GUIDELINES AUTISTIC BEHAVIOR
People with autism or Asperger syndrome may appear to behave unusually. There will generally be a reason for this: it can be an attempt to communicate, or a way of coping with a particular situation. Knowing what causes challenging behavior can help you to develop ways of dealing with it. You’ll find practical information and tips in this section.
Here, we give you a basic overview of some of the behavioral difficulties that may be experienced by children or adults with an autism spectrum disorder(ASD). Look at:
* why people with an ASD may have behavioral difficulties
* the purpose of the behavior
* ways to deal with the behavior
We will use the word ‘child’ throughout, but hope that the information is useful to parents and carers of adults, too. However, each person and situation is unique: not all the information given here will necessarily be relevant to everyone who has an ASD.
Why does my child have behavioral difficulties?
There is a range of reasons why children with an ASD have difficulties with behavior. The world can be a confusing, isolating and daunting place for your child and it is their fundamental difficulties with communication and social interaction that are often the root cause of difficult behavior. There are some other possible reasons, too. We look at all these reasons below, although this list is not exhaustive.
It’s important to say that your child’s behavior is not caused by bad parenting and is not your fault. It may seem as though your child’s difficult behavior is only ever directed at you – especially if it tends to happen at home, not at school. You are not the only ones in this situation, although we know that sometimes it can feel that way. Many parents contact us to ask about their child’s behavior. Children with an ASD can experience a number of difficulties with communication:
* communicating with others (expressive language)
* understanding what’s being said to them (receptive language)
* understanding non-verbal communication like facial expressions and body language (May, 2005).
Because of these difficulties children can find it hard to communicate their needs or to understand what other people are saying to them, or asking them to do. This can cause considerable frustration and anxiety which, if it can’t be expressed any other way may result in challenging behavior.
Social situations
Communication difficulties can impact on how children deal with social situations. They may find social situations very demanding or stressful because they have to work hard to communicate with other people (Whitaker, 2001). Not all children with an ASD will understand that other people hold different views from theirs. This may also make social situations difficult.
Children with an ASD may not understand ‘social rules’ – the unwritten rules that govern social situations, such as how close to stand to other people or how to take a turn in conversation. This is especially true if children find themselves in a new, unfamiliar situation. Therefore, social situations can be daunting and unpredictable. Some children may engage in a particular behavior to try and avoid social contact (May, 2005).
Unstructured time
Children with an ASD can find ‘sequencing’ difficult – that is, putting what is gong to happen in a day in a logical order in their mind. Many children have timetables so they can see what is going to happen, when, and plan for it. However, unstructured time, such as break times at school which can be noisy and chaotic, may be difficult to deal with. This is because it’s difficult for children to predict what will happen and how they are expected to behave (May, 2005). You may find that behavioral difficulties occur more in transition times between lessons or activities (Clements, 2005).
Abstract concepts such as time aren’t easy to understand and children with an ASD may find it hard to wait. It helps if you can be clear about why and for how long you are waiting. For example, ‘We have to wait for five minutes, until 10.30. This is because the doctor can see us at 10.30.’
Sensory processing difficulties
Many children with an ASD have difficulties processing sensory information. To give some examples, children may not be able to manage some tastes or food textures, or find that someone touching them – even lightly – is painful. For others, certain smells, lights or sounds can be distressing. Some children may find it difficult to block out background noise and what they experience as excessive visual information. Instead, sounds, lights and other sights are all processed at the same level of intensity and lead to sensory overload. You may find that your child starts a repetitive behavior in stressful environments, such as hand-flapping or spinning, to try and block out external sensory information. People with an ASD can be very sensitive to subtle changes in their environment. If there’s a sudden change in behavior, think about whether there has been a recent change in the environment.
Medical reasons
If your child’s behavior has suddenly changed, check that there isn’t a medical reason for the distress. Children can find it difficult to tell people how they’re feeling or where something hurts, even if their verbal communication is generally good. Some children have seizures that can cause irritability and confusion, or gastrointestinal problems which may be painful (Clements, 2005). You can try using a pain chart to help your child indicate where he or she is feeling discomfort: the paediatric pain profile (PPP) is one. See www.ppprofile.org.uk
Alternatively, some parents use symbols to help their child indicate where the pain is (you can print out a diagram, Visual support – where does it hurt? from our website). For information on where you can find free symbols on the internet, see the ‘Useful contacts and resources’ section. You may also find that a particular behavior returns during periods of illness. If this is the case, try using a strategy that has worked before to overcome it again (May, 2005).
