My son was sitting criss-cross wedged into a small space between the wall and the bookshelf, hands over his ears, screaming at the top of his lungs,”You are a horrible mother!” This had been a 45-minute meltdown that included throwing things across the room, punching and kicking me, and even a swipe at our poor dog. My body was shaking as I tried a breathing exercise to calm myself.
Although we had been here before, it was still traumatic–for all of us. I’m not going to lie, even though I understood why he was saying these things to me, it still hurt. I spent the rest of the evening failing to fight back tears.
Managing difficult behavior in autism spectrum disorder (ASD) can be a huge undertaking. It can make you and everyone else in your home feel overwhelmed. Challenging behaviors can be prevented and managed with the right support in place.
Today I would like to talk about ways of managing challenging behaviors. Your child’s behavior doesn’t have to have you walking on eggshells, there are helpful ways to get through with your sanity and relationships intact.
What kinds of behaviors do children with autism sometimes exhibit?
In one study called, Problem Behavior in Autism Spectrum Disorder: Considering Core Symptom Severity and Accompanying Sleep Disturbance, we learn: “In addition to the core symptoms that define autism spectrum disorder (ASD), many individuals experience broader problem behavior at a level significant enough for families to seek further clinical assessment and intervention.”
Many children with ASD present with challenging behaviors. These behaviors can include tantrums, meltdowns, or shutdowns and may include the following:
- self-injury
- throwing things
- punching, kicking or harming others
- screaming and yelling
- refusal to cooperate
- aggression
- mean, dismissive, or insulting to others verbally
Many times, after the behavior stops, the child switches into “normal” mode. It can be jarring, and super frustrating to have a child throwing things and yelling at you for an hour then suddenly being sunshine and rainbows. For me, it is difficult to make my own sudden switch from survival mode to ready to engage happily with my child.
As parents of the neurodivergent, we are often called to do the seemingly impossible, and do it well. As part of our search for strategies, I want to build our understanding of why these things happen, and what we can do about it.
Why do children with autism exhibit challenging behaviors?
When looking at the “why” of problematic behavior, it is important to understand the symptoms of ASD. When you get a sense of what could be going on in your child’s world, their inability to behave appropriately makes much more sense.
In order to reduce challenging behaviors, we must first understand what is causing them. Severe behaviors rarely occur without cause, figuring out the trigger is a good first step.
Identify triggers
The triggers to problem behaviors can be difficult to pin down. A little investigation, reflection, and tracking can be helpful. After each incident, think about the factors that were at play before, during, and after the meltdown or problematic behaviors occured.
Sometimes, patterns emerge and we can see what exactly is triggering our child with autism. For example, here are some triggers common to children with ASD:
- too much sensory stimulation
- too little sensory stimulation
- sudden change
- transitions
- poor social skills
- frustration or stress
- poor impulse control
- difficulty regulating emotions
- trouble understanding language
- lack of focus
- mental and physical exhaustion
- trouble with executive functioning
- Co-morbid conditions such as ADHD, anxiety, depression
Specific circumstances within these triggers may be more or less tailored to your child. For instance, sensory overload could cause your child to become frustrated with others as they try to focus on school work.
This happened to my child. His challenging behavior at school stemmed from irritability because other children were making a noise that was distracting for him; the addition of noise canceling headphones really helped.
Let’s look at some other strategies that might be helpful. The more we know, the more prepared we are, and the more likely we are to be able to help our kids.
What behavior management strategies can we employ?
In order to employ effective behavior strategies, we have to look at how we are engaging with everyone in our life.
Communication
Communication will be the base level of behavior management. If everyone is on the same page, the strategies implemented will be much more effective.
Your child’s school
Letting your child’s school know what is going on with them, their diagnosis, triggers, strengths and weaknesses is important. They may need to evaluate your child for an individualized education plan. The accommodations your child receives at school will only be available if the school understands their needs.
Your children with ASD
Communicate with your child in whatever way is best. Find out how they feel, ask questions and provide options for them. Work together to let them know how you feel as well. When challenging behaviors arise, work with them in safe ways, treat them with respect, and set boundaries to keep everyone safe.
Your partner
My husband and I found that we work best as a team, and often as a tag team. Our pact is, if one of us becomes too overwhelmed, angry, or just exhausted the other steps in. This prevents burnout and gives us each a partner, as well as someone to take over so we can have a break to collect ourselves.
When things are calm again it is good to have a conversation about what went right, what didn’t, what triggers were identified, and learn from each experience.
Yourself
Learn from each instance of behavior. Be kind to yourself. Celebrate wins.
Manage expectations
My mom always says, “Choose your battles”. Sometimes that cliche is annoying, but it is true. Expectations can make or break a situation.
We should not set the bar so low that our children don’t have to be challenged. Setting the bar too high, or an inappropriate height for the circumstance will set our children up for failure.
Here is the thing though, if your child has severe difficulty with wearing dress clothes for instance, don’t expect them to attend events where they have to wear them. The other options are to allow them to wear what is comfortable for them, or buying dress clothes that are designed for sensory needs. Don’t fight them on it, it’s not worth it.
