Here's a great post from the Autism Discussion Page" by Bill Nason on the topic of "resistant, oppositional and noncompliant behavior" and what you can do to help support your students in those situations:
Many children on the spectrum have problems
with following the lead of others, and are frequently oppositional.
This is frequently seen as “intentional” noncompliance, and the child is
often labeled as Oppositional Defiant Disorder (ODD). These children
frequently have to control all activity and interaction, lead the
activity their way, and refuse to follow the lead of others. When we
press the issue with them, they will often act out to re-establish
control. This reaction can occur if they don’t get something that they
want, are pressured to do things that they wish to avoid, and whenever
someone is trying to lead what they are doing. There can be a variety
of reasons why a child on the spectrum will be so resistant. Here are
several reasons why and strategies to support them. This list is not
all inclusive, but common issues.
1. Because of the variety of
processing problems (sensory sensitivities, delayed information
processing, auditory processing difficulties, etc.) many children on the
spectrum feel safe only when they are leading and controlling
everything they are engaged in. “Uncertainty” scares them, so they need
to control everything in order to maintain predictability to their
world.
Suggestions:
a. Respect and accommodate for sensory sensitivities and use a sensory diet to calm and organize the nervous system.
b. Break tasks down into smaller parts, make them concrete with visual
strategies, provide information in small bits that are clear and
concrete.
c. Let the child pace the speed that information is provided, and how they express what they know.
2. Because of the processing issues listed above, these children can
become overwhelmed very easily. By resisting, and controlling what they
are engaged in they can pattern how much stimulation they have to
process, avoiding overload which overwhelms them. They can pace the
information to meet their nervous system needs.
Suggestions:
a. Use strategies listed above under number 1.
b. Respect, avoid, and/or accommodate for situations that tend to overwhelm the child.
c. Teach the child coping skills for dealing with overload.
d. Teach the child (and those around them) how to appropriately escape
situations that overload them (break card, say “no”, ask for help,
etc.).
3. Difficulty understanding what is expected. Children
on the spectrum have difficulty appraising what is needed, so they are
either anxious about entering into new situations, or dive in to new
situations without understanding what is needed (then acting out when
they struggle). For these children they (1) do not know what to expect,
and (2) do not know what is expected of them. They need the world to
be very predictable so they know exactly what to expect.
Suggestions:
a. Preview, clarify and verify: Prepare the child before going into
situations (1) what they can expect to occur, (2) what is expected of
them, (3) how long it will last, and (4) what will come up next. Also,
anticipate any problem areas and how to handle them (e.g. withdraw and
regroup when overwhelmed.). Don’t assume the child understands,
clarify and verify that they understand.
b. For new situations,
while knowing the child’s vulnerabilities, try to make modifications and
accommodations to reduce the impact. Again, preview these ahead of
time.
c. During activities/tasks, “think out loud!” Provide a
narrative of what is needed, and how to do it. This can help guide and
coach the child through the tasks.
d. Use visual schedules to help provide predictability and understanding.
e. Ease transition by preparing ahead of time, and giving 5,3, and 1 minute reminders before transitioning between tasks.
4. From a history of constantly being place in situations where the
demands are stronger than their skills to handle them, they have learned
that it is simply safer to escape and avoid any activity that is not
initiated and lead by them. So, they have to control all activity.
Suggestions:
a. By understanding the sensory, cognitive, and performance issues of
your child, always look at how the demands can be lowered, presented
differently, or more support provided to make them match the current
skill level of the child.
b. Do the tasks/activities as “we-do”
activities (do them together, helping each other out) to frame and
scaffold the activity to maximize success. Match the demands to the
child’s skill level, and do it together to support them through it.
5. Many on the spectrum have strong task performance anxiety. So when
we ask them to perform, they will resist unless they know that they will
be “perfect” at doing it. Because of their “black and white”, “all or
nothing” thinking, unless they feel completely competent (which is often
just in their preferred, self-directed activity), they will pull back
and resist. It is an all or nothing response; resisting any activity
that will take some time to learn.
Suggestions:
a. Understand the child’s comfort zones and stretch slowly.
b. Start where the child is at; keep it simply, build one step at a time, maximize success.
c. Find the “just right” challenge and stay within it.
d. When possible, do the activity together (we-do activity) so you can
take the pressure off the child, thus lowering the task performance
anxiety.
6. Some children have a hard time “initiating” a task.
They simply cannot get themselves started. This is due to weak
executive functioning (brain wiring). They need you to “jump start”
them.
