The degree to which a person with autism experiences symptoms may differ. Some may experience mild symptoms manageable in day-to-day life with the correct provisions. However, others who experience more severe symptoms may require consistent care or supervision. Strategies have been implemented considering the behaviours to help people with autism.
- First, we will define autism and challenging behaviour.
- Then, consider some high-functioning autism behavioural problems.
- Following that, we’ll briefly discuss autism behaviour intervention strategies.
- We will also explore other behaviour strategies for autism, such as prevention strategies for challenging behaviour autism.
- Lastly, we will look at positive behaviour strategies autism.
Behaviour Strategies for Autism: Autism and Challenging Behaviours
Symptoms of ASD may appear as early as age 2-3. However, many people are undiagnosed until later childhood, adolescence or adulthood.
Autism spectrum disorder (ASD) is a developmental disorder that often impacts social, emotional and communication skills.
ASD may cause a person to perform repetitive behaviours, be highly revolved around routine and have attention difficulties. A person with autism may have problems learning and feel overwhelmed for various reasons, including sensitivity to sensory experiences (e.g., loud noises). Some examples of indicators of ASD include:
- Lack of eye contact
- Repetitive movements and habits
- Extreme dislikes of particular sounds, tastes, or smells
- Lack of response to social cues, e.g. smiling
- Difficulty understanding what others are thinking or feeling
Some examples of how a person with ASD may present challenging behaviours include the following:
- Physically challenging behaviours include biting, pulling hair, throwing things, falling to the ground, hitting others, or spitting.
- Emotionally challenging behaviours may include shouting, screaming, and angry outbursts involving swearing.
- Stimming is a kind of repetitive behaviour shortened from ‘self-stimulating behaviour’.
Examples of stimming include rocking, hand flapping, spinning, and repeating particular words or phrases. Stimming may not always necessarily be difficult and can often be harmless behaviour.
- Pathological demand avoidance (PDA) involves avoidance of everyday situations or demands.
Fig. 1 Anxiety and confusion are common characteristics of ASD.
What may lead to challenging behaviour in autism?
- Insensitivity to pain – Some people with autism may be more insensitive to pain than others. Those who are more insensitive may be more likely to display physically challenging behaviours, such as self-injuring or Pica.
- Anxiety – Changing routines or experiencing a sensory overload may trigger anxiety expressed through challenging behaviours. A person may be more sensitive to sensory stimuli and, therefore, more likely to experience sensory overload and anxiety.
- Confusion – A lack of structure, confusing information or new environments/situations may cause confusion and uncertainty, making it difficult for a person to understand what is happening around them. Such feelings may cause challenging behaviours.
High-Functioning Autism Behavioural Problems
The term ‘high functioning autism’ refers to people with autism who have average intelligence. However, they may have some deficits in communication, understanding emotions and social interaction.
A person with high-functioning autism may be able to function in day-to-day life and have developed life skills, reading, writing, and speaking skills.
Fig. 2 People with high-functioning ASD may not have as severe behavioural, social and cognitive deficits as those with low-functioning.
Some indicators of high functioning may include:
- Emotional sensitivity – Provocation from a particular use of words, tone of voice or event can lead to challenging behaviours. Following challenging behaviours, a person may face extreme guilt and feel they need to isolate themselves.
- Repetition – Brushing teeth for five minutes at the same time each day after a meal is an example of repetitive behaviour which a person with high-functioning autism may display.
Disruptions to this routine, such as delayed mealtime, can cause distress and challenging behaviours.
- Obsessive fixations – Fixations on hobbies or activities. Such fixations can be positive and lead to extensive knowledge of the subject and may lead to the development of social interactions through communicating with like-minded people.
Behaviour Strategies for Autism: Autism Behaviour Intervention Strategies
The National Autistic Society created a framework to help understand how to respond to the needs of a person with autism. The framework can be applied as an intervention strategy and help challenging behaviour.
| Description/ Examples |
| Structure | A structured environment involves predictability, e.g., knowing the noise level, who will be in the environment, and generally understanding what to expect. The individual knows what to expect, and the information may be presented in a way, so they don’t feel overwhelmed. |
| Positive approaches | Positivity can be reinforced to help a person with autism feel more confident and create positive associations with the environment. Self-confidence can be developed by positively supporting a person’s strengths and abilities and helping them develop and adapt to new situations. |
| Empathy | Using empathy is key to helping understand a person with autism. Through empathy, people can learn to understand the mindset of an individual with autism and try to understand what motivates, frightens, upsets or preoccupies a person with autism. |
| Low arousal | A person with autism may become anxious in an environment with a lot of noise, people, distractions, and an untidy environment. A calming atmosphere may support low arousal, avoid distressing feelings, and support relaxation and predictability. |
| Links | Sharing information between family members, friends and professionals supports open communication and helps people around a person to recognise and understand what they may be able to do or not do to help a person with autism. And can also be beneficial to the family too. |
An easy way to remember this is by using the acronym SPELL.
