Autism with Behavior Problems

Understanding Autism Behavior

To comprehend autism with behavior problems, it's important to delve into the types of behavior challenges usually associated with autism and the triggers that can lead to these behaviors.

Types of Behavior Challenges

Children with autism spectrum disorder (ASD) often exhibit a variety of behavior challenges. According to Autism Speaks, more than half of kids and teens with autism may display physical aggression towards caregivers or others, which can include hitting, kicking, and biting. These problems tend to occur more frequently if the child has sleep disturbances, especially if they wake up during the night. Younger children are more prone to hurting others, while older kids and teens are more likely to harm themselves, particularly if they have difficulties with speech.

Additionally, problem behaviors can include self-injurious behaviors, aggression, property destruction, non-compliance, and stereotyped (repetitive) behaviors as pointed out by the Marcus Autism Center.

Notably, these behaviors pose challenges not only to the children themselves but also to the people around them. As such, understanding these behaviors becomes crucial in managing autism effectively.

Triggers for Behavior Problems

While an autistic child's outbursts may seem to lack a clear cause, observing and recording the environment around and prior to these incidents can reveal triggers for such occurrences [1].

Factors such as hunger, noise, changes in routine, or specific triggers can lead to challenging behaviors in autistic children. These children might also display challenging behavior due to sensory sensitivities, social skills deficits, communication difficulties, or emotional regulation issues [3].

By paying careful attention to a child's actions and environment, parents and caregivers can start to understand the coded messages that the child is sending about things that are important to them [1]. This approach can lead to more effective ways to help the child and to respond more carefully to these behaviors, avoiding inadvertently reinforcing them.

Understanding the reasons behind these challenging behaviors is crucial in order to respond effectively and create a supportive environment for children with autism. The key lies in observation and interpretation of the child's actions, which, when decoded, can lead to a better understanding of their needs and necessities.

Managing Autism Behavior

Addressing and managing autism behavior problems requires a combination of evidence-based strategies, professional guidance, and patience. Here, we look at Applied Behavior Analysis, behavioral intervention strategies, and the role of behavior analysts in managing behavior problems in children with autism.

Applied Behavior Analysis (ABA)

Applied Behavior Analysis (ABA) is a treatment approach commonly used to address problem behaviors in children with autism. This method involves identifying the purpose of the problem behavior and developing treatments that encourage more appropriate means of communication or expression for the child [4]. ABA is a scientifically validated approach that uses positive reinforcement to encourage desirable behaviors and reduce those causing harm or interfering with learning.

Behavioral Intervention Strategies

Treatment for problem behaviors in children with autism often involves strategies such as providing immediate reinforcement, incorporating visual supports, breaking tasks into small steps, and gradually increasing expectations as the child succeeds.

In addition to these, other strategies to address challenging behavior include implementing consequences (positive or negative based on behavior), setting clear rules, providing downtime for sensory breaks, planning ahead for challenging situations, and fostering warm and caring relationships [2].

Working with Behavior Analysts

To effectively guide parents in addressing and managing problem behaviors in children with autism spectrum disorder, consulting with a board-certified behavior analyst (BCBA or BCBA-Doctorate) or a psychologist experienced in behavioral interventions is recommended.

These professionals can provide a thorough behavioral assessment to understand the triggers and consequences of challenging behaviors. They can also develop individualized behavior intervention plans and train parents to implement these strategies at home. If previous strategies have not been successful in addressing the behavior, seeking professional help from a pediatrician or psychologist can be beneficial.

In essence, managing autism with behavior problems requires a comprehensive approach involving structured interventions, strategic planning, and collaboration with experienced professionals. By implementing these strategies and resources, parents and caregivers can help children with autism improve their behavior and reach their full potential.

Intervention Approaches

Addressing autism with behavior problems involves a range of intervention approaches. These methods are primarily aimed at enhancing the abilities of individuals with autism spectrum disorder (ASD) while reducing challenging behaviors. Three effective interventions that have been studied extensively include Early Intensive Behavioral Intervention (EIBI), Cognitive Behavioral Therapy (CBT), and Parent-Mediated Intervention (PMI).

Early Intensive Behavioral Intervention (EIBI)

The foremost type of intervention for ASD individuals is Comprehensive Early Intervention, often referred to as Early Intensive Behavioral Intervention [5]. EIBI is a treatment approach based on the principles of applied behavior analysis (ABA). It is usually implemented intensively (20-40 hours per week) and involves individualized instruction to improve various areas of functioning.

EIBI has been found to be effective in improving intelligence and adaptive behaviors among ASD individuals. It's also reported to show promising results when packaged for implementation by nonspecialists, such as parents trained to use ABA interventions to prevent or reduce problem behavior [6].

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is another intervention method that has demonstrated effectiveness in managing emotional difficulties in individuals with autism [5]. CBT is a type of psychotherapeutic treatment that helps patients understand the thoughts and feelings that influence behaviors.

Although access to CBT is often limited due to a shortage of trained experts, its focus on problem-solving and communication makes it a valuable tool in managing autism with behavior problems. It is especially effective in addressing social skills, communication, and reducing sleep, eating, and toileting problems.

Parent-Mediated Intervention (PMI)

Parent-Mediated Intervention (PMI) is a unique approach that involves parents acquiring knowledge and specific skills to improve their child's functioning or reduce challenging behaviors. This intervention goes beyond the child and empowers the parents to play an active role in their child's development.

PMI has been shown to be effective in improving children's communication skills, expressive and receptive language, and adaptive behaviors. Additionally, it has been found to positively impact parental adjustment and mental health, making it a holistic approach to managing autism with behavior problems.

