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I've just been sent some info sheets from Aspect Autism Spectrum Australia and I thought I'd share:
Behaviour
Non-verbal behaviour may be the only effective method of communicating for children who have difficulties using and comprehending language. Some behaviour may also be related to sensory processing and modulation difficulties often experienced by children with an autism spectrum disorder. When attempting to change any challenging behaviour, it is important to try to understand what purpose the behaviour might be serving the child and what that behaviour is trying to communicate. If the behaviour is successful most of the time, the child is more likely to continue using that behaviour, because it works. The best predictor of future behaviour is behaviour that has been successful in the past.
When examining a child’s challenging behaviour, one of the questions asked is “Do they have the skills to communicate their need in a more appropriate way?” For many children with ASD, difficulties with non verbal communication are also evident (e.g. lack of eye contact, pointing, gesture) and therefore their ability to clearly communicate their needs is often quite restricted. One way of assisting the child is to teach them more functional and appropriate ways of meeting their particular needs, as will be described below.
Positive behaviour support
When attempting to change any behaviour, it is important to examine when the behaviour is more likely to occur, with whom and in what setting. This provides further information about the possible purpose of the behaviour and may allow changes to be made which may reduce the chances of that behaviour occurring in the first place. This approach is known as ‘Positive Behaviour Support’ and is different to more traditional approaches to ‘managing’ behaviour that only react to difficult behaviours, once they have occurred. Interventions that only react to a challenging behaviour are often focused on punishment and usually exacerbate the behaviour for the child as well as the carer. The most successful interventions are proactive and positive.
Most behaviour is communicating about something
Children with autism typically have difficulty communicating. While some children with autism become adapt to letting their parents know what they want, it is difficult for most children with autism to communicate which things they don’t want, about how they feel or of what they are afraid. When children are unable to communicate easily or when attempts at communication are misunderstood, often the only option left to them is a behavioural response. As one author writes, “Many of the challenging behaviours exhibited by individuals with autism are better understood as unconventional attempts to communicate in the face of serious communicative limitations” (Schuler & Fletcher, pg 130).
What is the function of the behaviour?
Finding out the function or purpose of the behaviour is the key to supporting difficult behaviours. The first step is to identify the behaviour that is causing the most difficulty and distress. We then need to observe the behaviour in a structured way as outlined below.
The “A-B-C” of behaviour
“A-B-C” stands for ‘antecedent, behaviour, consequence’ and relates to all the things that happen before, during and after the behaviour. By analysing the “A-B-C” of behaviour, we can start to see why the behaviour is occurring and what is happening to maintain the behaviour over time.
‘A’ is for antecedents
Antecedents are all the things that happen in the people environment and physical environment prior to behaviour occurring. When we analyse what happens prior to behaviour, we are able to get information about likely ‘setting conditions’ and ‘triggers’.
‘Setting conditions’ are the things that happen in the time before the behaviour, that make the behaviour more likely to occur but do not necessarily cause or trigger the behaviour. Good examples of setting events in children might be tiredness, illness, pain or someone new in their environment.
‘Triggers’ are the events that happen immediately before the behaviour and cause or trigger the behaviour. Trigger events for children with autism might include a change in routine, refusal of something the child wants, frustration due to comprehension difficulties, sudden sensory stimulation or lack of attention.
‘B’ is for behaviour
Children with autism can show a range of challenging behaviours. In order to analyse the particular behaviour, we need to be able to accurately describe the behaviour using the following questions as a guide:
• What does it look like?
• How often does it happen?
• How long does it last?
• How dangerous/disruptive is it?
The answers to these questions will allow the behaviour to be accurately described which means that improvements and changes in the behaviour over time can be clearly seen. When there are several difficult behaviours, these questions can also help with making a decision about which behaviour to address first.
‘C’ is for consequence
The ‘consequence’ of the behaviour is anything that affects whether the behaviour increases or decreases. In traditional ways of helping behaviour, the ‘consequence’ of a behaviour is seen as what the adult does to react to behaviour, for example, the ‘consequence’ of hitting your sister is to be sent to your room in the hope that this will discourage you from doing it again. In positive behaviour support, it is important to consider the consequences from the point of view of the person engaging in the behaviour. That is, what does the child get out of doing this behaviour? When we know what the child is getting out of a behaviour, we can then start to put in place strategies to teach new skills and avoid the behaviour occurring.
There are a range of different consequences that motivate difficult behaviours. The four main categories of consequences are:
• Attention
• Wanting something tangible
• Sensory stimulation
• Avoidance or escape of an activity or situation
Consider the following example:
A young child with autism hits another child during group time at preschool and is removed from the group to sit on a chair on the other side of the
room. What are the possible consequences for the child with autism?
