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Showing posts sorted by relevance for query behavior. Sort by date Show all posts

Identifying the Underlying Causes of “Difficult Behavior” in Kids on the Spectrum

"As a teacher, I would like to ask you what method you use to find the real reasons [or triggers] for behavior problems in students with high functioning autism?"

In order to identify the underlying causes of difficult behaviors in children with Asperger’s (AS) and High-Functioning Autism (HFA), a Functional Behavioral Assessment (FBA) must be performed. An FBA is an approach that incorporates a variety of techniques to diagnose the causes and to identify likely interventions intended to address difficult behaviors.

An FBA looks beyond the actual problem behavior, and instead, focuses on identifying biological, social, affective, and environmental factors that initiate, sustain, or end the problem behavior in question. The FBA is important because it leads the researcher beyond the "symptom" (i.e., the behavior) to the child's underlying motivation to escape, avoid, or get something (i.e., the cause of the behavior). Behavior intervention plans stemming from the knowledge of why a child misbehaves are extremely useful in addressing a wide range of issues.



The “functions” of behavior are not usually considered inappropriate. Rather, it is the behavior itself that is judged appropriate or inappropriate. For example, getting good grades and engaging in problematic behavior may serve the same function (e.g., to get attention), but the behaviors that lead to good grades are judged to be more appropriate than those that make up acting-out behavior.

As an example, if the IEP team determines through an FBA that a child is seeking attention by misbehaving, they can develop a plan to teach the child more appropriate ways to gain attention, thus fulfilling the child's need for attention with an alternative behavior that serves the same function as the inappropriate behavior. By incorporating an FBA into the IEP process, team members can develop a plan that teaches “replacement behaviors” that serve the same function as the difficult behavior.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

Before an FBA can be implemented, it is necessary to identify the behavior that is causing problems, and to define that behavior in concrete terms that are easy to communicate and simple to measure and record. If descriptions of behaviors are vague (e.g., child has a “bad attitude”), it is difficult to determine appropriate interventions.

It will be necessary to observe the child's behavior in different settings and during different types of activities, and to conduct interviews with parents and teachers in order to identify the specific traits of the behavior. Once the difficult behavior has been defined concretely, the IEP team can begin to devise a plan for conducting an FBA to determine the functions of the behavior.

Since difficult behavior stems from a variety of causes, it is best to examine the behavior from as many different angles as possible. The IEP team should assess what the "pay-off" for engaging in problem behavior is, or what the child escapes/avoids/gets by engaging in the problem behavior. This assessment will enable the team to identify workable techniques for developing and conducting an FBA and developing behavior interventions.

When carrying out these tasks, the IEP team should find answers to a few critical questions. Addressing these questions will assist the team in determining the necessary components of the assessment plan, and will lead to more effective behavior intervention plans. Questions to ask include the following:
  • Are there any settings where the problem behavior does not occur?
  • Does the child find any value in engaging in appropriate behavior?
  • Does the child have the skills necessary to perform expected behaviors?
  • Does the child realize that he is engaging in unacceptable behavior, or has that behavior simply become a "habit"? 
  • Does the child understand the behavioral expectations for the situation? 
  • In what settings is the problem behavior observed? 
  • Is it possible that the child is uncertain about the appropriateness of the behavior?
  • Is it within the child's power to control the behavior, or does she need support? 
  • Is the behavior problem associated with certain social or environmental conditions? 
  • Is the child attempting to avoid a demanding task?
  • Is there a more acceptable behavior that might replace this behavior? 
  • Is there evidence to suggest that the child does not know how to perform the skill – and therefore can’t? 
  • What activities or interactions take place just prior to the behavior? 
  • What current rules, routines, or expectations does the child consider irrelevant?
  • What usually happens immediately after the behavior? 
  • Who is present when the behavior occurs?



Interviews with the child may be useful in identifying how he perceived the situation and what caused him to act in the way he did. Questionnaires, motivational scales, and checklists can also be used to structure indirect assessments of behavior. For example:

1. Hypothesis statement— Drawing on information that emerges from the analysis, school staff can establish a “working hypothesis” regarding the function of the behaviors in question. This hypothesis predicts the general conditions under which the behavior is most - and least - likely to occur, as well as the likely consequences that serve to maintain it.

2. Direct assessment— Direct assessment involves observing and recording situational factors surrounding a difficult behavior (e.g., antecedent and consequent events). A member of the IEP team may observe the behavior in the setting that it is likely to occur, and record data using an Antecedent- Behavior- Consequence (ABC) approach.

3. Data analysis— Once the IEP team is satisfied that enough data have been collected, they should compare and analyze the data. This analysis will help the team to determine whether or not there are any patterns associated with the behavior. If patterns can’t be determined, the team should revise the FBA to identify other methods for assessing behavior.

After collecting data on a child's behavior, and after developing a hypothesis of the function of that behavior, the IEP team should develop the child's behavior intervention plan. It is helpful to use the data collected during the FBA to develop the plan and to determine the discrepancy between the youngster's actual and expected behavior.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

Intervention plans emphasizing the skills that AS and HFA children need in order to behave in a more appropriate manner will be more effective than plans that simply serve to control behavior. Interventions based upon “control” often fail to generalize (i.e., fail to continue to be used for long periods of time, in many settings, and in a variety of situations). Control measures usually only serve to suppress behavior, resulting in the youngster meeting unaddressed needs in alternative, inappropriate ways.

It is good practice for IEP teams to include two evaluation procedures in an intervention plan:
  • one designed to measure changes in behavior
  • one designed to monitor the accuracy with which the plan is implemented

In addition, IEP teams must determine a timeline for implementation and reassessment, and specify the degree of behavior change consistent with the goal of the overall intervention.

To be meaningful, plans need to be reviewed at least annually and revised as needed. However, the plan may be reviewed and re-evaluated whenever any member of the youngster's IEP team feels that a review is necessary. Circumstances that may warrant a review include the following:
  • It is clear that the original behavior intervention plan is not bringing about positive changes in the child's behavior.
  • The situation has changed, and the behavioral interventions no longer address the current needs of the child.
  • The youngster has reached his behavioral goals and objectives, and new goals and objectives need to be established.
  • The IEP team makes a change in placement.

If done correctly, the net result of an FBA is that school personnel are better able to provide an educational environment that addresses the special learning needs of the AS/HFA child.

CLICK HERE for an example of a completed Functional Behavioral Assessment (FBA) form…

CLICK HERE for a blank FBA and Behavior Intervention Plan (BIP) form…


More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

The ABC Model: Behavior Modification for Children on the Autism Spectrum


"What suggestions would you have for helping my child to increase his appropriate behaviors? I think I should focus on bringing out the positive instead of just punishing the negative."

