What Constitutes Effective Intervention for Individuals with Autism? The National Research Council’s report on Effective Treatments for Autism Still Stands True

In 2001, the National Research Council published findings effective treatments on Educational Interventions for Children with Autism from birth to age 8. The committee set out with the question “What are the characteristics of effective interventions in educational programs for young children with autism spectrum disorders?” The findings were published in a comprehensive book titled, “Educating children with autism.”

In answering the above question, the committee recognized that there were numerous articles written on autism treatment and that there were numerous treatment programs across the country claiming to be effective in helping children with autism. Treatments ranging from ABA-based programs to developmentally-based programs to diet-based programs or more idiosyncratic programs such as sensory integration. In order to base their recommendations on clear evidence of effectiveness, the committee ruled out treatment that did not base their statements on some form of data regarding the outcome of the children.

They took a look at over 900 articles written on the treatment of autism and also enlisted the assistance of ‘model’ programs currently in place for the treatment of autism.  These model or state-of-the-art programs were typically university or research ran programs who that enlisted the services of highly qualified professionals. Of the ten model programs selected, seven were from an applied behavior analysis framework, one was from a developmental framework, one was purely parent training, and the last was a combination of behavioral and developmental frameworks.

The committee listed key features seen as variables of effective programs in an effort to use this information from these state-of-the-art programs and translate it to publicly funded early education programs across the country and to begin some quality control.

The first characteristic identified as a key feature of an effective treatment program is that of early entry into a program.  When reviewing the information from these model programs and based on findings from the literature, the committee saw that the earlier a child is placed in treatment the better their chances of making gains.  Therefore, their first recommendation was that educational services begin as soon as a child is suspected of having an autism spectrum disorder highlighting the importance of early intervention. Early detection and treatment are key phrases often heard in the medical field and this is the exact same case when it comes to the treatment of autism.  So, early entry is recommendation number one.

Next, the committee looked at the intensity of these programs and what has been shown in the literature  to be an effective level of intensity. Their conclusion upon review of the information was that educational services include a minimum of 25 hours a week, 5 days a week, 12 months a year during which time a child is actively engaged. The word minimum in this recommendation is key as some children may need more than this minimum of hours given the severity of their symptoms or their resistance to treatment.

Additionally, the notion of active engagement is very important as the recommended number of treatment hours is not merely the number of hours recommended for a child to be placed in a treatment program, but the number of hours to child is actively learning while in the program.  This means that the child should not be just physically present in a treatment program, but that each and every hour of that program is designed in a way in which the child will learn for a minimum of 25 hours per week.

Another way of looking at this is if it was recommended that a child attend a special education program 30 hours a week, one would initially think that the recommendation for a minimum number of hours has been met. However, if, within these 30 hours, the child spends at least two hours a day playing alone in the playground, one hour a day eating lunch, a few hours a day in unstructured and unsupervised solitary play activities, and only two hours of actual teaching occurs within the school day, a child is left with only a 10-hour a week treatment program. And while play time is extremely important for any child, if a child does not yet have the skills to know how to play, how can the child be expected to interact with other children during these free play times without specific structured teaching?  So, it is important to look beyond the number of hours and actually look at what each hour of the treatment program will entail whether that be an ABA program, school-based program, or any type of recommended treatment program.  It’s imperative that a child be placed in a program where they can access the curriculum and where the teachers or therapists are actively engaging the child so as to capture each and every teaching opportunity and make it a worthwhile experience. There needs to be intensive teaching and learning occurring during a child’s time in an intervention program.

The committee actually described intensity as a “large numbers of functionally, developmentally relevant, and high-interest opportunities to respond actively.”  In other words, a child’s time spent in a treatment program should result in high levels of learning when it comes to the matter of reaching their educational goals. So, the higher the level of active engagement, the higher the intensity, the higher the change rate for steady gains.

