Wednesday, March 16, 2011

Discipline, Redirection and Keeping Our Cool: Autism and Difficult Behaviors

Dealing with challenging behaviors is not a 'one size fits all' for any child and definitely not for a child on the spectrum.  I wish there was a simple formula for combating behaviors we would like to decrease but the complexity of the issue is more than I can even touch on in this post. 

Your child, or a child that you work with throws a tantrum.  Imagine you are in the community, what is the response you receive?  "Look at that spoiled brat", "Why can't they just control their child?" or "If that was MY child, I would just (fill in the blank)"  It seems easy when you are outside looking in but after getting to know children on the spectrum you realize the issue is much more than what you see on the surface. 


What we may not see? 

  • Overstimulation - I am always shocked at how I myself forget to look at this issue at times.  Your child is at a overcrowded restaurant, with a loud band playing, the air conditioning is broken in 100 degree weather, and you are patiently waiting for a table for over an hour.  OK, that is a worst case scenario but look at the environment.  What is the noise level, what smells are around you, what amount of people are around, or what clothing are they wearing?  We have to sometimes do some detective work to figure out what the environment looks and feels like to our kids.
  • Basic Needs - Don't underestimate the power of a hungry child or an exhausted child.  Make sure these basic necessities have been met.  Bring snacks if you will be longer from meal times to try and avoid these situations.  If you know a child has had little sleep the night before, adjust your expectations.  That may not be the day you tackle a new activity, transition or academic skill. 
  • Communication - Sometimes children with autism are communicating but not by means that we understand.  Many children communicate that they are frustrated by throwing themselves on the floor, hitting or screaming.  On the outside, it looks like a child is "out of control" or the parents are "spoiling" him/her.  Even if your child has language, communication is something that does not come easily especially during times of stress and frustration. 
  • Changes in the Routine - The children and adolescents that I work with have a knack for remembering things I can't (and they frequently remind me!)  The order of activities becomes embedded in the minds of many individuals as a way of understanding the world around them.  Due to the fact that people and life itself can be confusing, memorizing when and how things happen can be a way of having some control over the situation.  Keep in mind what things are different that may be enhancing the challenges.  For some kids, stopping by the grocery store after school may not be a big deal.  For some kids on the spectrum this could throw them into an hour long meltdown. 
  • Expectations - We all approach our day, certain environments and new situations with expectations.  Those on the spectrum are often reading different cues rather than realizing our intentions.  This is probably one of the most important underlying issues to consider.  If we don't explain our expectations in an understandable manner, then the individual will draw his/her own conclusion.  Often when we, Molly and I, are transitioning a child from our 'break time' to 'work/academic time' it can initially be difficult.  They could be under the assumption that I am going to take this marble run toy away from them, possibly forever, and make them "work" for 10 hours straight.  Although this wouldn't be my intent, it doesn't mean that the expectation couldn't be there.  Trying to make it clear what will happen and when they get to do things they enjoy is very important.





What does NOT work

  • Corporal Punishment - Otherwise known as, spanking or other forms of physical discipline.  I personally am from the stance that this teaches children on the spectrum nothing helpful.  Often, understanding consequences is a very challenging concept for the kids we work with.  Making the association between doing one action and the consequence being related, such as being spanked, can be challenging.  Additionally, "Do as I say, not as I do" doesn't work so well with these children and adolescents.  Therefore, if we are teaching not to hit and then ourselves go and hit the child this is sending very mixed messages.  Often, spanking is used when we, the adults, feel out of control and at a loss of what to do. 
  • Yelling and Screaming - Again, when we are at a loss we often resort to exerting out of control behavior.  Individuals on the spectrum also have difficulties realizing this is due to a behavior they exhibited.  If they do recognize this connection, it can have the opposite effect.  I worked with a bright young man that said he used to take kids' toys and bite them because they made funny noises and silly faces.  He didn't recognize the emotion behind these actions, being mad or sad/crying, but rather just the faces and sounds.  Don't assume that your anger will be seen as such.  If anything your red face, distorted expression and crazy noises may be a form of entertainment.  Individuals on the spectrum have trouble reading other's emotions and understanding the perspectives of others.  Because you are louder and more animated does not mean they are more likely to understand.  If anything, they are probably less likely and may shut down and tune out. 
  • Talking about the Incident Now -  Wait to talk about the situation.  Discussing what is going on in the moment will often escalate rather than de-escalate the situation.  If you recall the 'Peanuts' cartoon with Charlie Brown where all the adults make the sound "Wah, wah, wah, wah, wah", that is probably what you sound like during the stressful event.  Individuals on the spectrum have difficulties processing language and the ability to process language is close to zero during times of stress and frustration.  Wait until later, with visuals supports, to discuss the situation for prevention in the future. 
  • Taking it Personally - The individual is typically not trying to upset you, disobey or irritate you beyond belief.  Those on the spectrum view the world very differently than we do.  This isn't wrong, just unique.  It isn't something to punish but rather understand and adjust.  Taking the personal aspect out allows us to focus on the details below the surface rather than attribute it to being person specific.  Try to take a step back and focus on the details of the problem rather than see the behavior as a personal attack. 







