You’re Not Alone

Every parent of a child with autism knows about challenging behavior. Whether it is perseveration on a preferred topic, inflexible adherence to routines, difficulty with transitions, challenges with new people, places, or activities, to tantrums, aggression and self-harm, raising a child with ASD often comes with managing a variety of challenging behaviors. It’s so common in fact, that a Google search of “autism problem behavior” returns 45 million hits.

Parents often report that while their child works well with their ABA provider, following directions, waiting for their reinforcer, tolerating non-preferred tasks, etc., once the therapist leaves their child acts out. Why do some children respond well during treatment sessions, but act out when the therapist is not there? There could be several factors at play. Let’s look at a few of these.

Attention

During treatment sessions, your child has the undivided attention of the therapist, in addition to social reinforcement such as praise, smiles, high 5s, etc., and possibly other preferred rewards. Often, our kids act out for attention, regardless of whether the attention comes in the form of smiles and praise or corrections and scolding. While parents cannot provide undivided attention at all times, there are some strategies that can help.

Reward Positive Behavior

Catch your child being good. Rather than focusing on the negative behavior, and consequently providing attention to it, look for opportunities to celebrate and praise your child for good behavior. Whether she’s following directions, sitting quietly watching TV, doing homework, putting dirty clothes in the hamper, a plate in the sink, or anything else that you would like to see them do more often, take a moment and say “Good job putting your plate in the sink.” “Thanks for placing your clothes in the hamper.” “I love the way you are watching TV so quietly.” The opportunities are many and the more you praise specific behavior, smile, give thumbs up, hugs, etc., the more likely your child will be to engage in this type of “good behavior” in the future.

Avoid Rewarding Negative Behavior

At the same time, as much as possible and safety permitting, avoid attending to problem behavior. Practice the art of maintaining a neutral facial expression and tone of voice; parents often report that this is the hardest skill for them to master. If you need to attend to your child during problem behavior, do so without reacting. Focus on the child not the behavior. For example, avoid saying “Stop banging on the table.” Instead, redirect them quietly to another activity.

Avoid using negative words such as “no,” “stop,” “don’t,” “can’t,” etc. Instead of telling your child what they can’t do, tell them what they can do! For example, let’s say Jimmy is drawing on the wall, you can say “You can draw on paper or on the white board” presenting these options to the child.

Remember that whatever you are directing your attention to, is what you are going to get more of.

Choose Your Battles

During therapy sessions, your child may be working and behaving toward earning preferred activities or items. The ABA therapist will be using schedules, token boards, timers, breaks, functional communication training, and other techniques, to help your child succeed in learning new skills and earning those preferred reinforcers for their hard work. In contrast, it’s not always possible for parents to provide frequent rewards for following directions and good behavior to their child. There are however, a few tactics that can help.

If you do say “no,” you will need to follow through.

If we tell Jane to stop jumping on the couch, and she does not comply, we will need to go help her get off the couch (thereby inadvertently providing attention to the behavior). At the same time, Jane can escalate this into a tantrum. If we do not follow through and get her off the couch, we are essentially teaching Jane that when mommy or daddy tell her to do something, she doesn’t have to do it.

What if Timmy asks for his tablet during dinner and we say no, and he subsequently starts screaming (or engages in any other inappropriate behavior)? Do we give him the tablet when he escalates, thereby teaching him that he can get what he wants when he “turns it up?”

This “battle of wills” can easily turn into a constant stream of no’s, stop’s and don’ts, as the child engages in one maladaptive behavior after another to get attention, access to an item or activity, or to avoid doing a non-preferred task. Most significant is that the child, at best, learns that these negative words don’t mean anything, or worse, that their behavior is garnering attention from the parent, albeit negative. These words lose their value in the absence of follow up. Children quickly learn to tune it out or “turn it up.”

Therefore, it is recommended to choose your battles. If playing on his tablet during dinner is disrupting Timmy from eating his meal, or dinner is sacred family time, then by all means, no means no. However, if the parents themselves tend to check their phones during meals then perhaps this is not a battle worth putting your foot down for. In order to provide consistency to our children, we should consider which behaviors we will not accept, and are willing to follow through with, in order for the “No” to be meaningful to our child.

Antecedent Interventions

Antecedent-based interventions, commonly referred to as antecedent manipulations, are various evidence-based strategies that modify the environment in some way before the target behavior occurs. They tend to decrease the likelihood that problem behavior will occur and promote the opportunity for replacement or desired behavior to take place.

Effective antecedent interventions include utilizing functional communication training to help your child communicate effectively their needs and wants for items and activities, attention, help, or when they need a break, as opposed to engaging in maladaptive behavior; providing your child with choices regarding what they will do and when they will do it; using pre-teaching which entails providing reminders to your child that an event is coming up to ease with transitions from preferred to less preferred activities as well as changes in routines; using reward charts and token boards to encourage good behavior; implementing a behavioral contract with your child; using picture or written schedules, and utilizing visual count-down timers.

These several tips are not meant to be exhaustive. There are many evidence-based strategies that can be utilized to decrease problem behavior. Work with your BCBA® to determine your child’s triggers and the consequences maintaining his or her problem behaviors and consistently implement the behavioral interventions they recommend to decrease maladaptive behaviors and increase replacement behaviors.

Sources:

https://www.parents.com/kids/discipline/strategies/is-your-child-acting-out-or-just-acting-his-age/

https://www.attentivebehavior.com/aba-therapy/

https://www.autismspeaks.org/help-and-information/