Behavior modification is an effective technique used to treat Asperger’s and High Functioning Autism (HFA). The fundamentals of behavior modification can be used to increase desired behaviors in the child, regardless of functional level (e.g., a mother who wants her youngster to consistently make the bed can use behavior modification to help achieve this goal).



In order to be successful, behavior modification techniques should be applied consistently across all areas of the youngster’s life. Also, understand that the longer a particular problematic behavior has been evident, the longer it will take to change it. Thus, it may take a while for the chosen techniques to be effective. The parents’ job is to focus on the behavior they would like to increase or decrease. The more parents learn about behavior modification techniques, the more tools they will possess to help shape and promote the behavior they want to see more often in their child.

Behavior is observable and measurable (i.e., any action that can be seen or heard). An effective method of examining behavior is the ABC model:

A=Antecedent: The event occurring before a behavior (the event prompts a certain behavior)
B=Behavior:  Response to the events that can be seen or heard
C=Consequence: The event that follows the behavior, which effects whether the behavior will occur again (when the behavior is followed by an unpleasant consequence, it is less likely to reoccur; when the behavior is followed by a pleasant consequence, it is more likely to reoccur)

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

Let’s look at a specific example of how the ABC model works:

A youngster who is exhibiting a temper tantrum may be seeking attention.  If the parent responds to the tantrum (whether to comfort or scold), the behavior is being rewarded by the parent’s reaction – even when it’s a negative reaction.  Thus, in this situation, it would be best if the parent waited for the tantrum to stop, and then reward (i.e., reinforce) the calm behavior verbally (e.g., “I like how quiet you are being right now”).  In this way, the youngster learns that he or she can gain the parent’s attention through more appropriate behavior.

Points to keep in mind when implementing the ABC model:

1. When “rewarding” appropriate behaviors, be sure to label the behavior you are praising. Be very specific (e.g., rather than saying “You’re being a good boy” …say something like “You did a great job of picking your toys up and putting them in the basket”).

2. Reward the appropriate behavior immediately after that behavior is exhibited. For example, Randy picks up his toys after his mother asks him to do so, yet she takes the time to finish folding clothes before she acknowledges Randy’s appropriate behavior.  Randy starts to have a tantrum, so his mother gives him a snack. Randy has now learned that he gets a treat for having a tantrum, and ‘putting his toys away when asked’ is forgotten.  Thus, it’s important to have reinforcers (i.e., rewards) handy, and reinforce immediately after the target behavior occurs.

3. Only chose one behavior at a time that you want to increase or decrease, and work on that.  Addressing several behaviors at once may backfire.

4. Make sure the request you are making is very clear and concise.  Don’t cloud the request with superfluous wording. Also, don’t make more than one request at a time.

5. Choose reinforcers that are meaningful to your youngster (e.g., if he has no interest in going shopping with you, and you say something like “If you’ll eat your vegetables, I’ll take you shopping with me” …then this is not likely to result in an increase in ‘vegetable-eating’ behavior).

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

6. When providing rewards for appropriate behavior, be enthusiastic and animated.  Whenever your youngster starts to master a target behavior, get excited, break out the potato chips, and give plenty of hugs and tickles all at once. Really show your youngster how pleased you are with him or her. 

7. Parents can also increase desirable behavior by “modeling” (i.e., a process whereby the child learns a skill through observing and imitating the parent).

8. Initially, you will need to reward your youngster every time the target behavior occurs. But as time goes by (assuming you are implementing the ABC model correctly), your child may begin to exhibit the preferred behavior without any rewards (in other words, the ‘new’ behavior will become a habit).

9. Another technique to use when starting out involves pairing edible, social or toy rewards with verbal praise. But as time goes by, you may only need to provide verbal praise. Your youngster will learn that pleasing you is a reward in-and-of itself.

10. Know the difference between “reinforcement” and “bribery.” Reinforcement comes after a behavior is exhibited (e.g., “You did a wonderful job of hanging up your clothes. Now you can go watch TV”), whereas bribery is offered beforehand (e.g., “O.K. You can watch TV, but then I want you to go and hang up all your clothes”). 

11. Create a list of reinforcers that seem to work with your child (literally write them down). Examples of effective reinforcers may include:
  • asking a question
  • complimenting your child
  • giving positive attention
  • having a conversation with her
  • joining in an activity 
  • leaning toward her
  • looking at her
  • making a comment
  • small gifts (e.g., toys, puzzles, books)
  • smiling
  • snacks (e.g., Gold Fish crackers) 
  • special activities (e.g., movies, zoo, going to the park)

12. In the later stages of behavior modification, you will need to change the “reinforcement schedule.” If a child is reinforced every single time she does something good, eventually the reinforcement loses its power. Thus, initially reinforce what you want with consistency, then as your child starts to respond, change your schedule of reinforcement to every second or third time she does what you want. Eventually, you may be able to change it again to every fourth or fifth time. Let's look at an example:

If you want your child to put her Legos away, then first arrange a situation where she has to gather them up (e.g., pile them in front of her bedroom door so that she either has to move them or step over them). Once your child puts the Legos in their containers, look her in the eye and tell her what a big help she is. Make sure that the comment directly follows the desired behavior. Eventually, your child may put her Legos away on a fairly consistent basis. Once that happens, don’t compliment her every time. Instead, change from a “modification stage” to a “maintenance stage” and compliment on average every second to fifth time she picks up after herself.




When using the ABC model, always remember that your child is not an experiment, rather he is an individual capable of changing unwanted behavior - when offered the correct means to do so.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Effective Interventions for Problem Behaviors in Children on the Autism Spectrum

In order to create an effective intervention for problem behaviors in children with Asperger’s (AS) and High-Functioning Autism (HFA), parents need to take into consideration a variety of aspects.

Let’s first look at “The 4-Step Plan”:

1. Hypothesize the Function of the Behavior:
  • Escape/Avoidance
  • Sensory Feedback 
  • Social Attention 
  • Wants tangible item or activity

2. Gather Information:

a. Antecedent: Does the behavior occur…
  • Following a request to perform a difficult task?
  • Repeatedly, in the same way, for long periods of time, even when no one is around? 
  • When a request for an item or activity is denied? 
  • When you are attending to other children in the room?

b. Consequence: When the behavior occurs, do you…
  • Allow your child to engage in inappropriate behavior?
  • Attend to your child? 
  • Leave him or her alone? 
  • Negotiate or give the desired item/activity?

