Having a better awareness of Autism Spectrum Disorder (ASD) allows us to understand why negative behaviours may occur in a person with this condition. Only when we understand the reason behind the behaviour can we help a person with ASD to develop strategies in order that they can behave in a more acceptable way.
Quite often we hear the saying 'There was no reason for that behaviour' but that is rarely the reality. There will be a reason - it is just that we may not know what it is and therefore we have have to initially carry out some detective work to find out what led up to that negative behaviour. This is so that we can find out what the antecedents/triggers are and hopefully prevent or reduce these behaviours in the future.
The person with ASD may not be able to tell us why they are upset due to lack of communication skills or because they lack 'Theory of Mind' and believe that because they know why they are cross that we know as well.
Once we can establish the causes, we can help the person with understanding what happened and help to prepare them with suitable strategies should the same, or similar, happen in the future. There is often a catalogue of events that has built up, which at the time the person was able to deal with or bury inside themselves, but gradually, there may be one final issue that makes them lose self control. This is similar to a firework, in that the match - the trigger; the fuse - the escalation phase and finally the explosion - the outburst.
Something else to remember is that people with ASD do not intuitively pick up appropriate ways to behave by watching others behaviour. Therefore they may genuinely not know any other way to express their upset other than to have a negative outburst, whether that is verbally or physically. We need to be able to help them develop strategies to be able to react more appropriately when upset.
By monitoring behaviours we can see if there are any patterns as to why the behaviour may be occurring, for example, certain times, places, people the child is with. To do this we can record the time, day, activity, person the child was with, where they were, the behaviour and what happened afterwards. Over a period of several weeks patterns can be noted, strategies devised and hopefully negative behaviours can be reduced. You can devise your own record sheet and record the information you want to monitor. Once you have monitored behaviours, it is best to deal with one behaviour at a time, picking the one that is giving the most concern.
Children with ASD can benefit from having clear and firm boundaries in order for them them to feel safe. Many children push these boundaries to the limits but they often want the boundaries to be enforced - knowing that someone else is actually in control will make them feel secure. In order for this to happen, anyone dealing with the person will need to be firm, fair and consistent. If they are not, if can be confusing for a person with ASD which will lead them to exhibiting negative and challenging behaviours. If you, or another person disagree about the boundaries and rules it is important that the person with ASD does not know this, as it could cause their anxieties to rise, therefore it is best to discuss the rules/boundaries privately with the other person and agree on what the boundaries will be. This may need some compromise.
The rules of the house/school may need to be written in clear, brief language and displayed where the child can see (and often laminated as they may tear them up when cross). They may also need to have these explained to them verbally and have their understanding of them checked. As an example, the rules may be:
• use kind words
• be gentle to yourself and others
• take care of property
• do talk about it
If parents live in different houses, the child needs to understand clearly that the rules and timetables for each house may be different and that this is okay. However, they will need to know what the rules and timetables of each house are and may benefit from having them in either written or picture format, so they can see them, at each house.
Quite often someone with ASD can repeat verbatim what someone has said to them, giving the impression that they have understood what was said. However, if they are then asked 'What does that mean?' they often do not know or answer with something quite bizarre. Therefore, it is important to check they have fully understood what has been said and get them to answer in their own words.
Children with ASD can take longer to process information and therefore need to be given time when asked a question or given an instruction before they answer or carry out the instruction. If we try to rush their answer or demand them to carry out the instruction before they have had time to process the information they may become anxious which can result in negative behaviours. Allowing about 5 seconds for them to process the information would not be unreasonable, but each person with ASD is different and therefore they may need more or less time.
Breaking tasks down
Often, as people with ASD can be academically able, it is assumed that they understand when they are asked to do something. However, they may not and may need tasks breaking down for them into smaller, achievable chunks in order that they do not become disheartened with the amount they have to do. Therefore it is important that their understanding is checked about what their task is. This may need to be done visually - with a list or by using a visual timetable. Some tasks that need breaking down can include:
• how to have a bath/shower - what they need to take into the bathroom as well as the actual process of bathing/showering
• how to get dressed, starting with underwear, socks, etc.
• how to tidy a bedroom - what to put where, from start to finish
• how to make a sandwich, including clearing up afterwards
Self esteem/Seeking perfection
Many children with ASD seek perfection in everything they do, dislike making mistakes and often compare themselves to others.
Sometimes, they will avoid doing tasks they feel they may not be able to complete without making errors - by not doing the work they cannot make a mistake. They often set themselves very high standards and goals which they are unable to achieve, such as completing a piece of school work with no mistakes. When they don't achieve it they can spiral into the false belief that they are hopeless.