Suggestions:
a. Assist them in starting the activity, then fade out the assistance as they get going.
b. Some of the kids with executive functioning issues cannot remember
multi-step directions. You may need to provide visual prompts for each
step. When we give the child a task, give them verbal instructions, and
then walk away, they may not be able to organize what is needed to
carry it out. Don’t label this as noncompliance. Provide the necessary
support.
c. Give written directions and a written outline (worksheet) to lead them from one step to the next.
7. Lack of motivation. Many children on the spectrum have low motivation to do things that are not exciting for them.
Suggestions:
a. Increase motivation by following “nonpreferred “ activity, with
“preferred” activity. Simply use the activity that they enjoy to
reinforce completion of other activity. First do homework, than watch
T.V.
b. Catch them being good! Provide three times more praise and
positive attention for being cooperative than for being resistant
(scolding, coaxing, etc.). Minimize attention for noncompliance.
c. Build in token systems, star charts, sticker programs, etc, only if needed to increase motivation.
d. Some children are resistant when tasks are boring. Try and build new learning around their strengths and interests.
8. For children that say no and fight all “directions” ! Often labeled ODD
a. Pick your battles. Reduce 80% of all “requests”, demands, and
directions. Telling them, or asking them to do things, will elicit an
automatic no! They will resist all imperative statements (questions,
prompting, instructions, directions, requests, etc.). It just gives
them ammunition to be noncompliant.
b. Use more declarative language
to invite engagement. For example “Wow…I could really use help with
this!” or “I bet you are better at this then me!”, rather than “Billy
help me do ___.” Invite without asking. It allows the child to feel
them self volunteering to help; being in control under his own volition.
c. Provide no negative emotion to refusal. The two main things to
avoid when child is resisting is “strong emotion,” getting upset, and
any scolding, negotiating, coaxing, or bribing. They feed off the
negative emotion (helps them feel powerful) and the attention that we
give counseling, scolding, and coaxing. However you choice to respond
to noncompliance, do it with little emotion, and with minimal talking.
d. For requests that the child “has to” do, use the following:
Get the child’s attention, face to face, eye level.
State the prompt in short, clear, concrete language.
Provide the child 10 seconds to respond (longer for delayed processing)
Repeat the prompt in firm manner; using same language.
Still no response (as long as you have been using the strategies above
to support all vulnerabilities) then continue to stand your ground,
saying nothing but repeating the same statement every 30 seconds.
For some children increase the assistance with physical guidance
(unless it agitates them more), or simply wait until they are ready to
respond.
Once the child respondes, provide support as needed, and reinforce all cooperative participation.
These strategies should only be used for those requests and blended in with the above positive strategies.
e. Often these children respond negatively to positive praise (just the
opposite of most children). They read “praise” as you controlling them
to do things. So, for these children do not praise performance, just
let mastery be motivating.
9. Because of our wish to avoid a
fight, many children on the spectrum have learned that by resisting,
people back off and withdraw the demands in order to avoid a meltdown,
or destructive behavior. By doing so we often get to the point that we
pacify the child so he will not get aggressive. We coax and bribe the
child to do things. Consequently, the child learns that by being
noncompliant, and acting out, he can manipulate the people around him to
give him what he wants, and to escape and avoid everything he wishes to
avoid.
Suggestions:
a. Of course, build in above proactive strategies to match the demands to the child’s current skill level.
b. Use a visual schedule so the routine is consistent and predictable
for the child, with preferred activity built into the schedule every 2-3
activities.
c. Do the activities as we-do activities as much as possible. Providing support and praise as you go along.
d. When child is resistant, take away the battle, and let the
consequences teach the behavior. Tell the child “You are too tired to
do it right now. That’s ok, you let me know when you are ready, and I
will help you.” Show no emotion, simply back away and ignore
noncompliance. However, the child cannot do any preferred activity
until they follow through with the routine task.
e. If they complain, simply remind them that it is their choice, and you are there to help them when they are ready.
f. It is important that you are very clear in the expectations and
consistent in following through with “life stops” until the child
becomes responsive again.
As you see, there are different
reasons why children on the spectrum are oppositional. However, assume
that the child is doing the best that they can, given the situation
they are in and their abilities to deal with it. Also, assume that the
more oppositional, the more incompetent the child feels. Focus on
helping the child feel competent, and responsiveness will increase. We
tend to focus too much on forcing compliance, when we need to be
assisting the child by taking away the fight, lowering the demands (at
least at first), providing increase supports, and focusing on what they
are doing right. Help them feel more competent, and they will follow
your lead.