Next on the list of key characteristics was the child to teacher ratio. The committee recommended that programs consist of sufficient amounts of adult attention in order for a child to meet their educational goals, either learning with one-to-one or very small group instruction. The decision of student-to-teacher ratio should be made, depending on the learning ability of the child rather than depending on the staffing needs of the program.  Therefore, if a child can learn in a small group of maybe two children and one teacher, then that should suffice; however, as is the case for many young children with autism, if the child cannot occupy their own free time in a constructive manner, redirect their attention when asked, or learn via observation of a peer, then the teaching instruction should be in a one-to-one manner, that is one teacher with one child.

The committee recognized the need for well-trained personnel.  The committee noted that all the model programs they reviewed were developed by persons with Ph.D.’s in autism-related fields and the programs were directed and implemented by teams of professionals who had extensive training and experience in autism spectrum disorders. It is so important that the person designing a treatment program for a child with autism has extensive knowledge not only in the field of autism, but hands on experience in designing effective programs.

Next, the committee recognized the notion of individualization. A key characteristic of these model programs was that of comprehensive, individualized treatment goals based on the needs of each individual child rather than a one-size-fits-all curriculum for all the children in the program. The curriculum or individualized plan developed for each child should be based on their own personal strengths and weaknesses.  The goals for each child should also focus on the development of a child’s social and cognitive abilities, their verbal and non-verbal communication skills, adaptive or self-help skills, and the reduction of behavioral difficulties using more positive behavioral approaches rather than punitive approaches.

The second part of this recommendation, that “goals “are frequently adjusted,” cannot be emphasized enough. While the initial curriculum and targets developed for a child may be individualized at the onset of a treatment program, it is critical that these goals and targets be reviewed routinely and adjustments be made when necessary.

And lastly, the committee recognized the important role parents have when it comes to the effectiveness of treatment programs. A key characteristic amongst all model programs was their emphasis on parental training and involvement in the program. The involvement of parents is a very valuable tool in the treatment of autism because children spend most of their time with their parents; therefore, parents must play an active part in the treatment team so as to continue where the formal treatment sessions end. With parents as active participants of the program, a child will always be in a consistent environment where their skills can be generalization generalized and maintained.

Increasing Language for Children with Autism

Impairment in communication is one of the main diagnostic criteria for a child with autism, specifically a delay in or total lack of spoken language.  Behavior analysts break down “language” into many reasons a child would communicate.  Based on these reasons, they identify where there are deficits and how they can increase these deficit areas.  We will outline some of them here in a very easy-to-understand manner and then give some advice on how to increase these forms of language every day.

The first form of language a child engages in is repeating.  This happens when a child repeats what another person says.  You may be thinking at this point that your child with autism does this a lot!  Many children with autism engage in this behavior although it is repetitive in nature and they do not do it to get attention from others (why typically developing children repeat language); they do it because it is fun for them. In order to learn other forms of language (which we will discuss below), a child should be able to repeat what an adult says on command. If your child does not do this regularly, give many opportunities for repetition, each day throughout the day.  Get your child’s full attention, say a simple sound or word very clearly to them (e.g., “ahhhh”) and continue to do this until they repeat or approximate what you are saying.  Provide lots of praise and even preferred items.

Another important form of language a child engages in is requesting.  Many children with autism engage in challenging behaviors as a form of requesting (e.g., crying to get a cookie and this results in them getting a cookie so they will quiet down), instead of using appropriate language (e.g., “mommy, can I have a cookie?”).  This form of language can be taught throughout the day, every day, if you know what your child wants.  Keep many of their preferred items out of reach, especially food items.  Whenever they show a desire for something, model what they should say or do to communicate (e.g., you say “cookie”, engage in the manual sign for cookie, or point to the cookie icon or picture for them to give you) and require them to engage in the same communicative behavior that you modeled before you give them the cookie.  Give them small pieces of food items, little sips of drinks, or a short amount of time to play with preferred toys so you can remove the item and practice requesting for the item again.  If you do this about three times each time they want varied things throughout the day, your child will begin to gain this requesting skill, and you may see a decrease in challenging behaviors.

Remember, to learn language your child must receive lots and lots of learning opportunities per day.  You can provide this by engaging in simple strategies such as the ones we discussed above.