The same can be said for some of these children regarding sports and games - many are not aware of the rules of playground games and things like football could be extremely difficult for them to understand. Although football has rules, they can change depending on who plays. Children with ASD can also be egocentric and therefore cannot comprehend that the ball may not always be passed to them, causing huge anxieties.
Added to that is the fact they may have difficulties with maintaining and keeping friendships, possibly being bullied for being different and often not understanding the work/task they have to do. Children with ASD often have their negative points mentioned, possibly because sometimes they can be extreme, particularly with some behaviours, but they actually do a lot of really positive things throughout the day which often go unnoticed. For example, if a child starts to play a game of football but then storms off the field it can be seen, by some, that they have failed again. However, what people may not have noticed is that this time they stayed on the pitch for 4 minutes longer than the last time. For these children's self esteem to have any chance of improving they need to know that people are recognising their efforts.
Children with ASD often get very anxious and can go into 'meltdown'. The idea is to put strategies in place beforehand (proactive strategies) so that they do not get so anxious that they are temporarily unable to function properly. However, it is important to understand and accept that this is not always possible but strategies need to be available when this does happen (reactive strategies).
Reactive strategies are strategies you use when things don't go to plan and the child reacts in a negative way. After the incident you can then devise a proactive strategy to use in future to try and eliminate this particular behaviour happening again.
Giving a child a 'safe place' to go when they are getting agitated can help but they may need a calm, verbal reminder to do this. The safe place could be a bean bag, a pop up tent, a certain seat somewhere in a garden or playground, a desk or chair outside the classroom, preferably where they are not watched by other children. It is important for the child to learn that they take themselves to their safe place so that they are able to manage their own behaviour.
Children with ASD can be physically aggressive and/or can go from seemingly very calm to very aggressive in a matter of seconds. If you can imagine a scale from 1-10, with level 1 being calm and level 10 being really angry and at full aggressive mode, these children can go from a level 1 to a level 10 in a matter of seconds. The scale of behaviour gets progressively worse as the levels get higher. At a level 7, the child has lost self control and is not capable of controlling their behaviour on demand but may not yet have reached their full aggressive/disruptive peak. The idea of building in regular daily exercise into their routine is that by getting rid of some of their energy; when the child does have an aggressive outburst they go in at a level 6, giving people working with them more time to redirect them or talk them down. Once a child has reached a level 7 or above, anything you say to them willbe futile as they are unable to process it. Shouting at them will do nothing to improve their behaviour because they are incapable of understanding anything at this stage.
Discussing behaviours: your versions and theirs
Once the person is calm after an incident, it is important to try to get them to talk about the incident from their point of view and then discuss what happened with them in a positive way so that you can both understand why it happened and learn ways to try and prevent it happening again. It may be at least an hour and a half, sometimes the next day, before they can fully undertand what is being said to them but when you do talk to them it is important to speak calmly and try to find out what caused their anxiety levels to rise - often their idea of what happened is totally different to what we have thought the problem was and it is important to keep in mind that children with ASD view things differently to the majority. This does not mean that their version of events is wrong, merely different. Pretending the behaviour did not happen so as to avoid any further confrontion is not helping the child develop their own behaviour management. If they are to become an acceptable member of society, they will have to take ownership of their behaviours.
Reward systems can work if they are clear, consistent and achievable and have a reward the person actually wants to earn. You decide on the behaviour you want to target, so for example, it could be reducing physical aggression but it needs to be achievable for the child and manageable by either school or home. The idea is that you are rewarding them for their positive behaviour (e.g. not being aggressive) on a regular basis, and by using a visual reward chart. If they are likely to tear this up, it may be worth laminating it. A certain amount of stickers will earn them a reward which you both agree on. If they show physical aggression, deal with the behaviour as you normally would, but do not make a fuss of the fact they have not earned the sticker, just encourage them to earn the next one. It may be that initally you need to make the reward easier to acheive such as per day rather than a whole week. Once they have earned a sticker/reward it should not be taken away for poor behaviour. Some children will say they don't want to earn their reward but this is often when they know they have not earned a sticker towards it. We would advise that if this is the case, you continue to reward positive behaviour so they do earn the reward. Rewards do not have to be expensive - they could be extra time on the computer/watching tv, a trip to the park, a magazine, a baking activity, etc.
For more information or advice, contact us here, or call 0161 507 3723.