Showing posts with label behavior management. Show all posts
Showing posts with label behavior management. Show all posts
Sunday, January 13, 2013
Consequences for Aggressive Behaviors
Frequently, I encounter situations where school teams are working with students with autism who demonstrate significant, physically assertive behaviors towards adults and peers. Many times, these behaviors are demonstrated by students with autism who have limited or no conventional communication skills and by students who have a unique cognitive learning style that makes temporal sequencing and cause and effect situations difficult to process and understand. Many times, when helping staff sort out and make sense of what's happening and how best to respond, some staff members feel that some sort of consequence (i.e., time out, response cost, or some other punitive intervention) is needed and advocate strongly that such interventions must be utilized.
Such interventions typically are not successful with most individuals with autism. In terms of reducing aggressive behaviors with students, we need to focus on why the behavior is occurring and teaching the students to communicate in different ways. In the heat of the moment (so to speak) we need to see the behavior as emotional disregulation and focus on helping the student de-escalate and keep himself and others safe. Applying some sort of negative consequence in response to the behavior in order to teach him or her to behave differently will not work. Once the student becomes more emotionally regulated, attention can be given to the function of the behavior and proactive strategies utilized to teach the student to communicate in a more conventional manner.
Such interventions typically are not successful with most individuals with autism. In terms of reducing aggressive behaviors with students, we need to focus on why the behavior is occurring and teaching the students to communicate in different ways. In the heat of the moment (so to speak) we need to see the behavior as emotional disregulation and focus on helping the student de-escalate and keep himself and others safe. Applying some sort of negative consequence in response to the behavior in order to teach him or her to behave differently will not work. Once the student becomes more emotionally regulated, attention can be given to the function of the behavior and proactive strategies utilized to teach the student to communicate in a more conventional manner.
Monday, November 19, 2012
Severe Self-Injurious Behavior
I have shared previous posts by Bill Nason, consultant and author of the Facebook page, Autism Discussion page. Today, I'd like to share his post on severe self injurious behavior (SIB). Bill does a great job of discussing not only why SIB may occur, but more importantly, what we can do to support a person during these episodes.
Severe Self-Injurious Behavior
A small percentage of people with developmental disabilities engage in frequent self injurious behavior. My first 12 years in the field were spent in an institutional setting providing services to severely impaired individuals with multiple behavior challenges. During this time I had the opportunity to work with some very fragile individuals, with severe physical
Severe Self-Injurious Behavior
A small percentage of people with developmental disabilities engage in frequent self injurious behavior. My first 12 years in the field were spent in an institutional setting providing services to severely impaired individuals with multiple behavior challenges. During this time I had the opportunity to work with some very fragile individuals, with severe physical
and
emotional vulnerabilities. Self injury took a variety of forms
including biting, digging, hitting, slapping, kicking, head banging, and
ingesting inedible items. During that time I learned that self
abusive behavior occurs for several reasons:
1. Self abusive behavior is more common with individuals who are nonverbal and have no consistent way of expressing themselves. Consequently, self abusive behavior often is communicating pain, discomfort, frustration, task demands, need for attention, etc. Self abuse can be used to communicate any intense emotional reactions.
2. Most self abusive behavior involves strong proprioception (tension to joints, tendons, and muscles), which reduces stress chemicals (cortisol) in the nervous system. Hitting, kicking, biting, and head banging provides strong proprioception that reduces stress chemicals during times of emotional outbursts. When the stress chemicals accumulate to boiling point, the “fight or flight” stress response is activated, seeking strong proprioception to reduce the stress chemicals.
3. Abusing yourself produces strong reactions from others and these reactions can increase the frequency of self abuse. The person learns that self injury gains a lot of attention, and also allows them to escape situations that they want to avoid. People around them will do anything to stop the self abuse. The individuals learn that the behavior can create a lot of control over their social environment (people let them escape unwanted situations, give them what they want, let them have their way in order to pacify them).
4. Self abusive behavior can be used to mask, or dull pain. Individuals may bang their head to mask pain from headaches and ear infections. They may hit themselves in the jaw to distract from toothaches. When self abuse begins, or increases significantly, medical evaluation is important.
5. Self abusive behavior can be for self stimulation, to help regulate the nervous system. It can alert the nervous system when under-aroused, and release stress chemicals when over-aroused. This behavior often occurs frequently during times of no activity or when overwhelmed by too much activity.