Bullying
Unfortunately, children with an ASD can be at more risk of being bullied than their peers. If you notice a sudden change in your child’s behaviour see if there has been any reported bullying or teasing in school. Your child may find it difficult to tell you if they have been bullied – not all children with an ASD even recognize what bullying is – so you might need to play detective.
Change
People with an ASD can find it difficult to cope with change, whether a temporary change to their timetable at school, or a more permanent change such as moving house. You may find that your child’s behavior alters at times of change, but settles as he or she becomes used to a new environment or routine.
Does the behavior have a purpose?
Here are two questions to ask yourself when looking at a particular aspect of your child’s behavior.
* What is my child trying to tell me by his or her behavior?
* What is the function of this behavior? (May, 2005)
What function does the behavior have?
The author Philip Whitaker suggests thinking of behavior as an iceberg: the behavior you are actually seeing is the tip of the iceberg but there’s a lot more going on under the surface (Whitaker, 2001). People with an ASD can’t always express their feelings through facial expressions, body language or speech. Instead, they may be expressed through other behaviors. Your child might be trying to tell you they are tired, stressed, annoyed by something that happened earlier, or in need of some time alone.
What causes the behavior?
It can be useful to use a behavior diary to try and find out what triggers a particular behavior. This helps you to monitor the behavior over time and see what the possible causes are, for example if it always happens at the end of the day when your child is tired after school. One way of recording behavior is an ABC chart. On this, you record the Antecedent (what happened beforehand, who was there, where your child was), the Behavior itself, and the Consequence (what happened following the behavior).
By identifying potential triggers for the behavior, it can be easier to come up with ways of preventing it from happening in the future. We call these ‘strategies’. Strategies are more likely to be successful if they address either the cause or the function of the behavior (May, 2005). You’ll find a sample ABC chart at the end of this information. There’s also a questionnaire to help you establish what the purpose of a behavior may be.
When trying to tackle behavioral difficulties, select two behaviors to focus on at a time. Using too many new strategies with your child at once may result in none of them working. You could write down all the behaviors you’re concerned about then prioritize them, choosing the two most important ones to concentrate on first (Clements, 2005). Don’t worry if things get worse before they get better; your child might at first resist change. This is a normal reaction when children want things to stay the same and try hard to see that they do. It’s important to continue with the strategies you are using and be consistent.
Ways to deal with difficult behavior
In this section you’ll find some strategies that can be used to deal with difficult behavior. But first, we have listed our top tips which, whatever strategies you choose, will be useful.
1. Consistency is of the utmost importance. Whatever strategies you decide to use to help your child should be used by everyone involved with him, including other family members and professionals such as teachers. Inconsistent reactions to behavior by different people cause confusion, stress and frustration for someone with an ASD, and can make the behavior more difficult to tackle.
2. Be patient: your child’s behavior generally won’t change overnight. You may find it useful to track your child’s behavior in a diary; then it may be easier to notice small, positive changes (Dickinson and Hannah, 1998).
3. Punishment rarely works as many children with an ASD don’t understand the connection between their behavior and a punishment they have received (Whitaker, 2001). Also, punishment won’t explain what you do want from your child or help to teach them any new skills.
4. Exercise can help to relieve stress and frustration. Some studies have shown that regular exercise throughout the day can have a positive affect on general behavior (Dickinson and Hannah, 1998). Many children with an ASD enjoy exercise like trampolining.
5. ‘Time out’ is a way for your child to calm down, especially if environmental factors, such as flickering lights, are causing distress. Whatever place your child goes to should be a calm, safe environment where they can be observed (May, 2005). This should only last a few minutes and your child then directed to an activity they find relaxing (May, 2005). Some children have time out at home, perhaps time alone in their bedroom, or the chance to do a favorite activity.
6. When tackling any behavior, be realistic and set yourself and your child achievable goals. You don’t want to cause yourself more upset and frustration by feeling you’ve ‘failed’ to meet goals that are not achievable. (Dickinson and Hannah, 1998).
7. People with an ASD can find it difficult to transfer (or ‘generalize’) new skills they’ve learned from one situation to another. Encourage your child to use new skills or coping strategies in different situations – at school as well as at home.