3. Plan an Intervention:

a. Based on information gathered, are environmental changes needed?
  • Limit toys and games available to your child
  • Less noise/chaos
  • Remove distracters

b. Based on information gathered, determine how you should react to the challenging behavior each time it occurs.
  • Plan to attend
  • Plan to ignore
  • Plan to redirect
  • Plan to remove privileges

4. Identify a Replacement Behavior:

a. What appropriate behavior is “functionally equivalent” to the challenging behavior?
  • Teaching your child to communicate his or her wants appropriately to replace escape/ avoidance behaviors
  • Teaching your child to ask if he or she can use the computer later to replace tantrum behavior 
  • Teaching your child to tell you what he or she wants/needs in order to replace attention-seeking behaviors

b. Create “replacement behavior” planning guide (write it down in a journal or notebook).
  • Describe how you will evaluate if – and how – your child uses the new response.
  • In what situations will “training” (i.e., behavior modifications) occur? 
  • What functionally equivalent behavior are you going to train in place of the problem behavior? 
  • What motivation system will be implemented during training? 
  • Which behavior are you going to target for replacement?

Next, let’s look at Differential Reinforcement:

Differential reinforcement is the process by which the frequency of a desirable behavior is increased while the undesirable alternative behaviors are eliminated. It is used when the desired behavior already occurs occasionally and when there is an available reinforcer.

The first step to differential reinforcement is to define exactly what the target behavior is, and also to define the undesirable competing behavior (e.g., if Michael plays video games twice as much as he does homework, the target behavior would be doing homework, and the undesirable behavior would be playing video games).

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's
 
The next step is to collect baseline data. Baseline is the period of time before behavior modification is implemented. The baseline serves as an indication of whether or not behavior modification is successful. So with Michael, the parent would record and graph the amount of time spent doing homework and playing video games each day.

In the third step, a reinforcer should be chosen (i.e., an item which the child is willing to work for), for example, snacks, praise, games, etc. With Michael, he could be reinforced with video game time.

Every time that the desirable behavior is demonstrated, it should be immediately reinforced. So, for every 30 minutes Michael spends doing homework, he would immediately be given 15 minutes of video game time. If too much time elapses before the child is reinforced, the target behavior will not increase in frequency.

Throughout the process, it is important for the parent to record the frequency of both the desirable and undesirable behavior so that progress can be tracked. After the desirable behavior is at the desired level, and the undesirable behavior is virtually eliminated, behavior modification can be decreased.

Lastly, here are a few additional interventions for problem behaviors in AS and HFA children:

1. Checklists and Schedules -- Provide visual structure and motivation needed to complete tasks/chores/activities, and stay on target by checking off tasks/chores/activities upon their completion.

2. Contingency Contracts -- The parent and child formalize agreements concerning specific behavior for the exchange of “reinforcers” (i.e., stimuli, such as rewards, the removal of unpleasant events, or punishments that maintain or strengthen a desired response) by writing an agreement. It outlines the behaviors and consequences of a specific behavior management system (e.g., good behavior “A” gets reward “A” …or misbehavior “B” gets punishment “B”).


3. Interspersed Requests -- Used to motivate AS and HFA kids to perform a difficult or unpleasant task by initially asking them to perform several easier tasks, which they can complete successfully in a short amount of time. This helps promote “behavioral momentum.”

4.  Premack Principle -- A method of maintaining and increasing compliance with rules through the use of positive reinforcement. A desired activity is available to the youngster on the completion of an undesired activity (e.g., the child who completes homework can earn an opportunity to play on the computer).

5. Redirection -- Introduce a novel stimulus to recapture the child’s attention by delivering verbal and nonverbal cues to the child to stop misbehavior, offering assistance with a task, engaging him/her in conversation, reminding him/her to focus attention on the task, or modeling calm and controlled behavior.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

6. Rules -- Establish, teach, and enforce house rules. Rules should be positively stated. Identify the specific behaviors you wish to see displayed.

7. Self-Evaluation -- A self-management system that has been used to promote appropriate behavior. AS and HFA kids are taught to evaluate their own behavior using a rating scale. For instance, a child can rate his or her behaviors using a 0-5 point rating scale ("unacceptable" to "excellent"). The child earns points, which can be exchanged for reinforcers based on both child-behavior and the accuracy of his or her ratings.

It is important for parents to know that, independent of their AS or HFA child's diagnosis, there are behavioral interventions that are very likely to help. A diagnosis of an autism spectrum disorder increases the likelihood that parents will observe behavioral problems, but that does not mean that they have to live with those problems. Understanding that kids on the spectrum experience the world in a different way is important. But, moms and dads also have a responsibility to work with their child so that he or she can develop more socially appropriate behavior. Using the methods outlined above can be a good start toward this end.




 
Resources for parents of children and teens on the autism spectrum:
 
 

Parent Management Training [PMT] for Parents of Aspergers Children

Parent management training (PMT) is an adjunct to treatment that involves educating and coaching moms and dads to change their Aspergers child’s problem behaviors using principles of learning theory and behavior modification.

Purpose—

The aim of PARENT MANAGEMENT TRAINING is to decrease or eliminate an Aspergers child’s disruptive or inappropriate behaviors at home or school and to replace problematic ways of acting with positive interactions with peers, moms and dads and such authority figures as teachers. In order to accomplish this goal, PARENT MANAGEMENT TRAINING focuses on enhancing parenting skills. The PARENT MANAGEMENT TRAINING therapist coaches parents in applying such strategies as rewarding positive behavior, and responding to negative behavior by removing rewards or enforcing undesirable consequences (punishments).

Although PARENT MANAGEMENT TRAINING focuses on specific targeted behaviors rather than on the youngster's diagnosis as such, it has come to be associated with the treatment of certain disorders. PARENT MANAGEMENT TRAINING is used in treating oppositional defiant disorder , conduct disorder , intermittent explosive disorder (age-inappropriate tantrums), and attention deficit disorder with hyperactivity (attention-deficit/hyperactivity disorder ). Such antisocial behaviors as fire-setting and truancy can also be addressed through PARENT MANAGEMENT TRAINING.

Description—

In PARENT MANAGEMENT TRAINING, the therapist conducts initial teaching sessions with the parent(s), giving a short summary of foundational concepts in behavior modification; demonstrating interventions for the moms and dads; and coaching parents in carrying out the techniques of PARENT MANAGEMENT TRAINING. Early meetings with the therapist focus on training in the principles of behavior modification, response-contingent learning, and ways to apply the techniques. Moms and dads are instructed to define the behavior(s) to be changed concretely and specifically. In addition, they learn how to observe and identify relevant behavior and situational factors, and how to chart or otherwise record the youngster's behavior.

