Low Arousal Designing Staff Approaches to People with Autism

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Low ArousalDesigning Staff Approaches to People
with Autism

• Bryan Evans
• Specialist Services Coordinator
• The National Autistic Society

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It has been suggested that carers supporting
persons with LD do not need to be highly trained
or expert(Harris Hewett BILD)
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Important for Staff to appreciate issues related
to supporting people with Autism

• The Triad of Impairments
• Social communication
• Social Interaction
• Social imagination and need for routines/rituals
• Sensory differences including hypo and
  hypersensitivity
• Cognitive differences
• T.O.M deficit
• C.C. style of processing information
• E.F deficit
• Increased vulnerability to mental health problems

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Staff perceptions

• Tendency to form negative dispositional
  attributions
• Staff have tendency to be more sympathetic/toleran
  t with those on the lower end of the spectrum
• Less tolerant of those who possess higher I.Q.

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Any knowledge or understanding of the illusion
we may gain at the intellectual level remains
virtually powerless to diminish the magnitude of
the illusion.
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Staff beliefs and assumptions

• The issue of whether or not someone is in control
  and aware of their behaviour.
• Errors in thinking can lead to a number of
  negative ideas arising such as

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• They know what theyre doing
• Theyre doing it on purpose
• Its attention seeking behaviour
• Theyre trying to wind me up
• I mustnt let them win or Ill be reinforcing
  negative behaviour
• Etc., etc.

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The low arousal approach - most appropriate and
effective for interacting positively with autism
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My concerns

• Limited research has indicated that a number of
  misconceptions prevail
• Many carers appear to misunderstand some core
  principles of low arousal
• Acquired beliefs can get in the way

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• Affecting the quality of interaction
• Creating inconsistency in approach
• Resulting in increased confusion and anxiety and
  an increase in critical incidents that could
  otherwise be avoided

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An overview of low arousal approaches

• A non-confrontational way of working with people
• A philosophy of care based on valuing people
• Specifically avoids aversive interventions
• Gets staff to reflect on their own behaviour
• Raises awareness of environmental effects
• Challenges staff perceptions of short term
  behaviour management
• A collection of strategies designed to rapidly
  reduce aggression

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True/False Statements

• 21 statements designed to test low arousal
  literacy
• Respondents are asked to answer what they believe
  to be typically true or false

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Examples

• The low arousal approach encourages staff to
  seek the least line of resistance in any
  confrontational situation.

TRUE
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Giving a person distracters, specifically
things that they like, when they are challenging
may resolve an incident but will definitely
reinforce negative behaviour i.e., they will use
that behaviour in future to get what they want.
FALSE
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Removing stressors during an incident may reduce
challenging behaviour but in itself does not
teach a person how to cope in the long run.
TRUE
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Several statements consistently trip respondents
up

• Low arousal attempts not only to manage
  challenging behaviour, but also attempts to
  change it as it arises
• Before we attempt to change a behaviour we must
  try to establish the cause
• Rather than simply give in to demands we should
  attempt to offer alternatives first
• Low arousal is exemplified by a firm, assertive
  approach
• Giving in to a persons demand in order to avoid
  an incident is not OK if it could potentially
  cause harm to the person in the long-term.

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My Objectives

• To continue to teach staff the virtues of
  following the low arousal approach to reduce
  challenging behaviour in autism
• To introduce a competency framework to aid staff
  development to move on from the current practice
  of simply awarding staff attendance certificates

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The End

• Thank you and any Questions?