A BRIEF INTRO TO MANAGING BEHAVIOR

WHAT IS A CHALLENGING BEHAVIOR?

There are two aspects to a challenging behavior. First, it can be a behavior that endangers the safety of the child or others nearby (e.g. self-injury or violence towards others). Two, it can be inappropriate behaviors that limit or prevent access to the community (e.g. screaming in public). So challenging behaviors include:
- self-injury
- violence toward other people
- damaging property
- impulsive behavior
- not complying with reasonable requests.

WHY NOT CALL IT ‘BAD BEHAVIOR’?

It is common to describe behaviors as attention-seeking, tantrums or simply bad behavior. But these descriptions are based on our own feelings and emotions. Our motivations for changing behavior are then likely to be based on personal embarrassment (e.g. a mother’s son is screaming in a crowded supermarket), frustration or annoyance.

The key to effective behavior change is that we consistently respond to challenging behaviors in a positive rational way that will eventually lead to appropriate behaviors. When our description of the behavior - and our response - is based on our own feelings then it is very unlikely that positive behaviors will emerge.

WHAT IS THE PURPOSE OF THE BEHAVIOR?

This is the most important question we can ask about a challenging behavior! There is always a message being communicated by a behavior. The problem is that a child on the autism spectrum will often have great difficulty in expressing this, so the parent has to work a lot harder to find the message. When we are tired or frustrated it is much easier to say ‘Oh he’s having another tantrum’ instead of looking for the message in the behavior.
For example, Ella begins throwing everything out of her school bag when her mother drives a different way to school to avoid a traffic buildup, because this isn’t part of Ella’s routine. Her mother’s response will be more constructive if she understands Ella’s discomfort with the change in routine, rather than just yelling at Ella to behave herself for being silly.
The message or purpose of a behavior will usually be communicating an unmet need. These could include:

- There is a change in my routine that is making me very anxious
- I’m bored!
- This environment is far too bright, loud, crowded or strange for me
- I’m experiencing a very unpleasant sensation e.g. rough fabric
- I’m very tired/sad/frustrated at the moment and I’m not able to deal with complex tasks
- Too many demands are being made of me at once and I can’t cope.

THE BEHAVIOR CYCLE
A challenging behavior goes through a range of steps, and there are positive responses we can make at each step to either prevent or minimise the behavior.

TRIGGER PHASE
We should learn of all the things that can act as a trigger for challenging behavior. These triggers can then either be avoided, minimized or we can provide our child with coping strategies. There should be a consistent response planned for each trigger (e.g. when Tim gets very anxious about a future event we remind him to do his deep breathing exercises). It is crucial that our response is done in a calm and non-judgmental way, as loud critical responses are almost guaranteed to escalate the situation for a child on the autistic spectrum!

ESCALATION PHASE

There is still a good chance here to prevent the behavior reaching a crisis point if we remain calm and provide the agreed upon responses to the given situation. Any instructions should be given in a simple way as a child’s comprehension and understanding are very limited at this point.

CRISIS PHASE
The main aim here is to minimise harm to the child, or other people (including yourself!). It is still very important to remain calm as criticism or yelling will only heighten or prolong the crisis phase.

RECOVERY PHASE
Do not attempt to talk through the situation until your child has completely calmed down. During recovery, your child will still have trouble thinking clearly so questions like “Now why did you behave like that?” or “How are we going to prevent this in the future?” could easily trigger the behavior again. It is important to review the situation with your child, but not until enough time has passed for them to be calm enough for this. Remember to actively listen and be empathetic. Often we are annoyed or frustrated at this point, but remember there is a message to every behavior about an unmet need - if your child is trying to tell you about this but feels you aren’t listening or are critical then you are likely to trigger the behavior again!

POSITIVE BEHAVIOR SUPPORT

Positive Behavior Support is currently the most effective response to challenging behaviors available. Why?
- It avoids old-fashioned approaches like punishment, but aims to encourage appropriate behaviors
- It provides your child with valuable life skills for dealing with difficult situations
- It isn’t just reactive but proactive, looking for ways to prevent challenging behaviors before they occur
- It provides consistent positive rational responses that aren’t based on our own negative feelings and frustration.

Any given challenging behavior is approached in the following way:
- Find the message behind the behavior, and the unmet need being communicated
- Determine the triggers, how can they be avoided, minimized or which coping strategies are needed
- Choose the best strategy for behavior change
- Develop the responses for each stage of the behavior (the behavior cycle above).

