Changing Challenging Behaviours

Every parent has to deal with challenging behaviours but parents of children with autism have much more limited tools. A child with autism may not be able to tell you if his or her stomach hurts or that they had a bad nightmare last night. It’s hard to tell if a tantrum is because your child is unwilling to do what’s been asked or because the light in the work area is too bright for their eyes. This section can help you to find out what your child can’t tell you. It’s not a substitute for professional help but it can get you pointed in the right direction.

Challenging behaviours are usually top of any parent’s list to change. There’s a wide range, going from the disruptive (reciting commercials in a loud voice) to the strange (flapping hands when excited) to the dangerous (running away from parents). You’ll have to decide which ones you want to change and which ones you’re willing to let go. It’s not a good idea to try and change too many things at once. It’s exhausting for the parents and overwhelming for the child.

The earlier you intervene, the easier it is to change a behaviour. Which means if your child has been doing something for a long time, it’s going to take a long time to fix it.

Here’s a quick overview of the main points:

Collect information, the more detail the better.

Use the information to figure out why the behaviour is occurring.

Find a way to prevent the problem or prevent rewarding it.

Be prepared for the behaviour to escalate at first.

Be consistent over several weeks to see if your plan is effective.

When in doubt, ask for professional help.

Applied Behaviour Analysis won’t automatically tell you how to change a behaviour but it can help you figure out why that behaviour is happening. The first step is to figure out what’s happening around the behaviour.

Collect Information:

Before you can change anything, you need to make sure you know what is happening around the problem. Sometimes a pattern will emerge that you didn’t expect. I had a challenge with my son whining and throwing tantrums when I asked him to do things. When I began to write down how often it was a problem, I noticed that the vast majority of incidents happened between 3 pm and his dinner at 4. I tried giving him a snack at 3 and pushing his dinner back to 4:30 and the tantrums became much less of a problem. I’m simplifying a process that took over a month, but it did work.

This is one area where the more detail you can write down the better. And I do recommend writing it down. It can be too easy for one bad day or challenging situation to colour your memories. If writing down all the incidents in a day seems too challenging, choose a particular time and record data at the same time each day. The therapists I’ve worked with have all recommended keeping track for a period of at least two weeks in order to get a generalized idea what’s happening and to give you the tools to find out why.

Create a chart for yourself that has an area to write down when the behaviour happened, where it happened, what was happening immediately before the incident, what happened during the incident itself and what the reaction or result was. Be as honest as you can. Even if you’re not proud of how you reacted, you should write it down. Accurate data leads to better results.

 Include a column for when, where, what happened before, the incident and what happened after.  It’s a good idea to note things such as: how long everything lasted, who was present, any detail that strikes you as significant. If more than one person is taking down information, you should include a column to note who observed the behaviour. And make sure that everyone agrees on what constitutes an incident. For example, if your child is pushing other children, you want to make sure you define what you consider a “push” so that people don’t record events you don’t care about. That makes sure that everything is consistent.

Imagine the behaviour is nose picking.  Here’s what your information might look like:

When: Monday, 4:30 pm
Where: Home
What happened before: Child playing with blocks, Mom in the kitchen making dinner.
Incident: Child stuck his finger in his nose.
What happened afterwards: Mom left kitchen, pulled his finger out of his nose and scolded him.  Child began to whine.

When: Monday, 8 pm
Where: Home
What happened before:  Child brushing his teeth, Dad supervising.
Incident: Child stuck finger in nose while brushing.
What happened afterwards: Dad pulled his finger out of his nose and made him finish brushing his teeth.  No further complaints.

When: Wednesday, 10 am
Where: Preschool
What happened before: Child trying to take toy from another child.
Incident: Child stuck finger in nose, wiped on toy.
What happened afterwards: Teacher told him to stop and removed toy to wash it.  Child went on to new activity.

The next step is to figure out the motivation behind the behaviour.

Find the Motivation:

Once you’ve collected your data, you can start searching for a pattern that could tell you why the behaviour is occurring. In the example of my son’s tantrums, I realized that the timing suggested that he was irritable because he was hungry.

There’s always a reason why people do things. There are four types of rewards people get for their behaviour and one or more usually apply.

Sensory rewards are those which simply feel good, like eating chocolate or squishing your toes in warm sand.

Escaping means you can get away from an unpleasant demand or situation, like pretending you got a call on your cell phone to get away from an uncomfortable conversation.

Attention is a big reward, even if it’s not positive attention. Everyone likes to have other people pay attention to them.

Tangible rewards mean specific toys or activities. Watching a favourite television program would be a tangible reward.

Sometimes children do things for more than one reason. If a child throws a tantrum in a store and the parent takes them to the car and explains why it’s not okay to throw tantrums, then they could get a reward both for escaping the boring store and by getting their parent’s undivided attention. Sometimes it’s not clear what the motivation is. If your child throws a fit at the dinner table, knocking aside their plate and throwing a tantrum until someone sits with them to eat in front of the television, it would be hard to figure out the problem. There could be a sensory problem with the dinner table (too bright, too loud, too crowded); the child might not like the food (escape); he or she might want individual attention or might just want the specific program (tangible). That’s why it’s important to record a lot of different incidents. I recommend recording incidents for at least two weeks to figure out the pattern.

In the example with the dinner table, after a few weeks you might see that the child throws a tantrum any time he or she has to sit at the table. That would suggest a sensory issue. You might see it only happens when spicy food is served (sensory and escape). Or it might happen with a parent is busy with something else (attention). Each option would need a different response.

