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The Use of “Structure” to Reduce Problematic Behavior in Kids with ASD [level 1]

"Any methods for preventing problem behaviors in an out of control child with an autism spectrum disorder? Please help with advice!"

For many children with Asperger’s (AS) and High-Functioning Autism (HFA), problematic behaviors are common. The term “problematic behavior” is a controversial one, but it’s intended to suggest that certain behaviors present a “problem” for parents, siblings, peers, teachers, therapists, etc. This helps to prevent internalizing the cause of the behaviors and blaming the “special needs” child.

This is a very important concept in AS and HFA, because it’s unlikely that any behavior which causes difficulties for parents and others is intended vindictively or maliciously. There is usually some other, unidentified, cause that provokes problematic behavior. Young people on the autism spectrum derive no enjoyment by being a problem to others.



Most problematic behaviors occur in the presence of parents and siblings (probably because AS and HFA children feel more comfortable simply being themselves when around familiar people). If such behavior is a problem for therapists and other professionals (which it is), then it can certainly be a challenge for moms, dads and siblings. Thus, it’s crucial that problematic behaviors are dealt with in way that (a) helps the entire family to cope more effectively, and (b) allows the “special needs” child to develop social skills and emotion management. 

Low-frustration tolerance is one of the most common problems in young people on the autism spectrum. They often appear to go into a state of anger, rage, anxiety, or fear for no reason. All children get frustrated and then act-out from time to time, but this problem is more of a challenge for moms and dads of autistic children. These children may seem inconsolable during the episode of frustration, the episode often lasts a long time, and the resolution that typically accompanies the end of feeling frustrated rarely occurs.

Low-frustration tolerance is just one example of problematic behavior. Similar episodes of panic, anxiety, anger, and aggression may be seen all through childhood, the teenage years, and even into adulthood (e.g., yelling, crying, resisting contact with others, pushing others away, refusing to respond to interaction, using others as objects, refusing to comply with daily tasks, etc.). These behaviors are “problematic” in the sense that they cause disruption (e.g., to a classroom engaged in a lesson, a family outing or event, etc.).

Children and teens with AS and HFA often rely on rituals, routines and structure, which helps define the world in terms of consistent rules and explanations. Consistency helps these young people to function more comfortably in a world that would otherwise be perceived as confusing, chaotic and hostile. Most kids on the autism spectrum find their own strategies for imposing structure and maintaining consistency. Without this structure, they would be totally overwhelmed and unable to function …they would be unable to understand the behavior of others …and the information they receive through their senses would be nearly impossible to bring together into a purposeful whole.

==> How to Prevent Meltdowns and Tantrums in Asperger's and HFA Children

When structure and consistency are disrupted in the AS or HFA child’s life, the world becomes confusing and overwhelming again – thus launching him or her into “problematic” behaviors as a response. This disruption of structure can be obvious (e.g., getting up at an unusual hour, having a collection of objects disturbed, not being able to engage in a favorite activity, being made to go a different way to school, etc.) …or it may be hidden (e.g., sensory sensitivities, subtle changes in the environment which the youngster is used to, etc.). Many of these “triggers” may be out of the control of the child. Thus, it’s important to remember that low-frustration tolerance and similar behaviors are not cases of “misbehavior” necessarily, rather they may simply be natural reactions to various unwanted stimuli.

"Structure-Dependent" Thinking in Kids with Asperger's and High-Functioning Autism 

 

How parents can begin to reduce problematic behaviors in their AS or HFA child:

1. At the time of the inappropriate behavior, be sure to limit your talking to “stating the rule and consequence.” Lengthy debates, explanations and arguments should be avoided at this time. Also, ignore complaints from your youngster. Further discussion about the rule and consequence can be done at a later time when things have calmed down.

2. Avoid anger and over-reaction to your child’s problematic behavior. Don’t let your emotions take control. Refrain from demanding or shouting. Stay calm! You’re “over-reacting” will through “gas on the fire.”

3. Establish family rules and put them in writing. Rules should be (a) specific, (b) easy to understand, (c) achievable, (d) age-appropriate, and (e) consistent. Rules should be discussed and decided upon ahead of time in mutual collaboration between the mom and dad without the youngster present. Then, after the rules have been agreed upon, they should be explained to the youngster in simple, concrete terms.

4. Help your youngster use problem-solving skills in order to make a plan for changing behavior in the future. For example, if the behavior involves difficulties getting along with peers, help your youngster learn appropriate communication and conflict resolutions skills.

5. Listen to your youngster’s point of view about a particular rule. When appropriate, consider making changes to the rule based on your youngster’s reasoning. This doesn’t mean you are “giving in” to your youngster’s demands, rather it means that (at times) you will negotiate with your youngster on a rule and reach a compromise.