Severe and persistent self injury can start for any of the above reasons, but can become addicting over time. The pain from self injury stimulates the body to release endorphins which is the body’s natural pain killer. Endorphins act like opiates, which feel good, and the person can get addicted to the “feel good” endorphins. Not only do endorphins help dull the sense of pain, but it also feels good. The individual self injures to stimulate the release of endorphins to maintain the “feeling.” Since the endorphins act to dull the pain, the behavior Is not felt as painful. Now, self abuse that occurs for this reason can get worse over time. Like all addiction, the body begins to “habituate” (gain a tolerance for) the stimulation, requiring the individual to do it more intensively, to stimulate the pain to release the endorphins. The brain has a defense mechanism to dull the sense of pain over time, making it necessary to increase the intensity to stimulate the endorphins. In addition, scaring that can occur from the injury dulls the pain, requiring the individual to dig or bite deeper to stimulate pain. These individuals will gradually go from minor injuries to creating severe injury as the skin becomes more and more scared. The individual then has to gouge or tear out tissue to get deeper for pain. In such case the medication naltrexone can be used to block the body’s release of endorphins. By doing so, the self abuse hurts more, plus it no longer releases the “feel good” endorphins. If this works, the self abuse begins to hurt more, and doesn’t release the “feel good” chemicals that is addicting.
In many cases chronic, persistent self injurious behavior ends up being maintained by several of the above functions. It can start because of only one of the functions, but once started, can gain many secondary values by the addition of several of the other functions. In most cases, professional help is needed to isolate the functions, and develop effective strategies to treat each function.
Treating Self Injurious Behavior
1. Treating self injurious behavior usually starts with doing a “functional behavior assessment” to identify the “functions” that the behavior serves (communication, stress release, escaping unwanted events, self stimulation, etc.) Functional behavior assessments involve tracking and identifying the situations under which the behavior occurs (when, where, with whom) and observing the immediate effects that the behavior produces. By identifying what triggers the behavior, and what occurs immediately after the behavior, we begin to get an idea of which function it provides.
2. Treatment the usually proceeds with changing the conditions (lowering demands, reducing stimulation, increasing support, etc.) that trigger the behavior, and teaching another, more appropriate, “replacement” behavior that meets the same need (function).
3. First we look at what environment demands are overwhelming, or lacking, for the person. This may require modifying the environmental demands, building in accommodations to lessen their impact, or providing greater assistant to support the person when faced with these conditions. If the person has too many demands placed on them, we look at providing less demands, lowering how hard the demands are, or providing added support in face of the demands. We want to better match the demands of the situation to the skill level of the person.
4. If the function of self abuse is to communicate needs and wants, then we focus on teaching the child communication skills. If person is nonverbal then we teach an alternative means of communication, such as pictures, gestures, signing, etc. We identify what the person is trying to communicate and then try and teach another, more appropriate way of communicating.
5. If the behavior is occurring to escape or avoid unwanted situations, we often need to look at “why” the person is trying to escape or avoid the situation in the first place. Then we build in added supports, or lessen the demands. In addition, we need to teach another way to communicate “stop” or “help”. Teach them another behavior to appropriately escape the situation. Then we prompt the child to use the replacement way of escape, and immediately allow them to escape. It is important that the new, more appropriate way of “escaping” is immediately reinforced with successful avoidance.
6. If the self abuse occurs for proprioception to release stress chemicals, than we look at (a) developing a sensory diet that gives frequent physical activity and other forms of proprioceptive stimulation (chewing gum, squish balls, weighted vest, etc.) that provides proprioception to release stress chemicals throughout the day, and (2) alternative replacement behavior to substitute for the self abuse. For example, if the child bites their wrist, we might provide a chewy tube to bite on. This would provide an appropriate form of biting/chewing. Substituting one form of proprioceptive tool for another.
7. If the person is engaging in self abuse to mask pain, than we identify the source of pain and treat it. We also try and teach the person a method of communicating to others that they feel pain.
8. If the person is self abusing to get strong reactions from others, we (a) lower the intensity of our reactions, and (2) provide stronger attention for other more appropriate behavior.
9. If the person is engaging in self abuse for self stimulation then we try and increase the stimulation the person Is receiving (keep them busier, provide an environment rich in stimulation) and teach other forms of self stimulation that either calms or alerts the nervous system. We also build in a sensory diet to provide the person frequent stimulation.