In conclusion, these intervention methods provide a multi-faceted approach to managing autism with behavior problems. Each method has its strengths and is most effective when tailored to the individual needs of the child. It's essential to consult with a healthcare provider or a trained professional to determine the most suitable approach for each child.

School-Based Support

School can play a pivotal role in managing autism with behavior problems. The environment offers structured routines, social interaction opportunities, and professional guidance, which can be critical in shaping a child's behavior. Two key aspects of school-based support are the Individualized Education Program (IEP) and Behavior Intervention Plan (BIP).

Individualized Education Program (IEP)

An Individualized Education Program (IEP) is a document developed for each public school child who is eligible for special education. The IEP is created through a team effort and reviewed at least once a year. For children with autism, the IEP can include services to address problem behaviors, with the guidance of a behavior analyst.

The IEP outlines the child's learning needs, the services the school will provide and how progress will be measured. Several people, including parents, teachers, and other school staff, work together to develop and implement the IEP to help the child achieve academic success.

Behavior Intervention Plan (BIP)

A Behavior Intervention Plan (BIP) is a plan that is based on the results of a functional behavioral assessment (FBA) and, at a minimum, includes a description of the problem behavior, global and specific hypotheses as to why the problem behavior occurs and intervention strategies that include positive behavioral supports and services to address the behavior.

For children with autism, specifically, a BIP can be developed to target specific problematic behaviors. This plan is often part of the child's Individualized Education Program (IEP) [4].

The BIP outlines:

Target behaviors that need to be addressed
Triggers or events that typically lead to the occurrence of the behavior
Prevention strategies to avoid the triggers
Teaching of replacement behaviors that serve the same function for the child
A reward system to motivate the child to use the replacement behaviors
A plan for how and when the intervention will be faded to more natural supports.

The development and implementation of the IEP and BIP require close collaboration between parents, school staff, and, in some cases, the child's healthcare provider. The child's progress should be continually monitored and plans adjusted as necessary.

School-based support is a key component of managing autism with behavior problems, but it's important to remember that each child is unique and what works for one child may not work for another. Therefore, these plans should be tailored to meet the specific needs of each child.

Strategies for Parents

Navigating the challenges of autism with behavior problems requires understanding, patience, and strategic planning from parents. Key areas of focus are recognizing sensory sensitivities and building positive behavior skills.

Recognizing Sensory Sensitivities

Sensory sensitivities are common in individuals with autism and can significantly impact daily activities and interactions. Some individuals may be hypersensitive to sensory input, while others may be hyposensitive. These sensitivities can affect various senses, including touch, taste, sound, smell, or sight.

Understanding and recognizing these sensitivities are crucial as they can lead to sensory overload and potential meltdowns, impacting routines and relationships. Recognizing sensory sensitivities can also help parents identify specific triggers for challenging behaviors. For example, autistic children might exhibit challenging behavior due to factors such as hunger, noise, changes in routine, or specific triggers [2].

Building Positive Behavior Skills

Equally important is helping autistic children build skills for positive behavior, including communication, emotional understanding, social skills, and practical daily living skills. It is through understanding and communication that parents can guide their children towards positive behavior [2].

Strategies to address challenging behavior in autistic children can be multifaceted. These include:

Implementing consequences (positive or negative based on behavior)
Setting clear rules
Providing downtime for sensory breaks
Planning ahead for challenging situations
Fostering warm and caring relationships

These approaches aim to create a supportive environment conducive to learning positive behavior.

However, it is crucial to note that using physical punishment, such as smacking, is not recommended for guiding behavior in children with autism. This approach does not promote learning about self-control or positive behavior. Moreover, it can potentially worsen behavior and harm the child.

As parents of children with autism, it's essential to equip oneself with the understanding and strategies needed to navigate the complexities of autism with behavior problems. By recognizing sensory sensitivities and building positive behavior skills, parents can help their children thrive.

Seeking Professional Help

Navigating the world of autism with behavior problems can be challenging for parents, particularly if multiple strategies have been attempted without success. In such cases, seeking professional help can provide much-needed guidance, support, and access to appropriate interventions and therapies.

Consulting Pediatrician or Psychologist

Consulting a pediatrician or psychologist experienced in behavioral interventions can be quite beneficial for parents dealing with challenging behavior in autistic children. These professionals can provide a fresh perspective, help identify underlying issues, and suggest new strategies or interventions that might be more effective.

In addition, a board-certified behavior analyst (BCBA or BCBA-Doctorate) can offer specialized knowledge in addressing and managing problem behaviors in children with autism spectrum disorder.

It's important to remember that managing autism behavior problems isn't about eradicating all unwanted behavior, but rather about understanding the function of the behavior, teaching alternative behaviors, and creating a supportive environment.

Importance of Professional Guidance

Professional guidance is not just about managing the behavior of the child with autism. It's also about providing support and guidance to the parents and family, which can contribute to the overall well-being of the family unit [7].

Professionals can help parents understand the triggers for their child's behavior, develop effective coping mechanisms, and build a network of support. They can also connect families with resources and services in their community that can assist in managing autism behavior problems.

Moreover, a professional can help monitor the progress of the child and adjust the strategies as needed. This continuous evaluation ensures that the interventions remain effective as the child grows and their needs change.

In conclusion, managing autism with behavior problems can be complex, but with the right help and guidance, it's possible to navigate these challenges. Don't hesitate to seek professional help if you're feeling overwhelmed or if previous strategies aren't yielding the desired results. Remember, you're not alone, and there are resources and professionals ready to assist.