hgh dhea metformin

Calendar

April 2024
M T W T F S S
1234567
891011121314
15161718192021
22232425262728
2930  

Pages

Archives

Recent Posts

Blogroll







mother and daughter

BEHAVIOUR MANAGEMENT – PART 2

First Published Tuesday, 29th April, 2008.

 

The ultimate objective when raising children, is to teach/enable them to self-manage and take responsibility for their own behaviour in the world at large. The most difficult task for parents who often struggle to interpret the meaning of their autistic child’s behaviour, is often in regard controlling and modifying their own behavIour in order to bring about change in the behaviour of their children.

 

Parents may find themselves disappointed in their child’s behaviour, but children must make mistakes in order to learn. It’s terribly important that we do not take away from children, the natural consequences of their own behaviour. How else can they learn, but by being allowed the dignity to experience those consequences? When adults do not allow children to experience natural consequences, they actually teach them that the rules of nature and society are not relevant to them.

 

In the following paragraphs, we’ll take a look at a number of challenging behaviours/scenarios in an endeavour to better understand and solve dilemmas.

cloud thinker

DISTRESS DUE TO CHANGE
 

Coping with change remains an ongoing issue for most autistic people throughout their lives. Any autistic person who has achieved any degree of success in the world at large, has had to overcome their anxiety to a degree and learn to cope.

 

Basically, if an autistic child, anxious due to the effects of change, is never exposed to change, then how will he ever learn to manage his anxiety and cope with change? You cannot bring about change in any person without some stress and for autistic people it’s the same. If a child’s comfort zone is not stretched, he will become increasingly intolerant of change. Older and stronger adolescents and adults do not necessarily become more flexible and accepting of change upon maturation. In fact, the opposite tends to be the case. It’s easy to let an anxious autistic child off the hook when he’s upset and to mollycoddle him, but such misplaced compassion is the ultimate handicap. Many adolescents on the spectrum who have been ˜mothered” all through their school lives, receive a real shock when they enter the adult world and are expected to be relatively independent. Some special school teachers have expressed the view that they consider their objective is to give young children a wonderful fun time at school. Is it not better to consider that children attend school to be prepared for life outside of school? A child who is essentially “babysat” in school, is done a huge disservice in both the short and long-term.

 

The primary treatment for anxiety is systematic and structured routine in which autistic children learn and practise all necessary age-appropriate tasks they can, to the highest level they can. If you baby young autistics and continue to do so, irrespective of their age, then a dependent 2 year old they likely shall remain. Many autistic people are of the firm belief that had they been born ten years ago, with a diagnosis obtained in late childhood perhaps, that they would not have achieved the level of success they have, as the expectation on them to achieve and behave in relation to the usual or NT standard, would not be there.

bubble blowing

ANSWERING BACK

 

Essentially, answering back only works for a child if adults buy into it, via response and anger. Adult anger is the child’s reinforcer. Remaining controlled, ignore any back-chat, asking him/her what they are supposed to be doing in a softer voice. Repeat the question once or twice in response to any further back-chat(do not nag), then move away and ignore them completely until they carry out whatever duty was assigned. If the task has not been carried out the next time you make contact with the child, then again ask “What are you meant to be doing?” Time should not be an issue, only calm repetition. He/she may become quite irritated at your question, perhaps calling you names(ignore this), but such behaviour is actually a good indicator that you are gaining control. Remember, backchatting is meant to cause you to become angry and lose self-control. Usually, it’s meant to cause you to forget what you want your child to do or distract you from some issue. It’s usually simple manipulation behaviour that all children try/test you with at some stage.

 

Importantly, let us never forget that developmental disability or difference must never be allowed as an excuse for a lack of manners. Nor is it a license to behave irresponsibly.

child warrior

WHINGING

Whinging/whining behaviour is one of the four patterns of social control/avoidance behaviours used by all people. The motivation of neurotypical children will tend to be social-personal, whereas for autistic children, it will be purely functional or instrumental in their attitude.

