We regularly get queries from young parents asking for support to understand the behaviour of their wards suffering from Autism Spectrum Disorder and the behaviour difficulties faced by the affected children.
Children suffering from ASD have behaviour issues which are quite common. These issue relate to more about their communication, social interaction,working within the structured schedule and processing of the sensory information.However if parents are trained and equipped with the appropriate strategies , much of the stress and strain can be reduced bringing relief to the family and the child.They can often be managed through effective activity and behavior management.
There are many difficulties, ASD children face in their behaviour. These issues can be identified as difficulties in communication, issues of sensory processing, social interaction, and physical balance issues that can make active play more difficult for these kids. Parents and caregivers need to understand that such behaviours as appear inappropriate are in reality symptoms of the difficulties the child with ASD is facing in his her day to interaction and communicate with others .
Understanding the Causes of Inappropriate Behaviour
The main causes of behavioral difficulties are generally as follows:
Difficulties with communication: Children with ASD struggle with both verbal and expressive language, understanding what is being said to them, and comprehending non-verbal communication cues. This can, become quite frustrating for both the communicator and the child .The child may not be into problem behaviour but to the other person it would appear so ,which causes frustration at both ends.
Difficulties with social situations: The difficulties presented by social situations for a person with ASD are much more than mere communication; people with ASD struggle to understand others’ points of view and grasp the “unspoken rules” of social interaction that state when to, begin and when end a conversation. They are in no position to get the emotional nuances of social communication. Due to all of this, children with ASD may avoid social contact, and they are more likely to experience being harrassed and feel overwhelmed by unnecessary intervention by others in their life .
Difficulties with unstructured time: People with ASD have a hard time dealing with situations where there is no set schedule, as their brains have a hard time sequencing activities on their own out of the given timetable and schedule. Due to this some of the children with ASD are more likely to act out during the period which is not scheduled earlier eg.free period or suddenly declared break times, as they feel confused and frustrated.
Difficulties processing sensory information: Those with ASD often have over or under-sensitive senses, leading to a tendency to get overwhelmed or to seek attention to such a degree that it becomes embarrassing for the accompanying parent and the person interacting with the child.. ASD affected child may react strongly to an unwanted touch, be very selective and particular food eater, get largely disturbed and irritated by loud noises ( be it a noise coming from far off .The child feels unable to concentrate on account of background noise and reacts adversely.
Additionally, one should always remember that people with ASD do not easily adapt to change.Parents managing their ASD ward should be aware of the changes being brought about in their environment or schedule that can trigger problem behaviours.A sudden bout of Illness (especially seizures, which ASD individuals may be prone to) can also trigger adverse reactions as the child with ASD cannot give verbal expression to his or her pain. Doctors advise parents to use picture posters or diagrams to help children express where they are feeling pain.
Dealing with Problem Behaviour
It’s key to understand that the child is using these behaviours to try to communicate something to you, or to achieve some specific function. It’s vital to look under the surface of these behaviours so as to discover the unaddressed needs below. Try to asses what you child is trying to tell you, rather than reacting to the behaviour itself (resist “punishing”; few ASD children actually understand the cause and effect implied by it). It’s also advised to keep a “behaviour diary” or chart so that one can identify patterns in a child’s behaviour and from there, isolate what’s triggering the child’s episodes. One can then develop strategies to avoid or manage the triggers (be sure to introduce these slowly, as sudden changes in routine will do more harm than good). Likewise, expect the child to initially resist the change; stay patient and be consistent with it regardless, and make sure that other family members, teachers, and caregivers are also keeping consistent with it.
One should also develop supportive therapies to help the child shed his or her frustration; these typically include: exercise, brief time out periods in a quiet, darkened space, and relaxing activities. Set achievable treatment goals and don’t push too hard for rapid improvement, as people with ASD can struggle to integrate new knowledge and change behaviours.
To get the best out of a child with ASD, it’s often helpful to employ the following strategies:
- Speak clearly and precisely (and use short sentences) in order to work around the difficulties that arise with complex verbal communication.
- Use visual supports. Many children with ASD process visual information more easily than other forms of information. Timetables can be helpful to assist children in understanding schedules.
- Create “social stories”. These are brief descriptions (using words and images) of situations, events, or activities that help tell a child with ASD what to expect during an upcoming social situation.
- Help the child identify his or her emotions. This is often challenging to a child with ASD; use visual aids (such as “stress scales”) to help the child quantify what he or she is feeling and how intensely, and help the child learn via physical associations, such as showing him or her that anger connects to a reddening of the face, stomach pain, the urge to cry, etc.
- Help them learn to relax. Children with ASD find it hard to relax, and can be very “intense” and obsessive in their interests. Try to work relaxing activities or some quiet “alone time” into his or her daily routine.
- Make their environment more soothing. As children with ASD can become overwhelmed by sensory information, it’s important to ensure their environments are as free as possible of sensory irritants. Flickering lights, devices that give off background noise, scented candles, etc., should be removed.
- Give praise, in the form your child likes best. Praise is as important to an ASD child’s learning as it is to most children’s learning, but depending on their unique needs, praise may have to be modified to suit the child. For example, some may not like hugs, some may not recognize verbal praise. Often visual cues like stickers on charts or time doing a favourite activity as a reward are effective forms of praise. Praise should be as immediate as possible so that the child can assess cause and effect.
Seeking Help
If your child’s behaviour is placing him or herself at risk, or others at risk, you should seek professional help by a psychologist or psychiatrist, rather than trying to handle the situation on your own.
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Alka Mansik Pramarsh Foundation Clinical Psychologists-Family therapists Indore 0731-4263087,9179383554 