Behaviour Strategies for Autism: Prevention Strategies for Challenging Behaviour Autism
Several preventative measures can be put in place to help reduce challenging behaviours. Together, these strategies can be used as a combined approach to reduce the likelihood of challenging behaviours. Prevention strategies for challenging behaviour include:
| Prevention Measure | Description |
| Relationship development intervention (RDI) | Families are involved in helping address and cope with the symptoms of autism and building on social and emotional skills. |
| Get to know the person | Understanding their personality, likes, dislikes, and triggers can help identify what may cause challenging behaviours and help implement strategies to reduce this likelihood. |
| Clear, simple language and gestures | Clarity is essential to avoid confusion and understand the information. This helps to avoid any unnecessary stress or other emotions. |
| Calming environment | A safe, relaxing space involving soft objects and sensory stimuli that a person likes, e.g., certain colours, sounds or textures, may help prevent challenging behaviours. A quiet, safe environment without hard, sharp objects may help reduce risks if challenging behaviours are displayed. |
| Sleeping | Some people with autism may have issues with sleeping. This can be due to several factors, including sensitivity to noise, light and anxiety issues. |
| Eating | A person with autism may have difficulties eating due to issues with particular textures and colours. This may allow the person to have a limited diet. To support this, positive reinforcement can be used to introduce a balanced diet, a food diary that records food intake, and GP support. |
Families, specifically the parents, are trained and act as therapists in this form of intervention, and it uses a dynamic approach to improve the quality of life for autistic children.
Overall, RDI focuses on emotional referencing, social coordination, declarative language, flexible thinking, relational, informational processing, and foresight and hindsight.
Behaviour Strategies for Autism: Positive Behaviour Strategies
Positive behaviour strategies (also known as positive behavioural support, PBS) can be used to help a person with ASD cope effectively and adapt to day-to-day life. As a result, these strategies can also be considered preventative to help reduce anxieties and challenging behaviours. They are delivered by professionals based on evidence, with professional standards.
Positive behaviour strategies focus primarily on improving the quality of life and use a data-driven approach throughout the entire process. Functional assessment is conducted to guide the strategy employed, and proactive and reactive methods help manage and change behaviour.
A specialist needs descriptions of challenging behaviours and identification of events and times to use positive behaviour strategies.
This helps understand routines and what could disrupt them. Then, they identify the consequences of what those behaviours do for the person (biting = frustration) and make summary statements. Direct observation data supports this process.¹
Examples of strategies used include:
- Supporting self-confidence – Self-confidence can help reduce any anxiety a person with ASD may have in their abilities.
- Positive rewards and reinforcement – Reinforcement and rewards may motivate and help people with ASD cope with a particularly challenging situation.
- Learning functional skills – Learning day-to-day independence skills, from making a drink to accessing public transport, can support a person to be more self-confident, reduce anxieties and become more independent.
- Adapting appropriate behaviours – A person with ASD may need guidance to learn appropriate and inappropriate behaviours. The person may also require additional support to carry out these behaviours or may need to know how to do this.
Behaviour Strategies for Autism: Picture Exchange Communication System (PECS)
Developed by Frost and Bondy (1984), Picture Exchange Communication Systems (PECS) provide autistic people with different ways to communicate if they struggle to use the more conventional methods (speaking, body language etc.). They use pictures instead, which can help communicate requests, thoughts, or feelings.
Symbolised images can be given more meaning through continued work with the people in mind. Sign language is a form of PECS, and PECS has been shown to help people develop their verbal language skills, despite needing to rely on image communication initially. PECS² is taught in phases:
- Associations, how to communicate: children are shown how to associate images with objects/activities/needs, and they can exchange them for what they want. To keep it simple, single images are used first.
- Distance and continued use: single images are still used, and children are encouraged to use them in different scenarios with different people.
- Discrimination: the distinction between images and what they want is identified and encouraged in a child, so they can choose from multiple options to indicate what they want.
- Sentence structure: images are combined with a written sentence that can be attached to describe what they want, aka, “I want”, would be attached to a picture.
- Questions and answers: children use PECS to discuss and answer simple questions using the above sentence structures with their carers.
- Sentence combining: the child can respond to questions more thoroughly, commenting on their feelings and what they see and hear.
Behaviour Strategies For Autism - Key takeaways
- Autism Spectrum Disorder (ASD) is a developmental disorder that often impacts social, emotional and communication skills.
- ASD may cause a person to perform repetitive behaviours, be highly revolved around routine and have difficulties with attention.
- A person with ASD may present challenging behaviours such as hitting, biting, stimming, Pica and Pathological Demand Avoidance (PDA).
- Behaviour strategies for autism involve SPELL, Picture Exchange Communication Systems (PECS), Relationship Development Intervention, and the adoption of various approaches to improve the overall quality of life for those with autism.
- PECS has shown that it improves verbal language skills alongside aiding communication in autistic people.
References
- Positive Behavioural Support (PBS) Coalition. (2015). Retrieved 7 April 2022, from http://pbsacademy.org.uk/wp-content/uploads/2016/11/Positive-Behavioural-Support-Competence-Framework-May-2015.pdf
- Sulzer-Azaroff, B., Hoffman, A. O., Horton, C. B., Bondy, A., & Frost, L. (2009). The Picture Exchange Communication System (PECS) what do the data say?. Focus on autism and other developmental disabilities, 24(2), 89-103.
- Fig. 2 – Autistic Child Drawing 3 Friends (https://commons.wikimedia.org/wiki/File:Autistic_Child_Drawing_3_Friends.jpg) by MissLunaRose12 (https://commons.wikimedia.org/wiki/User:MissLunaRose12) is licensed by CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/deed.en)
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