10. . If the behavior is the result of high anxiety, and the above doesn’t help, then medications are often used to calm the nervous system.
11. In rare occasions when the self injurious behavior may be maintained by endorphins (as discussed above) then we give naltrexone to block the release of endorphins.
1. Self abusive behavior is more common with individuals who are nonverbal and have no consistent way of expressing themselves. Consequently, self abusive behavior often is communicating pain, discomfort, frustration, task demands, need for attention, etc. Self abuse can be used to communicate any intense emotional reactions.
2. Most self abusive behavior involves strong proprioception (tension to joints, tendons, and muscles), which reduces stress chemicals (cortisol) in the nervous system. Hitting, kicking, biting, and head banging provides strong proprioception that reduces stress chemicals during times of emotional outbursts. When the stress chemicals accumulate to boiling point, the “fight or flight” stress response is activated, seeking strong proprioception to reduce the stress chemicals.
3. Abusing yourself produces strong reactions from others and these reactions can increase the frequency of self abuse. The person learns that self injury gains a lot of attention, and also allows them to escape situations that they want to avoid. People around them will do anything to stop the self abuse. The individuals learn that the behavior can create a lot of control over their social environment (people let them escape unwanted situations, give them what they want, let them have their way in order to pacify them).
4. Self abusive behavior can be used to mask, or dull pain. Individuals may bang their head to mask pain from headaches and ear infections. They may hit themselves in the jaw to distract from toothaches. When self abuse begins, or increases significantly, medical evaluation is important.
5. Self abusive behavior can be for self stimulation, to help regulate the nervous system. It can alert the nervous system when under-aroused, and release stress chemicals when over-aroused. This behavior often occurs frequently during times of no activity or when overwhelmed by too much activity.
Severe and persistent self injury can start for any of the above reasons, but can become addicting over time. The pain from self injury stimulates the body to release endorphins which is the body’s natural pain killer. Endorphins act like opiates, which feel good, and the person can get addicted to the “feel good” endorphins. Not only do endorphins help dull the sense of pain, but it also feels good. The individual self injures to stimulate the release of endorphins to maintain the “feeling.” Since the endorphins act to dull the pain, the behavior Is not felt as painful. Now, self abuse that occurs for this reason can get worse over time. Like all addiction, the body begins to “habituate” (gain a tolerance for) the stimulation, requiring the individual to do it more intensively, to stimulate the pain to release the endorphins. The brain has a defense mechanism to dull the sense of pain over time, making it necessary to increase the intensity to stimulate the endorphins. In addition, scaring that can occur from the injury dulls the pain, requiring the individual to dig or bite deeper to stimulate pain. These individuals will gradually go from minor injuries to creating severe injury as the skin becomes more and more scared. The individual then has to gouge or tear out tissue to get deeper for pain. In such case the medication naltrexone can be used to block the body’s release of endorphins. By doing so, the self abuse hurts more, plus it no longer releases the “feel good” endorphins. If this works, the self abuse begins to hurt more, and doesn’t release the “feel good” chemicals that is addicting.
In many cases chronic, persistent self injurious behavior ends up being maintained by several of the above functions. It can start because of only one of the functions, but once started, can gain many secondary values by the addition of several of the other functions. In most cases, professional help is needed to isolate the functions, and develop effective strategies to treat each function.
Treating Self Injurious Behavior
1. Treating self injurious behavior usually starts with doing a “functional behavior assessment” to identify the “functions” that the behavior serves (communication, stress release, escaping unwanted events, self stimulation, etc.) Functional behavior assessments involve tracking and identifying the situations under which the behavior occurs (when, where, with whom) and observing the immediate effects that the behavior produces. By identifying what triggers the behavior, and what occurs immediately after the behavior, we begin to get an idea of which function it provides.
2. Treatment the usually proceeds with changing the conditions (lowering demands, reducing stimulation, increasing support, etc.) that trigger the behavior, and teaching another, more appropriate, “replacement” behavior that meets the same need (function).
3. First we look at what environment demands are overwhelming, or lacking, for the person. This may require modifying the environmental demands, building in accommodations to lessen their impact, or providing greater assistant to support the person when faced with these conditions. If the person has too many demands placed on them, we look at providing less demands, lowering how hard the demands are, or providing added support in face of the demands. We want to better match the demands of the situation to the skill level of the person.
