A New Year, A New Approach to Challenging Behaviors

Editor’s Note – The following post was written by Louise Buchholz Southern, M.Ed., BCBA, Training Specialist for the Autism Society of North Carolina (ASNC).

As professionals working in the field of Autism Spectrum Disorder (ASD) intervention and as parents of individuals with ASD, it’s likely that we have all experienced challenging and persistent behaviors. These behaviors come in many forms including aggression, property destruction, non-compliance, and self-injurious behavior, to name a few. When we experience these behaviors in an individual with ASD, one of the first questions we should ask ourselves is, “What is the individual trying to communicate with this behavior?” What want, need, confusion, or fear is the individual trying to express? As one individual with ASD stated, “You can’t not communicate. Everything you say and do or don’t say and don’t do sends a message to others.”

Some behaviors take us by surprise, and seem to appear without any cause. However, if we operate under the assumption that there is always a reason for the behavior, we are more likely to take the action necessary to change behavior. Changing someone else’s behavior always requires a change in our own behavior first. So as the New Year begins and as we continue to face challenging behaviors, let’s assume that behavior is always meaningful and let’s ask ourselves these questions:

• Does the individual have a way to communicate his/her wants, needs, and choices all of the time and across contexts? In order to teach an individual the power of communication, we cannot compartmentalize their communication to certain parts of the day or to certain locations (e.g. only when the instructor directs the individual to a choice board that is affixed to the wall).
• Even if the individual is “verbal,” does s/he functionally communicate? For example, some individuals script from TV shows, or they repeat back what they hear rather than responding. Some individuals are nonresponsive to anyone other than people with whom they are very familiar. Some individuals use language that does not seem to make sense given the context. Some individuals label everything, but don’t use language to express wants or needs, or to respond to questions and statements. In all of these examples, while the individual is “verbal,” we need to explicitly teach and reinforce functional communication.
• Note: ASNC’s Training Department is preparing to launch a functional communication training workshop this spring. In addition, the Autism Internet Modules website http://www.autisminternetmodules.org offers a range of free trainings on evidence-based practices such as functional communication training and the Picture Exchange Communication System (PECS).
• Have we identified a behavior that we can teach and reinforce to replace the behavior that we don’t want to see?
• Are we effectively reinforcing those behaviors that we want to see? Are we applying consequences that are actually reinforcing /motivating to the individual? Are we reinforcing the appropriate behavior consistently, and are we making sure that the individual understands the connection between behavior and consequence (reinforcer)? Are we attending to (and reinforcing) those behaviors that we want to increase significantly MORE than we are attending to those behaviors that we want to reduce? Are we missing opportunities to reinforce the individual when s/he is doing what is expected?
• Are we delivering instructions/information in a way that the individual with ASD can understand?
• Are we visually structuring academic, leisure, and work activities so that the individual understands what to do, how much to do, when finished, and what next? Many individuals with ASD experience significant anxiety and frustration when they don’t understand the expectations, the “rules” of the game, or when the activity will be finished.
• Has there been a change to the routine or has something unexpected occurred? How can we better prepare the individual for these inevitable events?
• Does the individual have a strategy in place to regulate his/ her sensory needs? What self-calming activities do we need to explicitly teach? How does the individual indicate that he needs a break?

For more information about support services available to individuals, families and professionals through the ASNC Training Department contact Louise via email at lsouthern@autismsociety-nc.org.

For titles related to challenging behavior please visit the Autism Society of North Carolina Bookstore located at www.autismbookstore.com.

Staying 2 Steps Ahead: Safety in the Community and at Home

This week’s Blog post comes from Autism Society of North Carolina Parent Advocate/Trainer Judy Clute.

Parents worry about their children’s health, happiness, and well-being, but parents of children with autism spectrum disorder (ASD) must look at their environment closely and take great care to ensure that their kids are safe both inside and outside the home. Why is safety for the person with ASD different from any other safety measures you would put in place for any child? Here are some things to consider:

• Communication – Whether there is a lack of language or whether language is limited, this is the top reason we need to think ahead for our family members with ASD. Can they communicate to someone if they are lost or hurt? Will they be able to ask for help? Even if they are verbal, will they be able to communicate appropriately and effectively?
• Judgment – Consider that sometimes people with ASD have poor judgment. They may not recognize who is safe to go to for help. Do they know where to seek out help? Do they know who in the community is safe to go to?
• Sensory issues – People with ASD may run toward something of interest (ie: a train, a sign, music, water) or run away from something that is overwhelming (i.e. : music, loud sounds, too much commotion, lights). Needless to say, this can be a safety issue.
• Problem solving skills – Such skills may be impaired by rigid thinking, lack of perspective and/or anxiety. If your child were lost or hurt, would they know what to do next?
• Different learning styles - How can you teach your child about safety issues? Because of poor communication skills, many individuals with autism cannot share information verbally, some use visual cues, some use technology. How can they use these things in case of an emergency?

Children with ASD can be much more impulsive than neurotypical children. They may run away or wander off more than their typically developing peers. This can put them in greater danger of becoming lost, getting hurt, and becoming vulnerable to strangers. So what can we do?

