Impulsivity

Disclaimer: This information sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What is impulsivity?

Impulsive actions are those made without taking into account possible problems or thinking about possible consequences. Children with an acquired brain injury may be more impulsive than they were before their injury because they can have difficulty controlling and checking their behaviour. Rather than stopping and thinking before acting, they will act quickly on an urge that will meet their immediate goal without considering all the potential, perhaps unwanted, effects.

Examples of impulsive behaviour

• not looking for traffic before crossing the street
• reaching up to retrieve a toy near the hot stove
• trouble waiting and taking turns
• using a sharp knife to cut fingernails
• rushing into an activity, making lots of mistakes
• commencing another task prior to finishing the first
• lashing out physically or verbally without thinking of the consequences
• making inappropriate comments (see inappropriate behaviour & disinhibition)

Suggestions to assist a child with impulsive behaviour

Impulsivity is challenging to manage as the child's urge to act is sudden and strong. It is important to remember that the child is often not aware of their impulsive behaviour nor the consequences of their actions. Some strategies to assist the child to control impulsivity include.

• Attempt to minimise situations that may place the child in danger. Examples include providing supervision when crossing roads, not leaving dangerous tools around the house.
• The child's ability to plan his/her actions does not come naturally. Breaking tasks down into a set of steps (oral/written) and check lists can facilitate planning and reduce the chance of impulsive behaviour.
• Cue the child with verbal or visual prompts (eg. `stop, think, do') as a reminder to think before acting. During the task, it may help for you and the child to say the steps out loud.
• Establish clear rules and make sure the child understands the rules, the consequences of breaking them, and also the rewards for complying with them.
• Provide clear feedback and assist the child in recognising the consequences of his/her actions on themself and others. Talk with the child about the steps involved in a task, discuss the mistakes as well as the successes following the task. This approach can help the child to respond better when faced later with similar situations.
• Try to be positive and calm and not respond in anger.

Who do I see?

If the behaviours occur frequently and are impacting on the family, referral to a Clinical Psychologist may be recommended. The clinical psychologist can develop individual strategies to modify and cope with the child's impulsivity. A program would usually involve ways to develop alternative responses as well as consequences for problem behaviours.

Rehabilitation Department The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 2132 - Fax: (02) 9845 0685 http://www.chw.edu.au/rehabilitation/