants. Medications are not first-line treatment for most mental health problems in preschool-aged children because of limited research about their effects and safety.

When should I ask for additional support?

Staff members should always seek additional support if a child becomes violent. If warning signs and risk factors lead to a suspicion that a child may need additional supports, caregivers should seek consultation and/or support from a mental health professional immediately. Even if the child does not demonstrate violent behaviors, when the risk factors and warning signs are present, the child is demonstrating a need for mental health support.

What training and/or policies may be needed?

Staff members should be made aware of warning signs and risk factors of violent behaviors and should understand that it is more beneficial for a child to receive services quickly when these warning signs are seen than to wait for possible escalation of the behaviors. Staff members should be made aware of the center or school’s policy on how to respond to a violent situation. In addition, several of the risk factors for violent behavior (eg, abuse or exposure to violence in the home), if suspected, will most likely warrant a child abuse report. Teachers should have clear knowledge of when and how to report suspected abuse or neglect.

Where can I find additional resources?

American Academy of Child and Adolescent Psychiatry (https://www.aacap.org)

Adapted from Managing Behavioral Issues in Child Care and Schools: A Quick Reference Guide.

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The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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