==> How to Prevent Meltdowns and Tantrums in Asperger's and HFA Children

6. Make your expectations very clear. For example, let your child know that (a) she WILL be required to perform certain tasks (e.g., completing homework, cleaning her bedroom, getting ready for school on time, etc.), and (b) there WILL be consequences for not completing such tasks.

7. Set up routines for daily living that are consistent and predictable (e.g., morning, mealtime, and bedtime routines). Your youngster will learn many things from these routines (e.g., how to take care of herself, how to interact with others, discovering that life runs more smoothly if things are organized and predictable, etc.).

8. Simply ignore some behaviors (e.g., whining and complaining).

9. Structuring your youngster’s environment. Determine what activities he will engage in and how he will fill his time. Also, be available physically and mentally to provide appropriate monitoring and supervision.

10. Try to anticipate problem situations (e.g., don’t let your youngster get into a situation where he becomes overly tired, hungry, or bored).

11. Use distraction techniques. If your youngster is acting-out, distraction with something of interest can focus her on more positive behaviors.

12. Use rewards to increase appropriate behavior. When it comes to children on the autism spectrum, it’s usually better to reward desirable behaviors than to discipline undesirable ones. Also, it’s best to provide the reward immediately after the desired behavior has occurred.

AS and HFA Kids Want Structure 

 

Note: While providing structure and consistency are important skills for you to use with your AS or HFA child, it’s also important to be aware of the importance of allowing her some independence and autonomy. As often as is appropriate, allow your child to have opportunities to make her own choices and decisions, respect her choices and decisions, and allow natural “real-world” consequences to occur (when safety is not an issue, of course).

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Behavioral and Cognitive Rigidity in Kids with High-Functioning Autism

Behavioral rigidity refers to a child’s difficulty maintaining appropriate behavior in new and unfamiliar situations. The opposite of rigidity would be flexibility, which enables children to shift effortlessly from task to task in the classroom, from topic to topic in conversation, from one role to another in games, etc.

Rigidity can also affect thinking. Cognitive rigidity occurs when the child is unable to consider alternatives to the current situation, alternative viewpoints, or innovative solutions to a problem. The child with rigid thinking tends to view things in “either-or” terms (e.g., things are either right or wrong, good or bad). He or she wants concrete, black and white answers. The “gray areas” of life are very uncomfortable (e.g., often has an exact way of doing things with no variations).

Children with High-Functioning Autism (HFA) often demonstrate extreme forms of rigidity or inflexibility. This may manifest itself as difficulty with (a) ending an intense emotional feeling, (b) making transitions during the school day (e.g., from lunch back to the classroom), and (c) tolerating changes in schedules or everyday routines.

Rigidity and Defiance in Kids with High-Functioning Autism 



 Here is a 3-step process for helping your HFA child with his/her rigidity issues:

Step 1—

Realizing that your HFA youngster will not be a good observer of her behavior is your first step. She will not know what to do in certain situations, because she doesn't understand how the world works. Not knowing what to do usually results in anxiety that leads to additional ineffective and inappropriate actions. HFA behavior is usually a result of this anxiety, which leads to difficulty moving on and letting go of an issue, and "getting stuck" on something. This is “rigidity,” and it is the most common reason for behavioral problems.

Reasons for rigidity may include the following:
  • A misunderstanding or misinterpretation of another's action
  • A violation of a rule or ritual (i.e., changing something from the way it is “supposed” to be)
  • Anxiety about a current or upcoming event
  • Attention difficulties
  • Difficulty transitioning from one activity to another
  • Immediate gratification of a need
  • Lack of knowledge about how something is done  
  • Sensory sensitivities
  • The need to avoid or escape from a non-preferred activity (e.g., doing Math homework)
  • The need to control a situation
  • The need to engage in - or continue - a preferred activity (e.g., an obsessive action or fantasy)

Often times, parents of children with HFA do not fully understand what their youngster is thinking, how he interprets the world, and how his deficits cause problems. After their child receives an official diagnosis, parents often rush into action before collecting enough information about the disorder. If they don’t learn about the ins-and-outs of the disorder, parents may very likely do the wrong thing. So, the second step in effectively dealing with rigidity is to understand some of the associated theories on HFA. Below are the prominent theories that will shed light on this topic:

Cortisol Deficit: According to researchers, cortisol (the body’s stress hormone) may be a key factor in understanding HFA. Cortisol is one of several stress hormones that acts similar to a “red alert” that is triggered by stressful circumstances, which helps the individual to react quickly to changes. In “typical” children, there is a two-fold increase in levels of cortisol within 30 minutes of waking up, with levels gradually declining during the day as part of the internal body clock. One study found that children with HFA didn’t have this peak, although levels of cortisol still decreased during the day as normal. This difference in stress hormone levels may be highly significant in explaining why kids on the autism spectrum are less able to react and cope with unexpected change. The study suggests that these young people may not adjust normally to the challenge of a new environment on waking, which may affect the way they subsequently engage with the world around them. By viewing the symptoms of HFA as a “stress response” rather than a “behavior problem” can help parents and teachers develop techniques for avoiding circumstances that may cause anxiety in kids with the disorder.

