Primary Years Behaviour - Autism Help Geelong

Aggression, Frustration and Temper Tantrums

What you can do

Remain calm and remind yourself that the child’s behaviour is an attempt at communication; not just being naughty or difficult for the sake of it. Children with high functioning autism are rarely manipulative, lying or scheming.
The child may become quite upset and abandon a task completely if not succeeding. Give the child lots of encouragement and reassurance. Children with autism seem to need a lot more reassurance than other children
Consult an occupational therapist if the child appears to have sensory problems. Ear plugs may help to filter out excessive noise if this is a problem.
If aggressive behaviour occurs in order to avoid a task, use clear, simple language to tell the child firmly what is expected. If the child is still acting aggressively, calmly remove him from the situation for a few minutes. Do not look at him or give him any attention during this time. Bring the child back to finish the job. Give lots of praise when the job is completed.
If the behaviour is attention seeking, attend to your child with a firm, no-fuss approach. Take the child to a quiet place for a few minutes until calm, then return to the task or activity. Ensure other staff and adults know how to deal with the behaviour and agree on the manner in which it will be handled.
It may take some time for the child to understand the social rules of sharing and turn-taking. While progress may be slow, these skills should be practised and repeated frequently from a young age and well into primary school.
Not all children with autism have behavioural problems. Those that do are often reacting to a world that they find confusing and unpredictable.

What you can do

Reinforce your expectations for good behaviour.

Aggression towards others

Immediately after the incident –

Remain calm and direct the child to a quiet space. If it is a minor incident, pay attention to the other child who is hurt and totally ignore the child who hit.
Deal with the behaviour at a later time. It is important that both you and the child be calm when talking about the behaviour as there is more chance the child will process the information. When stressed or angry, the child’s ability to understand language decreases.
Often children on the spectrum find it difficult to talk about situations when they are ‘personalised’ and find it easier when the discussion is ‘de-personalised’. This means that you talk about the situation in the third person. This can be done through the use of toys, drawings or role-plays.
Tantrums.
Remain calm and look at the tantrum as an act of communication. Try to establish why the behaviour is occurring. Try not to give any verbal or visual messages until the tantrum has stopped and then give full attention to the child. Praise the good behaviour. Use time out – see Behaviour modification – what works, what doesn’t?

Resistant or oppositional behaviours – gaining compliance.

First, ask yourself if the child could be behaving this way out of anxiety, fear of failure, lack of comprehension, lack of interest or attention seeking. Treat the behaviour according to the cause.
The child may try to distract you from the request by arguing. Try not to become involved in the argument. It wastes time and the child can become more confused due to the increase in language.

Re-look at what you are asking the child.

Are you making statements and not questions? Don’t give too many at once. Is the child too busy? Have you failed to gain his attention? See also Communication > Not responding to instructions.

Refusals

If the child constantly refuses to perform a particular request give him the opportunity to do it for a very short period then heavily praise him. Over time, gradually increase the period he engages in the behaviour and decrease the amount of reinforcement.

Follow through

If you have set up a particular consequence such as time out then you need to make sure you (and other staff) apply the consequence each time the behaviour is displayed. This can be tiring and time consuming so make sure you are prepared. If you have asked him to do something then you need to see that he follows it through and does it, even if you have to physically do it with him.

Keep your sense of humour

This can be really difficult but it’s important to keep your sense of humour and use it in appropriate situations. Not only will this help you see the funny side of situations, it will prevent you from becoming too stressed. Acting the fool can often be really effective as you are doing the exact opposite of what the child expects.

Note

Some young children with autism have a very strong negative reaction to hearing the word ‘no’. It seems it is often interpreted as meaning “no” forever. Something like “maybe later” or “next week” might not cause the same reaction. Like a red rag to a bull, this word can provoke an outburst or a full-scale tantrum. If you are dealing with behaviours of concern, be aware of your language and how the child responds to your words.

