Positive Behaviour Strategiesfor

Students With Autism

Aims• To develop our understanding of the needs of students

with autism

• To explore the processes operating during episodes of challenging behaviour

• To develop a range of proactive, active and reactive strategies which will enable positive behaviour support for students with autism

• To consider ways in which we can bring about positive lifestyle changes for students who display challenging behaviour

Part One

Autism:

Developing Our Understanding

Autism is a part of who I am

Temple Grandin

Kanner’s Key Features

• ‘the inability to relate themselves in the ordinary way to people and situations’

• ‘the absence of spontaneous sentence formation’

• ‘insistence on sameness’

Asperger’s Key Features

• difficulties in interpreting non-verbal communication such

as facial expressions and body movements

• peculiar use of language

• obsessive interests in narrowly defined areas

• clumsiness and poor body awareness

• behavioural problems

• familial and gender patterns

Hans Asperger 1944

APA Diagnostic Statistical Manual DSM-IV (1994)

‘Onset before three years of delayed or abnormal function

in at least one of: social interaction, language for social

communication, symbolic or imaginative play.’

WHO’s International Classification of DiseasesICD 10

‘Impaired or abnormal development must be present

before 3 years of age, manifesting the full triad of

impairments.’

Autism: A definition

a behaviourally defined developmental

condition resulting from neurological

characteristics caused by

genetic factors

Prevalence

• Estimated half a million people in the UK

• 1:100

• Gender bias: Classical Autism = 4 boys to 1 girlAsperger’s Syndrome = 9 boys to 1 girl

• Increasing prevalenceBetter identificationNeo-natal care

The Triad of ImpairmentsSocial Understanding

ImaginationSocial Communication

Mind-blindness• People with autism lack a Theory of Mind

• Theory of Mind is the ability to appreciate the mental

states of other people

• Evident from about age four onwards

• Theory of Mind is essential for forming social groups

Central Coherence

The ability to …

– see the bigger picture

– understand the context

– get the gist

Executive Function

1. switch our attention from one thing to another

2. prioritise

3. make decisions

4. plan strategically

The Senses• Visual – what we see

• Auditory – what we hear

• Olfactory – what we smell

• Gustatory – what we taste

• Tactile – what we feel

• Vestibular – where we are in relation to the world (balance)

• Proprioceptory – where we are in relation to ourselves (co-

ordination)

Sensory Processing

• Hyper- or hypo-sensitive – do not easily filter

information

• Mono-processing

• Difficulties with focusing on what neuro-typical

thinkers consider salient information

• Attention channel – incredible knowledge and

detail in this

Part Two

Challenging Behaviour:

A Process and Not an Event

What is Challenging Behaviour?

Definitions

‘… behaviour that challenges – whether it is

a challenge to our understanding, our own

well-being or a child’s or else to our ability to

carry out our responsibilities as parents or

professionals.’(Whitaker 2001: 4)

Definitions

‘… behaviours which involve significant risks

to people’s well-being or act to reduce

markedly access to community settings.’

(Emerson 2001: 3)

Challenging Behaviour

A Working Definition

Episodes or patterns of behaviour which

present significant risk of harm or restriction

to an individual and the people around them

and are likely to be severely detrimental to

the

quality of life experienced by those

individuals

and the people around them.

Domains of Challenging Behaviour

Violence Self-injury Destruction Disruption Excessive self-stimulation

Behaviour directed at other

people which is likely to

cause

injury

Behaviour directed at

themselves which is

likely to cause injury

Behaviour directed

at

the environment

which is likely to

cause

damage

Behaviour which

interferes with

organised

activities

Behaviour which is

generally repetitive

in

nature and provides

a

reinforcing stimulus

Attacking with objectsBitingHair-pullingHead-buttingKickingPinchingPunchingPushingScratchingSlapping

Attacking with objectsBitingEye gougingHair-pullingHead-bangingHead-slappingKnee droppingPinchingPunchingScratching

ArsonPushing items overRipping furnishingsSmashing windowsSmearing faecesTearing resources

Inciting othersRefusing to moveRunning awayScreamingShouting

Eye-pokingFlapping objectsHand-flappingMasturbationRockingSpinning

Challenging Behaviour• Functional

• It does something for the person

• Effective• It works for them

• Learnt• It is a consequence of previous experiences

• Ingrained• It is part of the person’s repertoire

• Communicative• It is telling us something

Also …

• Subjectively defined• A product of our personal histories

• Context specific• Varies according to settings and situations

• Socio-culturally constructed• May vary in impact from group to group

Need

• All human behaviour is driven by needs

• Identify the need … understand the behaviour

• Meet the need … address the behaviour

Four Areas of Need

• Attention

• Escape

• Sensory

• Tangible

Functional Assessment

• All behaviour is functional

• Remember, it is doing something for that person

• If you want to prevent or modify the behaviour you have

to find a way of doing that same something for the

person

• The person will find a way of meeting his or her needs

Functional Behaviour and Autism

• Many people with autism have a limited range of

behaviour and a limited capacity to learn new skills

• Given this, they are likely to ‘stick with what works’

• Behaviour becomes deeply ingrained through repetition

• If ‘what works’ is inappropriate we need to replace it

Challenging Behaviour• Challenging behaviour serves a necessary purpose for a

person

• Challenging behaviours are learned through a history of

interactions between a person and the environment

• Problem behaviour may communicate something about

a person’s unmet wants or needs

• A single behaviour may be maintained by more than one

outcome and group of behaviours may be used to

achieve a single outcome

Part Three

Proactive, Active and Reactive Strategies

Behaviour Support

• Emphasis on enabling individuals to develop behaviour patterns

which are positive and fulfilling

• Focus on developing an individual’s capacity to respond to

challenges and obstacles they face

• Endeavours to enhance an individual’s repertoire of skills via

proactive strategies

Three Tiers of Strategy

• Proactive – things we teach

• Active – things we introduce to calm or distract

• Reactive – planned interventions

Proactive

Reactive

Active ActiveProactive

Arousal

Time

Proactive Strategies

• Learning

• Delivered in optimum learning conditions

• Positive outcomes

• Enabling

• Address the need

Active Strategies

• Palliative

• Temporary – not designed for deep effect

• Portable

• Quick thinking

• Return to proactive state

Reactive Strategies

• Last resort

• Principles of least restriction

• Non-physical or physical

• BILD accredited physical interventions

• Critiqued – something is failing

• Recorded and evaluated

Part Four

Positive Lifestyle Changes

Improved Lifestyle Options

• Long term

• Enduring

• Trans-disciplinary audit

• Forward thinking

• Capacity assessment

Areas for Improvement

• Diet

• Health

• Leisure

• Self-advocacy

• Sensory support

• Skills and knowledge

Incident Specific Strategies

• Short term

• Instant pay off

• Not sustainable

• No deep effect

• Bridging strategy

Categories of Strategy

• Avoidance

• Calming techniques

• Distraction

• Options