What challenges have you faced? Please write us back and we will respond.

How to teach your child to wait and what you could do before and after telling your child “no”

Two common difficulties that we encounter when working with families over the years are regarding waiting and when a child is told no.  These two scenarios can be overwhelming as they are often accompanied by the most intense challenging behaviors.  We will go over these on this this post.

First off, the skill of requesting appropriately must be well-established already.  If this skill is not yet in your child’s repertoire then it must be taught first. If the skill is already there, but it’s not as fluent as we’d need it to be, then work on that first.

Let’s say your child can already ask for a cookie—this is great, but what can you do if for some reason, you child has to be told to wait?   If your first thought given that question you just read is along the lines of “oh…” then do consider the following.  There is this passage of time that happens between being asked to wait for something and finally getting that something.  The key here is working on that gap.  Depending on how your child “understands” that concept—time—you may have to be more hands-on when helping out your child go through it.   Instead of simply saying “wait,”  try giving your child something that he likes to “kill time.” This is not something out of the ordinary. Case in point: look at long lines of people at a grocery store, a theme park ride, at a bank, et cetera.  It is very rare to see a long line of people, waiting, just starting blankly at the back of the head of the person in front of them (unless you’re in the military or something similar) and just “wait” for their turn.  Perhaps you’ll notice a handful dealing with waiting in not-so-positive ways but for the most part, people will do something to pass time.  From being on their phones, talking to someone whom they are with, looking around, reading a book—we, again, most of us, can handle waiting because we fill that gap with something else.  And that is something that you can try out—offer your child something that they will not mind doing while they wait.  The more reinforcing that activity the better. When starting to teach your child to wait while engaged in something, make sure to keep the wait-time very short. How short?  It depends on each child really, but a good rule of thumb is to end the wait when your child is still behaving well (i.e., before your child starts that path to a full-blown tantrum). Let’s say that time is around one minute—great. Keep it around that time limit and systematically increase the time just a bit and stay on that higher limit (e.g., from one minute to about two minutes) until your child gets used to it.  From there, you can once again increase the limit to say three minutes.  This does not happen without any difficulty—the key here is you being consistent.  Also, avoid a situation wherein the wait time had been too long that your child “forgets” about whatever it is he or she is waiting for.  You need your child’s motivation for whatever it is he or she is waiting for for the learning process to “click.”  Once that motivation goes away, the teachable opportunity is lost so it is best to be realistic on how long you really want your child to wait.

Again, teach waiting only if they can truly have that cookie, but at a later time (or after a number of activities).  If they cannot have that cookie, then don’t say wait (after which they do) then tell them no in the end. Hence, the next topic: what can you do when you are about to tell your child no (i.e., denial).

True: a no is a no and that is something our children must learn; however, before we get to that lesson, let’s take a few steps back.  If you know that your child cannot have that cookie, give your child’s behaviors a chance to not escalate.  Offer your child something she likes instead of whatever that is she wants at the moment.  The key here is you offering an alternative that she truly wants—whatever that is given that moment.  If your child accepts the alternative—great!  If your child does not like your attempts to compromise—and if your child is capable—ask her to choose her own alternative item/food/activity.  Be prepared to honor her choice.  If your child accepts that scenario—great!   If not, time to roll up your sleeves—it’s time to teach your child that no means no.  There is no going around this.  You have offered her alternatives. You have also given her a chance to choose her own alternative.  If those fail, you have done your job but despite your efforts to teach alternatives, the tantrums will happen. As those behaviors are happening, the worst thing that you can do is give in—no.  Don’t give in as that will only reinforce all those not-so-nice behaviors.  It will be difficult, but a no is a no.

When your child’s behaviors start to de-escalate, it is still possible to offer her alternative and/or giving her a chance to select her own, but never give in.

If your child already engages in the most extreme challenging behaviors such as self-injurious behaviors or property destruction or any other behaviors that compromise the safety of others during times when he or she is denied access to something, we highly recommend that you immediately seek assistance from a trained professional.

