SEN talks to behaviour expert Paul Holland about the complex subject of autism and behaviour
SEN Magazine: In what was can autistic spectrum disorders (ASD) impact on a child or young person’s behaviour?
Dr Holland: ASD is commonly known to be characterised by a “triad of impairments”, which essentially means that three areas of development are affected: communication, social interaction, and repetitive and stereotyped behaviour. Each of these impairments can be considered to be broadly linked to specific behavioural difficulties.
Communication impairments can affect the abilities to both understand language and express oneself. Individuals with ASD often interpret information literally and, at times, find it difficult to communicate using conventional language systems. Considering these difficulties, challenging behaviour is often exhibited by those with ASD as a means of communication. Such behaviour may show up as feelings of frustration, anxiety or confusion, or may simply be an effective, albeit inappropriate, means of receiving attention.
Due to difficulties with interacting at a social level, individuals with ASD often behave in ways that are deemed inappropriate by their peers and others around them. Such behaviours may include, standing too close, not providing eye contact, excessive interrupting, one-sided discussions/conversations and overall failure to adhere to social etiquette.
Due to sensory problems, individuals with ASD often exhibit repetitive and/or stereotyped behaviours. These may include repetitive actions, such as hand flapping, flicking, spinning, jumping and rocking. Individuals with ASD may also be either hypo-sensitive or hyper-sensitive to sensory stimuli. This may mean that they are able to tolerate extreme amounts, or alternatively, incredibly limited amounts, of sensory input.
It is important to understand why individuals with ASD exhibit the behaviours that they do. If we can determine the function of the behaviour (what they get from it) we can deal with it more appropriately. All of our behaviours serve a purpose, but the reason why I exhibit behaviour “x” may be completely different to why you do. To attempt to understand this we can conduct a functional analysis of the behaviour/s. This might involve collecting data for specific behaviours; every time the behaviour occurs, note what happens immediately before the behaviour, the time of day, lesson, people present, and what happens immediately afterwards. If we collect this data for long enough, we can often see trends. From these trends we can determine what it is that is triggering and maintaining the behaviour and have a clearer and more informed understanding of how best to deal with it.
SEN Magazine: What can teachers and parents do to address challenging behaviour, and to minimise its incidence, in children on the autistic spectrum?
Dr Holland: Both parents and teachers can begin by understanding that, although we all behave the way we do for a reason, the reason/s may be different for different individuals. To simplify this, there are five main reasons why we behave the way we do:
- to receive attention
- to avoid certain situations
- to escape certain situations
- to receive desired items
- to receive self-stimulation.
The best way to deal with challenging/inappropriate behaviour is by ascertaining the function of it and then responding accordingly by removing the reinforcement that is maintaining the behaviour. For example, if a child is “tantruming” so as to receive attention, this attention needs to be removed.
The other side of the coin also needs to be addressed, though. If a child is “tantruming” to receive attention, we need to provide an alternative means for them receive it. This may include some form of communication (PECS, Makaton, or verbal requesting). In addition, we should be providing the child with attention for appropriate rather than inappropriate attention-seeking behaviours.
It is important to remember that children with autism (and typically developing children) do not exhibit challenging behaviour because they are “bad”. Rather, they behave the way they do because they often have no alternative means of receiving the reinforcement that they desire or need. What we need to do as parents and teachers is to understand the difficulties that individuals with autism experience, and provide them with support and encouragement. Such support may include alternative or augmentative communication, visual support (for example, visual timetables), social stories, achievable and realistic goals, additional support within the classroom setting, structured play activities, circles of friends, Handwriting Without Tears, speech and language therapy and occupational therapy.
There is a lot that we can do. However, it is crucial that we provide support that is specific to the individual. We cannot assume, with such a complex diagnosis as ASD, that one intervention fits all.
SEN Magazine: What strategies and interventions can help children with ASD when they are feeling anxious in public?
Dr Holland: For children who tend to feel anxious when in public or social situations, it is important to give prior warning and to be clear with expectations. Typically, anxiety arises when you cannot predict what will happen next or when the near future is uncertain. These feelings are heightened for those with ASD. Two strategies come to mind when thinking about anxiety: shaping and social stories.
Shaping is a procedure whereby a target goal is determined (for example, being able to cope in public situations for “x” amount of time) and where this goal is reached by gradual increments. It is important to begin from a position in which the individual can be independently successful. This may be according to time (for example, two minutes), the number of people present (for example, two to three unknown people) or some other variable. You should only increase your expectation when this beginning goal is achieved and only move on to higher goals when each successive goal is met.
Social stories provide socially relevant information to individuals, using positive language which is pitched at the level of the person for whom the story is directed. For more information, see My Social Stories Book by Carol Gray and Abbie Leigh-White.
SEN Magazine: Should teachers aim to structure the play and free time of children with ASD at school?
Dr Holland: Considering that social skills and play abilities are impaired for those with a diagnosis of ASD, it is important to provide some structured play and social activities. However, just like anybody else, individuals with ASD need their own space and time to be themselves. Often individuals with a diagnosis of ASD are bombarded with interventions and expectations. It is vital that they, like the rest of us, have time to re-group, relax, and generally be free from expectation. A successful strategy to support play/social skill development is “circles of friends”. For further information, see Circles of Friends by Colin Newton and Derek Wilson.
Dr Paul Holland is a behavioural psychologist renowned for his personal, child-friendly approach.
Article first published in SEN Magazine issue 43: November/December 2009.