Teaching “Trigger-Identification”: Help for Children with High Functioning Autism

When a crisis event occurs, it can cause strong reactions in parents, teachers – and kids, especially those with High Functioning Autism (HFA). There are many “crisis response” resources that are appropriate for use with "special needs" children, provided that individual consideration is given to the youngster’s developmental and emotional maturity.

How parents and teachers react, respond, or express their feelings will influence the reactions of HFA kids.  Furthermore, these young people will react to the stress based on their past experience and awareness of the current situation. Adults who know the youngster well can best predict his or her reactions and behaviors, because they have observed the youngster’s response to stress in the past.

A trigger is a thought about a situation that leads to an inappropriate response to that situation (i.e., it is not the situation or the feeling that is the problem, rather it is how the children “think” about these things and what they say to themselves that causes problems). Kids on the autism spectrum generally have very specific “triggers” (i.e., words, images, sounds, etc.) that signal danger or disruption to their feelings of safety and security.  
These are unique to each youngster, but come from past experiences, association with stressors, seeing anxiety in parents and teachers, and so on. These young people tend to develop their own “cues” in response to “trigger events” (i.e., warning signals that parents and teachers can “read” to understand that the youngster is having difficulty).  These cues may include:
  • becoming quiet
  • becoming withdrawn
  • changes in speech patterns
  • complaining
  • exhibiting a fear response
  • exhibiting an avoidance response
  • facial expressions
  • feeling ill
  • getting irritable
  • nervous tics
  • sweating

When parents and teachers anticipate these triggers and observe these cues, they should provide assurance, support and attention as quickly as possible. If they miss these cues, HFA kids may escalate their behavior to a point where they completely lose control.  If this occurs, the parent or teacher needs to take the youngster to the safest place available, allow him or her to calm down, and then talk to him or her about the triggering fears or situation.

Some HFA children act-out more passively (e.g., the youngster might pretend she doesn’t hear the parents when they ask her to do something). What the child might be thinking to herself in this case is, “They can’t control me. I can do whatever I want,” right before she decides to ignore her parents.

HFA children can also act-in (i.e., they withdraw, shut down, or refuse to speak to parents when they try to find out what the problem is). These children might think, “I’m so inept. I can’t do anything right, so there’s no point in trying.”

Because moms and dads and educators see kids in different situations, it is essential that they work together to share information about triggers and cues. This is best done on a regular basis (e.g., during an IEP meeting, a periodic review meeting, etc.) rather than in response to a crisis. However, when a crisis occurs, people who work with the youngster should meet briefly to discuss specific concerns and how to best address the youngster’s needs in the current situation.

In the context of prevention and the development of effective IEPs, some HFA kids need specific training and interventions to help them to develop self-management skills.  During the teaching process, these skills should be taught so they can be demonstrated successfully under stressful conditions so that these children can respond appropriately.  Parents and teachers should still expect that HFA kids will demonstrate their self-control skills with less efficiency when confronted by highly unusual or anxiety-provoking situations.

Young people with “special needs” benefit from concrete information presented at the proper level of understanding and maturity. Helping these kids to stop and think about their reactions and behavior (especially with regard to anger and fear) is recommended and often necessary in order for them to make “good choices.”  For some HFA children with behavioral disorders, training in anger management, coping and conflict resolution skills are important additions to a comprehensive intervention program.
Remember that any change in routine may result in additional emotional or behavioral upset. If the youngster’s routine or environment must be changed, try to maintain as much of the normal routine (e.g., meals, play, bedtime, etc.) as possible – even in the new environment.  In addition, try to bring concrete elements from the youngster’s more routine environment (e.g., a game, blanket, eating utensils, etc.) into the new environment to maintain some degree of “sameness” or constancy.

Many children on the autism spectrum can be helped to comprehend behavior they observe - but poorly understand - through the use of “social stories.” The explanation of what is happening can be reduced to a social story. A storybook can then be kept by the youngster to help reinforce the information on a concrete, basic level. For further information on the use of social stories, visit www.AspergersSocialStories.com

Kids with developmental delays may not understand stressful events – or their own reactions to such events.  Parents and educators need to determine the extent to which the youngster understands and relates to stressful events.  Some of these young people will not be able to understand enough about the event to experience any stress, while others may understand the event, but respond to it like a “typical” youngster.

Overall, kids with developmental delays may respond to stressful events based more on their observations of adult and peer reactions rather than the verbal explanations that they may receive. Discussions with them need to be specific, concrete and basic. The use of pictures in explaining these events is ideal.  These kids will need concrete information to help them understand that any particular stressful event is not going to hurt them – it’s just going to make them feel uncomfortable for a short time.

Children with HFA will most likely need supports that are different from “typical” children, depending on their level of emotional maturity and ability to understand the concepts discussed. Many children on the spectrum are able to apply abstract concepts without difficulty, while others have specific deficits in these skills. In particular, most of these children interpret very literally; therefore, moms and dads and educators need to choose their words carefully to insure the youngster will not misinterpret.

HFA children who have serious emotional and behavioral problems are at higher risk for severe stress reactions following a crisis. Typically, these children have limited coping skills with which to handle “normal” daily stress. They are likely to be overwhelmed by unexpected events (e.g., loss of a family member). 
Those who also suffer from depression and anxiety are likely to exhibit exaggerated symptoms (e.g., greater withdrawal, heightened agitation, increased feelings of worthlessness and despair, increase in nervous behaviors, etc.). HFA kids with a history of suicidal thinking or behavior are especially prone to increased feelings of hopelessness and need to come to the attention of parents and school personnel following any serious event likely to trigger these feelings.

Those HFA kids who experience conduct problems, noncompliance and aggression are also likely to exhibit more extreme versions of problem behaviors (e.g., higher levels of disruptive and oppositional behaviors, more frequent and severe acts of aggression, etc.). These children thrive on the consistent, predictable routines that are difficult to maintain in an emergency or crisis situation.

Consider the triggers and cues for these children, and anticipate rather than react. For example, allow time for discussion of the stressful event in a safe and familiar setting, prepare them for changes in routines, and provide choices in activities to the extent feasible to give them some sense of control over even a small part of their lives.

Some HFA children may need to be more protected or isolated to minimize distractions and sources of agitation during the height of a crisis, and adult supervision may need to be more intense for a while. Expect some regression (i.e., increase in problem behaviors) and deal with inappropriate behaviors calmly and consistently. It helps these children to understand that - despite a lot of other changes and disruptions - there are some constants in family and classroom rules and expectations, and that they can depend on their support network to be available.

Learning the triggers is THE first step to helping HFA kids learn better self-management skills. When they are able to learn their triggers, they will start to recognize them when they come up. Only when these children recognize their triggers can they start to use new techniques to manage them. The process itself will involve a lot of problem-solving discussions and will take repetition and time, but it’s something most children on the spectrum can learn.

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