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A
Guide to Improving Behaviors in Children with Autism Spectrum Disorders
By
Laurie Stephens, Ph.D.,
Children
with Autism Spectrum Disorders (ASD) experience the world in a very
different way than other children. For these children, behaviors
considered to be inappropriate, such as outbursts, tantrums or "meltdowns"
may be their only way to communicate their needs, wants and frustrations.
Sadly, many parents and family members often do not understand why
a child is misbehaving and their actions may make a behavior worse.
In addition to causing family problems at home, these behaviors
may also result in children with ASD doing poorly in school and
at community events, and lead to a difficulty maintaining friendships.
Understanding
potential causes of behavioral difficulties for children with ASD
and developing tools and techniques to improve your child's behaviors
can lead to a happier and more fulfilling life for the whole family.
Leading
Causes of Inappropriate Behaviors
Communication
delays: Children with ASD may not always understand what is being
said to them or asked of them, due to their communication delays.
They also may lack the language to adequately express their wants
and needs. Acting out, or throwing a tantrum, is a good way to get
attention and often is the only way the children can express themselves.
Sensory
dysfunctions: Sensory dysfunctions can also be a primary cause of
behavioral issues. A common feature of ASD is oversensitivity to
sounds, texture, smell and lights. For a child with ASD, it can
be as bad as experiencing his or her environment as a jarring alarm
going off constantly, a strobe light flashing, a putrid smell everywhere,
a feeling of clothing being overly tight and itchy, being asked
questions in a foreign language and getting in trouble when the
answer is wrong. Very few people would be able to keep their behavior
in check under such circumstances, but this is often an everyday
reality for children with ASD.
Need
for routine: A core feature of ASD is the need for sameness or routine.
When children impose a high level of rigidity and structure on their
environment, they are setting up unrealistic expectations. When
these expectations are not met, it leads to an increase in anxiety
and frustration, which, in turn, leads to an increase in behavioral
problems.
Tips to Avoid Behavioral Difficulties in Children with ASD
1.
Focus on the positive: The best way to eliminate negative behaviors
is to reinforce the positive behaviors children engage in throughout
the day. This will increase the likelihood they will repeat those
behaviors. For example, praising children for homework they've already
completed is more effective than yelling at them to finish it. Use
motivating statements like, "Wow, I see you've been working
hard on your homework. I'll bet you'll be finished in no time at
all." When children with ASD finish a task, it is important
to give some kind of reinforcement, such as a treat, a token or
praise.
2.
Tell the child what to do instead of what not to do: In general,
it is more effective to give children direct commands. This is particularly
true for children with ASD as they often take language literally.
When we tell kids what not to do, we assume they will know what
the appropriate alternative behavior is. For instance, if you tell
a child with ASD "do not jump in the puddle," he may not
understand that means "go around" the puddle; instead,
he may think it is ok to splash in the puddle, walk through the
puddle, etc. Saying, "Walk around the puddle" makes expectations
clear and reduces behavioral outbursts or unexplained reactions
to what they perceive to be correct.
3.
Avoid using too much language: Children with ASD often have communication
deficits. When frustrated or anxious, they may be even less able
to understand spoken language than usual. Rather than trying to
reason with a child in the middle of a tantrum, try to use few words
and concrete language. Statements such as, "It is time to get
in the car" are more easily understood and followed than if
you explain why the child needs to get in the car, how you are going
to be late and what will happen if he or she doesn't get in the
car.
4.
Warn your child of upcoming changes or transitions: While it may
not always be possible, it is best to tell a child with ASD about
any change that may be occurring and give them plenty of time to
adjust. If you are buying new furniture, share pictures or bring
your child to the showroom to see and touch it. Ask for help to
decide where to place the furniture. This prepares the child for
change and reduces anxiety.
5.
Use visual schedules or reminders: Structure and consistency are
two keys to improving behaviors. A fun way to do this is to develop
simple visual reminders or schedules. This can be as simple as putting
a picture of your child's teacher on the calendar for every day
that he or she needs to go to school, or as complex as having a
full schedule written out for every step for getting ready to go
to school, along with the expected times of completion.
6.
Teach calming techniques: Often, we tell a child to "calm down"
when they are feeling anxious or upset. The problem is that we only
use the word "calm" when a child is upset. It is important
to identify for children what it means to be relaxed or "calm"
so that they know the feeling we want them to experience. Try different
relaxation techniques - counting to 10, taking deep breaths, yoga,
music - to see which ones works best for your child. What calms
any child may be highly individualized.
7.
Beware of sensory overload: It is always important to look at the
environment that your child is in, and determine if it is over-stimulating.
A child may throw a tantrum in the grocery store because it is too
bright or the "beep beep" of the price scanners is bothersome.
The tantrum may be the only way the child knows to quickly get parents
out of the store. If you think your child has sensory issues, develop
coping strategies, such as letting him or her wear sunglasses in
the shop, or listen to music to drown out upsetting sounds.
Use
"time-out" effectively: The use of techniques, such as
"time-out," - a common punishment that removes a child
from an enjoyable activity -- needs to be used with careful consideration
in a child with ASD. Time-out may not be effective because what
other children consider an enjoyable activity may not be fun for
your child with ASD. For example, a child may be held back from
recess because she hasn't finished her work. However, if the child
finds recess too loud, too unstructured and too crowded, she will
actually prefer staying in over going to recess, and may even stop
doing school work in an effort to avoid recess. The teacher in this
case has mistakenly reinforced the negative behavior by assuming
that the child wanted to go to recess. At home a child may be sent
to his room after having a temper tantrum during the family dinner.
The child may have thrown the tantrum because there was too much
language being used at the table, or he did not like the smell of
the food. Therefore, sending him away from the table and allowing
him to be alone in his room may actually be what he prefers.
These
simple strategies are applicable in any environment and can be used
by parents and family members as well as health care professionals
and educators. Consistent and regular use of these tips can prevent
or reduce inappropriate behaviors. It's important to always keep
in mind that children with ASD are not necessarily being manipulative
or stubborn when they are having behavioral difficulties. They may
not have any other way to express what they are experiencing. If
we learn to listen to behaviors, we'll be able help them handle
them in a more effective and productive manner.
Laurie
Stephens, Ph.D., is the Director of Autism Spectrum Disorders Programs,
The Help Group, www.thehelpgroup.org
The
information presented on this site is intended solely as a general
educational aid, and is neither medical nor healthcare advice for
any individual problem, nor a substitute for medical or other professional
advice and services from a qualified healthcare provider familiar
with your unique circumstances. Always seek the advice of your physician
or other qualified healthcare professional regarding any medical
condition and before starting any new treatment.
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