Make a Behavior Intervention Plan for an Autistic Child

Autistic children often have difficult behaviors because they lack the ability to communicate their needs and wants in an appropriate way. To eliminate the unwanted behavior, the child needs to be helped to have their needs and wants met in a constructive way.

Steps

Making the Plan

  1. Target only one behavior at a time. Different negative behaviors likely have different causes, and thus different solutions. Typically, it is too difficult to address all of these at once. Additionally, focusing on one thing is more likely to be successful.
  2. Talk with the child about the behavior, if possible. If your autistic child can explain why he or she does what he does, that is an excellent place to start. The behavior may be a solution he or she has come up with to solve a problem (such as humming in class to drown out unpleasant sensory input). In this case, your goal is to expand their repertoire of ways to solve the problem.[1]
    • Encourage self-advocacy.[1] Teach the child to speak up, using words or AAC. Reward this by paying attention and respecting what they have to say.
    • Explain other people's thoughts and feelings in a clear, concrete way. It may help to draw stick-figure pictures, with thought bubbles, where you and the child can write down what others are thinking.[2]
  3. Keep a log, if you can't ask the child. To identify possible reasons for the behavior, keep a log of what happens before the behavior, the behavior itself, and what happens afterwards. It won't be as direct as asking the child, but if the child cannot speak or use AAC, it is your best bet.
    • Example log entry: At 4:30, Joey came into the kitchen and grabbed two cookies. When I told him he could not have them, he began to throw a tantrum. When he calmed down, I gave him a cookie.
    • After math class, Marcia and her peers went to the school assembly. Marcia grew increasingly agitated as we waited, and began chewing on her fingers. This escalated until she was viciously biting her own arms. An aide took her to the office so she could calm down.
  4. After keeping this log for several days to a week, try to identify the cause of the behavior.
    • Joey's tantrums are the result of a desired item (cookie) being taken away after he tried to access them inappropriately. Brainstorm possible reasons: perhaps Joey is very hungry at 4:30, and wants to express that he needs something to eat.
    • Marcia began biting herself as she waited for the assembly. School assemblies can be quite loud, and perhaps they feel frightening or painful to her. Anxiety about a painful assembly could cause the biting.
    • Be aware that what causes an autistic person to act out may not be obvious to non-autistic people. For instance, it may not be obvious why at first that a child has issues in one bathroom, but never the other. However, it may turn out to be a flickering light or fan that irritates the child, but they cannot express this.
  5. Fix the underlying problem. Remove the stressor, and/or teach them a way to handle it when it arrives. If it is successfully addressed, the problem behavior will cease.
    • Joey can be taught to ask for a snack ("I want a snack, please"), or taught to show you a picture of a snack when he is hungry (Picture Exchange Communication System).
    • Marcia bites as a way to cope with the stress of waiting for a painful assembly. She can be given chewy jewelry for when she needs to bite, taught to say "that hurts" when she is hurting, and kept in class with a helper and a box of crayons during assemblies.
  6. If the problem behavior does not decrease, then you have not found the right solution yet, or they are not developmentally ready. Go back to making a log, and trying to figure out what causes it.
    • Research how autistic people have handled situations like this. The internet is full of autistic writers. The hashtag #AskAnAutistic is an easy way to contact them.
  7. See what happens. If you have correctly identified the cause of the problem behavior and provided a solution that works for the child, then they will begin to use the better strategy instead. This will take some time and gentle reminders, but if the child is capable of using the new strategy, it will happen.
    • When the child uses the bad strategy, gently remind them to use the new one: "What do you say when you want a snack?"
    • Never hold their needs hostage. Address a frightening or overwhelming situation right away, regardless of whether they handled it "correctly" or not. The child needs to know that you will help them if they are hurting.
  8. Celebrate their initiative. When the child uses a good technique (e.g. speaking up or getting a stim toy), praise them for doing well.[1] Explain that you're glad that they're self-monitoring, and taking steps to get what they need.
    • For example, "Thank you for telling me that it hurts, Marcia! Now that I know, I'll make sure you don't have to do it again."