Remember who your child is. They are the same sweet baby who wanted to listen to you read to them, had a great day at school, or built towers of blocks with you when things were good. I often remind myself to drink in the triumphs and treasure moments to store for the times when the rage has taken over my baby boy.
We cannot expect our neurodivergent child with autism to react in neurotypical ways in all circumstances. We also cannot change the world for them. What we can do is build a relationship with our child, know them, and empower them to engage with the world on their terms, and to build safe places to let others interact with them as well.
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Have a plan in place
For a child who is resistant to change, having a plan is the key to managing challenging behaviors. Though we cannot plan for every eventuality, we can plan more than we might think. Preparing in advance reduces anxiety, empowers us in the moment, and is helpful in preventing challenging behaviors before they occur.
Change the environment
Just because you want your child to experience something, doesn’t mean they have to experience it in a traditional way. Providing an environment for your child that promotes calm, exploration, and safety will go a long way.
Events
Events take place in everyone’s life. The pressure to act appropriately can bring on challenging behaviors. Be picky about which events you attend, for how long, and why.
Elements
One tip I have for making sure we are experiencing everything we can to the fullest is to choose one activity, or two, out of the many involved in each event. This allows us to enjoy certain aspects of the event, without taking on the entire overwhelming thing.
For example, birthday parties are usually events that our children want to attend. We want them to experience joy and make good memories of these times. If the noise and chaos are triggers, choosing to go late to the party (maybe when it is time to sing and blow out candles) then staying for a specified amount of time after could be a good idea. This way, the party is enjoyed by all and challenging behavior is nipped at the bud.
Identify safe places
Identifying a place your child can go when they are feeling overwhelmed cannot be overestimated in its effectiveness. If, going into a trigger filled situation, your child knows where to go to self regulate or get away from the fray, they will be able to act appropriately. This will reduce the likelihood they will engage in challenging behavior.
Bring a toolkit
I like to travel with a toolkit at all times. I would have made an excellent boy scout. Many parents think to do this well into toddlerhood, but most do not pass that phase. For neurodivergent kids, it can be just as important as a diaper bag is to an infant well into adulthood.
This toolkit can be as simple as a bag with as many “tools” as possible, or contain what they will possibly need for a particular event. Problem behavior can be curbed by self advocacy. If your child has their kit ready, they can have the tools they need at their fingertips to employ as they need, without being required to ask permission.
Toolkits can include:
- a sensory activity
- noise canceling or reducing headphones
- fidgets
- tablet or phone
- reward chart and rewards
- exercise ball and pump
Practice
Practice with your child. Practice appropriate responses, accessing their tool kit, and let them choose as much as possible what they are involved in. Set them up for success.
Find the best strategies available
Aside from what we can do at home for our children, challenging behavior often requires assistance from professionals. The methods for dealing with challenging behavior have changed quite a bit over the years. The triggers for behavior will be a guide to choosing the right behavior management strategies.
Applied behavior analysis
Applied behavior analysis (ABA) is one of the most controversial methods available to ASD families. There has been a shift in this field however, and the changes have been more widely accepted.
Applied behavior analysis used to include helping autistic children learn how to better fit into society. This included trying to change some of the “symptoms” of ASD, and looking for a “cure” for the behaviors. Some of those behaviors they wanted to change included:
However, autism advocates argue that autistic children do not need to fit the mold of society, but rather, they need to learn more healthy ways of engaging with it. Instead of trying to change them, the new wave of ABA therapy is about helping people with autism feel accepted by themselves and others, and to function within society in ways that foster relationships, build on their skills, and empower them to reach their own goals and dreams.
Find the best approach for your family member
Here are some behavior management strategies:
- provide visual cues to replace verbal ones
- ease transitions with countdowns
- be consistent
- easy toolkit access
- tour venues ahead of time if possible
- lead by example
- remember tantrums sometimes occur, that’s ok
- teach safety first
- recognize wins
- build language skills
- provide alternative communication methods
- reduce stress
- teach social stories
Summing Up
Challenging behaviors occur no matter how prepared you are. How you handle them matters. Keeping yourself calm is often the first challenge. Helping each person in our child’s life use the same strategies when challenging behaviors occur can go a long way.
Knowing what is behind the behavior is important. In order to stop biting, we must find out why the child choses biting in the moment. There are more articles here at Autism Parenting magazine, feel free to click the links in this article and explore others as well.
References
Lindor, E., Sivaratnam, C., May, T., Stefanac, N., Howells, K., & Rinehart, N. (2019). Problem Behavior in Autism Spectrum Disorder: Considering Core Symptom Severity and Accompanying Sleep Disturbance. Frontiers in psychiatry, 10, 487. https://doi.org/10.3389/fpsyt.2019.00487
Linstead, E., Dixon, D. R., Hong, E., Burns, C. O., French, R., Novack, M. N., & Granpeesheh, D. (2017). An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Translational psychiatry, 7(9), e1234. https://doi.org/10.1038/tp.2017.207
Rachel Andersen
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