Thursday, October 13, 2011

Managing Tantrums in Autism Spectrum Disorders

When dealing with tantrums and difficult behaviors in autism spectrum disorders, using behavioral approaches alone can sometimes fail. What is the missing piece to managing these behaviors that a behavioral approach alone may not address?

To start, we need to look at the reasons for behavior. According to behavioral approaches, most of the behavior we see results from one of three reasons: a request, seeking attention, or a sensory reason. Let's look deeper at these three reasons for behavior and the ways we currently handle them.

Handling a request is fairly straightforward. To put it very simply, a request is usually something externally controlled by both reinforcing appropriate requests and not reinforcing inappropriate ones, such as a tantrum.

For negative attention-seeking behaviors, we can eliminate the behavior by not giving the negative behavior attention and give attention for desired behavior - very straightforward, and again, usually externally controlled.

The sensory reasons arise from both the external and internal events that a child experiences through the five senses, and may or may not be externally controlled.

In all of these situations, our internal responses - our feelings and thoughts about events fire us into action. In stressful situations, the resulting "knee jerk" reactions are often difficult to manage with a purely behavioral approach for a few reasons:

1. Thoughts and feelings are often lightning-fast, internally-controlled events, therefore difficult to manage through external behavioral modifications.

2. Thoughts and feelings can't be measured, and as a result, behavioral approaches simply don't address them. It doesn't mean that these things don't exist or aren't important. It just means that they're left out of the equation.

3. Behavioral approaches address the cause and consequence of behaviors - the beginning and the end. But internal responses (ie thoughts and feelings) happen in the moments between the cause and the consequence. By not dealing with thoughts, feelings and solutions at these moments, we leave a child to figure out solutions on his or her own.

4. Children on the autism spectrum have a limited ability to adapt to new or changing situations, solve problems, compare past to present, or see possibilities. Because of this, if a child never learns how to think through a challenging situation during the emotional moments, when faced with it again, the same behavior will probably repeat itself, no matter what the consequence, or how many times they've been through it before.

This situation calls for tools to deal with overwhelming thoughts, feelings and strategies in the moment before the tantrum, not just consequences after.

In the book The Explosive Child , Ross Greene talks about this situation. This book applies to any disorders that have limitations in problem solving and executive thought, including all PDD's, including Asperger's Syndrome, PDD-NOS, and all autism spectrum disorders, ADD, ADHD, and various other developmental disabilities.

In the book, first we pick our battles carefully, and then talk through our thought process out loud. This way our children can hear us think through situations before tantrums. This also creates a memory of how they triumphed in the situation without resorting to negative behaviors.

Progress is made in small increments, but as time goes on, tantrums should decrease, and you can even start to ask your child to contribute ideas about solving problems during those emotional moments. In doing this, you help your child learn how to solve problems and become confident about handling new, changing, or challenging situations. You'll combine the best of all worlds, to the benefit of your child.

Sandra Sinclair is a parent of a child with PDD-NOS. She is author of "Newly Diagnosed Autism Spectrum"- A free mini-course with 7 clear steps you can take to help your child.

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