Primary Care Clinical Pathway for Supporting Children
with Challenging Behaviors
Preliminary Assessment and Interventions
- Recognition of Challenging Behaviors
- Proactive Interventions
- Communication Strategies
- Environmental Modifications
- Room patient, minimize wait time, address sensory sensitivities
- Safety Planning
Patient Engaged in Visit
Behavioral Escalation Event
De-escalation Techniques and Safety Response
Proceed with Visit
- Assess opportunity for additional interventions or
- De-escalation Techniques or
- Biopsychosocial Pain Management
Unable to Proceed with Visit
- Caregiver/provider/nurse Discussion of supportive options
- Reschedule visit
- Debrief with staff
- Notify leadership, complete KAPS
Discharge and Documentation
- Document behaviors in narrative note, complete Behavior Safety Alert if applicable
- Consider Consults to Child Life, HMHK, Social Work, Psychology or Sedation
- Consider reviewing Medications or Pennsylvania Telephonic Psychiatric Consultation Service Program (TiPS) for upcoming appointment
Evidence
CHOP Programs
- Child and Adolescent Psychiatry and Behavioral Sciences
- Child Life, Education and Creative Arts Therapy Resources
- Child and Adolescent Mood Program (CHAMP)
- Anxiety Behaviors Clinic
- Behavioral Health Integrated Program
- Healthy Minds, Healthy Kids: Integrated Care Program
Media
Related Links