Defining, observing and recording behavior are essential to the success of this method, because when such behaviors as fighting or tantrums are highlighted in concrete, specific ways, techniques of reinforcement and punishment can be put to use. Progress or its absence is easier to identify when the description of the behavior is defined with enough clarity to be measurable, and when responses to the PARENT MANAGEMENT TRAINING interventions are tracked on a chart. After the Aspergers child’s parents grasp the basic interventions as well as when and how to apply them, the techniques that the moms and dads practiced with the therapist can be carried out at home.

Learning theory, which is the conceptual foundation of PARENT MANAGEMENT TRAINING, deals with the ways in which organisms learn to respond to their environment and the factors that affect the frequency of a specific behavior. The core of learning theory is the notion that actions increase or decrease in frequency in response to the consequences that occur immediately after the action. Research in parent-child interactions in families with disruptive, difficult or defiant kids shows that parental responses are unintentionally reinforcing the unwanted behavior. PARENT MANAGEMENT TRAINING trains moms and dads to become more careful in their reactions to a youngster's behavior.

The parents learn to be more discerning: to provide attention, praise and increased affection in reaction to the Aspergers child’s behaving in desired ways; and to withdraw attention, to suspend displays of affection, or to withdraw privileges in instances of less desirable behavior.

The most critical element of PARENT MANAGEMENT TRAINING is offering positive reinforcement for socially appropriate (or at least non-deviant) behaviors. An additional component involves responding to any undesired behaviors by removing rewards or applying punishment. These two types of response to the youngster must be carried out with great consistency. Consistent responding is important because erratic responses to unwanted behavior can actually cause the behavior to increase in frequency. For instance, if a youngster consistently throws tantrums in stores, hoping to be given something to end the tantrum, inconsistent parent responses can worsen the situation. If a parent is occasionally determined not to give in, but provides a candy bar or a toy to end the tantrum on other occasions, the youngster learns either to have more tantrums, or to have more dramatic tantrums. The rise in the number or intensity of tantrums occurs because the youngster is trying to increase the number of opportunities to obtain that infrequent parental reward for the behavior.

Planning responses ahead of time to predefined target behaviors by rewarding desired actions and by withdrawing rewards or applying punishment for undesirable behavior is a fundamental principle of PARENT MANAGEMENT TRAINING. Consistent consequences, which are contingent on (in response to) the youngster's behavior, result in behavior change. Moms and dads practice therapeutic ways of responding to their Aspergers child’s behavior in the PARENT MANAGEMENT TRAINING sessions with the therapist.

Through PARENT MANAGEMENT TRAINING, parents learn that positive rewards for appropriate behaviors can be offered in a variety of ways. Giving praise, providing extra attention, earning points toward obtaining a reward desired by the youngster, earning stickers or other small indicators of positive behavior, earning additional privileges, hugging (and other affectionate gestures) are all forms of reward. The technical term for the rewarding of desired behavior is positive reinforcement. Positive reinforcement refers to consequences that cause the desired target behavior to increase.

PARENT MANAGEMENT TRAINING instructs moms and dads to cancel rewards or give punishments when the Aspergers child behaves in undesirable ways. The removal of rewards usually entails time away from the circumstances and situations in which the youngster can do desired activities or receive attention. The concept of a "time out" is based on this notion of removal of rewards. Time out from rewards customarily means that the youngster is removed from people and stimulation for a certain period of time; it can also include deprivation of privileges.

Punishment in PARENT MANAGEMENT TRAINING is not necessarily what parents typically refer to as punishment; it most emphatically is not the use of physical punishment. A punishment in PARENT MANAGEMENT TRAINING involves a response to the youngster's negative behavior by exposing the Aspergers child to something he or she regards as unpleasant. Examples of punishments might include having to redo the correct behavior so many times that it becomes annoying; verbal reproaches; or the military standby—"drop and give me fifty"—having to do pushups or sit-ups or laps around a playing field to the point of discomfort.

The least challenging problems, which have the greatest likelihood of successful change, are tackled first, in hope of giving the family a "success experience." The success experience is a positive reinforcement for the family, increasing the likelihood that they will continue using PARENT MANAGEMENT TRAINING in efforts to bring about change. In addition, lower-level behavioral problems provide opportunities for moms and dads to become skilled in intervening and to learn consistency in their responses. After the parents have practiced using the skills learned in PARENT MANAGEMENT TRAINING on the less important problems, more severe issues can be tackled.

In addition to face-to-face sessions with the parents, some PARENT MANAGEMENT TRAINING therapists make frequent telephone calls to the moms and dads between sessions. The purposes of the calls are to remind moms and dads to continue to be consistent in applying the techniques; to answer questions about the work at home; and to praise the parents' attempts to correct the youngster's behavior. In addition, ongoing support in sessions and on the telephone helps parents feel less isolated and thus more likely to continue trying to use learning principles in managing their youngster. Troubleshooting any problems that arise regarding the application of the behavioral techniques is handled over the telephone and in the office sessions.

An additional aspect of learning theory is that rewarding subunits of the ultimately desired behavior can lead to developing more complex new actions. The subunits are finally linked together by changing the ways in which the rewards are given. This process is called "chaining." Sometimes, if the youngster shows no elements of the desired response, then the desired behavior is demonstrated for the Aspergers child and subsequent "near hits" or approximations are rewarded. To refine "close but not quite" into the targeted response, rewards are given in a slightly "pickier" manner. Rewarding successive approximations of the desired behavior is also called "shaping."

Risks—

The best way to learn to alter parental responses to Aspergers child behaviors is with the support and assistance of a behavioral health professional (psychologist, psychiatrist, clinical social worker). As noted earlier, moms and dads often inadvertently reinforce the problem behaviors, and it is difficult for a parent to see objectively the ways in which he or she is unintentionally supporting the defiant or difficult behavior. Furthermore, inappropriate application of such behavioral techniques as those used in PARENT MANAGEMENT TRAINING can actually make the problem situation worse. Families should seek therapists with valid credentials, skills, training and experience in PARENT MANAGEMENT TRAINING.

Normal results—

Typically, the parents should notice a decrease in the unwanted behaviors after they implement the techniques learned in PARENT MANAGEMENT TRAINING at home. Of the various therapies used to treat childhood disorders, PARENT MANAGEMENT TRAINING is among those most frequently researched. PARENT MANAGEMENT TRAINING has shown effectiveness in changing Aspergers kid's behavior in very well-designed and rigorous studies. PARENT MANAGEMENT TRAINING has a greater effect on behavior than many other treatments, including family therapy or play therapy.