The child may require a medical review to rule out seizures that could be the cause of aggression. Epilepsy occurs in 10-30% of children who have autism. (Gabis, Pomery Andriola 2005)

Fear of Failure

“Ben is a bright student but he is so afraid of getting things wrong he rarely completes any work”

Points to Note

Many students with ASD are very particular about certain aspects of their work. They may insist on getting things right; they will start an activity, make a mistake, then start over again. Such perfectionism means they may never see a task through to completion.
Some students become really frustrated by their mistakes leading to great distress.
A young person with ASD can struggle for a long time over what seems to be a straightforward choice, reluctant to make a decision because of the risk of doing something wrong.
Some students are acutely aware of their inadequacies. For example, they may have very poor handwriting and be so embarrassed by it that they will refuse to hand in written work.
The student may be very reluctant to participate in any unfamiliar activities, or may do something once and refuse to do it again if it didn’t work out the first time.
The student might receive a lot of negative comments, be subject to bullying and teasing or even physical violence. The young person with ASD may have low self esteem or struggle with depression and anxiety.

What you can do

Don’t comment on failure; just show the young person the correct way to complete the task.
Work through instructions together step by step.
Avoid negative comments, like saying ‘no’ or ‘that’s not right’.
Show the student that you make mistakes too, and show how you deal with them, i.e. if you make a spelling mistake, you simply put a line through the word.
Young people with ASD need to learn that it is OK to make mistakes.
Young people with ASD can be very insecure about appearing “stupid” or needing extra help (eg having an integration aide) and may be reluctant to seek help. Have an agreed code or signal for when the student requires assistance, such as placing an item in a certain position on the desk.
Build success into activities – ensuring that tasks are not too difficult.
Computer use alleviates a lot of stress that can arise from handwriting. Advocate for the student to be able to use of a computer for written work whenever possible.
Ensure the young person has someone they trust to talk to about any problems with bullying and how they are feeling.

Behaviour Modification – What Works, What Doesn’t

Behaviour ‘modification’ and support for people with autism is sometimes a confusing and contentious issue. Many approaches used to modify behaviour have failed in the past.

We now know that:

It is far better to put strategies in place to prevent or minimise inappropriate behaviour than to react to that behaviour after it has occurred.
It is better to use positive behaviour supports that teach functional skills to modify behaviour.
All behaviour has a purpose or function that produces a result. For a child with ASD, the desired result may be to get something they want (object or an activity), get away from something that is annoying them (sensory) and reduce stress.
A coordinated approach is required to undertake behaviour modification.

Punishment

There is often a big emphasis on punishing the perceived ‘naughty’ behaviour of children with autism. Punishment for children with ASD often does not work, as children with ASD are often impulsive, unable to control their actions or do not know how to behave appropriately in certain situations.

Punishment teaches the child that they have done something wrong. However, it does not teach what is appropriate or acceptable.
Children with autism often need to be told HOW to behave in certain situations (before an issue arises) and will unintentionally display inappropriate behaviour if they do not know what to do or how to behave.
Children with autism may not necessarily understand why they are being punished or associate the punishment with the incident.
The children with autism may not understand why you are upset or angry due to difficulties reading body language and emotion.
The child should not be punished for inappropriate behaviour arising from their disorder, such as being inattentive, disorganised or misinterpreting verbal instructions.
Time out may be ineffective for some children with ASD. In timeout the ‘punishment’ may be seen as a break from a task that the person wanted to avoid in the first place. Time out can actually be a great relief from stress and anxiety.
Short term strategies may keep the behaviour under control but long term strategies are required to avoid an increase in problems over time.
When trying to decrease behaviours they will tend to get worse before they get better. In fact it is a good sign that the method is working if you notice increases in frequency and intensity for a short time.

Time Out

Time out is a consequence where the child or is transferred to a less reinforcing (more boring) situation for a period of time immediately following an inappropriate behaviour. This is an effective way to deal with problem behaviours, especially if the behaviour involves non-compliance, hitting or antagonising others physically or verbally.
Time out is often done incorrectly, making it unsuccessful in changing behaviour. In addition, it takes a period of time for the child to understand the process of time out and during this time their behaviours often increase and the amount of time used in taking them back to time out is considerable.
Time out as a response to behavioural issues is different to having some down time in a safe space to keep relaxed.
Some important points about time out:
Time out should never be conducted in a dark room or small space that will scare the child or young person.
An empty hallway or a chair in a corner of the room works best.
The area the person is sent to should be free of any interesting or distracting objects.

