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Understanding Challenging Behavior

As we have all been home for quite a while now every day, all day, I know many of you have been experiencing some challenging behavior.  Although this can be a difficult area to address, I wanted to provide some basic guidelines as to how to identify the function (or cause) of behavior and then a few solutions as to how to address it.  By no means is this an exhaustive list of ideas to manage challenging behavior, but I hope it gives you some helpful advice.  
 
Identifying Functions of Behavior:
Before we try and address challenging behavior, it is imperative that we understand why it is occurring.  If we try and address it before we understand the cause, we can accidentally do the wrong thing and actually increase the behavior.  Below are the 4 functions of behavior:
 
1.   Escape or avoidance:
When behavior is maintained by escape or avoidance, the person is attempting to get out of or delay a situation they don’t like.  This situation could be anything aversive such as demands, loud noises, group settings, physical activity, etc.  For example, when asked to sit at the dinner table to eat broccoli, the individual might engage in behaviors to escape eating broccoli.
 
2.   Attention:
When behavior is maintained by attention, the person is attempting to get some form of attention.  Remember, attention can come in many forms.  The attention might not always be seen as “good” attention.  Even reprimands or strong reactions may serve as reinforcement.  For example, when a parent is speaking with their other child, the individual engages in behavior to get the attention off of their sibling and on to themselves.
 
3.   Access to Tangibles:
When behavior is maintained by tangibles, the person is attempting to get a preferred tangible item or activity.  For example, the individual may scream when they want a piece of candy.
 
4.   Automatic:
When behavior is maintained by automatic reinforcement, some may say that the individual is seeking a sensory experience.  Automatic reinforcement maintains behavior due to the person’s own experiences, and not due to what is happening outside of his/her body (not to get attention, escape, or access items). For example, when the individual is sitting by himself and has attention and preferred items, he continues to rock back and forth.  The rocking may be due to the sensory experience or automatic reinforcement.
 
Proactive and Reactive Procedures based on Function:
This section will give a few general ideas for what you can do proactively and reactively to decrease the likelihood of behavior occurring and to decrease the frequency of behavior once it does occur.  This is not an exhaustive list, so if you need further guidance, please reach out to your clinical supervisor or myself.
 
1.   Escape or Avoidance

Proactive (before behavior occurs):

  • Build in regular breaks into the daily schedule- this should decrease the need to escape at other times.  Keep in mind, breaks will be more effective if they are structured and the individual knows how much time before they are finished.
  • Teach the request for a break- to teach this, you should help your child to request a break upon any signs of frustration so that behavior doesn’t escalate. You should not have them ask for a break after behavior has escalated (since this will actually allow escape based on the behavior).
  • Identify non-preferred activities or items and work on the toleration by gradually and systematically exposing them to those activities.  While you’re doing this, you may want to avoid exposing your child to this non-preferred situation until they are tolerating it.
  • Provide a lot of reinforcement for all instances that your child does complete the non-preferred activity.
    • You may even want to use escape as the reinforcer.  For example, if your child completed a non-preferred activity, they could get out of doing their chores that night.
  • Use a token board to show how much of something needs to be completed before escaping that situation

Reactive (after behavior occurs):

  • Ideally, do not allow your child to escape the situation.  You should continue to prompt them through the situation they were trying to avoid so that they learn the behaviors do not allow them to get out of it. 
    • If this is not possible, try to prompt your child through a small portion of the activity (e.g. one bite of broccoli) before allowing escape.

 
2.   Attention:

Proactive:

  • Provide lots of attention when your child is not engaging in behaviors and is demonstrating appropriate behavior. Sometimes we forget to provide attention when s/he is demonstrating “good” behavior, but this is essential in trying to differentiate attention for the behavior we want to see increase.
  • Teach the request for attention- this might be calling your name or asking to do a specific activity with you.
  • Teach the toleration of denied or delayed attention.  You can do this by practicing this skill with contrived periods of time where attention is diverted. For example, you could use a timer and say, I’m going to do homework with your sister for 5 minutes, use the iPad while I do that.  Show him/her the timer and when it goes off, if s/he does not engage in challenging behavior, provide reinforcement.

Reactive:

  • Ideally, do not give any attention to the behavior.  You should ignore until the behavior ceases.
    • Due to dangerous behavior, this may not be possible.  If this is the case, one option is to provide attention at the first sign of behavior to reinforce a lower level of behavior instead of waiting until it escalates and then reinforcing a high level of behavior. 

 
3.   Access to Tangibles:

Proactive:

  • Provide access to preferred tangible items or activities when your child is not engaging in behaviors and is demonstrating appropriate behavior.  For example, when your child completes their work without behaviors, give them their favorite snack or activity.
  • Teach the requests for preferred items or activities.  If they don’t have the words to request the items they want, it is very likely challenging behavior will be used to access them.
  • Teach the toleration of denied and delayed access.  Frequently, we see challenging behavior when we say “no” or “not right now.” 
    • We can teach toleration of denied access by practicing denied access first with things they don’t care about as much and then later to things they care a lot about. 
    • To teach toleration of delayed access, practice waiting for gradually increasing durations of time for something they want.  Timers are very helpful to teach this.
  • Use a schedule to list the activities to be completed with the preferred item/activity at the end

Reactive:

  • Ideally do not give any access to the items/activities they want.
    • Sometimes it may be too quick to stop them from getting the item.  If you can get it back, go for it.  If it is going to become a battle, just let that time go and be aware of it for next time.
  • Don’t negotiate with your child.  You don’t want the behavior to get you to negotiate.

 
4.   Automatic Reinforcement:

Proactive:

  • Try to identify what type of sensory reinforcement they are looking for and then find activities that can give them that same sensory experience that are more appropriate.  For example, if s/he is constantly making vocal sounds, try an app where s/he can record their voice and play it back.  If s/he is watching the wheels spinning on toy cars instead of playing with them, try teaching him/her to use a spinning top.
  • Teach the requests for preferred sensory items/activities.
  • Block access to the sensory experience.  For example, if s/he is scratching or picking at their skin, put lotion on to lessen the amount of sensory input s/he is getting. 

Reactive:

  • Redirect the behavior to a more appropriate behavior. You can guide him/her to engage in the appropriate behavior and once they do, provide reinforcement.  For example, when watching a video, your child rewinds it over and over again, prompt him/her to continue the movie and if s/he does it without behaviors, provide reinforcement.  The best reinforcement may be allowing him/her to rewind.