Using Structure and Scheduling for Your Child and Taking Much Needed Time for You

When you arrive home with the kids after school and work, the first thing you may want to do is relax!  Turning on the television for your child, letting her watch a movie, or allowing her to engage in her repetitive behaviors to her heart’s content is very tempting.  You have had a long day and rest is probably the first thing you would like to do.  Allowing these things just discussed though should be kept to a minimum and used as “earned” activities or used in emergency situations (i.e., when you just can’t take it anymore!).

So, what do you do instead?  When do you get “you” time?  First, focus on creating structure for your child during these down times.  Structure and routine are so important for children with autism. They are important for just about everyone but when it comes to children on the autism spectrum, they really thrive on routine and structure. You establish predictability with structure and routine and it can also help with meltdowns.

Create a visual schedule for your child for the evening routine using printed out photographs which you can Velcro in order to a piece of paper (a laminated paper is best).  A child can, by following clear pictures, recognize the order and importance of daily activities.  This reduces stress and anxiety because they know what to expect and what will be happening next. For example, you may allow 15 minutes of free play time, then homework, then dinner, then bath/shower, then bedtime routine activities, then bed.  It allows your child to see what to expect for the evening and also guides you as the parent, reminding you each evening what the structure should be.

What if your child does not follow visual schedules independently?  That’s okay!  It may take a few days, or even a few weeks, but after you guide them through the schedule each night, using a timer to signal the end of each activity, and guiding them to take off each picture as it is completed, they will learn to follow the schedule themselves and become independent before you know it.

Final tips: Be sure to include fun things that your child likes on the schedule, not just work activities and boring nightly activities.  Sometimes let them choose the activities during certain times (e.g., bedtime routine activities).  Lastly, be sure that when your child has successfully completed their schedule and is successfully in bed, do something good for you!  Enjoy that piece of cake that’s been sitting in the refrigerator or that glass of wine you’ve been waiting for all week.  Watch a movie with your partner.  Now it’s you time!

How to Make a Visit to the Grocery Store a Learning Opportunity for Your Child with Autism

A visit to the grocery store for parents with a child with autism can be quite stressful. On the other hand, it can also be a wonderful learning experience if parents take the time to follow a few simple strategies.

Before the shopping experience begins, it may be beneficial to state what is expected from your child, approximately how long it will take, and what can be expected afterwards. A method to increase motivation may be to state a clear if/then contingency. For example, “Johnny, if you stay next to mom/dad, help pick out your items, then after shopping we can get visit a nearby store you like.”

Make a list of items, either drawn out, printed out, or cut out from advertisements that your child can keep track of during the shopping trip. These can be items they prefer and would be interested in tracking and finding. Ask your child to cross out the items or put the picture in an envelope when you both find the item, signifying one step closer to being done with the shopping experience. Give your child a shortened list without all the items you need to get on it. Save the last item that you get for his list so that he can directly see when the last item is crossed out, you are done!

Have a back-up enjoyable activity that your child can engage in while you are completing the remaining part of the shopping trip that is not on his list. A small coloring book, games on your phone, a squishy toy, or some music through headphones may work to keep him engaged.

Use the experience to teach language skills. Grab a green and a red apple and ask your child to identify which one is red. Grab a big and a small can of tomatoes and ask your child to identify which one is bigger. Ask your child to label items that you grab from the shelves, especially preferable items. Based on how advanced your child’s speech is, tailor what you ask of them to their level.

Last, if your child has difficulties walking through an entire shopping experience, allow your child to catch a ride on the shopping cart only if he has walked and helped for a certain amount of time, or when all of his grocery list is completed. If you base it on time, be sure to have a visual chart (e.g., have 5 boxes, each representing 2 minutes) or timer for him to know how much time he has left of walking.

Hopefully these strategies will aid in creating a productive and enjoyable grocery shopping experience for you and your child!

