Behaviour What Works 2

1
BEHAVIOUR AUTISM WHAT WORKS 2
GEOFF EVANS Deputy Director Options Group Autism
Services www.optionsgroup.co.uk
2
Overnight changes in your childrens behaviour
are not likely.After all it took a long time for
them to get where they are.

• 100 WAYS TO ENHANCE SELF CONCEPT IN THE CLASSROOM
• Canfield, J. and Wells, H. 1976 Prentice Hall

3
CONSIDERATIONS

• We all have behaviour that challenges at times
• We are part of the problem and the solution
• What one person finds challenging may not be a
  challenge to others
• Keep the problem in perspective
• Language and attitudes around behaviour (describe
  dont label attention seeking, he knows what hes
  doing)

4
WHAT CAUSES OR CONTRIBUTES TO BEHAVIOUR
DIFFICULTIES IN INDIVIDUALS WITH AUTISM

• Impact of the triad of impairments
• Impact of sensory differences
• Difficulties with understanding other people and
  their behaviour
• Difficulties with flexibility of thought and
  behaviour, which allows us to explore other
  options and possible behaviours,
• Difficulties with Transitions and change

5
WHAT CAUSES OR CONTRIBUTES TO BEHAVIOUR
DIFFICULTIES IN INDIVIDUALS WITH AUTISM

• Health and physical difficulties
• Over or under demands made upon the individual
• Lack of appropriate social and life skills
• Lack of self esteem
• High levels of stress and anxiety
• Difficulties understanding and experiencing self

6
THE IMPACT OF THE TRIAD OF IMPAIRMENTS
Communication Impairments
Impairment of Social Interaction
Sensory Processing
Flexibility of Thought and Behaviour (Imagination)
7
THE IMPACT OF COMMUNICATION DIFFICULTIES ON
BEHAVIOUR

• Not understanding the function of communication
• Not knowing how to appropriately initiate,
  maintain and end communication.
• Not understanding or misunderstanding
  communication
• Requiring more time to process communication
• Not able to communicate needs effectively.
• Literal understanding and use of language

8
SUPPORTING BEHAVIOUR THROUGH COMMUNICATION

• Provide the individual with ways of communicating
  needs
• Ensure that we communicate effectively at all
  times e.g. (using visual)
• Use their name first
• Ensure that they are paying attention
• Match your language to their level of
  understanding
• Give time for information to be processed and
  acted upon
• Avoid confrontation

9
THE IMPACT OF SOCIAL INTERACTION DIFFICULTIES ON
BEHAVIOUR

• Not understanding the rules that govern social
  interaction and behaviour
• Difficulties with personal space
• Ways Forward
• Provide rules and guidance for places and
  situations where difficult behaviour is likely to
  cure.
• Teach social interaction skills and provide
  opportunity for rehearsal.

10
THESE ARE MY FRIENDS
MY FRIEND
MY FRIEND
Activities I can do with each friend Places I can
go to with each friend How often can I contact my
friends Things my friends like me to do Things my
friends dont like me to do
11
MY SOCIAL CIRCLE
People I meet occasionally
Friends and People I know well
Can be used to provide information about
appropriate behaviour, activities with each group
My Family
Me
12
RULES FOR PLACES I GO TO
School
Youth Club
Swimming
Important school rules
Important youth club rules
Important swimming rules
13
SOCIAL RULES(The Hidden Curriculum Brenda Smith
Myles)

• Refrain from making negative comments try to be
  polite all the time.
• When people are crying or angry do not laugh or
  it will make them feel worse.
• Do not hit other people
• If someone intrudes into your space, ask them
  politely to move over without touching them.
• When someone asks how do you like my.. they
  usually really want you to tell them you like it.
  Even if you dont like it try to find something
  positive to say.

