Working with individuals with developmental disabilities who are confrontational
pose a unique challenge for the caregivers.  If allowed, the confrontational
person will bulldoze right over whomever willing to stand in front of him.  
Consider that if it is not a learned behavior that has been rewarded in the past,
when a person reaches this level he or she maybe beginning to lose his or her
rationality.  This is important to know because usually trying to rationalize with
an irrational person can prove to be fruitless and at times counter productive.  
This doesn't mean that the caregiver should stop speaking to the individual.  
Rather the focus should shift toward shortening statements to two or three words
while increasing the body language like saying, "calm down" while lowering you
arms from your abdomen area downwards. Maintaining a calm composure can
also help deescalate the situation.  I can recall several instances in which an
irrational individual misinterpreted my words.  One instance was me saying "we
are not here to hurt you" which was interpreted by the person as "I am going to
hurt you."  Try to avoid these type statements.  "You are alright" would have
been a better choice in that instance.  Again, trying to solve an emotional issue
with logical argument rarely will result in a positive outcome.  
Confrontation as a form of manipulation for the purpose to obtain a desired
effect is a powerful tool some individuals have learned to utilize.  The caregiver
should be able to distinguish between an irrational act of confrontation and the
learned behavior so he can deal with each situation accordingly.
In dealing with the learned behavior, the caregiver should try to understand the
physical or emotional outcome individual is seeking:   
A.  Is it an attempt to get one's way?
B.  Is it an attempt to intimidate?
C.  Is it an attempt to cause guilt?
D.  Is it an attempt to satisfy physical need?
E.  Is it an attempt to establish authority or dominance?
F.  Is it an attempt to control situations?
If you ever watched the movie "groundhog day," giving into an individual who
has learned to confront for a reward will result in a reoccurring confrontations
one does not wish to awake to everyday.
The process of writing objectives for these types of situations are fairly similar to
one another.  non-confrontational behaviors are rewarded and the
confrontational behaviors are ignored; but not the person.
A behavior objective for the behavior, "confronts to intimidate" may be the
combination of the following:

Tesla will improve her personal and social skills by refraining from intimidating
caregivers and acknowledging her intimidating behavior.
Method: Staff will: When Tesla begins to engage in intimidation, staff will say,
Tesla you're intimidating; when you stop, we can talk about what you want.
By responding to this request, Tesla would have had to acknowledged to herself
that she was engaging in intimidation.

Tesla will increase her social skills by identifying negative consequences of
intimidation during a 7 minutes discussion with staff
Method:  Staff will:  Ask Tesla to name 4 different negative outcomes she would
experience if someone intimidated her. Ask Tesla the negative consequences of
intimidating caregivers.

Tesla will increase her personal and social skills by describing alternatives to
intimidation when she desire something in a 10 minute conversation.
Method:  Staff will:  Allow Tesla to verbalize alternatives to intimidation.  Assist
in describing alternatives when necessary.  Discuss the positive consequences of

Tesla will increase her personal and social skills by, in a mock conversation,
negotiating a request absent of intimidation.
Method:  Staff will:  Allow Tesla to come up with appropriate ways to negotiate
a request.  Provide direct training on how to negotiate when necessary.  Discuss
the possibility of the desired outcome when negotiating verses intimidation.  

Tesla will increase her personal and social skills by describing the negative
physical and mental affects of intimidation for all persons involved.
Method:  Staff will:  Allow Tesla describe her physical status during intimidation
i.e., heavy breathing, accelerated heartbeat, other physical experiences during or
after the event such as blood pressure.  Allow Tesla to describe her mental status
during and after intimidation such as guilt, anger, hate, betrayal.  

Working with lower functioning/non-verbal individuals poses its own difficulties.
Caregiver needs to understand what the person is trying to communicate.  For
example the person approaches the caregiver, raises his fist over his shoulder, a
few seconds later he begins to cry and points to a candy bar on caregiver desk.  
If you want this behavior to increase, give him the candy bar or share it with
him.  To decrease or possibly eliminate such behaviors, the caregiver needs to
negotiate a different form of communication than what was displayed.  To do so,
the caregiver will be most successful by using short duration reinforcements and
visual description of how the process works.  
Combination of objectives below maybe an appropriate way to deal with this
Symore will earn a token when he successfully performs 4 out of 7 daily chores
displayed on his picture chore chart.  
Method:  Staff will:  Show Symore his picture chore chart after breakfast, lunch
and dinner and allow his to choose an appropriate chore.  Provide direct training
if needed.  Praise Symore for his success and give him a token when last task is

Symore will earn a token when he refrains from displaying an aggressive posture
between awaking in the A.M. and lunch.
Method:  Staff will:  Ask "Symore, did you raise your fist today?"  When Symore
replies "no" or shake his head, give verbal praise with a token.

Symore will earn a token when he refrains from displaying an aggressive posture
between lunch and supper time.
Method:  Staff will:  Ask "Symore, did you raise your fist today?"  When Symore
replies "no" or shake his head, give verbal praise with a token.

Symore will purchase one item from the selection of items (to include a mini
candy bar) with 3 earned tokens After supper.
Method:  Staff will:  Allow Symore to choose an item from the selection.  Ask
Symore to give you 3 tokens prior to giving him his snack of choice.

Symore will earn a token when he refrains from displaying an aggressive posture
between dinner and bed time.
Method:  Staff will:  Ask "Symore, did you raise your fist today?"  When Symore
replies "no" or shake his head, give verbal praise with a token.
I call this last token a comfort token or a motive token since Symore will end up
with one token to sleep with and wakeup to
Predatory behaviors such as intimidation and bullying are very uncomfortable to
deal with especially for personalities that rather avoid conflicts.  Intimidators can
be dangerous and may easily become physically violent.  Knowledge of past
history of the individual can help caregivers overcome perceived fear and
anxiety.  Nevertheless, engaging with an intimidating person alone is not
recommended.  Be prepared to deal with physical aggression and if possible
create a barrier such as a desk between yourself and the person and have an exit
plan if you are in a room or office.  Should  physical aggression occur, the
caregiver is most likely to be blamed for the act.  
I recall a young man who knew exactly what buttons to push to provoke his
caregivers.  In one case he threatened to "cut up to pieces" a caregiver's new
born baby.  He was capable of such act but could in no way have access to the
child.  Nevertheless, the emotions he induced in the caregiver caused her to act
inappropriately and he was able to have her fired.  Domination, power, control
and impulse are some for the attributes associated with intimidating person.  He
may see himself as superior to others and reward those who submit to him and
punish those who refuse.  He question the submissiveness of his victims by
testing them every now and then and thus creates confusion in their minds.  
These types of tactics tend to "freeze" the victims mind to the extend that they
can not make rational decisions; it can possibly result in PTSD.  We all function
well in our relationships because there are consistencies that contribute to a
healthy relationship.  Once that consistency is removed, the relationship becomes
unhealthy and confusing.  Battered person syndrome is a good example for this
case.  Since it is not advisable to deal with this type of behavior alone, a team
oriented setting with professional mental health resources and trained staff to
deal with aggression is the appropriate intervention.   
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