What To Do:
  • Desensitize the Environment - We discussed how overstimulation can contribute to behavior difficulties so learn how to subdue the world.  Every child on the spectrum is different and their sensory needs are different as well.  I have worked with many children that do great with headphones with or without music to cancel out noise or ear plugs to help subdue noise around them.  Weighted vests can help to modulate or feel where your body is in space and help to control implusive behavior when overwhelmed.  Sunglasses or tinted glasses are sometimes a 'cool' way of closing the world out when necessary. 

  • Show What will Happen - Don't say it, show it.  I can't repeat this enough.  Some of our kids are verbal so we assume that verbal directions and descriptions of events is the way to go.  Processing language doesn't always happen very easily so use visual information in the form of objects, pictures and words to show what will happen.  Write, draw or hand an object to represent what will happen.  Written, picture or object schedules of events can help the person to see what will occur and when.  As I said before, we need to clarify the expectations so they are clear.  This includes showing when activities will end.  Use timers (I especially love visual Time Timers) so they can see when something will end rather than relying on you saying "5 more minutes of video games". 

  • Ignore, Redirect and Remove - It is hard at the time but in the midst of a tantrum it is not the time to teach.  Remove the child if they are going to be a safety risk to themselves or someone else.  Ignore as much as possible if they aren't hurting anyone.  Redirect them to a calming activity or get them engaged in something else.  This is not a 'reward' for the behavior but rather a way of having the individual cope.  We typically use time out as a 'break time' or 'relaxation time' rather than a punitive time.  It is a time to cool off, use items that are relaxing to the individual and remove themselves from the problem.

  • Reward Systems - Work towards things rather than taking away.  A token system can be used to give small rewards towards TV time, video game time, special snacks, small toys, etc.  If you are trying to get your child to stop hitting his brother don't focus on 'No Hitting your Brother'.  Instead, focus on the positives.  Reward each time he shares with him, plays nice, talks nice, hugs gently, etc.  This way you are calling attention to what you want to see rather than what you don't want to see. 

  • Social Stories - Carol Gray has developed amazing ways of teaching children various appropriate behaviors through personalized stories.  Read more about how to write stories for your child here.  Use pictures to help visualize and understand.  These are things that should be reviewed when calm, long after the tantrum or meltdown has occurred.  This will help the individual on the spectrum prepare for a similar situation in the future. 

  • Find a Means to Communicate - Communication systems and strategies is a whole other topic but definitely something to keep in mind.  Many situations can be alleviated or avoided with adequate means to communicate.  Objects, pictures or written words can be wonderful tools to use to support even verbal individuals.  Work on labeling emotions and feelings (on that child's level of understanding) to make it easier to identify how they are in the moment. 

  • Support - Parents/caregivers need support.  If you are stressed, dealing with difficult behavior at home will be even more challenging.  Find groups in your area through the Autism Society or other local organizations.  Meet up with parents or chat in online forums; sometimes just hearing you are not the only alone can be therapeutic. 

  • Advocate - Let other's know what your child needs.  Parents, many of you deal with difficult behaviors on a regular basis.  If you know things that work, share!  Let the teacher, therapist, etc know routines, visuals supports and other strategies that work best for your child. 

Discipline is a topic that we will  discuss frequently because it is an issue that needs to be revisited often.  This is a very brief list of things to try but we hope to build on all of these strategies through further posts.  Also, here at The Autism Angle we have developed our own Coping Kit to help during these difficult times!
-Abby

7 comments:

  1. You guys are working hard. Thanks very much, this is the best commentary I have sean. WE love Teacch.

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  2. Thanks SO much, this is VERY helpful!!

    Kara

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  3. Thanks everyone, your input is invaluable!!

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  4. Great post. So many people talk about what not to do. You give some good ideas of what to do, which is so helpful.

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  5. Thanks, Linda! We love hearing from our readers!!

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  6. Linda recommended your blog to me and I can already tell that I've come across an incredibly rich knowledge bank. This is so what we need. Thank you.

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  7. Thank YOU! Your input is so important to us!!

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