If you’re having trouble figuring out a pattern, then it’s best to speak to a professional therapist before starting on any kind of changes. You might inadvertently reward the behaviour with attention.

Changing the Behaviour:

 Once you’ve figured out why a behaviour is occurring, you can try to change it. The most important thing is to be consistent with what you’ve decided to do. There are two reasons for this. First, irregular rewards are the hardest to overcome. It’s why people get obsessed with slot machines. If it might pay off this time, then it’s worth trying. The second reason is that once you try to stop a behaviour, your child is going to try harder to get it to pay off. If screaming stops working, your child may start to scream louder and longer, or add kicking to the picture. If you give in, the child will learn that escalating their behaviour gets what they want. A lot of parents get caught in this cycle. They try something and the child’s behaviour gets worse instead of better, so they give up. With a child with autism, you’re going to have to be consistent over an extended period, probably several weeks, before you see results.

There are two types of strategies: preventative and reactive. To be effective, your strategy should provide the child with the same reward as the problem behaviour, prevent the child from getting the reward, or both. Preventative strategies work to avoid the situation. If your child likes intense pressure and has been squeezing himself into small spaces, you could roll a soft ball or pillow over his body. It gives him the same sensation and could stop him from crawling into inappropriate places. Or if you know your child gets upset whenever he has to switch from one activity to another, a visual schedule could give him the warning he needs to prepare himself.

Reactive strategies deal more with your reaction than your child’s. It may be hard to imagine, but some children with autism find a parent yelling to be funny. They don’t have the social awareness to realize this should be upsetting, so instead the strange faces and loud noises are entertaining. If your child is doing something for attention, you need to figure out a way to deal with the situation without giving your child any more attention than necessary. For example, your child with autism knocks down a sibling in order to get a toy. Rather than focusing on the child with autism, you concentrate on the sibling (although you should make sure to get the toy in question as well).

I have a more thorough list of strategies in the Tips and Tricks section.

Solutions should seem relatively clear once you’ve figured out why a behaviour is happening. Most of the time, preventive strategies are more effective. If a particular show or movie upsets or agitates your child, don’t watch that show or movie and the problem disappears. If you’re having a lot of trouble figuring out how to deal with the situation, then it’s time for professional help.

Asking For Help:

Lots of parents find themselves over their heads when it comes to figuring out their child’s behaviour. A professional behaviour therapist can be a godsend. But usually one of the first things they’ll ask you to do is to collect information about incidents over a period of time. By having your data ready to go, you can all get started faster.

A professional should work with you and your child either in a therapy center or in your home. Be careful of people who offer to help you over the internet. If you’re already having problems by yourself, then the situation may be more complicated than you can deal with. Professionals pick up a lot of information by observing your child and how you and your child interact. They might spot something you’re unaware of.

If the behaviour therapist has made a suggestion, then do your best to follow it consistently. If you’ve been irregular, it becomes impossible to figure out if the strategy is effective. If you disagree or have concerns, then you should bring it up with the therapist before beginning. Our therapist suggested writing out common greetings for our son to prompt him in polite conversation. I’d been verbally prompting him (Say hello to the lady) without much success. I didn’t think having a card with the words would make much difference but I didn’t think it would hurt. I tried it and to my surprise, after a week, my son began reading the cards without my prompting. In another case, we suspected our son was being aggressive to get attention. The therapist suggested ignoring the aggression. We ignored it as best we could for a month and found the number of incidents kept increasing. Clearly, attention wasn’t the main motivation. But because we had been consistent (and had a reputation for following directions), the therapist didn’t waste more time trying to come up with an attention-based strategy.

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Dealing with Diagnosis: Parents talks about the emotional impact of diagnosis. This is a major life-changing event which can leave people feeling isolated, angry and hopeless. You’re not alone in this.

Dealing with Diagnosis: Friends and Family offers suggestions to the extended family and friends of newly diagnosed families. We all want to help and make things better but sometimes the best-intentioned gestures can end up hurting.

Dealing with Other People's Reactions warns of some of the less than positive responses you can expect and talks about the stigma of accepting the "special needs" label.

The Autism World is an explanation of how people with autism experience the world around them. The ability to guess what your child is experiencing is one of the best tools you can have in helping and teaching them.

Tips and Tricks is a collection of suggestions and ideas contributed by parents. I’m always looking for more suggestions to share. Contact me with your ideas.

Choosing Therapies and Treatment isn’t about specific types of treatment. Instead it’s about what you should be looking for in a therapist or treatment expert. Every child with autism is unique and there’s no universal treatment.

Changing Challenging Behaviours is a basic overview of the Applied Behaviour Analysis system. While I recognize that not every child works best with the intense behaviour treatment based on ABA, the system of figuring out what is behind challenging behaviours is an effective way to understand what your child is trying to tell you. Understanding is the first step to trying to change the problem.

Communication offers ideas on how you can help your child with autism to communicate. Without an ability to tell you what he or she wants, frustration quickly leads to behaviour problems.

Referrals for Families are options for families with special needs to enjoy some of the ordinary experiences in life. It lists examples of non-therapy professionals and businesses who are willing and able to adapt to autistic children.

Finding Help: There are three sections, pre-diagnosis, getting a diagnosis and post-diagnosis. It's my attempt to give you a checklist of options.

Helpful Books: A list of books that I've found to be useful, in the order I discovered them.

My Blog is where I share new information, what's working (and not) for our family. Posted daily (mostly).