4. If the function of self abuse is to communicate needs and wants, then we focus on teaching the child communication skills. If person is nonverbal then we teach an alternative means of communication, such as pictures, gestures, signing, etc. We identify what the person is trying to communicate and then try and teach another, more appropriate way of communicating.
5. If the behavior is occurring to escape or avoid unwanted situations, we often need to look at “why” the person is trying to escape or avoid the situation in the first place. Then we build in added supports, or lessen the demands. In addition, we need to teach another way to communicate “stop” or “help”. Teach them another behavior to appropriately escape the situation. Then we prompt the child to use the replacement way of escape, and immediately allow them to escape. It is important that the new, more appropriate way of “escaping” is immediately reinforced with successful avoidance.
6. If the self abuse occurs for proprioception to release stress chemicals, than we look at (a) developing a sensory diet that gives frequent physical activity and other forms of proprioceptive stimulation (chewing gum, squish balls, weighted vest, etc.) that provides proprioception to release stress chemicals throughout the day, and (2) alternative replacement behavior to substitute for the self abuse. For example, if the child bites their wrist, we might provide a chewy tube to bite on. This would provide an appropriate form of biting/chewing. Substituting one form of proprioceptive tool for another.
7. If the person is engaging in self abuse to mask pain, than we identify the source of pain and treat it. We also try and teach the person a method of communicating to others that they feel pain.
8. If the person is self abusing to get strong reactions from others, we (a) lower the intensity of our reactions, and (2) provide stronger attention for other more appropriate behavior.
9. If the person is engaging in self abuse for self stimulation then we try and increase the stimulation the person Is receiving (keep them busier, provide an environment rich in stimulation) and teach other forms of self stimulation that either calms or alerts the nervous system. We also build in a sensory diet to provide the person frequent stimulation.
10. . If the behavior is the result of high anxiety, and the above doesn’t help, then medications are often used to calm the nervous system.
11. In rare occasions when the self injurious behavior may be maintained by endorphins (as discussed above) then we give naltrexone to block the release of endorphins.
Friday, October 19, 2012
Don't Punish Meltdowns
For all you facebookers, if you have not liked the "Autism Discussion Page", I'd highly recommend that you do so. Bill Nason has created a very useful page that is chock-full of great insights, ideas, and strategies for understanding and supporting individuals with autism. Here is a recent post that I found particularly relevant:
Don't Punish Meltdowns!
Often we want to punish "bad" behavior, since this is a time told way
of teaching discipline. However, when the child is overloaded and
melting down their judgement and reasoning and cognitive coping skills
crumble. Their brain is in panic, "fight
or flight". In times like these the child needs understanding,
acceptance, and the opportunity to pull back, escape, and rebound. We
also need to recognize that at the moment the demands of the situation
outway the child's current abilities to handle them.
This
does not mean that we allow the child's autism to excuse his behavior.
The autism may explain, but should not excuse his behavior. However,
the consequence should be pull away, regroup, then come back and repair
the damage. To decrease meltdowns we need to reduce the stressors and
teach the child "how" we want the child to "behave" (cope) with the
stress before reaching overload. Then we can practice the coping skill,
cue them to use it when first getting upset, and reinforce them heavily
for using it during times of stress.
Consequences (punishment) works if (1) the child has control over his
behavior,(2) knows how he should act instead, and (3) makes the choice
to act badly even though he knows how to act otherwise. If the child is
overwhelmed to the point of activating
his "fight or flight" response, his coping skills will fall apart and he
will act to escape or avoid the stressful situation. Once the stress
chemicals reach boiling point, the child will act in a way to (1) escape
the stress and (2) release the stress chemicals. New learning cannot
take place in situations of overload. We need to (1) reduce the demands
that produce overload, (2) teach better coping skills to deal with the
stress, and (3) teach another way of responding once overload occurs.
This cannot be taught during the meltdown, but practiced and role played
when not stressed.
It is important that we do not punish
meltdowns. If the child loses control, scolding, counseling, or
threatening only makes things worse. It is best to focus on the
"feelings" behind the behavior and not the behavior itself. Acknowledge
and validate that he is upset, and that you will keep him safe. You can
set boundaries and consequences for behavior, but at the moment of
impact, focus on acknowledging and validating the feelings, removing all
demands and stimulation, and helping the child feel "safe" until it is
over with.
Don't Punish Meltdowns!