Use time out immediately following the inappropriate behaviour.

Use clear, precise language to tell the child why they are going to time out and state the reason why. “Time out, no hitting.”
Remain calm.
Take the child to the time out area.
Do not lecture the child- ignore them for the duration of time out.
If the child leaves the timeout area escort them back as many times as necessary until calmed and the time limit has been reached. Time out for a child with autism should only be of a short duration- no more than 5 minutes. The child will need a visual prompt- such as a clock or timer so they know how long they must remain in time out.
Once time out is finished act as normally as possible and do not reprimand the person again.
If you sent the young person for time out because of refusal to comply with an instruction, they young person should be asked to do the requested behaviour when they return from time out.
Redirection

Redirection is prompting the child to act appropriately BEFORE he starts to display an inappropriate behaviour. Therefore you are trying to prevent undesirable behaviours before they occur. If you see the child becoming ‘wound up’ you can intervene first and direct him into another appropriate activity.

This means being in the right place at the right time, perceiving the child’s signals and pre-empting the situation.

Incompatible behaviours.

Instead of moulding the behaviour to a more appropriate one you introduce an activity that is incompatible with the problem behaviour. For example, if the child is squealing, have him blow bubbles until his urge to squeal has stopped. If he is flapping or biting his hands, give him something to hold onto such as a stress ball and say ‘squeeze.’

This is also encouraged by constructive positive instructions. Tell the child the behaviour you want him to perform rather than the behaviour you want him to stop. Instead of ‘no flapping’ say ‘hands down’.

Another way you can manage the environment is to alter time expectations. If 10 minutes is too long for the child to sit with a group, change this expectation to 2 minutes and then slowly work your way up to the full 10 minutes.
Offer choices- give the child control. Many inappropriate behaviours occur due to requests or expectations that are too difficult for the child to accomplish.

Constant commands and directions can also be frustrating for the child. It is important to give him choices so that he does not feel that he is constantly being ‘bossed’ around. Keep the choices limited to two and use visual cues as some children may only state the last or first thing they are offered rather than what they really want.

In summary, an analysis of the negative behaviour needs to be undertaken, specifically looking at the communicative intent of the behaviour.

When this intent has been identified, teachers and support staff can work on the skills the child needs to acquire to prevent this behaviour from re-occurring and put reward systems in place that will motivate the child to behave in an appropriate manner.

Positive Behaviour Support

Positive Behaviour Support aims to support the person to improve their behaviour through teaching functional skills and changing the environment. I.e. the more the child is able to communicate their needs the less likely they are to engage in problematic behaviour.
Positive Behaviour Support aims to improve a child’s communication skills – through teaching sign, using PECS, providing communication aids. Positive behaviour support rewards the person when they ask for what they want instead of engaging poor behaviour to get what they want. There are some agencies that can provide training in Positive Behaviour Support methods.
Self care skills- teaching the child to be more independent helps to reduce their dependence on others and their frustration level. Learning a new skill helps increase the person’s self esteem.
Choice and decision making skills- increasing a child’s ability to make choices and informed decisions allows the person to communicate their needs more accurately, which in turn reduces frustration and behaviours of concern.
Self awareness- teaches the child to be aware of their own emotional states and express themselves in other ways rather than becoming aggressive i.e. using an emotional thermometer or pictures or photographs to demonstrate their mood state.
Environmental modification- the environment is modified to support the child. Visual schedules, changing the layout of the room, reducing sensory input and providing a safe space for time out are examples of environmental modification that supports the child to avoid a meltdown.