Using Social Stories to Help Individuals with Autism in Classrooms and Other Settings

Using Social Stories is a strategy that is likely not new to teachers. However, not all teachers know that they can be used to work with and teach individuals with autism specific skills surrounding social and behavioral needs. Social stories interventions enhance social skill acquisition for many students with autism. They help individuals with autism to better understand the tones of interpersonal communication so that they can interact in an effective and appropriate manner.

Let’s take a look at social stories are and how can they be used with students with autism?

A social story is a mini book that describes a social situation and the appropriate social responses. Social stories are individualized for each student and teach a specific desired response. They are used to seek answers to questions that an individual with autism may need to know to interact with others, for example, answers to who, what, when, where and why in social situations.  Social stories can also be used to learn new routines, activities, and how to respond appropriately to feelings like anger and frustration.

Social stories are written using four sentence types. Descriptive sentences, which provide information about the subject, setting, and action; directive sentences, which describe the appropriate behavioral responses; perspective sentences, which identify the possible feelings and reactions of others; and control sentences, which describe the actions and responses of the story participants. A sample control sentence might be, a puppy barks to get its owner’s attention. Or, Ginny yelled to get the teacher’s attention. It is customary for social stories to have two to five descriptive, perspective, or control sentences in the story. Writing social stories for lower functioning students or students who have the tendency to over focus on a specific part of the story may require dropping the control sentence.

When creating a social story there are 10 steps that are used: One, identify the target behavior in the problematic situation. Two, define the target behavior. Three, collect baseline data on the target behavior. Four, write a social story using the four-sentence types. Five, present one to three sentences on each page. Six, use photographs and drawings or icons. Seven, read the social story to the student and model the desired behavior for them. Eight, collect data on the target behavior. Nine, review the data and the social story procedures and modify if they are not effective. Ten, plan for maintenance and generalization.

Social stories are written in the first-person point of view or the child’s point of view. It should also be in the present tense and the child’s level of vocabulary and comprehension should be considered.

Remember that students with autism frequently do not maintain or generalize skills that they have learned. Although you will ultimately fade the use of a social story, plan activities to assist the student in generalizing skills across content, persons, environment, and situation. Remember to transition the newly acquired skill to the naturally occurring contingencies. Social stories appear to be a promising intervention method for improving the social behavior of individuals with autism.

How to Teach Children with Autism How to Play Independently

Do you ever wonder how you make it through each day, getting your child dressed and to school?  What about shopping, laundry, house cleaning, and dinner? Somehow you do it, and that is enough for anyone to be proud of.  We want to provide you with some additional techniques that may help with the time when your child with autism is home and needs to be looked after, but you also have things to accomplish.

Preparing dinner is a great scenario that many parents have difficulties with.  The solution for many parents is to put a movie on, give the child the iPad, or to allow the child to engage in whatever self-stimulatory behaviors they enjoy most (e.g., running around the house repeating phrases, flapping objects up and down, or rolling cars back and forth on the floor while lying down staring at them).  Although these may be activities that make your child happy and allow you to get dinner ready, there are additional techniques that foster appropriate independent engagement by your child with autism during times you cannot provide your full attention.

Activity schedules work wonders for this purpose. Activity schedules are visual guides that lead a person through a series of activities, leading to an ultimate prize.  Visual schedules help with transitioning from one activity to another with minimal prompting.

There are some pre-requisites to being able to utilize schedules although these can be worked on in the meantime if your child does not have them.  Your child should be able to independently play with some objects, even if the object is as simple as a peg board, or as complex as a 100-piece Lego structure.  Laminate pictures of these activities and velcro them to a vertical strip hanging on the wall.  At the bottom should be a picture of what your child really wants to do in the moment, even if it’s dinner!  If your child has never had experience with an activity schedule, guide them through the process of pointing to the first picture, finding the activity, playing with the activity, putting the activity away, taking that picture off the schedule, pointing to the next picture, and so on and so forth until the ultimate activity or item is achieved.