Furthermore, the results— improved child behavior and reduction or elimination of undesirable behavior— are sustained over the long term. When a group of kids whose families had used PARENT MANAGEMENT TRAINING were examined one to fourteen years later, they had maintained higher rates of positive behavior and lower levels of problem behavior.

Managing Disruptive Behavior in Children with High-Functioning Autism and Asperger's

“We've been going in circles with our high functioning (autistic) 8 y.o. and his disruptive behavior – hitting, kicking, throwing things, just to name a few. We have tried all that we know to try. It's been difficult when he acts out, not respecting us or his siblings. It impacts the entire family! Do you have any ideas of how to handle disruptive behavior of this kind?”

One of the biggest obstacles a parent faces is managing disruptive behavior in the child with Asperger’s (AS) or High-Functioning Autism (HFA). Whether the child is refusing to eat what was prepared, or throwing tantrum on the way to school, the parent can find herself at a loss for an effective way to respond.

If you are at your wits end, the ABC method can provide a roadmap to a calmer, more reliable way to manage problematic behaviors. This method also offers a chance to help the AS or HFA child to gain the developmental skills he needs to regulate his own behavior.



The ABC Method of Behavior Management

To understand and respond successfully to misbehavior, parents have to think about what came before it – and what comes after it. Here are the 3 crucial features to any given behavior:
  • Antecedent: This is the preceding factor (or trigger) that makes a behavior more or less likely to occur. Learning and anticipating the antecedent is a very helpful tool in preventing problematic behavior.
  • Behavior: This, of course, is the specific action the parent is trying to discourage - or encourage - as the case may be.
  • Consequence: This refers to the result that logically and naturally follows a behavior. The consequence affects the likelihood of a behavior recurring, whether it’s positive or negative. Also, the more immediate the consequence, the more influential it is.

Identifying “target behaviors” is the first step in a good behavior-management plan. These behaviors need to be (a) specific (so both parent and child are clear on what is expected), (b) observable, and (c) measurable (so parent and child can agree whether or not the behavior happened). An example of poorly defined behavior is “acting-out,” or “being mean.” An example of well-defined behavior is “completing homework” (good) “pushing your sister” (bad).


==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

Antecedents—

Antecedents come in many forms. Some are wonderful tools that assist the parent in managing misbehavior before it begins as well as bolstering appropriate behavior, while others facilitate misbehavior. Let’s look at each of these in turn…

Antecedents that bolster appropriate behavior:

1. Providing countdowns for transitions: As often as possible, the parent should prepare her AS or HFA child for an upcoming transition. For example, let the child know when there are 15 minutes remaining …then 10 minutes …then 5 before he must come to dinner or start his homework. Note: Making the transition at the stated time is just as important as issuing the countdown.

2. Making expectations clear: Parents will get better cooperation if they and their youngster are clear on what is expected. Its best to sit down with the child and present the information verbally – and then put it in writing and post it in a prominent location. Even the child “should know” what is expected, explaining expectations at the outset of a task will help avoid misunderstandings down the line.

3. Letting children have a choice: As the child grows up, it’s crucial she has a say in her own scheduling. Giving a structured choice can help her feel empowered and encourage her to become more self-regulating (e.g., “Do you want to pick up your dirty clothes before or after dinner?”).

4. Being aware of the situation: Parents need to consider and manage both emotional and environmental factors. For example, anxiety, hunger, fatigue, or distractions can all make it much more difficult for the youngster to effectively manage his behavior.

5. Adjusting the environment: Examples of adjusting the environment are (a) removing distractions such as video screens and toys when it’s time to do homework, (b) providing a snack, (c) establishing an organized space for the child to work, and (d) making sure to schedule some breaks.

Antecedents that facilitate misbehavior:

1. Initiating transitions without warnings: A transition is hard for a child with AS or HFA – especially in the middle of something he is enjoying. Providing a warning gives the youngster the opportunity to find a good stopping place for an activity and makes the transition less stressful.

2. Shouting instructions out from a distance: It’s helpful to give the child important instructions face-to-face. A parent’s request that is yelled from a distance is less likely to be understood and remembered.

3. Assuming expectations are comprehended: Parents should not assume that their child automatically knows what is expected of him. The expectation needs to be spelled out! Demands change from circumstance to circumstance, and when the youngster is unsure of what he is supposed to be doing, he’s more likely to engage in problematic behavior.

4. Giving too many instructions at once: If parents deliver a series of instructions or ask a lot of questions, it limits the likelihood that the child will hear, answer questions, remember the tasks, and do what she has been instructed to do.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

Consequences—

Not all consequences are created equal. Some have the potential to do more harm than good, while others are an exceptional way to create structure and help AS and HFA children understand the difference between unacceptable and acceptable behaviors. As a mother or father, having a good understanding of how to consistently and intelligently employ consequences can make a huge difference in outcomes.

Consequences that bolster appropriate behavior:

1. Being clear and concrete when using time-outs: Parents should establish which behaviors will result in a time-out. When the AS or HFA youngster exhibits that behavior, the corresponding time-out needs to be relatively brief and immediately follow the misbehavior. If a time-out was delivered for not complying with a task, once it ends, the youngster needs to be instructed to complete the original task. In this way, he or she won’t begin to see time-outs as an escape method. During the time-out, parents should not talk to their youngster until he or she is ending the time-out. It should end once the youngster has been calm and quiet for a brief amount of time so that he or she learns to associate the end of time-out with this desired behavior.

2. Staying consistent: If parents arbitrarily issue time-outs when they are feeling aggravated, it will undermine the behavior-management system and make it harder for the youngster to connect behaviors to consequences.

3. Using active ignoring: Ignoring is used for minor misbehaviors and involves the deliberate withdrawal of attention when the youngster starts to misbehave. With this method, parents pick their battles carefully and save their energy for the larger issues that need to be addressed (e.g., verbal or physical aggression). As parents ignore, they wait for appropriate behavior to resume. Then they should give positive attention as soon as the desired behavior starts. By withholding attention until positive behavior is exhibited, parents are teaching their youngster what behavior gets acknowledged and praised.

4. Using positive attention for positive behaviors: When parents give their youngster positive reinforcement for behaving appropriately, it helps maintain that ongoing good behavior. Positive attention improves self-esteem and enhances the quality of the parent-child relationship. Positive attention to “brave behavior” can also help alleviate anxiety, as well as help the child become more receptive to instructions and limit-setting.

