Primary Care Clinical Pathway for Supporting Children
with Challenging Behaviors
Preliminary Assessment & 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 & 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
Discharge and Documentation
- Complete Behavioral Safety Alert.
- Consider consults to Child Life, HMHK, Social Work, or Psychology.
- Consider reviewing Medications or Additional Interventions for upcoming appointment.
- Complete KAPS safety event or employee event, if necessary.
Posted: December 2020
Revised: August 2022
Authors: J. Ginsberg, MSN; M. Hoynoski, CCLS; V. Scheid, MD; W. Wallace, DO; E. Steinmiller, MSN;
N. McCartney, RN; A. Hansel, BSN; W. Serdich, LPN; J. Lee, PharmD; E. Gatto, LCSW; B. McGovern, LSW
Revised: August 2022
Authors: J. Ginsberg, MSN; M. Hoynoski, CCLS; V. Scheid, MD; W. Wallace, DO; E. Steinmiller, MSN;
N. McCartney, RN; A. Hansel, BSN; W. Serdich, LPN; J. Lee, PharmD; E. Gatto, LCSW; B. McGovern, LSW
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