Handling Problems

  1. De-escalate if you see stress building up. If a child's "fight-flight-or-freeze" mechanism has activated, they may not be able to control themselves, even though they know that it's not good to hit people or scream in public. The best way to stop it is to prevent it from getting that far.[2]
  2. Minimize talking. When stressed, a child may have trouble with auditory processing, and not be able to understand what you are saying.[2] In these circumstances, talk less, and instead focus on de-escalating.
    • Try to use nonverbal communication. For example, instead of asking "Do you want your bunny?", show them the bunny so they can grab it if they want. Instead of saying "Let's go outside," point to the door and have them take your hand so you can lead them out.
  3. Give them an AAC device. When stressed, the child might lose the ability to speak, while still being able to use AAC. Handing them a device shows that you aren't going to pressure them to speak, and that you'll listen if they advocate their needs.[2]
    • Watch for deteriorating speech abilities. If an ordinarily articulate girl points to a peanut shell and cries "bug," then she might be having trouble processing things,[3] and may communicate better with AAC.
    • If they have several forms of AAC, let them choose. If they are more overwhelmed, a simpler form will do better. For example, maybe your student is too frazzled to type, but can show you the picture card for "too loud."
  4. Have an exit strategy ready, including scheduled rewards if needed. For example, if a boy knows that when he gets into the car, he will get a tasty snack, and he can play a game at home, he might be more willing to leave the park.[2] Implement the strategy if you see stress building. (You can always come back later, once the child is calmer.)
    • Explain the exit strategy beforehand—don't wait until the child is mid-meltdown. Use visual supports, like a keyring with pictures, if needed.[2]
    • Tailor the rewards to the child's favorite things. Make sure that they are available; if you run out, the child may stop trusting the routine and stop doing what you want.
    • Older children might be able to self-monitor, initiate the exit strategy when needed, and do it without rewards. Younger children might need you to watch their mood, and reward them more for following through.

Lowering Environmental Stress

Autistic children may lose skills when over-stressed. Living up to a world based upon non-autistic standards can be very difficult, so they might not have much energy left for additional tasks. Here is how to reduce this.

  1. Keep a daily routine. A predictable routine can feel safe to autistic children. It can be especially helpful to make a visual schedule, so that they can see exactly what is going to happen.[2] Try cards that can be rearranged, or a dry-erase board, to account for changes in routine.
    • Pictures can also help support the child's memory, because some autistic children may have difficulty remembering important things.[4][5] For example, if they have a picture of homework on days when they have homework, it can help them remember.
  2. Encourage sensory regulation. Sensory needs can interfere with self-control and other abilities,[2] so keep them on a healthy sensory diet. Provide a calming, low-input environment for Help a Hypersensitive Autistic Person, and have activities prepared for Help a Hyposensitive Autistic Person.
  3. Make a calming down area that the child can use as needed. Because autistic children struggle with self-regulation, having a quiet space where they can retreat can help them balance themselves when they are overwhelmed or moody. Encourage the child to use it whenever they need to.
    • Place stim toys and ways to block sensory input in the corner. Divide it from the rest of the room with a curtain, shelf, or other barrier.
    • Leave the child alone when they are using the corner.[6]
  4. Recognize that not all autistic "behaviors" need to be changed. Just as autistic people work hard to accommodate non-autistics, non-autistic people need to be helpful and understanding towards autistic people. If a behavior is not harming anyone, then non-autistic people need to learn to accept it.[3] Don't micromanage.
  5. Watch for anxiety disorders. Autistic children are at risk for anxiety, and may need anxiety medication or cognitive behavioral therapy (CBT) to keep it under control. Managing any anxiety disorders can help the child be healthier and happier.
  6. Keep communicating and enjoying positive interaction. Maintaining a good relationship with the child is important for both people's well-being.[7] Do fun things together, talk to them, and take time to listen carefully to what they have to say (whether it's verbal or not).[8]

