"My child’s behavior is often very difficult to understand. And since I don’t really understand a lot of his behavior, it makes it difficult to think of an intervention to change it. Why does he over-react to certain things (e.g., flipping into an intense temper tantrum when asked to put his Legos away -- even when I ask him nicely), and what can I do to help?"
There is a range of reasons why kids with Aspergers and High-Functioning Autism have difficulties with behavior. The world can be a confusing, isolating and daunting place for your youngster, and it is his fundamental difficulties with communication and social interaction that are often the root cause of difficult behavior. There are some other possible reasons, too.
It's important to say that your youngster's behavior is not caused by bad parenting – and is not your fault. It may seem as though your youngster's difficult behavior is only directed at you - especially if it tends to happen at home, not at school. You are not the only parent in this situation, although sometimes it can feel that way.
Reasons for behavior:
1. Bullying— Unfortunately, kids with Aspergers and High-Functioning Autism can be at more risk of being bullied than their peers. If you notice a sudden change in your youngster’s behavior, see if there has been any reported bullying or teasing in school. Your youngster may find it difficult to tell you if they have been bullied (not all kids with High-Functioning Autism even recognize what bullying is) so you might need to play detective.
2. Change— Children with Aspergers and High-Functioning Autism can find it difficult to cope with change, whether a temporary change to their timetable at school, or a more permanent change such as moving house. You may find that your youngster's behavior alters at times of change, but settles as he/she becomes used to a new environment or routine.
3. Communication— Kids with High-Functioning Autism can experience a number of difficulties with communication: (a) understanding what's being said to them (i.e., receptive language), (b) understanding non-verbal communication (e.g., facial expressions, body language), and (c) communicating with others (i.e., expressive language). Because of these difficulties, ASD kids can find it hard to communicate their needs or to understand what other people are saying to them, or asking them to do. This can cause considerable frustration and anxiety which, if it can't be expressed any other way, may result in challenging behavior.
4. Medical reasons— If your youngster's behavior suddenly changes for the worse, check that there isn't a medical reason for the distress. Kids can find it difficult to tell parents how they're feeling or where something hurts, even if their verbal communication is generally good. Some kids have seizures that can cause irritability and confusion, or gastrointestinal problems which may be painful. Parents can try using a pain chart to help the youngster indicate where he/she is feeling discomfort. Alternatively, some moms and dads use symbols to help their youngster indicate where the pain is.
5. Sensory processing difficulties— Many kids with ASD have difficulties processing sensory information. For example, kids may not be able to manage some tastes or food textures, or find that someone touching them - even lightly - is painful. Certain smells, lights or sounds can be distressing. Some kids may find it difficult to block-out background noise and what they experience as excessive visual information. Instead, sounds, lights and other sights are all processed at the same level of intensity and lead to sensory overload. You may find that your youngster starts a repetitive behavior in stressful environments (e.g., hand-flapping, spinning) to try and block-out external sensory information. Children with Aspergers and High-Functioning Autism can be very sensitive to subtle changes in their environment. If there's a sudden change in behavior, think about whether there has been a recent change in the environment.
6. Social situations— Communication difficulties can impact on how these kids deal with social situations. They may find social situations very demanding or stressful because they have to work hard to communicate with other people. Not all kids with High-Functioning Autism will understand that other people hold different views from theirs. This may also make social situations difficult. Kids with Aspergers and High-Functioning Autism may not understand 'social rules' (i.e., unwritten rules that govern social situations), such as how close to stand to other people or how to take a turn in conversation. This is especially true if kids find themselves in a new, unfamiliar situation. Therefore, social situations can be daunting and unpredictable. Some kids may engage in a particular behavior to try and avoid social contact.
7. Unstructured time— Kids with Aspergers and High-Functioning Autism can find 'sequencing' difficult (i.e., putting what is going to happen in a day in a logical order in their mind). Many kids have timetables so they can see what is going to happen, when, and plan for it. However, unstructured time (e.g., break times at school), which can be noisy and chaotic, may be difficult to deal with. This is because it's difficult for kids to predict what will happen and how they are expected to behave. You may find that behavioral difficulties occur more in transition times between lessons or activities. Abstract concepts such as time aren't easy to understand, and kids with Aspergers and High-Functioning Autism may find it hard to wait. It helps if you can be clear about why and for how long you are waiting (e.g., “We have to wait for five minutes, until 10.30. This is because the doctor can see us at 10.30.”).
Your child behaves the way he does for a particular reason...
In other words, he is trying to accomplish something (or avoid something). Here are two questions to ask yourself when looking at a particular aspect of your youngster's behavior:
- What is the function of this behavior?
- What is my youngster trying to tell me by his behavior?
Think of your child’s behavior as an iceberg. The behavior you are actually seeing is the tip of the iceberg, but there's a lot more going on under the surface. Children with Aspergers and High-Functioning Autism can't always express their feelings through facial expressions, body language or speech. Instead, they may be expressed through other behaviors. Your youngster might be trying to tell you she is tired, stressed, annoyed by something that happened earlier, or in need of some time alone.
It can be useful to use a behavior diary to try and find out what triggers a particular behavior. This helps you to monitor the behavior over time and see what the possible causes are (e.g., if always happens at the end of the day when your youngster is tired after school). One way of recording behavior is an ABC chart. On this, you record the Antecedent (i.e., what happened beforehand, who was there, where your youngster was), the Behavior itself, and the Consequence (i.e., what happened following the behavior). By identifying potential triggers for the behavior, it can be easier to come up with ways of preventing it from happening in the future. Interventions are more likely to be successful if they address either the cause or the function of the behavior.