- attention from the teacher?
- removal from overwhelming sensory input?
- escape from an activity he doesn’t like?
- getting to sit on a chair, rather than the floor?
It is possible that even though the teacher thinks she is helping to stop the behaviour, the child might find the ‘punishment’ of sitting by
himself very rewarding and so it is likely that the behaviour might happen again.
We need to consider how our actions might be helping to maintain a difficult behaviour, even when are trying to stop that behaviour from happening.
Promoting appropriate behaviour
There are many ways to begin promoting positive behaviour. First, we need to look at how we can avoid a behaviour from happening in the first place and then we need to look at teaching the child new and more appropriate ways of getting what they need, without using difficult behaviours.
Managing antecedents
An obvious short term strategy is to avoid the problem situation altogether. For some families, this is a good short term solution to very difficult behaviours that occur in shopping centres or in response to particular sensory environments. Parents can aim to have the child avoid the difficult situation as a way of managing stress in both the child and other members of the family. Avoiding antecedents, however, can only ever be a short term or ‘circuit breaker’ solution. To help behaviours where the trigger can’t be avoided, we need to look at longer term antecedent management.
The main long term strategy for managing antecedents is to change the environment. While it is unlikely and generally impractical to make major physical changes to the environment, there are many ways that the environment can be made more structured, more predictable and less confusing difficult for children with autism. This can happen in a number of ways:
- using clear communication
- using visual supports to make the environment easier to understand
- visual supports to show when an activity will finish
- creating routines so the child can predict what will happen next
- supporting the child’s sensory needs by helping them appropriately avoid or receive the sensory input they require
Positive reinforcement
When something positive follows a particular behaviour, that behaviour is more likely to occur in the future because it is perceived favourably. Positive reinforcement is therefore a good way to encourage a child to engage in appropriate behaviours. Positive reinforcement may be anything that that is meaningful and relevant to the child:
- tangible reinforcers such as a lolly or sticker
- social praise such as “Good boy! Good sitting!”
- positive attention
- favourite toys
For example, the child might:
use the toilet and is immediately given a chocolate teddy
get dressed by herself in the morning and is given a ‘high 5’
finish a puzzle and gets to play with his music box
Teaching new skills – the Competing Behaviour model
The Competing Behaviour model is based on the logic that many different behaviours may serve the same function and can produce the same consequence. When a positive behaviour provides the same type of consequence that challenging behaviour produces, the likelihood that a child will use the alternative behaviour increases. This is especially true if the positive alternative is easier, more efficient or more rewarding than the problem behaviour.
Establishing a competing behaviour may require the teaching of that skill, providing a minimal response to the challenging behaviour and an immediate and rewarding response when the new behaviour is used by the child. Sometimes, the child may already have the skills to use a competing behaviour and therefore changes can be made immediately to how others react to this behaviour and in particular, how they react to the problem behaviour. In the case of the child who needs to be taught a new skill, achieving change may take a little more time.
. I put him outside & DH ended up going out there with him & basically watched him while he screamed & yelled how he doesn't care about anything, tried his hardest to break anything he could get his hands on etc. All the while I was inside just fuming & telling DH to stop being an audience for him, he is just playing it up because you are watching. They eventually come inside (after about 20 minutes) & Evan is still carrying on. He started screeching in Iains face & pushing at things with is feet (chairs, a couple of stripy bags I have linen in against the wall) trying to push them over etc. I told Simon he needed to take him out of the house before I smack him, I will not tolerate him screaming at the little ones like that (DH was trying to ignore him & was sitting on the computer about a meter from him, I was in the kitchen trying to get dinner sorted). DH needed up taking him into the bathroom & eventually got him to have a shower (Evan is refusing to have baths/showers lately)
you are NOT a terrible mum! We all have days like that. Also, you're only starting out on your journey to find the tools and understand the uniqueness of your son's condition, and at first there is a lot of hit and miss. What works one day might not work another, and unfortunately it takes time and experience to build your arsenal of tricks. It sounds like it is definitely over-stimulation from being at the shops. Outside didn't work this time, it's a better tool for when they are reacting to a lack of stimulus. Perhaps if it happens again, can you try to get your DH to do deep pressure (squishing him between two pillows) making a game out of it. Deep pressure is meant to be calming it might work better at times like that. Even a bear hug could help a lot. What you DH says about a fit is actually how I would describe it too. My DD used to fit for real and she has a very distinctive cry that she only makes after having one, and also after she has calmed down on the occasions when she has gone so off the handle that I've had to restrain her during some meltdowns.
everyone.
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