Often we want to punish "bad" behavior, since this is a time told way
of teaching discipline. However, when the child is overloaded and
melting down their judgement and reasoning and cognitive coping skills
crumble. Their brain is in panic, "fight
or flight". In times like these the child needs understanding,
acceptance, and the opportunity to pull back, escape, and rebound. We
also need to recognize that at the moment the demands of the situation
outway the child's current abilities to handle them.
This
does not mean that we allow the child's autism to excuse his behavior.
The autism may explain, but should not excuse his behavior. However,
the consequence should be pull away, regroup, then come back and repair
the damage. To decrease meltdowns we need to reduce the stressors and
teach the child "how" we want the child to "behave" (cope) with the
stress before reaching overload. Then we can practice the coping skill,
cue them to use it when first getting upset, and reinforce them heavily
for using it during times of stress.
Consequences (punishment) works if (1) the child has control over his
behavior,(2) knows how he should act instead, and (3) makes the choice
to act badly even though he knows how to act otherwise. If the child is
overwhelmed to the point of activating
his "fight or flight" response, his coping skills will fall apart and he
will act to escape or avoid the stressful situation. Once the stress
chemicals reach boiling point, the child will act in a way to (1) escape
the stress and (2) release the stress chemicals. New learning cannot
take place in situations of overload. We need to (1) reduce the demands
that produce overload, (2) teach better coping skills to deal with the
stress, and (3) teach another way of responding once overload occurs.
This cannot be taught during the meltdown, but practiced and role played
when not stressed.
It is important that we do not punish
meltdowns. If the child loses control, scolding, counseling, or
threatening only makes things worse. It is best to focus on the
"feelings" behind the behavior and not the behavior itself. Acknowledge
and validate that he is upset, and that you will keep him safe. You can
set boundaries and consequences for behavior, but at the moment of
impact, focus on acknowledging and validating the feelings, removing all
demands and stimulation, and helping the child feel "safe" until it is
over with.
Thursday, May 24, 2012
The Litmus Test for Behavior/Treatment Strategies
The Litmus Test for Behavior/Treatment Strategies -- Bill Nason
Autism Discussion Page
This page is developed around a tool box of strategies to help the child feel “safe, accepted, and competent.” After 30 years in the field I have narrowed my analysis down to a foundation that we all have a strong need to feel safe, accepted, and competent. In my job, most people approaching me are seeking help in dealing with a host of social, emotional, and behavioral challenges; almost everyone feeling vulnerable and inadequate in dealing with these challenges. Every individual comes with their own unique strengths and vulnerabilities, social and emotional challenges, and a past history of repeated failure in trying to integrate in society. In addition, all the people supporting the individual (parents, relatives, teachers, etc.) also are frustrated and vulnerable, and feeling incompetent in dealing with the challenges.
In our drastic attempts to “change behavior”, others may want to assign harmful intent to the child, and wish to punish, suspend, or otherwise “force” the child to comply. When we don’t understand the conditions presenting the challenges, we turn to modifying behavior by manipulating consequences. More times than not it either doesn’t help, or makes things worse. It often ends up not reducing the conditions presenting the behavior, but usually ends up invalidating the child. Often we are acting out of frustration when we ourselves are feeling inadequate. Just like the child who needs to “control” when feeling inadequate, us adults will do the same when feeling incompetent.
In my 30 years in the field, I’ve found that if we change the conditions around the child so he feels safe, accepted, and competent, then every child grows and develops. Problematic behavior occurs when we put the child in situations for which the demands of the situation outweigh the child’s current skills for dealing with them. Either the child feels insecure, unaccepted, or incompetent in dealing with the current demands. When the child feels (1) safe and secure (physically, socially, and emotionally), (2) accepted, respected, and valued, and (3) competent in tackling the current demands, then problem behavior subside, and adaptive growth occurs. This is why the current “positive behavior supports” systems are mandated (but rarely used correctly) in our school systems. Positive behavior supports are strategies to lessen the stressors, accommodate for vulnerabilities, match demands to current abilities, and teach better skills for dealing with the social and emotional demands.