When trying to tackle behavioral difficulties, select at the most two behaviors to focus on at a time. Using too many new strategies with your youngster at once may result in none of them working. You could write down all the behaviors you're concerned about then prioritize them, choosing the two most important ones to concentrate on first. Don't worry if things get worse before they get better. Your youngster might at first resist change. This is a normal reaction when kids want things to stay the same and try hard to see that they do. It's important to continue with the strategies you are using and be consistent.
Ways to deal with behavior problems:
1. Be patient. Your youngster's behavior generally won't change overnight. You may find it useful to track your youngster's behavior in a diary; then it may be easier to notice small, positive changes.
2. Check that skills have not been forgotten. If you have used strategies successfully in the past, it might help to revisit them from time to time so that your youngster remembers how to use them. You may also need to use them at periods of stress, illness or change when old behaviors can return. Visual supports can help with this.
3. Consistency is of the utmost importance. Whatever strategies you decide to use to help your youngster should be used by everyone involved with him, including other family members, teachers, babysitters, etc. Inconsistent reactions to behavior by different adults can cause confusion, stress and frustration for a child with Aspergers and High-Functioning Autism, and can make the behavior more difficult to tackle.
4. Exercise can help to relieve stress and frustration. Some studies have shown that regular exercise throughout the day can have a positive effect on general behavior. Many kids with High-Functioning Autism enjoy exercise like jumping on a trampoline.
5. Give praise where praise is due. As your youngster learns a new skill or coping strategy, give him/her as much praise as possible. Some kids like verbal praise. Others might prefer to get another kind of reward, like sticker on a star chart, or five minutes with their favorite activity or DVD. Try to give your youngster praise in a way that is meaningful. Try also to offer praise immediately after your youngster has demonstrated a skill. Your youngster will hopefully learn to make an association between the skill and the reward and start to use the skill more often.
6. Learn to identify emotions. Many children with High-Functioning Autism find it difficult not only to understand how others are feeling, but also how they feel themselves. Emotions are abstract concepts, and we need a degree of imagination to understand them (we can't simply 'see' anger, for example). There are ways to turn emotions into more 'concrete' concepts, though. For example, stress scales are a good way of helping kids with ASD to identify how they're feeling. You can use a traffic light system, visual thermometer, or a scale of 1-5 to present emotions as colors or numbers. For example, a green traffic light or a number 1 can mean 'I am calm' …a red traffic light or a number 5 can mean 'I am angry'. You need to help your youngster understand what 'angry' means. One way to do this is to refer to physical changes in the body (e.g., “When I'm angry, my tummy hurts/my face gets red/I want to cry”). When your youngster has begun to understand the extremes of angry and calm, you can start helping him/her to understand the feelings in between. If your youngster sees that he is getting angry, he can try to do something to calm himself down, or he can remove himself from the situation. Alternatively, other adults can see what is happening and take action.
7. Learn to relax. It can be very difficult for kids with High-Functioning Autism to relax. Some have a particular interest or activity they like to do because it helps them to relax. It is, of course, worth being aware of these. Can time doing their favorite activity be built into their daily routine? However, special interests or activities can sometimes be the cause of behavioral difficulties if a youngster can't do them when he wants to. Other ways to relax include having time alone for short periods of the day to unwind, playing soothing music, or using homeopathic remedies. Some children may find lights soothing, especially things like spinning lights or bubble tubes which are repetitive.
8. Modify the environment. Kids with High-Functioning Autism can have difficulties processing sensory information. Some things in their environment can act as severe irritants. If this is the case, it can be easier to remove the thing that might be irritating your youngster rather than trying to change a behavior pattern. Flickering fluorescent lights, humming noises, certain smells, etc., may be causing distress. It may be something you have hardly noticed at all, while your youngster experiences it much more intensely.
9. Children with ASD can find it difficult to transfer or generalize new skills they've learned from one situation to another. Encourage your youngster to use new skills or coping strategies in different situations (e.g., at school as well as at home).
10. Punishment for ASD-related symptoms (versus true misbehavior) rarely works, because many of these kids don't understand the connection between their behavior and a punishment they have received. Also, punishment won't explain what you want from your youngster or help to teach him any new skills.
11. Speak clearly and precisely. Some behavioral difficulties arise from kids’ frustration at not being able to communicate what they want. Some kids with High-Functioning Autism have a good grasp of language and speak quite fluently. However, they may struggle to tell you something when they are anxious or upset, or find it difficult to understand what you are saying to them. As a general rule, use short sentences, with your youngster's name at the beginning so that they know you're speaking to them. If you use short, clear sentences, your youngster won’t have to try to filter-out the less important information. If your youngster finds spoken communication difficult, consider using alternative ways of communicating (e.g., visual supports).
12. 'Time-outs' are a way for your youngster to calm down, especially if environmental factors are causing distress. Whatever location your youngster goes to should be a calm, safe environment where she can be observed. This should only last a few minutes, and your youngster should then be directed to an activity she finds relaxing. Some kids have time-out at home, perhaps time alone in their bedroom, or the chance to do a favorite activity.
13. Use visual supports. Children with Aspergers and High-Functioning Autism often find it easier to process visual information. Some kids use picture symbols or photos to communicate what they want, while others use sign language. Using a visual timetable can make it easier for a youngster to understand what's going to happen throughout the day. It also gives a sense of routine, which kids with Aspergers and High-Functioning Autism usually like, and removes feelings of uncertainty.
14. When tackling any behavior, be realistic and set achievable goals. You don't want to cause yourself more frustration by feeling you've failed to meet unachievable goals.
15. Write a social story. Social stories are short descriptions of situations, events or activities, often with pictures, which include information about what to expect in that situation and why. They can give a youngster with Aspergers and High-Functioning Autism some idea of how others might behave, and therefore be a guide for appropriate behavior.
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