Staying Positive and Kind

  1. Presume competence. Begin with the assumption that the child is capable, they mean well, and they are trying hard already.[9][10] Help them rise to meet your expectations. Optimism can lift the child's spirits, and bring positive results.
  2. Recognize that no behavior is meaningless. Even if it doesn't make sense to you, it is fulfilling some sort of purpose for the child, or expressing something.[11] There is a reason; you just don't know it yet.
  3. Be cautious about assigning motives to the behavior. Each person thinks differently, and these differences can be especially profound between autistic and non-autistic people. The child's reasoning may be completely different from what you think it is.[11]
  4. Don't confuse "they can't" with "they won't." Gaining abilities is not a linear progression,[12] and if a child is stressed or worn out, they might not be able to do things that they otherwise could.[13] If a child is resisting your attempts to make them do something, it might be that they can't do that thing at the moment,[11] or that they don't understand.[14]
    • For example, instead of "Jamal is angry and won't tell me why. He's so difficult!," you could think "Jamal is angry and can't tell me why. Maybe he's too upset to speak. I'll help him calm down, and then maybe I can figure out what's going on."
    • Sensory input, exhaustion, stress, seizures, anxiety, and more can affect ability levels. For example, perhaps your daughter can usually put her plates in the dishwasher, but after a night of bad sleep and hearing pots clanging in the kitchen, it is too overwhelming one day.
  5. Respond with patience and compassion. This may be frustrating to you, but chances are, it is even worse for the child. Responding kindly can lessen the child's stress, making it easier for them to communicate or do a difficult thing.[11]
  6. Focus on rewards, not punishment. Remember, positive strategies help more than negative ones. The child will see you as a friend and ally, not a punisher.
    • Autistic children might not be able to understand why they are being punished, making it completely ineffective.[2]
    • Be a team. You are not the child's opponent, nor are they the passive object of a project.[3] The child needs to feel that you care about their feelings, that you'll listen to them, and that they can come to you with problems.
    • Never make basic needs contingent on a certain level of behavior. An autistic person may resort to "behaviors" when under extreme duress, and they may not be capable of producing the desired solution at the time.
  7. Provide love and acceptance.[15] Show the child that you care about them, autism and all, and that they are not a burden to those around them. Make it clear that you don't need them to pretend to be "normal."[16] Encourage their strengths, embrace their uniqueness, and make it clear that you love them just the way they are.

Tips

  • Choose one very specific behavior that you want to change, e.g. throwing food at meals.
  • Determine what happens before the behavior that might be causing it, for instance, does the autistic child finish eating more quickly that everyone else? Is there some way you can eliminate or change that, or provide an alternative (e.g. something else to do at the table) to address the reason behind the action?
  • Remember that behavior communicates something—"I'm upset", "I'm scared", "I need your attention", "I'm bored" , etc. What the child is communicating may or may not be appropriate to the situation, but figuring out what the message could be can help you find possible solutions.

Warnings

  • Be aware that autistic children can be affected by things you might not even notice, for instance you always eat off of certain plates and you changed them, someone is sitting in a different place, you ate before bath time rather than after, etc.
  • Be warned that some professionals may recommend damaging practices). Never do something to the child that makes them scream, cry, or panic (even if their therapist recommends it).

Related Articles

Sources and Citations

  1. ↑ 1.0 1.1 1.2 http://ollibean.com/fear-anxiety-and-autistic-behavior/
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 http://ollibean.com/autism-and-consequences/
  3. ↑ 3.0 3.1 3.2 http://ollibean.com/autistic-people-persons-or-projects/
  4. ↑ http://ollibean.com/autism-visual-thinking-parking-system/
  5. ↑ http://ollibean.com/autism-perseveration-and-holding-onto-thoughts/
  6. ↑ http://ollibean.com/changing-implementation-accommodations/
  7. ↑ http://ollibean.com/parenting-caregiving/
  8. ↑ http://ollibean.com/parents-are-you-listening-to-your-child/
  9. ↑ http://ollibean.com/autism-accommodation-differential-expectations/
  10. ↑ http://ollibean.com/believing-child-matters/
  11. ↑ 11.0 11.1 11.2 11.3 http://ollibean.com/autism-behavior-impact-kindness/
  12. ↑ http://ollibean.com/autistic-neurology-or-psychiatric-symptomatology/
  13. ↑ http://realsocialskills.org/post/115675562952/stress-makes-everything-harder
  14. ↑ http://ollibean.com/autistic-visual-thinking-impacts-comprehension/
  15. ↑ http://ollibean.com/acceptance-starts-home/
  16. ↑ http://ollibean.com/normalcy-is-an-ableist-concept/
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