14
THE IMPACT OF FLEXIBILITY OF THOUGHT AND
BEHAVIOUR

• Follows rigid routines without variation
• Finds change difficult
• Special interests can become all - absorbing
• Difficulties working out what comes next
• Difficulties transferring skills and behaviour
  from one setting to another
• Difficulties adjusting behaviour according to the
  situation

15
SUPPORTING FLEXIBILITY OF THOUGHT AND BEHAVIOUR

• Discuss and explain other possible ways of
  behaving. Encourage problem solving.
• Provide structure, plan transitions. build in
  small changes
• Try using role play to help the individual
  understand other viewpoints
• Have set times to discuss favourite
  questions/topics/explore misunderstandings
• Expand favourite topics. use them to teach,
  motivate and move the individual on.
• Have armistices for collections that get out of
  hand

16
PROVIDING STRUCTURE GOING SHOPPING
Get a carrier bag
Pick up my shopping list
Walk to the shop
Look at my list and find the first item
Put the item in my basket
When I have got all the items on my list I will
take them to the checkout
I will pay for my shopping
If I have any problems, I can talk to ...
17
WHAT PEOPLE WITH AUTISM SAY DIFFERENCES IN
FLEXIBILITY OF THINKING

• From an early age, I developed narrow
  all-encompassing interests and it has been
  difficult for me to be interested in two or more
  things at once. So I would usually rotate between
  interests, being obsessed with one subject for a
  month or two and the go back to other special
  interests. When Im fascinated by something, I
  try to learn everything I can about it. These
  interests largely involved the rote memorization
  of facts. 
• (Sarah in Claire Sainsbury)

18
Displays indifference
Joins in only if adult insists and assists
One-sided interaction
Indicates needs by using an adults hand
Lack of creative pretend play
Handles or spins objects
Echolalic speech
Talks incessantly about one subject
Variety is not the spice of life
Does not play with other children
But some can do some things very well
Idiosyncratic mannerisms
Inappropriate laughing or giggling
eye contact lacking or inappropriate
19
SENSORY PROCESSING AREAS OF DIFFICULTY

• Different sensory experience different behaviour
• The perception of sound
• Visual perception
• Tactile difficulties
• Olfactory
• Vestibular
• Proprioception
• Gustatory

20
THE IMPACT OF SENSORY DIFFERENCES AND
DIFFICULTIES ON BEHAVIOUR

• Sensory difficulties or differences can bring
  about the following response
• Fear
• Flight
• Fight
• Sensory responses can be Hyper, Hypo or Mixed

21
SUPPORTING SENSORY DIFFERENCES AND DIFFICULTIES

• Try to understand the individual with autisms
  experience of the world.
• Assess the environment and make necessary and
  reasonable adjustments.
• Try to provide them with ways they can be in
  control of their sensory experience.
• Develop a sensory support plan

22
SENSORY SUPPORT PLAN
23
BEHAVIOURS THAT CAUSE CONCERN

• Hitting, kicking biting etc.
• Throwing objects
• Not staying on task
• Swearing
• Running around the classroom
• Disrupting the learning of others
• Causes harm to the child

24
BEHAVIOURS THAT CAUSE CONCERN

• Causes harm to others
• Impedes learning
• Contrary to social norms
• Challenges family
• Challenges service
• Restricts access to the community
• Behaviour inappropriate to persons age and
  development

25
EXAMPLES OF SPECIAL INTERESTS

• Fascination with mythological or historical
  characters
• Obsession with real people
• Collecting information and facts
• Obsession with certain words
• Obsession with objects
• Creating large collections

26
THE FUNCTION OF SPECIAL INTERESTS

• The reduction of anxiety
• In times of great instability, my obsessions
  provided some much needed stability. In times of
  great stress, my obsessions provided me with
  those rare moments of calm. As a person with
  Asperger's syndrome, my mind was constantly
  whirling with thoughts, worries and concerns. The
  time spent with my obsessions was the only time
  in which I had a clear mind-it gave me that much
  sought after relaxation. If obsessions serve as
  such a comfort to people with AS, I think it
  would be an act of cruelty to try and take it
  away from them.
• Dean Beadle

27
THE FUNCTION OF SPECIAL INTERESTS

• For the pure pleasure it brings
• The pleasure of saying a word over and over
• The sheer excitement of watching a bus go by on
  time
• The satisfaction of having every Thomas the Tank
  book
• To gain understanding of
• The physical world
• Their own existence
• Their autism
• Something, someone you can identify with

