The aim of this study is to use Q methodology to explore how school staff experience the behaviours of children with Smith-Magenis Syndrome (SMS) in school and how they manage working with these children. Q methodology utilises by-person factor analysis to investigate subjectivity. Fourteen school staff of students with SMS in Norway participated and sorted 40 statements according to their own experience working with a student with SMS. Two distinct viewpoints were revealed, namely, (1) Managing challenging aggressive and self-injury behaviours in school where school staff experienced a range of challenging behaviours, especially aggressive behaviours. (2) Struggling with intense non-physical challenging behaviours in school where school staff experienced behaviours such as the students being very intense, craving attention and pushing buttons. In conclusion, there must be a greater emphasis on education and advising and supporting school staff's work with the non-physical challenging behaviours aspects of teaching children with SMS, as well as a continued focus on challenging aggressive behaviours.