Supporting Children with Challenging Behaviors Clinical Pathway — Primary Care

Behavioral Safety Alert

If the parent/caregiver indicates any behavioral concerns prior to an appointment or behavioral needs are identified during the appointment, please complete or update the Behavioral Safety Alert within the Visit Navigator. The alert will be added within the encounter under the "Rooming" or "Review" tabs. No questions should be skipped.

If the alert has already been added, it will appear within the BestPractice Advisories header.

Behavioral History
Patient Behavioral History
  • None
  • Elopement
  • Physical aggression
  • Verbal Aggression
  • Self-injury
  • Other
Are there developmental issues on the patient's problem list?
  • None
  • Developmental delay
  • Autism spectrum disorder
  • Other
How does the patient communicate?
  • None
  • Verbal
  • Non-Verbal
  • iPad/Tablet
  • Communication on board
  • Sign language
  • Foreign language
  • Other
What behaviors does the patient display when he/she is upset/agitated?
  • None
  • Kicking
  • Screaming
  • Thrashing
  • Hitting
  • Punching
  • Cursing
  • Eloping
  • Biting
  • Spitting
  • Property destruction
  • Other
Are there any triggers or sensory considerations that we should be aware of (things that make him/her upset, angry, agitated)?
  • None
  • Shots
  • Vitals taken
  • Lights
  • Noise
  • Specific words
  • Times of transitions
  • Unfamiliar places
  • Too many people in the room
  • Waiting rooms
  • Too many demands
  • Caregiver
  • Other
What can we do to de-escalate the patient?
  • None
  • Distraction
  • Family Member
  • Staff Member
  • Music
  • Toys
  • Breaks in care
  • Review procedures before
  • Offer choices
  • One person speaks at a time
  • Limit number of people
  • Other
Environmental considerations
  • Move medical equipment after use
  • Remove extra furniture
  • Items with wires should not be left in room
  • Remind parent to take belongings with them and out of touch from patient
  • Other
What is the best way to approach the patient?
  • None
  • Age appropriate, child-like friendly approach
  • Helpful phrases
  • Explaining care clearly
  • Neutral Tone
  • Make eye contact
  • Introduce self and what you are doing
  • Other

Consider any needed referrals (Social Work, Child Life, Healthy Minds, Healthy Kids, Psychology).