28
THE FUNCTION OF SPECIAL INTERESTS

• To bring order into their lives
• In a confusing chaotic world that seems
  disjointed and lacking in coherence assembling
  collections of making lists may help bring a
  sense of order to the individual with autisms
  life and experiences.
• Organising something is a wonderful way of
  shaking off the feeling of chaos that comes from
  living in such a disorganised world.
• L Jackson

29
THE FUNCTION OF SPECIAL INTERESTS

• Meeting a sensory need
• Many of my fixations initially had a sensory
  basis. In the fourth grade, I was attracted to
  election posters because I liked the feeling of
  wearing the poster like a sandwich man.
  Occupational therapists have found that weighted
  vests will often reduce hyperactivity. TG

30
WAYS FORWARD WITH SPECIAL INTERESTS AND OBSESSIONS

• Functional analysis
• Consider early intervention
• Explore ways of reducing levels of stress and
  anxiety, environmental adjustments.
• Teach alternative ways of dealing with problems
  and difficulties
• From trees to twigs (graded change techniques)
• Give insight into the obsession or behaviour
• Welcome and work with the obsession, special
  interest
• Increase levels of structure, set boundaries

31
WHAT PARENTS SAY

• Turn bizarre behaviours into strengths.
  Focussing on restricted interests reduces
  anxiety. It is a balancing act for parents. I
  think we can use our childs restrictive
  interests in a positive way. Rather than trying
  to distract our children it is important to give
  them time to pursue their interests. We never
  know if their interests will become a basis for a
  career in later years.
• Fern Lee Quint

32
WHAT INDIVIDUALS WITH ASD SAY

• So, next time you parents and teachers sit with
  your head in your hands, wishing your child would
  stop going on about their special interest,
  perhaps the feeling of despondency will be
  punctuated by a feeling of relief relief in the
  knowledge that these special interests are making
  the world a happier and more manageable place for
  your child. Perhaps then it will not be such an
  ordeal to listen to them talk about it.
• Dean Beadle

33
RESISTANCE TO CHANGE

• The need to do things at the same time and in the
  same way, every time
• The fear and anxiety about new places, people and
  activities
• Fear of the unexpected
• Having to have things in the same place

34
WAYS FORWARD WITH RESISTANCE TO CHANGE

• Try to warn and plan for change
• Provide information about the change
• Teach coping strategies
• Role play
• Social stories
• Power cards
• Derailing

35
TRYING TO MAKE SENSE OF THE BEHAVIOUR

• Information you may want to know
• When is the behaviour most likely to take place?
• Where is the behaviour most likely to take place?
• Who is most likely to be there?
• Are their identifiable triggers if so what are
  they?
• How long does the behaviour typically last?
• What causes the behaviour to stop?

36
THE CRISIS CYCLE
37
A MODEL OF AROUSAL AND BEHAVIOUR (Clements
Zarkowska)
38
(No Transcript)
39
(No Transcript)
40
(No Transcript)
41
ASSESSING BEHAVIOUR USING ABC CHARTS
42
PRIORITISING THE BEHAVIOUR YOU WANT TO ADDRESS

• What is the function of the behaviour?
• Does it impact upon the quality of life and
  learning?
• Does the behaviour cause distress?
• If we stopped the behaviour would it be replaced
  by something more harmful or sever?
• To what level does the behaviour impact upon
  others and their quality of life?
• Is the behaviour lawful?
• Do we have the means and resources to change the
  behaviour can we do it?

43
Prioritising BehaviourName
..

• To help prioritise behaviour you may wish to use
  the following rating scale. Give each factor a
  score between 5 and 1. The least impact scores 1,
  the highest 5. Total the score. Do this for each
  behaviour. Commence working on the behaviour with
  the highest score in total. You can add factors
  that are important to you and your family.
• Impact on quality of life of child and other
• Impact on learning
• Causes distress to the child
• Causes distress to others
• Breaks the law
• Causes harm

44
TO INTERVENE OR NOT TO INTERVENE,THAT IS THE
QUESTION

• What is the function of the behaviour?
• Right time, right place, Right response.
• Does it impact upon the quality of life and
  learning?
• Does the interest/behaviour cause distress?
• If we tried to take away the interest/obsession
  would it be replaced by something more harmful?
• To what level does the behaviour impact upon
  others and their quality of life?
• Is it lawful?
• In what ways can it benefit the person with
  autism , now and in the future?