Some tips: start with only one or two activities until your child can independently utilize the schedule and transition from activity to activity.  Also, remember that the activities should be somewhat preferred by your child, as this is their independent time and we want to increase the success of them playing independently.  If they dislike activities, this increases the chance of challenging behaviors and the need for more of your attention.  It may take a few days, or even weeks to develop this skill. Over time, your child will be able to complete this task with increasing independence, practice decision making and pursue the activities that interest him or her and it will give you some much needed time to get things done while at the same time knowing that your child is being productive.

How Choice Boards and “Wait Supports” Can Be Used to Support Students with Autism in Classrooms

A “Choice Board” is a type of visual environmental support that can be beneficial for students, especially students with ASD. Choices should be incorporated into as many activities as possible as choice boards provide students with decision-making opportunities. As such, it can display the objects, pictures, icons, or words that would represent a menu of activities or reinforcers. These can easily be made with supplies such as poster paper, card stock, white boards, or on any surface that you can attach or write on. Choice boards are often placed next to a student’s daily schedule, and when a designated time arrives, students simply select a preferred activity from the board. Choice boards with preferred activities can be placed near the free time or break time area of the room, and provide a stimulus for independent selection of an activity.

Similar to choice boards, ‘Waiting Supports’ are another visual strategy, or tool that can be incorporated throughout the school day. As we know, waiting is a difficult skill for many children, with or without disabilities. But for students with autism in particular, waiting typically presents problems because they have limited ability to delay gratification and comprehend the concept of waiting. We also know that if a student is waiting too long or is not engaged in some type of activity, even if it is a simple activity such as putting a back pack away or clearing a desk, then more than likely, unwanted behaviors will occur. Therefore, students with ASD will typically require specific instructions to develop appropriate waiting behaviors. When developing waiting supports, we need to determine if the student has the prerequisite skills that are necessary to engage in waiting behaviors. This is easy to do. First, role-play and practice waiting using different instructions and in different settings when you want to identify this skill. Keep in mind that when you are practicing ‘learning to wait’ with your students, make sure it is authentic and in an actual setting where you would expect the student to use this skill. Again, be sure to teach waiting skills across a variety of settings to increase the likelihood of generalization. Even using a peer model or a peer buddy during waiting times can offer support for desired behaviors, and specific ‘physical supports’ such as chairs near the waiting area, setting a timer, or holding a picture representing “wait” can also help a student learn this concept.

As we know, for any kind of learning to take place, it is essential for students to have active involvement with their teachers, peers, and the curriculum. Students with autism tend to be passive learners. Therefore, it is necessary to plan activities that require students to become active participants. Creating opportunities for students to respond is a high instructional priority. Research supports a functional relationship between academic performance and how often a student is able to respond. Therefore, the more a student participates in an activity, the more off task and disruptive behaviors will decrease.

Some Simple Strategies to Help You Go to the Park with Your Child with Autism

Many parents of children with autism run into barriers when taking their children out into the community. The park is one place where children typically enjoy their freedom and thrive, which can be a nice relief for many parents. Although, for parents of children with autism, this can be a stressful situation for many reasons. Children with autism may not have the social skills to play with other children and they may not interact in ways that are socially appropriate. Many children with autism also engage in observable self-stimulatory behaviors that may seem awkward to uninformed people. Other children may have difficulties with transitions and therefore, leaving the park is always a struggle for the parent of a child with autism, more so than that of a parent of a typically developing child.

Nevertheless, there are some strategies for parents of children with autism to practice to help relieve some of these stressors and make the park a more enjoyable experience for everyone.

First, if your child is not interested in other children but rather enjoys playing on or around the apparatus, be present if other children are around. Always be within a close distance so that any pushing or bumping can be easily and quickly dealt with. Attempt to block your child from running away and assist him with saying “sorry” or “hi” to the other child. Allow your child to leave and in a friendly manner, engage in a simple conversation with the other child such as “are you having fun at the park today?!” This way, the experience ends on a positive note instead of the memory of your child engaging in an aggressive behavior towards the other child.