Executive Dysfunction: Executive function theory deals with impulse control, inhibition, mental flexibility, planning, the initiation and monitoring of action, and working memory. This theory explains some of the symptoms of HFA. For instance, poor social interaction may be due to a defect in cognitive shifting, which is a vital part of executive function. Also, repetitive and restricted behavior observed in young people on the autism spectrum may be explained due to executive dysfunction.

Brain Dysregulation: Another theory suggests that the brains of children on the autism spectrum are structurally normal, but “dysregulated.” In other words, there is an impaired regulation of a bundle of neurons in the brain stem that processes sensory signals from all areas of the body.

Weak Central Coherence: Weak central coherence theory describes the inability to understand the context of a situation or to see the “big picture.” This might explain common behaviors found in HFA children (e.g., repetitiveness, focusing on parts of objects, persistence in behaviors related to details, etc.).

Theory of Mind Deficit: Theory of mind is the intuitive understanding of your mental state, and the mental state of other people (e.g., emotions, thoughts, beliefs, perceptions, knowledge, intentions and desires) – and of how those mental states influence behavior. Kids with HFA have difficulty understanding others thoughts, which according to this theory, is the core cognitive deficit.
 

Step 3—

The following strategy is your third step for dealing with rigidity, and can be used with a variety of activities (e.g., chores and homework). There are two main parts to this strategy: 1) practicing in small steps, and 2) providing praise based on effort.

Practicing in small steps: The first part of this strategy is the use of subgoals. Setting a subgoal helps the youngster focus. In any activity, watch for him to begin to lose interest, become bored, get frustrated, or become distracted. At that point, set a subgoal that requires him to attend only slightly longer than he initially desires. For a 5-year-old, this may mean a subgoal that can be completed in 30 seconds. For a 10-year-old, a subgoal that lasts 3 minutes may be more appropriate. The goal is to give the youngster brief practice in “being patient with the process” without overloading him by extensive demands.

Providing praise based on effort: Whenever the youngster puts in "a little extra effort" or works beyond the frustration point, the second part of the strategy can be employed. This is “praise based on effort” instead of “praise based on level of performance.” Usually, moms and dads focus on their youngster’s “productivity” rather than focusing on “the amount of energy the youngster had to devote to the activity.” When using praise, acknowledge the amount of “applied effort,” and point out that the youngster’s “attempt at being productive” paid off (e.g., "You worked very hard and trying to solve that Math problem!"). If you build pride in this extra effort, rigidity will likely lessen.

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Here are two specific examples of how to apply this strategy:
  1. If your youngster is helping you fold clothes and begins to lose interest or focus, you can assign a very small number of clothing items to be folded before she takes a break. This minimizes the frustration and the amount of distraction. Once your youngster makes this extra effort, use “praise based on effort” in order to build pride. This strategy can be used even when she is not “successful” (e.g., doesn’t finish folding all the clothes). Any extra “pride in effort” is likely to reduce rigidity and attention difficulties.
  2. If your youngster is working on a lengthy Math assignment and shows signs of frustration or boredom, set a subgoal that requires completion of only a couple more problems before taking a short break. This should help minimize angry outbursts and distraction. Next, use encouragement, rewards, or loss of privileges in order to get your youngster to focus slightly longer. If your child has an angry outburst when the subgoal is set, give him an opportunity to take a “time-out” before working. He can choose to either work on the subgoal, or to go to a designated area until he calms down (e.g., "You can finish your Math assignment now, or take a time-out and finish it in a few minutes”). However, make it clear that once he has calmed down, the only choice is to return to work on the subgoal. This provides your youngster a chance for an outlet for his frustration, but it also sets clear limits so that he must eventually complete the subgoal. This will also help you limit your “lectures about the importance of completing homework.”

The strategy described in Step 3 will have the most impact if it is used daily. Look for opportunities involving homework, chores, or play activities. Look for every chance to build pride and “effort.” Pay less attention to “productivity” or “successful completion” of activities/tasks.


==> Need tips on how to handle your child's fixations and obsessions? You'll find more than you'll need right here...


Resources for parents of children and teens on the autism spectrum:
 
 
 
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Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

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Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

Click here for the full article...

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Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

Click here to read the full article…

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Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

Click here to read the full article…

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Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

Click here to read the full article...

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Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

Click here for the full article...
 
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A child with High-Functioning Autism (HFA) can have difficulty in school because, since he fits in so well, many adults may miss the fact that he has a diagnosis. When these children display symptoms of their disorder, they may be seen as defiant or disruptive.

Click here for the full article...
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