Behaviour Support Plans

Children with ASD often need a support plan to address behavioural issues. A support plan documents the person’s behaviour of concern, the strategies used to deal with the behaviour and how the behaviour will be decreased over time. A support plan is shared between the person’s family, school and service providers to ensure that all people working with the young person with ASD can appropriately and consistently deal with the behaviour.
When writing a behaviour support plan or seeking to modify behaviour under any circumstances you first need to gather information and document the behaviours that are causing the most concern.

Questions to ask during information-gathering:

Which behaviours are most difficult or disruptive?
Is the behaviour hurting themselves or someone else?
Is the behaviour interfering with their or others learning?
Is the behaviour limiting access to everyday experiences settings and services?
Only tackle behavioural issues that affect the person’s ability to learn, are safety issues, or reduce the ability of the person to integrate into the community.
Obsessive or odd behaviour may keep the young person calm and do not necessarily inhibit learning. For example, the person may hum softly or flick their fingers to keep calm. When told to stop it is likely the person will become even more anxious and upset.

What is happening immediately before and after the behaviour occurs?

When is the behaviour most likely to occur?
When is the behaviour least likely to occur?
Who is present when the behaviour occurs? (i.e. is the child only reacting to certain people
In what environment does the behaviour occur? (Home? School? Bathroom? Shopping centre?)
What activity is happening at the time the behaviour occurs?
What time is it when the behaviour occurs?
How frequent is the behaviour? i.e. Constant? Only sometimes? Rare?
Is the person possibly hungry, thirsty, overtired, or unwell?

What is the function of the behaviour –

All behaviour serves a purpose. For children with autism problem behaviours usually occur for one of the following reasons:

To get attention
To get something (object/activity/food)
To meet a sensory need (escape or request)
To escape something or someone
Communication

What do you believe is being communicated by the behaviour?

It is important to understand the message motivation and reinforcement behind the behaviour and what the child gets out of it. Something is gained by engaging in the behaviour. Does the child gain attention? Escape? Food?

Sometimes a behaviour problem can highlight a missing skill

What skill does the person lack that may contribute to the inappropriate behaviour? i.e. not knowing how to ask for help, not knowing how to ask to play, being unable to do something.

What has been tried to stop the behaviour?

Which consequences have failed?
Which, if any, have worked?
What motivates the person?
What might be an effective reward system for good behaviour?
What strategies could be implemented to prevent this behaviour?
What consequences will be used when the behaviour occurs in future?

Once you have identified the purpose of the behaviour you can identify what to do about it.

Does the environment need changing?
Does a new skill need to be taught? How will we teach the skill?
Is there a sensory issue that needs to be addressed?
Does a routine need changing or to be introduced?
How will we reinforce and motivate the new behaviour?
Use the person’s interests and obsessions to help motivate and reward positive behaviour.
Motivators are different for each person with autism.

Other ways to positively support behaviour

Give warning if a change or transition is about to happen.
Provide visual cues and aides whenever possible.
Prompt positive behaviour before entering a situation – i.e. “in the restaurant we will sit to eat and use a small voice”.
Give choices- provide the person one or two choices of activity or action that they can engage in.
Set up the environment – if certain toys or objects are distracting put them away.
Minimise sensory input that will cause behavioural issues such as excessive noise, smells or visual input.
Tell the person what to do, not what not to do – instead of “don’t hit” say “hands down.”
Provide alternate activities – blowing bubbles instead of squealing, squeezing squish balls instead of flapping or hand biting
Alter expectations- allow shorter times for sitting on the mat or group work.
Allow plenty of activity breaks to burn up excess energy and to provide a circuit breaker.
Encourage plenty of water, cold drinks, wet wash cloths etc depending on the child – hot and bothered and autism DON’T MIX!
Keep a strong and consistent routine- the more predictable things are for the person with autism the less anxious they will be.
Ensure the person has a good diet, plenty of exercise and drinks lots of water.
Maintain a consistent approach to inappropriate behaviour. Good communication between parents, teachers and support staff is essential in ensuring a consistent approach. Use a Communication Book or electronic communication methods.
Remember lecturing and threatening will not work on problem behaviours. The child or young person needs continual reinforcement of the correct behaviour.