So, my request of you is to use this model as a litmus test when evaluating strategies that professionals, teachers, family and friends recommend to use. Ask yourself (and them) “In what way does this strategy help my child feel more safe, accepted, or competent?” If they want your child to loss privileges, force them to stay in situations that are overwhelming them, suspending them from school, or pressure them into compliance, ask them “In what way does this procedure support my child to feel safe, accepted, and competent.” If it doesn’t help support one of those three things, then be very cautious. Most likely the procedure will just invalidate the child even more, and lead him or her to feel even more incompetent than they already feel. If the procedure doesn’t (1) lessen stressors, (2) change demands, (3) accommodate vulnerabilities, or (4) teach better skills, it probably is not a good procedure to use. Whatever strategy that is used, ask yourself how does it support my child to feel “safe, accepted, and competent.” If it does, then you cannot go wrong. Everyone will benefit, feel more competent, and grow more connected with each other. This litmus test is simple, and accurate
Autism Discussion Page
This page is developed around a tool box of strategies to help the child feel “safe, accepted, and competent.” After 30 years in the field I have narrowed my analysis down to a foundation that we all have a strong need to feel safe, accepted, and competent. In my job, most people approaching me are seeking help in dealing with a host of social, emotional, and behavioral challenges; almost everyone feeling vulnerable and inadequate in dealing with these challenges. Every individual comes with their own unique strengths and vulnerabilities, social and emotional challenges, and a past history of repeated failure in trying to integrate in society. In addition, all the people supporting the individual (parents, relatives, teachers, etc.) also are frustrated and vulnerable, and feeling incompetent in dealing with the challenges.
In our drastic attempts to “change behavior”, others may want to assign harmful intent to the child, and wish to punish, suspend, or otherwise “force” the child to comply. When we don’t understand the conditions presenting the challenges, we turn to modifying behavior by manipulating consequences. More times than not it either doesn’t help, or makes things worse. It often ends up not reducing the conditions presenting the behavior, but usually ends up invalidating the child. Often we are acting out of frustration when we ourselves are feeling inadequate. Just like the child who needs to “control” when feeling inadequate, us adults will do the same when feeling incompetent.
In my 30 years in the field, I’ve found that if we change the conditions around the child so he feels safe, accepted, and competent, then every child grows and develops. Problematic behavior occurs when we put the child in situations for which the demands of the situation outweigh the child’s current skills for dealing with them. Either the child feels insecure, unaccepted, or incompetent in dealing with the current demands. When the child feels (1) safe and secure (physically, socially, and emotionally), (2) accepted, respected, and valued, and (3) competent in tackling the current demands, then problem behavior subside, and adaptive growth occurs. This is why the current “positive behavior supports” systems are mandated (but rarely used correctly) in our school systems. Positive behavior supports are strategies to lessen the stressors, accommodate for vulnerabilities, match demands to current abilities, and teach better skills for dealing with the social and emotional demands.
So, my request of you is to use this model as a litmus test when evaluating strategies that professionals, teachers, family and friends recommend to use. Ask yourself (and them) “In what way does this strategy help my child feel more safe, accepted, or competent?” If they want your child to loss privileges, force them to stay in situations that are overwhelming them, suspending them from school, or pressure them into compliance, ask them “In what way does this procedure support my child to feel safe, accepted, and competent.” If it doesn’t help support one of those three things, then be very cautious. Most likely the procedure will just invalidate the child even more, and lead him or her to feel even more incompetent than they already feel. If the procedure doesn’t (1) lessen stressors, (2) change demands, (3) accommodate vulnerabilities, or (4) teach better skills, it probably is not a good procedure to use. Whatever strategy that is used, ask yourself how does it support my child to feel “safe, accepted, and competent.” If it does, then you cannot go wrong. Everyone will benefit, feel more competent, and grow more connected with each other. This litmus test is simple, and accurate
Saturday, November 5, 2011
Data is your friend
This week I found myself in a very emotionally-charged meeting. Several team members were advocating what I perceived to be drastic changes in a student's program based on concerns they had. A closer look at the data indicated that overall, things were looking pretty good for the student. The concerns that team members had were based on a couple difficult situations but did not represent a consistent pattern of behavior.
When students are having difficult moments, it's important to remain calm and focused and intervene as necessary to keep everyone involved safe. Programming decisions should be made based on patterns of behavior and not isolated incidences. To this end, teams need to take data and utilize this objective information, not emotionally-charged reflections, to guide programming decisions.
Need a good review of data collection methods, including some handy printable data sheets? Check out this useful and informative website on the topic.
When students are having difficult moments, it's important to remain calm and focused and intervene as necessary to keep everyone involved safe. Programming decisions should be made based on patterns of behavior and not isolated incidences. To this end, teams need to take data and utilize this objective information, not emotionally-charged reflections, to guide programming decisions.
Need a good review of data collection methods, including some handy printable data sheets? Check out this useful and informative website on the topic.
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