5. Using reward menus: A reward is a tangible way to give your youngster positive feedback for desired behaviors. It’s something that is earned, an acknowledgement that the child is doing something that’s difficult for him. A reward is most effective as a motivator when the youngster can choose from a variety of things (e.g., a special treat, extra time on the computer, etc.). This reduces the possibility of a reward losing its allure over time. Also, the reward needs to be linked to specific behaviors – and always delivered consistently.

==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism 

Consequences that facilitate misbehavior:

1. Using positive consequences for negative behaviors: This reinforces the behavior you are trying to eliminate. For example, if your youngster procrastinates instead of putting on her shoes or pouring milk for her cereal, in frustration, you do it for her, you have just increased the likelihood that she will procrastinate again in the future.

2. Giving negative attention: Negative attention actually increases bad behavior over time (e.g., raising your voice, threatening to issue a consequence, etc.). Also, reacting to misbehavior with criticism or yelling negatively affects your youngster’s self-esteem. Kids value attention from their parents so much that any attention — negative or positive — is better than none.

3. Using disproportionate consequences: As a parent of a child on the autism spectrum, you understandably get perturbed from time to time. You may even have become so frustrated at a particular behavior that you said or did something that you felt guilty about later. This is normal and to be expected.  But, keep in mind that issuing a massive consequence – especially out of anger – that is not in proportion to the misbehavior is demoralizing for kids, and they may even give up trying to behave well.

4. Delaying consequences: Effective consequences are immediate. Every minute that passes after a behavior, your youngster is less likely to link his misbehavior to the consequence. As a result, you end up punishing for the sake of punishing, which makes it much less likely that the misbehavior will change.

Though kids with AS and HFA are found to have neurologically and developmental related symptoms over time, the primary problem is behavior. Moms and dads need an arsenal of coping methods to reduce the behavioral problems at home. By utilizing the suggestions listed above, such problems can be reduced to a more manageable - and livable - level.




==> More parenting strategies for dealing with behavioral problems in children and teens on the autism spectrum...


More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

"Emotionally Fragile" Children with Asperger's & High-Functioning Autism

"Any tips for dealing with a very fragile and overly sensitive child on the autism spectrum ...he's a chronic worrier to say the least and will go back and forth between being extremely shy or very aggressive?"

As some parents may have discovered, many young people with Asperger’s (AS) and High Functioning Autism (HFA) are “emotionally fragile” (to coin a term). In other words, these individuals have great difficulty coping with day-to-day stressors, and exhibit unusually withdrawn or aggressive behaviors as a defense mechanism.

Emotional fragility is most prevalent in school-age AS and HFA kids. It can manifest itself in many ways, all of which are challenging for the youngster, parents, and teachers. These young people often exhibit a variety of symptoms that cause school psychologists to misdiagnose them with depression, bipolar disorder, or some other disorder. A wrong diagnosis can often lead to the youngster being placed in inappropriate special education classes, or even being treated with the wrong medication.



Traits of Emotional Fragility —

1. An emotionally fragile AS or HFA youngster may become socially anxious and withdrawn in public. When faced with risks or decisions, however trivial, he may become tense and fearful. He may have extremely poor self-esteem, and may seem to have a distorted sense of reality, usually preferring to live in his own fantasy world. These kids will often internalize their feelings and emotions, and have difficulty talking about them when asked. Occasionally they may act out and hurt others out of fear and a desire to be left alone.

2. Emotional fragility often causes AS and HFA kids to regress developmentally. They may behave as though they were much younger, even to the point of seeming overly dependent on others. As these kids become older, they may be at risk for substance abuse, although due to their lack of social skills, they may be less likely to use drugs in a peer-group context.

3. An AS or HFA child with emotional fragility usually has some degree of difficulty at school. A “typical” child will be able to follow a teacher's instructions independently, and will have no problem asking for help if needed. The emotionally fragile youngster will have difficulty carrying out these same age-appropriate instructions, and may be fearful of asking for help. This can create an inability to learn on the same level as other peers of the same age, which causes the youngster to view school as a source of misery and confusion. This often leads to poor grades and excessive absences.

4. Emotional fragility can have detrimental effects on a youngster's ability to make friends and interact with others. A “typical” youngster will be able to approach a group of his peers, converse, and join in their activities. The emotionally fragile youngster will be consistently rejected or ignored by these peers due to a lack of appropriate social skills, and may even be taunted or called names. This youngster may be viewed as immature or "weird" by his peer group.

Warning Signs—

Some of the most common warning signs of emotional fragility are a loss of interest in school, depression, social withdrawal, hyperactivity, sleep problems or fatigue. However, these are just a few of the most common warning signs. It is also important to keep in mind that just because a youngster has some of these behaviors doesn't necessarily mean that she is emotionally fragile. All kids experience these things at different points in their lives. Parents should only be concerned if their youngster is displaying any of the associated behaviors over a prolonged period of time.

The most difficult part of determining eligibility for special education services is deciding if the child is emotionally fragile, or has a behavior disorder (one can often look like the other).

