I did a survey a few years ago as I was creating my first online course and 300 autism professionals and parents responded within a week. They told me that their #1 challenge by far, hands down, was handling problem behavior. As a Board Certified Behavior Analyst at the doctoral level, I have analyzed a lot of different problem behaviors ranging from severe self-injurious behavior to one student who said “Are you happy?” 48 times in 10 min to another boy who became aggressive if anyone said the word “OK.” At that point, I realized how much I say OK each and every day!
No matter what the problem behavior is, the first step is to always start with an assessment and don’t just assess the problem behaviors. Instead assess the whole child and look at the entire situation. Let me tell you about a 6 year old boy, I’ll call him Tony. He was in one of my classrooms and I met him a few times. I was working at school only, not in the home. I was coaching the staff to work on manding and early learner programming. Tony had some words, not a lot and had only a few mastered skills. He ate cereal and corn chips during the time I saw him.
Tony’s mom requested to meet with me and when Tony’s mom came in, she told me that her husband, Tony’s dad, was serving in the military and overseas. She was having financial difficulties and Tony was very disruptive in the community. He was clearing shelves when they go to the grocery store. He was just having a difficult time, which was not really behavior that I would have expected out of Tony. He was also not toilet-trained and since he was 6 years old, she was spending a lot of money on diapers.
When I assessed his food intake, she had told me about the french fries, corn chips, and other neutral colored crunchy foods. When I asked her, “Does Tonny get any vegetables, fruits or protein in his diet?” she casually said, “Only in the baby food.” Without looking shocked, I said, “Oh, he gets baby food?” She’s replied, “Yes, it’s the only way I can get anything into him of substance.” I said, “How many jars of baby food does he go through?” She said, “52 jars a week of baby food.”
Financially, the diapers, the baby food, the ability to not be able to take him out to the stores to do her grocery shopping – all of these things were so much more important than some of the things we were working on at school. Without an assessment of all these areas, we’re not able to program effectively.
You can download a one page assessment I used or Tony and initially for all my clients that I created using the button right below the video. If you have the time, funding, and an experienced person to complete a VB-MAPP assessment, that would be my recommendation but if you can’t, this 1-page assessment can get you started. And the best news is that it will only take you 5 or 10 minutes to complete.
After you do this general assessment, then next I would recommend getting more details about the actual problem behaviors. I want the parent or professionals that work with the child to fully describe the problem behavior or behaviors.
When you describe behaviors be as specific as possible. So instead of saying, “He melts down or He has a tantrum,” tell me what that looks like. To coach other professionals and parents to be more specific, ask them “If he melted down right now, what would that look like? What exactly would I see?” Would a melt-down include flopping to the floor, screaming, hitting mom, biting other peers or his own hand?
When you hear a behavior described such as, “He gets anxious.” What does being anxious for the child look like? Does he pace around the room? Does he verbal stim? Does he script? Does he lay his head down? How do you know he’s anxious and what does it look like?
Being out-of-control, frustrated and being anxious are not specific behaviors that you and I can count reliably. Describe what the behavior looks like in a way we can see and count because it helps us to get an accurate starting point so we can develop interventions. For instance, one boy was hitting his head on the wall during instruction, so while this was certainly not my only recommendation, moving his desk away from the wall was a good start.
As a behavior analyst, I know it’s important to define a behavior clearly, especially when conducting a functional behavior assessment. So instead of Suzie hits her head, BCBAs would say something like. “Susie hits the right side of her head with a closed right-handed fist or Suzie bites the knuckle index finger of her right hand and will sometimes draw blood and will always make indent marks. That gives you a sense of how severe the behavior is. If the child causes open wounds, indent marks or lesions, that certainly is important too.
In summary, the first step to tackling any problem behavior is an accurate assessment of the whole child, including a thorough description of the problem behaviors he or she is exhibiting. For more information on turning autism around for your child or client with autism, make sure to review my 3-Step-Guide today.