Managing challenging behaviour in children who have Asperger’s

March 02nd, 2012

Students who have Asperger’s Syndrome can display challenging behaviour. They may be ‘runners’ or they may lash out at teachers among other things. They usually do so because they are experiencing some form of emotional distress as a result of excessive/unpleasant sensory stimulation, because they have difficulty understanding other people’s perspectives, because they have difficulty coping with change, or because they have an otherwise inflexible behavioural repetoire, amongst other things.

A patient (male, 10 years of age) who we will call Jack (isn’t every second boy called Jack?) has been ‘running’ or punching/hitting/biting others, including teachers, when he is distressed. Jack’s support teacher has indicated to his mother that his behaviour is unpredictable and that therefore they are having difficulty managing him. In other words, they are finding it hard to identify the antecedents of his behaviour. Identifying antecedents is a good thing to do and changing them is very effective. For example, a child who becomes anxious about not knowing what to do when he first arrives in the classroom each morning (i.e., he doesn’t have a routine) can be assisted by getting him to class early and giving him a job (e.g., he can be book monitor or fish feeder etc). However, antecedents can be hard to find and it is not always possible to change them even if one is aware of them. Changing the behaviour of children who have Asperger’s therefore often requires a different type of behaviour therapy. Before we look at what that might be let’s quickly revisit B.F. Skinner’s laws of the universe.

  1. Positive reinforcement. When a behaviour is followed by a rewarding stimulus the likelihood of the behaviour occurring again is increased.
  2. Negative reinforcement. When a behaviour is successful in eliminating or reducing a distressing stimulus it is rewarded and the likelihood of the behaviour occurring again is increased.
  3. Punishment. When a behaviour is followed by a punishment the likelihood of the behaviour occurring again is decreased.
  4. Shaping. Human behaviour rarely changes immediately, just as young canines do not learn to walk without a leash on their first day of obedience training. Shaping is a conditioning procedure in which successive approximations of a behaviour are reinforced. Successive approximations refer to increasingly accurate representations of the behaviour desired by the teacher.  The principles of shaping can be illustrated in the training of a puppy. If one desires the puppy to sit and stay while you are out of sight, one doesn’t sit the puppy down and walk around the corner. Rather one teaches it to stay while you are beside it and have it on a tight leash. A reward is provided after it stays for the briefest of moments. The period for which it must stay and the distance between the puppy and owner is increased with rewards provided for successful performance at each increment until, finally, it is able to perform the desired behaviour.
  5. Positive reinforcement is more effective at changing behaviour than punishment.
  6. Behaviour management methods are neither right nor wrong; they’re just effective and ineffective.

Getting back to Jack; like many kids who have Asperger’s, he lacks the ‘software’ that allows him to make sense of his social world. He needs the adults around him to provide him with software ‘plug-ins’. How can we accomplish this? By using Skinner’s laws of positive reinforcement and shaping.

Jack is clearly trying to avoid distressing situations. That he continues to do so shows that the punishment being used by the school is not working and that his current behaviour, while maladaptive, is having a negatively reinforcing effect. A more effective method must be found.

The new approach can begin by writing a Social Story that describes for Jack how he might respond in a particular situation. This might include suggesting to Jack that when he begins to feel distressed in the classroom he is to (a) go to his teacher and ask for his iPod, (b) move to his quiet time area, (c) stay in his quiet time area until he feels like he can manage himself back in the class, (d) return to the class and discuss a solution to the problem with his teacher. Parents and the school then need to identify an external reward that may serve as positive reinforcement. Next, the teacher has to shape Jack’s behaviour by paying attention to him and trying to catch him doing something that resembles the terminal goal of following the ‘calm down’ procedure described above. When she catches him he should receive the stimulus we hope will be positively reinforcing.

A new shaping procedure begins once Jack is able to perform the terminal behaviour. At this point the teacher begins to fade the Social Story by requiring him to perform successively more difficult versions of the Social Story until he can eventually solve the problem/distress by simply leaving his seat and discussing a solution with his teacher.

Finally, learning doesn’t occur when the child is in distress. Teachers and parents are often so relieved when the child behaves appropriately that they forget to catch them being good and provide reinforcement. The trick to successfully teaching an kid with Asperger’s how to behave is to use these “good” times as teaching moments. Grab them (not literally for those readers who may have Asperger’s themselves:) and talk about the behaviours they used that were successful. Discuss why they might have been successful and how they might be used in the future. Refer back to them before future events and discuss whether the previously successful behaviour might be worth another shot. If it works, debrief again. Eventually, if a behaviour works often enough it can become a rule and we all know that Aspies love rules.

 

 

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