Let’s draw a distinction between the two along the following domains:
  1. Affective Reactions— Emotional Fragility: disproportionate reactions, but not under child’s control. Behavior Disorder: intentional with features of anger and rage; explosive.
  2. Aggression— Emotional Fragility: hurts self and others as an end. Behavior Disorder: hurts others as a means to an end.
  3. Anxiety— Emotional Fragility: tense; fearful. Behavior Disorder: appears relaxed; cool.
  4. Attitude toward School— Emotional Fragility: school is a source of confusion or angst; does much better with structure. Behavior Disorder: dislikes school, except as a social outlet; rebels against rules and structure.
  5. Conscience— Emotional Fragility: remorseful; self-critical; overly serious. Behavior Disorder: little remorse; blaming; non-empathetic.
  6. Developmental Appropriateness— Emotional Fragility: immature; regressive. Behavior Disorder: age appropriate or above.
  7. Educational Performance— Emotional Fragility: uneven achievement; impaired by anxiety, depression, or emotions. Behavior Disorder: achievement influenced by truancy, negative attitude toward school, avoidance.
  8. Interpersonal Dynamics— Emotional Fragility: poor self-concept; overly dependent; anxious; fearful; mood swings; distorts reality. Behavior Disorder: inflated self-concept; independent; underdeveloped conscience; blames others; excessive bravado.
  9. Interpersonal Relations— Emotional Fragility: inability to establish or maintain relationships; withdrawn; social anxiety. Behavior Disorder: many relations within select peer group; manipulative; lack of honesty in relationships.
  10. Locus of Disorder— Emotional Fragility: affective disorder; internalizing. Behavior Disorder: conduct disorder, externalizing.
  11. Peer Relations and Friendships— Emotional Fragility: difficulty making friends; ignored or rejected. Behavior Disorder: accepted by a same delinquent or socio-cultural subgroup.
  12. Perceptions of Peers— Emotional Fragility: perceived as bizarre or odd; often ridiculed. Behavior Disorder: perceived as cool, tough, charismatic.
  13. Risk Taking— Emotional Fragility: avoids risks; resists making choices. Behavior Disorder: risk-taker; daredevil.
  14. School Attendance— Emotional Fragility: misses school due to emotional or psychosomatic issues. Behavior Disorder: misses school due to choice.
  15. School Behavior— Emotional Fragility: unable to comply with teacher requests; needy or has difficulty asking for help. Behavior Disorder: unwilling to comply with teacher requests; truancy; rejects help.
  16. Sense of Reality— Emotional Fragility: fantasy; naïve; gullible; thought disorders. Behavior Disorder: street-wise; manipulates facts and rules for own benefit.
  17. Social Skills— Emotional Fragility: poorly developed; immature; difficulty reading social cues; difficulty entering groups. Behavior Disorder: well developed; well attuned to social cues.
  18. Substance Abuse— Emotional Fragility: less likely; may use individually. Behavior Disorder: more likely; peer involvement.


Accommodations for Emotionally Fragile AS and HFA Children: Tips for Parents and Teachers—

1. AS and HFA kids with emotional fragility are often achieving academically below their “typical” peers in reading, writing, and arithmetic. Accommodation: early detection and intervention is the best strategy; set up personalized goals and strategies so that the youngster can find success.

2. Kids with emotional fragility may appear easily distracted, less attentive, and have poor concentration. Accommodation: by setting up an environment and materials that are stimulating, these kids can stay more engaged and interested; set clear rules and expectations with visual stimulating material.

3. Some young people with emotional fragility may be blame others, manipulate situations, and even bully others. Accommodation: use behavior contracts; use a highly structured environment; stay consistent in expectations; set limits and boundaries; develop a cue word for the youngster to note inappropriate behavior; clearly post rules.

4. AS and HFA kids who are emotionally fragile often have skewed views of their long term possibilities and desires. Accommodation: include these children in the planning process and IEP so they can visualize and voice their goals; it can also be helpful for them to note the goals it will take to get there.

5. Youngsters with emotional fragility may present extra challenges to parents in the form of outbursts and disobedience. Accommodation: parents should not give into this as it only validates the youngster’s behavior; instead parents need to challenge their child to keep him learning new skills.

6. Children with emotional fragility may have difficulty establishing a variety of relationships. Accommodation: use seating arrangement to encourage social interaction; use role-playing situations; set up goals aimed at social interactions.

7. Children with emotional fragility often have low self-esteem, high stress points, and may engage in self-injurious behaviors. Accommodation: be aware of your speech and non-verbal cues when talking to the child; establish a quiet cool off area; provide time for relaxation techniques; teach and put in place self-monitoring and self-control techniques; teach self-talk to relieve stress and anxiety.

8. AS and HFA children with emotional fragility are often truant from school and disruptive when present. Accommodation: communicate with moms and dads so similar strategies and expectations are used at home.




Additional Strategies to Assist Emotionally Fragile AS and HFA Children—

1. Create a new behavior to replace the behavior you want to change. If the AS/HFA youngster is aggressive toward others while working in a group, you may want him to take turns or talk in a quiet tone of voice while in a group. Remember to create an alternative behavior that is directly observable.

2. Establish rewards and/or consequences for behaviors. Overall, it's more effective to reward the positive behavior that you are trying to increase than to punish the behavior you are trying to decrease. If the behavior does not pose an immediate threat to you, the AS/HFA youngster or other kids, or does not disrupt the entire group lesson, try to ignore the disruptive behavior while rewarding the positive behavior.

3. Identify the behavior you want to change. Keep a written record of the behaviors the AS/HFA youngster exhibits during social and independent play and academic activity (e.g., "I want Julie to play without pushing other kids …or to remain quiet during a test …or to stay seated during a lesson"). Once you describe the youngster's behavior in terms of observable actions, you will be able to monitor and mediate the behavior.

4. Provide plenty of opportunities to practice new behaviors. AS and HFA children with emotional fragility usually have difficulty working with others whether they are aggressive or withdrawn. You will want to set up social situations where the youngster can practice taking turns in a group or with a partner, and sharing and talking appropriately.

5. Role-play and hold conflict-resolution meetings so the AS/HFA youngster can practice and discuss alternative responses to social situations.

6. Teach the youngster to monitor progress independently. Have charts in folders, in a locker, or at home where she can document progress in achieving a particular behavioral goal. Have her write or verbally explain why a certain behavior is unacceptable and what behavior she can do to change it.

Services—

Children with emotional fragility often have an early diagnosis among school districts. This is because educators initiate the referral process among concerns over behavior in class. Often, the DSM is used by a school psychologist, whom may conduct interviews and distribute surveys as part of the social-emotional evaluation.

When it is determined that the child is emotionally fragile, he should receive an Individualized Education Plan (IEP). Children can also receive specific behavioral plans such as a 504 in the state of California. This often includes goals towards appropriate behavior, productive coping strategies and academic skills. Effective services should focus on these, and can mandate an educational assistant for support in regular education classes, access to a resource room for individualized instruction, medication management provided by a mental health professional, as well as individual counseling.

Emotionally fragile children are often considered at-risk for dropping out of school, suicide, criminal activity, as well as being diagnosed with a learning disability. Nonetheless, with the appropriate supports in place, these young people have been shown to have enormous potential to succeed.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

The Functional Analytic Approach to Behavior Modification for Kids on the Autism Spectrum

A “functional analytic approach” to developing effective behavioral modification in children and teens with ASD utilizes a process known as “functional behavioral assessment.” 
 
Functional behavioral assessment involves employing a variety of strategies (e.g., child-centered planning, treatment team meetings, systematic interviews, direct observations, etc.) to formulate hypotheses about why a child behaves the way she does.

In order to accomplish a functional behavioral assessment, several assumptions about behavior must be regarded as valid:

• Behavior has communicative value. Though it is generally accepted that all behavior has communicative value, it is important to remember that children with ASD generally do not have a behavioral intent to disrupt classroom settings, but instead problematic behaviors may arise from other needs (e.g., self-protection in stressful situations). Although children with the disorder typically have excellent language skills, their ability to use communication effectively in a social context may be limited. Inappropriate behavior may be the only available communicative response to difficult situations until other options are learned.