8. Check that skills have not been forgotten. If you have used strategies successfully in the past, it might help to revisit them from time to time so that your child remembers how to use them. You may also need to use them at periods of stress, illness or change when old behaviors can return. Visual supports can help with this.
Strategies
Here is a brief overview of strategies you can use to address difficult behavior.
Speak clearly and precisely
Some behavioral difficulties arise from children’s frustration at not being able to communicate what they want. Some children with an ASD have a good grasp of language and speak quite fluently. However, they may struggle to tell you something when they are anxious or upset, or find it difficult to understand what you are saying to them.As a general rule, use short sentences, with your child’s name at the beginning so that they know you’re speaking to them. If you use short, clear sentences your child won’t have to try to filter out the less important information.If your child finds spoken communication difficult, consider using alternative ways of communicating, like visual supports.
Use visual supports
People with an ASD often find it easier to process visual information – this can include those who are good at verbal communication. Some children use picture symbols or photos to communicate what they want; others use sign language. Using a visual timetable can make it easier for a child to understand what’s going to happen throughout the day. It also gives a sense of routine, which children with an ASD usually like, and removes feelings of uncertainty.
Write a social story
Social stories are short descriptions of situations, events or activities, often with pictures, which include information about what to expect in that situation and why. They can give a child with an ASD some idea of how other people might behave, and therefore be a framework for appropriate behavior.
Identify emotions
Many people with an ASD find it difficult not only to understand how other people are feeling, but also how they feel themselves. Emotions are abstract concepts and we need a degree of imagination to understand them: we can’t simply ‘see’ anger, for example. There are ways to turn emotions into more ‘concrete’ concepts, though. For example, stress scales are a good way of helping children with an ASD to identify how they’re feeling. You can use a traffic light system, visual thermometer, or a scale of 1-5 to present emotions as colors or numbers. For example, a green traffic light or a number 1 can mean ‘I am calm’; a red traffic light or a number 5, ‘I am angry’.
You need to help your child understand what ‘angry’ means. One way to do this is to refer to physical changes in the body. For example, ‘When I’m angry, my tummy hurts/my face gets red/I want to cry’. When your child has begun to understand the extremes of angry and calm, you can start helping him or her to understand the emotions in between. If your child sees that they’re getting angry, they can try to do something to calm themselves down or they can remove themselves from the situation. Or other people can see what is happening and take action.
Learn to relax
It can be very difficult for children with an ASD to relax. Some have a particular interest or activity they like to do because it helps them to relax. It is, of course, worth being aware of these. Can time doing their favorite activity be built into their daily routine? However, special interests or activities can sometimes be the cause of behavioral difficulties if a child can’t do them when they want to. Other ways that people with an ASD say they can relax include having time alone for short periods of the day to unwind; playing soothing music; or using homeopathic remedies (under supervision). Others may find lights soothing, especially things like spinning lights or bubble tubes which are repetitive.
Modify the environment
As previously mentioned, children with an ASD can have difficulties processing sensory information. Some things in their environment can act as severe irritants. If this is the case, it can be easier to remove the thing that might be irritating your child rather than trying to change a behavior pattern. Are there flickering lights, humming noises or smells that may be causing distress? Remember that it may be something you have hardly noticed at all, while your child experiences it much more intensely.
Give praise where praise is due
As your child learns a new skill or coping strategy, give him or her as much praise as possible. Some children like verbal praise, others might prefer to get another kind of reward, like sticker on a star chart, or five minutes with their favorite activity or DVD. Try to give your child praise in a way that is meaningful.Try also to offer praise immediately after your child has demonstrated a skill. Your child will hopefully learn to make an association between the skill and the reward and start to use the skill more often.
Possible reasons for social isolation
Many people with autism, including Asperger syndrome, experience social isolation. This may be due to a range of reasons. For example:
* the person may prefer to be on their own and enjoy their own company
* adults with autism may want to engage with others but lack the skills to do so
* some people with autism find it difficult to maintain contacts due to a lack of understanding of small talk and other conventions of social behaviour.
* a bad experience in a social situation in the past may have been generalised and the person with autism is now trying to avoid a repetition of this negative experience
* some people with autism may need a higher level of support for activities than their family, friends and/or carers are able to provide
* a person with high-functioning autism or Asperger syndrome may live independently, without family, support workers or a social network
* the person with autism or their family, friends and/or carers may not know about suitable activities in their local area.