BBB AUTISM SUPPORT NETWORK/AUTISM SOCIETY ONTARIO YORK REGION CHAPTER...present...

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Hi Everyone!

Challenging behaviours is a topic that comes up weekly at BBB Autism Support Network.  If you are interested in changing inappropriate behaviours, this issue is for you!

Many of us know (at least in theory) about the “Functional Behavioural Assessment” a.k.a. the ABC method.  This issue of the e-news will attempt to demystify this method and put it into terms that will help you utilize it easily.  Before too long, it will become second nature.  You don’t have to employ a full-blown ABA program in your home to use this behavioural strategy.  It works well in a variety of settings (it is an excellent strategy for teachers) and works well for typically developing very young children as well. 

You do need to know that “behavioural intervention” addresses many of the deficits of many kids. Research shows it addresses all of the deficits of some kids. But the glass that is half full is also half empty: the same data proves ABA does not address all of the needs of some children. And, there is no reliable way to predict how much behavioral intervention will do for your child. It is important to work with a consultant or educational team that is not only well qualified in ABA, but also understands and is familiar with interventions for learning disabilities.”[1]

We can’t get rid of all challenging behaviours.  Then again, if we did our lives would be pretty boring!

Bee Cool,   Liz

Behaviour does not occur in a vacuum; it serves a function for the individual.  Your child’s behaviour typically serves one or more of the following purposes:

It is important to determine the correct function of the behaviour so that your child can be taught an appropriate way of having these needs met.  If appropriate replacement behaviour is not taught your child will find another, usually inappropriate way, to have his/her needs met.  For this reason, it is equally important to focus on increasing the appropriate replacement behaviour while decreasing the inappropriate behaviour.

A=Antecedents:  The factors that occur immediately before the behaviour and provide the occasion for it to occur.  Antecedents are measurable and can be seen or heard (i.e. transitions, demands/requests/instructions, inattentiveness, changes, visual/physical stimuli).

B=Behaviours:  Actions that can be seen or heard.

C=Consequences:  The factors that immediately follow the behaviour and are related to the behaviour (i.e. immediate responses from people, the environment or an internal response that is not observable).  Consequences determine whether the behaviour will occur again.

By establishing what comes directly before the behaviour (antecedent), you can figure out what the trigger is.  By establishing the reaction to the behaviour (consequence), you can figure out the ‘pay off’ or the rewarding aspect of the behaviour.

Noting the start and end times of the behavior will help you to determine if behaviour is improving or worse. Before the behavior is completely extinguished, it will typically get much worse, peak, and then extinguish itself. This is called an extinction burst.  Do not be discouraged.  Work through the extinction burst to see results.

Use the chart to establish a pattern (the ‘setting’ and ‘activity’ columns will aid in this), and then change the antecedent and consequence to extinguish the behaviour.

You can customize this chart by adding the names of individuals present when the behaviour occurs and can also keep track of the intensity of the behaviour.

Charley is a 5 year old boy with PDD-NOS.  Charley speaks quite well and can usually articulate his needs, but tends to become frustrated very easily.  Every day, Charley comes home from school and runs into the kitchen.  He immediately throws himself on the floor and begins tantruming.  Charley’s mom works from home and is usually quite busy during this time of day so older sister, Ruth (11) is in charge.  Ruth yells at Charley to stop; she tries to tempt him with cookies and videos, but nothing seems to work.

After about an hour of this, Charley’s mom, unable to continue working, comes down stairs and fixes the kids some chocolate milk.  They sit at the kitchen table and talk about their day.  Charley calms down and takes joyful part in this exchange.

Charley’s father arrives home from work at 5:15 every day, at which time Charley is quite well-behaved (even if mom and Ruth are exhausted!).  The family noted that Charley’s tantrums did not occur during the weekend when daddy was home.

This is a small sample of data taken over a 2 week period.  As noted above, the family thought initially that daddy’s presence was the consequence to Charley’s behaviour; Charley would come home from school and scream until mommy calmed him down and told him daddy would be home soon. 

Although this was very observant of the family, the chart uncovered a different story:  It was the ritual of sitting at the kitchen table, drinking chocolate milk with his mom and sister that was calming Charley down.

The family changed the antecedent by having their drink and talk as soon as Charley came home from school.  Now Charley’s tantruming is not being rewarded with chocolate milk and mommy – the reward actually comes before the behaviour even starts.

Mommy spends 20 minutes with the children, then goes upstairs to work and Charley and Ruth settle down to homework.  Mommy gets her work done in a much less stressful state of mind.  This also results in daddy coming home to a calmer environment.

There was initially an extinction burst where Charley’s behaviour worsened before it got better.  The family did not provide reinforcement for this; they ensured his safety but did not speak to him while doing so.  They did not provide the attention Charley was seeking in direct response to his tantrums.

All members of the family reinforce Charley’s appropriate behaviour with treats like high fives, hugs, and free time.  Thus the appropriate behaviour is now being rewarded and this increases the likelihood of it being repeated.

Fiona is a 10 year old girl who is very severely affected by autism.  She is non-verbal and often exhibits behaviours that her parents find difficult to interpret.  Lately, she has started licking the sliding glass doors in the basement of her home.

The family doesn’t know what to do; they would like to get rid of this behaviour which is happening with more and more frequency.  Fiona only stops licking when she is let outside to run around in the backyard. Daddy goes outside too and produces a lollipop with the idea that, when Fiona has the lollipop, she can lick the glass.

The family was on the right track by trying to redirect the behaviour, but on further analysis, they discovered that the true reward for Fiona wasn’t the lollipop; it was going outside to run around. 

The solution seemed to be to allow Fiona access to the backyard to run around whenever she felt the urge, but obviously there would be times this would be inappropriate.  The family began scheduling ‘outdoor time’ on Fiona’s picture activity schedule and being sure to let her know when this time was coming up.  Scheduling this activity before ‘down time’ seemed to work best.

There was an extinction burst but the family solved this by using the “Premack Principal”.  This employs the use of picture cards and communicates the idea that a pleasurable activity will follow a less-pleasurable one:

It may be necessary to temporarily avoid triggering events until your child learns the needed replacement skill(s); for example, avoiding the candy aisle until your child learns the steps required to earn candy and has acquired an increased tolerance to “No” type responses. 

The function of the behaviour can also be determined by completing the Durand Motivational Assessment Scale (see http://www.monacoassociates.com/mas/aboutmas.html).  The scale will establish whether your child is seeking:

1. attention
2. escape
3. tangible
4. sensory

With this information, we gain more insight.  Charley’s behaviour was used to gain attention from his mom, while Fiona’s was sensory seeking (she loved the feel of running around). 

1. Only work on one behaviour at a time
2. Take data for at least two weeks
3. Take data to establish improvements and extinction bursts of the behaviour
4. The longer the behaviour has been rewarding for the child, the longer it may take to extinguish
5. Just because the consequence doesn’t look rewarding to you, doesn’t mean it isn’t rewarding to your child
6. If aggressive, destructive or self injurious behaviour occurs, contact a behavioural consultant or autism specialist immediately
7. Always rule out physical issues by taking your child to the doctor and dentist
8. Some seemingly innocuous behaviours can become concerning; for example: scratching at a mosquito bite can cause the skin to become inflamed and infected!

This type of behavior can be characterized by any behavior, which causes bodily harm to the individual.  The most commonly observed self-injurious behavior can include head banging, hand biting, and excessive scratching or rubbing. Problems may occur due to some individuals with ASD having a high tolerance to pain.

There are two main sets of theories as to why people engage in self-injurious behaviors:

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