By Kasia Motylewicz
Autism is a neurobehavioral spectrum disorder that can affect a typical development. The symptoms usually occur in the first three years of a child’s life and present mostly as:
- Social interactions impairments
- Communications impairments
- Repetitive and stereotypical behaviors
Children who have difficulties in these core areas tend to develop variety of unwanted behaviors. They don’t use gestures, facial expressions, motions, or spoken language as their typically developing peers. Inability to express wants and needs results in frustration and development of aggressive, disruptive, and self-injurious behaviors (SIBs). Impairments in social-communication area impacts social interactions and ability to learn. That in return prevents children from using appropriate communications skills and creates a vicious circle of:
- impairments leading to communications deficits
- communication deficits leading to frustration and maladaptive behaviors
The highest priority in each therapeutic approach should be to reduce unwanted behaviors. Functional Behavioral Assessment should be implemented in order to establish functions of these behaviors. In order to successfully implement behavioral intervention the function(s) of these behaviors have to be established. Simply, we have to know why the child is doing what he is doing. Humans learn in the same way regardless of their developmental level and the presence or absence of a disability. We engage in specific behaviors in order to get something, escape from something, avoid something, or just to make ourselves feel better. Children with autism acquire these skills in the same way but with one difference. Typically developing children do those in a socially acceptable way while children with autism most of the time don’t. If a head banging will always result in mommy bringing milk, the child will learn that head banging is a functional request and will engage in that behavior in the future.
Parents can successfully implement behavioral interventions at home. In fact, all therapeutic approaches should focus on parent training as one of the most important aspects of the therapy. Different behavioral strategies are usually recommended in order to reduce or eliminate problem behaviors based on the FBA. Extinguishing unwanted behaviors is closely related to teaching a behavior that serves as a functional alternative. Let’s take a look at our target behavior which is screaming. We want to eliminate screaming and increase the use of gestures and initiate verbal responses in the context of requesting.
- Child engages in screaming because that is the only way he communicates his needs (i.e. he wants milk), wait for a brief pause and then give him milk. Do not give him anything while he is engaging in a behavior you want to decrease or eliminate.
- Once the child learned that screaming does not result in milk but “non- screaming” results is getting milk, you can teach him how to point to milk and make an eye contact (use of gestures).
- Present a bottle of milk and slowly move it out of reach so that child can reach for it.
- Immediately bring it to your eye level and once the child tracks it and makes an eye contact, give it to him.
- Once you taught your child how to reach/point and you are prompting him to look up, do not step back with accepting a request without eye contact.
- Next, you want your child to look up independently without prompts. Once the bottle of milk is out of reach, wait until the child looks up. Once the child learned how to initiate reaching and make an eye gaze shift to your eye level, it is time to pair it with a simple sound “mmm”(vocal request).
- Each time the child wants milk he needs to reach, look, and you will say “mmm.”
- After mastery of that step, the child initiates reaching, makes eye contact, and says “mmm.”
There are a few important aspects that have to be taken into consideration when addressing challenging behaviors.
- You can’t give in when the child screams. It may initially take a long time as it is a typical for a behavior to be at a high response rate when it is on extinction.
- Once you give in, the behavior will be only strengthened as it is reinforced on the intermittent schedule of reinforcement. Slot machines in casinos pay randomly and that makes gambling difficult to get rid of.
- When you teach that “non-screaming” can result in something good, be generous and give your child what he likes during these periods.
Don’t forget to provide your child with frequent rewards when he does not engage in maladaptive behaviors. There are numerous interventions that can be successfully implemented by the parents. These should always start as least intrusive intervention and should be based on reinforcement and motivation.