Consider sparking interest in your child for other people, activities, toys, and conversations by pointing  these out in his or her environment: “Wow, those kids are going down the slide really fast, that looks fun!” or “That boy has a really cool race car, maybe you can ask to see it?” These are minimally intrusive ways to promote engagement with surrounding people, objects, and activities. With repeated exposure and positive interactions with people and activities at the park, your child’s positive engagement at the park may be reinforced over time. In other words, it may get stronger, more frequent, and trips to the park can turn into something he looks forward to.

Second, if your child engages in many self-stimulatory behaviors and they are difficult to avoid at parks, go to parks during less crowded times so you can allow your child to have fun without having to always remind him about keeping his “hands down”. If you can only go during highly crowded times, be sure to be present with your child, prompting him to engage in appropriate activities at the park such as monkey bars, swings, and slides to decrease the chances of him engaging in self-stimulatory behaviors. Keep your child “busy” with these alternative, appropriate behaviors so that engaging in undesirable or self-stimulatory behaviors becomes incompatible. It is difficult for a child to engage in self-stimulatory behaviors when he or she is having fun climbing a monkey bar, going down a slide, or playing with shovels and buckets in the sand.

Last, if transitions are difficult, let your child know from the time of arrival how much time he or she will have at the park. Have a visual countdown (e.g., boxes that are crossed off every 5 minutes) until it is time to leave. If your child prefers electronics and timers, start a timer on a phone or electronic device instead. Provide reminders when time is almost up, so your child is not “surprised” when it is time to transition. When time is up, it helps to have something positive that your child can look forward to after the park (e.g., frozen yogurt, pick up brother, dinner, or treat in the car).

We hope that these strategies may help relieve some of the stress associated with going to parks and both you and your child can enjoy and have fun!

What should you do IN RESPONSE to your child engaging in challenging behavior?

Remember those four reasons why people may engage in challenging behaviors discussed in the previous post?  People may want attention from other people, may want something, may want to get out of something, or may enjoy how the behavior feels.  If you haven’t already read it, we suggest reading the prior post so the information below is as useful as possible.

This post will focus on reactive strategies, based on the reason your child is engaging in the particular challenging behavior.  In other words, what should you do in response to your child engaging in the behavior?  This is probably the most stressful for parents as they may wonder if what they are doing is right.  They may wonder if they are hindering or helping their child.  Hopefully we can provide some guidance.

If your child engages in a particular challenging behavior to get something that he/she wants, it is important for him to learn that his behaviors do not lead to getting what he/she wants.  You should avoid giving them what they want when engaging in the problem behavior, and even after the behavior ends.  The child should only be allowed to get what they want if he engages in a more appropriate behavior, which we will discuss in a future post. This can be difficult for parents as giving the child what they want quiets them down and relieves much of the stress in the home or community setting.  The problem is that your child will learn this connection and continue to engage in this behavior in the future when they want to same thing. It will become a repeated cycle.

If your child engages in a particular challenging behavior to get out of something, such as homework or eating dinner, it is important to not allow him to get out of the situation until they engage in a more appropriate behavior.  If the child hits and screams while doing homework, it is important to follow through, require them to complete a few more problems without hitting and screaming, and then they can leave.  More appropriate behaviors to get out of doing things they don’t want to do will be discussed in future posts.

If your child engages in a particular challenging behavior to get attention, you should avoid providing attention to them until the behavior is not occurring or he engages in a more appropriate behavior to get your attention.  Providing attention only teaches them that this bad behavior leads to what they want.  This connection needs to be disconnected and the child needs to be taught more appropriate ways to get attention.

Last, if your child engages in some challenging behavior because it feels good, such as head banging, it is important to block this behavior so that this particular behavior does not provide the sensory satisfaction that your child is receiving (in addition to preventing them from doing harm to themselves).  You can physically block the behavior or there are many devices created for this purpose.

Stay tuned for a future post providing suggestions for what to teach your child to do instead of engaging in the bad behaviors they currently know will get them what they want.  Just reacting how we have described above will not teach new, appropriate ways to get what they want.  Teaching a new, more appropriate behavior is the key to decreasing challenging behaviors.

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