“An ounce of prevention is worth a pound of cure” but for parents of a child with ASD, it may feel more like a pound of prevention is needed. But the saying holds true, it’s better to prevent a problem than trying to fix it afterwards. Here are some tips for caregivers to consider:

1. Do not isolate yourself – Inform you neighbors about your child or family member with ASD. Educating your neighbors about your child and their challenges can help if he/she ever wanders out of your home or yard. Give them your contact information and let them know what your child likes and dislikes.
2. Contact first responders – Go to your local police station, fire station, and EMS. Take a current photo of your child along with a personal information handout (available in the ASNC Safe in the Community Kit). Include as much detail as possible about your child.
3. Plan and rehearse – Does your loved one with ASD know what to do in case of a home fire? Are you prepared? The National Fire Protection Association has a great website that can help you and your family member with ASD be prepared. Their website has activities for children and a social story that can be individualized for your child. Another important skill to know involves teaching your child when and how to call 911.
4. Securing your home – Consider putting safety items in place such as a home security alarm system, window locks and/or alarms on windows and doors to alert you if someone is trying to open them. Sometimes putting a “stop” sign on doors and windows can prevent a person with ASD from going any farther. If your child runs or wanders, consider putting a fence around your home with locked gates. If you have a pool, make sure the pool is not accessible without supervision. Teaching you’re child to swim is important, but it isn’t a guarantee that it will save someone from drowning.
5. Communicate with your school – Discuss with your child’s teacher your concerns about your child’s safety. You may want to suggest that they offer a “Safety in the Community” workshop or other such training. Make safety part of his or her IEP goals. Work on how to safely cross the street, learn to recognize street signs (like “STOP”), and discuss who is a safe person and who is a stranger.

The Autism Society of North Carolina’s “Safe in the Community Kit”

The Autism Society of North Carolina can provide you (free of charge) “Safe in the Community” kits that contain some simple stickers to put in your windows to let first responders know if there is someone in the home with ASD. This simple sticker can make a huge difference in case of emergency. The kits include personal information sheets that can be shared with caregivers, first responder agencies, and others as well as ID cards that you can teach your child to carry with him or her at all times.

Kit Contents

Here are some great websites for resources to help you keep your ASD family members safe.

• www.AutismSociety-NC.org — We can help with education, resources and provide “Safety in the Community” kits
• www.mypreciouskid.com – has safety items for home and community (i.e. Signs, ID bracelets, home safety items)
• www.AWAARE.org – has several caregiver resources and tips

Adult Issues
What about adults with ASD or those with High Functioning Autism or Aspergers? These people may have wonderful spoken language but may not respond appropriately to a first responder or neighbors. They may be anxious or afraid. It is important to teach these individuals what to say in the event they are lost or hurt. They should be taught who they can trust – like a police officer, a fireman, a teacher. Introduce them to neighbors and family members that you trust. Help these individuals learn to self-advocate.

Another thing to consider is bathroom etiquette. You may wonder what this has to do with safety? Well, does your child go to the bathroom in restaurants or public parks by themselves? Most women do not realize that there is different bathroom etiquette for men than for women. Women frequently make conversation with others they may not know in a public restroom. This is not true for men. Children, especially boys, need to know not to talk to strangers in public restrooms and what to do if a stranger approaches them. Again, do they know who a stranger is? If not, teach them. They need to know how to address or respond to a policeman? They may be in a situation where it would be important to disclose that they have autism and need help. Teaching self-advocacy skills is extremely important.

Another consideration is internet safety. Many individuals have poor social skills and social judgment. For these individuals safety measures should be put in place to manage internet access – whether at home, school, or in the work place. If you have a child/young adult who is visual, place instructional picture cards directly on the computer. If they can read and understand written language, keep those rules right next to the computer and negotiate an internet use contract. Check with your ISP on safeguards. The NC Department of Justice has a website that contains several safe guards for internet safety: http://www.ncdoj.gov

Be proactive! Contact the Autism Society of North Carolina and let’s work together to keep our children and loved ones with ASD safe and sound.

Judy Clute is a Parent Advocate/Trainer in the ASNC Raleigh office. If you have any questions or concerns, please do not hesitate to contact her by email at jclute@autismsociety-nc.org or call 919-865-5091.

Teaching Life Skills and Building Self-Esteem

Image courtesy of DrMommyOnline.com

 

Editor’s Note – The following article was written by Kathleen Dolbee, mother, educator, and Autism Society of North Carolina Parent Advocate.

Teaching your son or daughter to do household chores is an important part of teaching them independent living skills. Be careful not to presume that your child already knows how to do a job, simply because he has seen you do it. Remember, our kids are visual learners and sometimes have difficulty sequencing the steps of a particular job.

Patiently teach your child, step by step. Using visual supports doesn’t always mean writing a schedule.

For instance, if you want your child to pick up his toys (Lego’s, for instance), try breaking the job into smaller pieces. Try using a Hula Hoop or even a broomstick to segment the job into more easily managed task. Give him a clean dustpan and teach him to scoop and dump into a bucket “just like a construction machine”. You can even do the sound effects if that helps get the job done. Taking turns tossing stuffed animals into a bin could teach turn-taking and organization at the same time.

Vacuuming becomes easier when the carpet is sprinkled with something that will help your child see where to vacuum and to know when he is finished (I used the round circles left by a hole punch).

Start off with simple tasks like watering the plants, putting books or videos on a shelf or wiping the table. Make it a game! Masking tape in a child’s hand is a great way to pick up little messes without dragging the vacuum out. A game that is my personal favorite in the classroom I named, “The Dirtiest Wet Wipe Wins”. Each child is given a clean wet wipe and the fun begins!

Just remember:

1.  Teach the skill.
2.  Make it visual.
3.  Share the load.
4.  Make it fun.

Many thanks to Kathleen for sharing this article. Beginning this month the Autism Society of North Carolina Blog will begin adding content on a more regular basis. The new posting schedule includes:

• 1st full week of month – Parent/Family Advocacy
• 2nd week of month – Training, Treatment, & Best Practice
• 3rd week – Events, activities, and observations
• 4th week – Legislative Advocacy and Policy Issues