• Behavior is context related. All children demonstrate some level of variability in behavior across different settings. This is just as true for children on the autism spectrum. In fact, understanding how the environment impacts a child is one of the chief outcomes of a functional behavioral assessment. This information has particular value for preventive methods or to set the stage for teaching alternative skills. Effective behavioral support is contingent on understanding the child, the context in which he operates, and the reason(s) for behavior.

• Behavior is functional. Behavior serves a specific purpose(s). For children with the disorder, these functions may be expressed in highly idiosyncratic and often complex verbal ways.

Though there is some disagreement about the best way to conduct a comprehensive functional behavioral assessment, most clinicians are in agreement about the key outcomes of such an assessment. They are:
  • identification of the consequences that maintain behavior (i.e., once a behavior starts, what keeps it going over time?)
  • description of situations most commonly associated with the occurrence of problematic behavior
  • clear and unambiguous description of the problematic behavior(s)

A functional behavioral assessment should provide information that:
  • guides the development of supports that are logically connected
  • increases understanding of the child
  • describes the physical and social setting(s) in which the behavior occurs
  • describes the problem behavior itself

Once an understanding of problem behaviors is achieved, it is helpful to come up with a behavioral modification plan. A good behavioral modification plan includes focus on:
  • expanding beyond consequence strategies (e.g., time outs)
  • preventing the occurrence of problem behavior
  • teaching socially acceptable alternatives to problem behavior (especially alternatives that serve the same purpose as the problem behavior and therefore are more likely to be adopted by the child)



Next, the clinician should use a comprehensive format for outlining multi-component supports that addresses the following:
  1. Antecedent/setting event strategies
  2. Alternative skills training
  3. Consequence strategies
  4. Long-term prevention

Let’s look at each of these areas:

1. Antecedent/setting event strategy: The primary goals of this strategy are to prevent or reduce the likelihood of problem behavior and to set the stage for learning more adaptive skills over time. For example, many children on the spectrum have difficulty with noisy, crowded environments. Therefore, the newly arrived middle school student who becomes physically aggressive in the hallway during passing periods may need an accommodation of leaving class a minute or two early to avoid the congestion which provokes this behavior. Over time, the student may learn to negotiate the hallways simply by being more accustomed to the situation, or by being given specific instruction or support.

Key issues to address when discussing this strategy are:
  • What can be done to eliminate the problem (i.e., the antecedent condition)?
  • What can be done to modify the situation if it can’t be eliminated entirely?
  • Will the antecedent strategy need to be permanent, or is it a temporary "fix" which allows the student to increase skills needed to manage the situation in the future?

The importance of using antecedent strategies should not be underestimated. Kids on the spectrum often have to manage a great amount of personal stress. Striking a balance of short and long term accommodations through manipulating antecedents to problem behavior is often critical in setting the stage for later skill development.

2. Alternative Skills Training: The primary purpose of this strategy is to teach skills that replace problem behavior by serving the same purpose as the challenging behavior. For example, a student with the disorder may have trouble "entering" into a kickball game by asking to play and instead simply inserts himself into the game, thereby offending the other players and risking exclusion. Instead, the youngster can be coached on how and when to ask to enter into the game.

Here is a particularly useful framework for guiding efforts towards teaching alternative skills by examining the following three categories:

A. Equivalence training
B. General skills training
C. Self-regulation training

A. Equivalence training requires support persons to ask the following sequential questions:
  • How will alternative skills be taught?
  • What alternative skill(s) will be taught which serves the same function as the problem behavior?
  • What is the function of the problem behavior?

B. General “skills training” requires asking the following sequential questions:
  • How will alternative skills be taught?
  • What other academic, social, or communication skills will be taught that will prevent the problem behavior from occurring?
  • What skill deficits are contributing to the problem behavior?

C. Self-regulation training requires asking the following sequential questions:
  • How will skills be taught?
  • What events appear to be contributing to the child's anger or frustration in reference to the problem behavior?
  • What self-control skills will be taught to help the child deal with difficult/frustrating situations?

One particularly relevant means to teach alternative skills is through the use of self-management strategies. Self-management is a procedure in which autistic children are taught to discriminate their own target behavior and record the occurrence or absence of that target behavior. Self-management is a particularly useful technique to assist children to achieve greater levels of independent or even inter-dependent functioning across many settings and situations.

By learning self-management techniques, children can become more self-directed and less dependent on continuous supervision and control. Instead of teaching situation specific behaviors, self-management teaches a more general skill that can be applied in an unlimited number of settings.

Self-management strategies have particular relevance and immediate utility for children on the autism spectrum. The basic steps for teaching self-management are:
  • clearly define the target behavior
  • identify child reinforcers
  • design or choose a self-management method or recording device
  • teach the child to use the self-management device
  • teach self-management independence

It is also important for teachers to monitor their own behavior when working with "special needs" students. Each time a teacher reprimands a child for misbehavior, an opportunity to reframe the moment in terms of the child's need to develop alternative skills through a means such as self-management training may be lost.

3. Consequence strategies: Though consequences have traditionally been framed in terms of how they reduce problem behavior as a form of discipline, reframing consequences in terms of “reinforcement for achieving alternative behaviors” should be the focus for ASD kids. One way to reframe the use of consequences is to develop them as “planned responses to instructional situations.” This shifting of the use of consequences does not mean that negative consequences should be eliminated (especially in moments of crisis), but that multiple negative consequences are likely to heighten anxiety levels for the child and compete with teaching alternative skills.

4. Long-term prevention: In the presence of immediate behavioral concerns, it may be difficult to come up with a long-term approach to a child's educational program. However, it is critical that plans for supporting a child over the long-term be outlined from the beginning. Many supports with the most relevance for kids on the spectrum (e.g., specific accommodations, peer supports, social skills, self-management strategies, etc.) must be viewed as procedures that are developed progressively as the youngster moves through school. These are not “crisis management” techniques, but the very strategies that can decrease crisis situations from developing.

Those involved with the child will need to collaborate on a behavioral modification plan that is clear and easily implemented. Once developed, the plan will need to be monitored across settings. Inconsistencies in expectations and behaviors will only serve to heighten the challenges demonstrated by the child.

 
Resources for parents of children and teens on the autism spectrum:
 

==> Videos for Parents of Children and Teens with ASD
 
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