June 17, 2016

Basics Of Supporting Challenging Behavior


Parents of children on the spectrum know all too well the challenge of dealing with behavior difficulties, as well as the judgement they may receive from others during the most difficult times. Understanding “how behavior works” is not as intuitive as many may think, especially when you compound the issues inherent to people with an ASD and the assumption by many that it’s the autism causing the behavior. So what is there to do but whatever it takes to make it stop?
Turns out there is a lot that can be done!   But if you focus just on stopping challenging behavior in the moment, there is a good chance you are in fact helping that behavior to continue. We call this reinforcing it: scream for the candy, get the candy (screaming stops) but next time I will scream when I want the candy, or anything else for that matter! And while this simple example illustrates an important concept, when the person on the spectrum is having difficulties and you don’t know why, or you need them to accept a situation (doctor exam for example?), it’s neither simple nor easy for anyone.

But understanding the root cause is an important first step and this is usually called the “function” of the behavior. And while it can get more complicated when it comes to building the skills necessary to replace the problem behavior, finding the function or purpose usually takes just a little bit of problem solving and can be narrowed down to a few basic wants or needs.
Broadly speaking, you can even break it down do just two needs? Do they want to GET something or do they wish to AVOID something? And then those ‘somethings’ can be divided into just three basic categories: Attention, Tangible, and Sensory. Let’s look at these three concepts individually.

Attention: Most everyone wants positive attention at least once in a while, especially from those they love. But somehow when a person does it ‘just for attention’ we view that negatively and something that should be dismissed. If a child is seeking attention through challenging behaviors it doesn’t discount the very real and legitimate need on their part. With communication and social skill deficits a major part of the very definition of ASD it is no surprise that many wind up turning to inappropriate actions that are in fact very effective at getting attention, even if it is negative!  And again, the social challenges also mean that they may wish to avoid attention.  Hitting and screaming or yelling insults is often the quickest way to turn others away or get sent to your room!
Tangibles: These are items, experiences or activities. They want to play video games or they don’t want to take out the trash. They want to stop at McDonald’s, they don’t want the peas on their plate. This one is often easy to spot but no less frustrating to deal with.

Sensory: These are often particularly difficult to understand because people with ASD have unusual responses to sensory stimuli – what they see, hear, taste, smell, and feel as well as how they experience movement and gravity. And they are key to being able to regulate our emotions as well. And when a sensory need is denied it triggers us to go into the infamous ‘fight or flight’ mode, which often means a challenging behavior is inevitable. Knowing your child’s sensory ‘profile’ and finding ways to prevent or compensate for triggers is often the best way to approach behaviors based on escaping sensory challenges and then also teaching more appropriate and less intrusive methods for accessing sensory needs. If your child has on occupational therapist, they can be a great help in understanding their specific needs.
Once you have figured out the function of the child’s behavior you then have to figure out if there is a better way for them to meet their needs. Functional communication training for non-verbal individuals is a critical step in changing behaviors and reducing frustration. Perhaps it is more a matter of teaching specific social skills or building awareness of typical sensory challenges so that they can more successfully navigate their world.

Remember that ASD’s (and other disabilities) are never the cause of challenging behaviors. What they do cause are skill deficits! And the lack of skill is what leads to behaviors of concern. And it is much more effective and rewarding for all if skill development is the focus rather than punishing or extinguishing behavior.
 Remember if you just focus on finding that magic consequence to change behavior you are likely just setting everyone up for failure. This is because there are three parts to the behavior chain and the consequence is just the last link. You have to look closely at what comes prior to the behavior (antecedents) and focus your efforts on pro-active solutions. These can be simple but effective steps that build predictability, reduce sensory overload, embed choices or simply take into account a range of issues in the moment when setting a boundary or deciding your course of action. Remember, changing their behavior starts by changing ours.