45
(No Transcript)
46
DEVELOPING A BEHAVIOUR SUPPORT PLAN
47
FURTHER WAYS OF SUPPORTING BEHAVIOUR

• Programme factors that support behaviour
• Responding to early warning signs
• Preventative measures
• Dealing with agitated behaviour
• Managing fear and panic
• Developing self esteem
• Teaching new and compensatory skills

48
PROGRAMME FACTORS THAT CAN SUPPORT PUPILS WITH
THEIR BEHAVIOUR

• Programmes that
• - Have a balance of activities e.g. physical,
  educational, social and community
• - Are designed together with the pupils
• - Are possible to implement and manage
• Activities that
• - Are of interest to the pupils and have meaning
• - Are of the right length/duration for the
  individual pupil
• - Take into account, existing skills and
  emerging skills
• - Build on strengths while addressing needs
• - Have outcomes which are meaningful to the
  pupil
• - Involve pupils in their own learning

49
RESPOND TO EARLY WARNING SIGNS

• Learn to recognise the early signs that thing are
  not going well
• Try to be aware of over stimulation and
  hyper-saturation.
• Encourage relaxation deep breathing etc
• Redirect
• Distract
• Introduce incompatible behaviours
• Reduce levels or type of demand

50
PREVENTATIVE MEASURES

• Create a safe environment, a place to retreat to
• Try to maintain an appropriate level of arousal
• Try to identify and manage unwanted stressors
• Teach the child the skills needed for the
  situation
• Ensure the child is free from discomfort
• Ensure that reinforces are available
• Ensure that the child knows an acceptable way of
  responding to the situation

51
PREVENTATIVE MEASURES

• Build in breaks between activities
• Ensure that the child knows
• - Where they are supposed to be
• - What they should be doing
• - Who they are with
• - How they are supposed to do it
• - When the activity is coming to an end
• - What they are supposed to do next

52
DEALING WITH AGITATED BEHAVIOUR

• 1. Identify Signals which indicate increased
  levels of stress e.g. Sounds, Words, Actions
• 2. Distract/Redirect - e.g. use some alternative
  routine activity, something they are good at.
  Avoid criticism as this can inflame the
  situation.
• 3. Relaxation or Physical activity
• (a) Relaxation - e.g. take to a quiet place,
  play calm music, show/read a book
• (b) Physical Activity - e.g. walk, play a game,
  jog such activities need to be continuous,
  vigorous and for a minimum of five minutes
• 4. Impose Verbal Control - e.g. saying very
  firmly sit down
• 5. Leave well alone

53
MANAGEMENT OF FEAR OR PANIC

• Reassurance should be given
• Give opportunities to calm down
• Dont criticise or threaten
• Redirect away from the stimuli
• Give them a task to do
• Use ear plugs/headphones/walkman/play music
• Allow them to use their own means of blocking out
  unpleasant situations
• Desensitisation

54
DEVELOPING SELF-ESTEEM

• Identify existing strengths, emerging skills
  acknowledge and build on these
• Give positive feedback of child's responses and
  contribution
• Gradually encourage independent complication of
  tasks
• Develop the child's areas of responsibility
• Encourage the use of the childs skills to
  benefit others

55
TEACHING NEW SKILLS

• What skills does the child need to function,
  behave appropriately and or improve quality of
  life in school?
• Be clear about the expected outcomes
• Formal and informal teaching of the skills
• Model, demonstrate, provide examples, social
  stories, video coaching.
• Provide opportunities to practice new skills
• Reinforce

56
SKILLS YOU MAY NEED TO TEACH

• To ask for help
• Greet people appropriately
• To follow school rules
• To turn take
• Have a strategy for solving problems
• Manage stress and anxiety
• Manage feelings and anger
• Relaxation skills

57
IN CONCLUSION

• All behaviour can be changed over time
• Aim for consistency
• Dont give in when its about to work.
• Deal with now, keep an eye on the future
• Its not our fault (avoiding the vicious cycle of
  blame)