Communication deficits are a central trait of autism spectrum disorders from birth. As a result, individuals can experience challenges when trying to express their needs throughout their lifespan. Individuals with autism often develop coping behaviors to express themselves. These coping behaviors frequently include a negative-attention aspect since, typically, negative behaviors will generate a faster response. Some commonly observed negative-attention seeking strategies include:

  •  Self-Injury
  •  Aggression
  •  Property destruction
  •  Tantrum behavior 
  •  Disruptive behavior
  •  Noncompliance
  •  Repetitive behavior/stereotypy

There are many reasons why an individvual with autism may engage in one of these behaviors and before creating a treatment plan, it is important to perform a functional behavioral assessment to understand the underlying problem. Once you understand the context around the behavioral issues you can begin to craft an intervention plan for your loved one with autism.

The strategies listed below are commonly used to treat behavioral issues in individuals with autism.

behavioral issues autism

Prevention strategies for behavioral issues

Prevention strategies are used to alter the events that can lead up to a problem behavior. These strategies help the individual with autism prepare for something that they find unpleasant or unfamiliar. As a result, the problem behavior less likely to occur. These strategies include: 

1) Visual schedules

Visual schedules are picture sequences that show a visual outline of a sequence of activities. This can be used to outline an individual task, the tasks in a day, or the individuals schedule for the week.

Visual schedules can help make tasks more predictable and less overwhelming. They also enhance the individual’s sense of control over the environment by preparing them for upcoming events and transitions. 

2) Advanced warnings with timers or countdowns

Timers and countdowns give an individual time to prepare and help to make transitions a gradual process rather than an abrupt ending.  Scheduled times for play and desired activities can enhance the individual’s sense of control. Timers and countdowns help increase predictability and can reduce the frustration associated with transitions.

3) Priming/social-stories

Priming is a way of previewing future events. This can be done using a social story or video footage of the setting to show the environment as the individual would see it. (i.e. using a video of an airport to prepare to take a family vacation)

4) Providing frequent choices within a task

Providing choices can give an individual the opportunity to become an active participant in the situation, rather than a passive and helpless bystander. This can also help increase motivation. (i.e. choosing the location to do homework, choosing to do homework with mom or dad, choosing which kind of pencil to use, etc.) 

For individuals that are non-verbal, choices can be made using picture boards.

5) Embedding disliked tasks in enjoyable tasks

Embedding allows the individual to intersperse highly preferred, easy tasks among more difficult and disliked ones. Some examples of embedding could be taking two or three bites of favorite food and one bite of the new food or doing two easy math problems and then one hard one.

6) Incorporating perseverative interests

A perseverative interest is an object, activity or topic with which an individual is intensely interested in or even preoccupied with.

Incorporating perseverative interests gives an individual the opportunity to complete a task that they don’t like in the context of something they do like. (i.e. handwriting book exercises replaced with copying instructions from preferred movies or video games or incorporating Legos or other favorite toys into math assignments).

7) Generalized reinforcement

Generalized reinforcement allows the individual to pair an aversive situation with a wide variety of highly preferred tangible, activity or social reinforcers. 

This ultimately makes the formerly aversive situation become something that they look forward to. (i.e pairing a staff member or teacher the individual with autism does not respond well to with tangible items or social activities that the individual loves)

Replacement strategies for behavioral issues

While preventative strategies are helpful, especially at the beginning of an intervention plan, they should not be relied on completely.

Replacement strategies are used to teach an individual how to cope with unpleasant situations and gain their desired outcome. Teaching replacement strategies will help the individual rely less on the problem behaviors and help them meet their needs in more appropriate ways.

Replacement strategies can include: 

1) Functional Communication Training

Teaching communication skills can help the individual with autism express what they want without resorting to tantrums, self-injury or other behavioral issues. The most important part of this skill is to identify the specific need that is causing the outburst and teaching the individual a more appropriate response for that need.

For example:

  • For outbursts related to attention teaching how to ask, “Am I doing a good job?”
  • For outbursts related to escape teaching how to say “I need a break.”

For individuals with limited speech, you can teach them to use one word instead of several (i.e., “iPad” instead of “I want the iPad”)

For more extreme problems with speech, augmented communication devices or picture aids can be helpful.

2) Coping skills

Coping skills can include relaxation exercises such as deep breathing or progressive muscle relaxation.

Individuals can also benefit from positive self-reinforcement (i.e. teaching the individual to say to themselves “I can do it! or “Mom will be so proud of me.”)

Teaching the individual to think of something pleasant, such as a favorite cartoon, during an unpleasant situation can also be helpful.

3) Tolerance for delay of reinforcement (waiting)

When you first start to teach communication skills, it is important to honor the individual’s request immediately and consistently when they ask for it. Otherwise, they will understand that the problem-behavior is a more effective way to get what they want and will continue to use it.

However, after a few weeks of successful communication, you can begin to introduce delayed reinforcement. For example, if the individual asks for a break, ask them to finish one minute of the task first. Then, slowly build on this by gradually increasing the waiting time.

Timers and visuals are also helpful for this.

4) Daily living skills

Daily living skills can help the individual achieve what they want without assistance. (i.e. practicing motor skills to obtain the item that they want).

Response strategies for behavioral issues

Response strategies are consequence-based strategies that are used to reinforce good behavior. In other words, this involves altering the consequence that occurs after the problem behavior to make it less likely to occur. This also includes reinforcing positive behaviors to make them more likely to occur.  

1) Positive reinforcement

Positive reinforcement should happen right away when an individual uses an appropriate behavior in place of a problem behavior (unless of course, you are teaching waiting).

For example, if the individual asks for a break from doing homework instead of throwing a tantrum, reward them by giving them a break immediately.

This will ultimately teach them that using communication is more effective than bad behavior. 

2) Extinction 

Extinction is meant to draw as little attention to the problem behavior as possible so as not to reinforce it. For example, if a child bangs their head to get a toy, safely stop them from banging their head but do not give them the toy. 

Here it is also important to identify the specific cause of the problem so as not to accidentally reinforce the issue.

Stay calm, things may get worse before they get better

The beginning of any intervention can be difficult for an individual with autism and you may notice their behavioral issues get worse during this time. This is a tough phase for many families to get through but if you can slowly and patiently work through the intervention process, in the long term things will get a lot better. 

These behavioral strategies were collected from Lauren Moskowitz’s webinar on Assessing and Treating Behavioral Issues in individuals with autism. View the full presentation.

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