EXAMPLE
John is twelve years old and at times will begin yelling when taken to the shops, throw any items that he can get hold of then run away to a quieter area.

The message of this behavior is that John is at times unable to cope with going the shops and gets extremely anxious.

Careful analysis shows that the triggers are dogs, the sounds of young children yelling and when the crowds get too thick. This is why the behavior only occurs sometimes. In some cases, the triggers can now be avoided, such as walking the other way when a dog is spotted. Shopping can be schedules for times when it is not so busy.
Strategies for behavior change are selected. For example, John may find certain relaxation exercises can help when the triggers can’t be avoided. Graduated exposure may be used, where it is explained to John you will only go into the crowded supermarket for thirty seconds to see if he can successfully use his coping strategies, then next time this may be for one minute, and so on. Social stories can prepare John for how these uncomfortable environments feel, but the actions he can take to cope with them.

A response plan is developed based on the behavior cycle:
TRIGGER PHASE: Try to avoid the trigger, but if it can’t be helped remind John to do his deep breathing exercises. Be empathetic and positive: “I know you are feeling anxious John, but we’ll be out of here shortly. Remember how well you coped last time because you did the deep breathing?” Stay calm and non-judgmental.

ESCALATION PHASE
John gets increasingly agitated, but there is still a good chance here to prevent a crisis point if we remain calm and provide the agreed upon responses to the given situation. Any instructions should be given in a simple way as a child’s comprehension and understanding are very limited at this point.

CRISIS PHASE
John starts yelling, grabbing supermarket items and throwing them. Minimise harm to others by asking them to leave the supermarket aisle. Keep directions very simple, calm and non-judgmental e.g. “John, follow me out of the supermarket”. If John runs out of the supermarket, follow him but don’t restrain him unless he is a danger to himself or others e.g. tries to run across the street, or tries to throw items in a crowded place.

RECOVERY PHASE
Once outside allow John time to calm down, and keep all responses calm and non-judgmental. Don’t talk about the situation until sufficient time has passed for John to be completely calm again. When reviewing the situation later, remember to listen! Discuss how the situation could be improved next time. Remember to compliment him on the smallest gains too - even if he only lasted thirty seconds more before damaging supermarket goods he should be praised for his attempts to use the coping strategies.

BEHAVIOR RESPONSE PROTOCOLS

This is simply a term for the planned responses you develop to each challenging behavior. These can be written out on reference cards for each behavior for quick reference, so that you can consistently apply the best responses for the trigger, escalation, crisis and recovery phases. An example of the behaviors covered could include:

- YELLING AND THROWING ITEMS AT THE SHOPS
- TAKES ALL HIS CLOTHES OFF IN PUBLIC
- STARTS HITTING HIS HEAD WHEN ASKED TO EAT AT THE TABLE.

Effective behavior change needs consistency, so ideally these behavior protocols would be shared with any key people spending time with John, such as baby sitters, other family members, the parents of John’s friends and school teachers. In fact developing a consistent response with school teachers is critical. If the school has well developed behavior response protocols in place, it would pay to discuss these with the school and see if you can implement similar responses at home. Consistency is crucial for any child, but even more so with children on the autistic spectrum!

Autism tends to lead toward a very logical approach to the world based on rules, so if a child finds that a certain behavior always leads to a certain response from parents, other key adults and teachers then learning appropriate behavior can occur much faster. This is why consistent rational responses are critical. Imagine how confusing it is for a child when their behavior is either ignored, yelled at or found amusing when it all depends on the mood of the parents on any given day. Then imagine how much more confusing it is for a child with autism who struggles to read and understand the moods, emotions and communication of others!

WHAT SORT OF BEHAVIOR STRATEGIES ARE AVAILABLE?

There are many strategies available to suit the particular challenging behavior, and its causes, that you are dealing with, such as:
- positive reinforcement
- tactical ignoring
- desensitization
- time-out
- managing anxiety through relaxation techniques
- token economies
- social stories
- natural consequences.

Remember it is important to respond to appropriate behavior too, not just the challenging behavior. Compliment your child regularly on their appropriate behavior, particularly when you see them attempting to use the coping strategies you’ve been teaching them. We all know how demoralizing it is to only have our mistakes acknowledged, but not have our achievements noted!

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