The other three patterns of behaviour are:

 

  1. Direct confronting tantrums.

  2. Planned ignoring: I can’t see/hear you, therefore I don’t have to respond.

  3. Cute ingratiating behaviour to distract from some unacceptable action or to avoid doing some required task.

The standard response to such avoidance/distractor behaviour is to ask the child what they are meant to be doing. Never talk about the whining behaviour for that would reinforce it, which in turn effectively draws and distracts you from your agenda onto theirs. Whenever the child whinges, pleasantly ask them whether they have done the task. Regardless of tantrums, the assigned task never goes away, even it goes into the next day. Once your child learns that you do not give in, he/she will stop trying. Whinging is simply just nagging behaviour and its purpose is to make adults uncomfortable so they may give up and yield to their child to reduce their own discomfort. However, to yield to nagging/whining is to negatively reinforce whining/nagging as an effective form of social/communication that your child will use again in the future.

Nemo

TV ADDICT

 

Every autistic person from low to high functioning requires stable structure to cope and feel safe. If it is not given to us, we make our own. A parent once wrote that their child wanted to watch videos all day long and asked what could be done to curb this. After a video finished, the child would walk around the house, reciting the same video out loud repeatedly.

 

Watching an endless stream of videos is likely the symptom of insufficient structure linking the parts of the day from beginning to end. The child was rehearsing the videos out loud while roaming the house, in other words, giving himself the structure through self-rehearsal, but it is not a real environment in which he is living. It is a TV environment. Very many autistic people with ID do not understand that what is on TV is not real.

A young child is in no position to establish a structure that will be adaptive for life and that will also fit in with the needs of his family. Either you give him a totally structured day in substitute for the video structure he has found or he will continue watching videos and, in a sense, live in the world of videos he learns by rote. This is why some children like to watch the credits on videos. Their need for structure is so great that the entertainment content of the video is not sufficient, but the patterns of the credits are discrete and tight. It’s best to develop a timetable of activities of your choice that runs through the day in small steps. It can be set up so he can communicate and make choices based on your perception of what he and the rest of the family needs. Parents must be in control, not the TV/video player.

 

If a child’s learning is not based on systematic practice in a structured manner so that information learned is stored in the brain along with similar information, then the information is not useful. Though learning occurs all the time, the problem in the scenario of a child watching TV most of the time(without being given coherent structure by parents), essentially means that the learning is randomly stored or associated in the brain, and may be enlikened to a jigsaw after you’ve put it back into its box, or to a library, but only where books are stored randomly and not in alphabetical order. There are autistic children, adolescents and adults with very high IQ s who are unable to carry a conversation or speak sensibly due to the chaotic lives they are leading or have led up to this point. They live in a fragmented fantasy world in which they are in total control. They may well have a tremendous vocabulary and talk incessantly, but their speech is meaningless and lacking sense. They are often anxious and their comprehension limited. A life without structure coupled with chaotic experiences leads to chaotic learning and dysfunction.

 

It’s best to give children structure in the form of a detailed daily routine, being prepared to use TV as reinforcement for positive behaviour(if desired and at your discretion), as well as ensuring that you as a parent/carer are in charge of everything in your house, instead of the TV.

dad and daughter

PEOPLE HAVE TO BE IN THE APPROPRIATE PLACE”
 

For many autistic people, particularly those who are very young and those with intellectual impairments, the world is discontinuous and fragmented in both dimensions – time and space. The world essentially “happens” to such children/adults and is unpredictable and frightening. In their efforts to prevent change or control situations, some have even been known to “attempt” to make time go in reverse or happen faster. They can only understand the world as discrete and separate settings.

 

Without having developed a sense of Self(all encompassing), different people become ˜learned” in different settings and remain in effect, referenced to those settings. In this case, the child/adult has essentially developed a separate sense of self in each setting with each person, but has not been able to join all the settings and people together conceptually so that he can understand that he can be both a son to his mother, a grandson to his grandmother, a student in school to his teacher etc. In essence, this child/adult cannot reconcile him/herself as having more than one social role or face at a time. Many highly competent autistic/AS adults can only function in a few social settings and feel safe, without disintegration. A fragile sense of Self inevitably lends itself to anxiety and panic, even terror. Autistic people are referenced to people/objects, settings and structure. We require that these be safe and predictable with clear rules. Anything less sees a rise in anxiety and our sense of self rapidly disintegrates. This is why structure and consistent rules of behaviour and communication styles across all settings are so critical to us and our sense of Self. We are only stable if the specific settings in which we operate are consistent and stable.

 

Some children may require scripted responses for daily routines in order to understand that things are more the same than different. Some may have difficulty with extended family members coming into their home environment as they are not seen as ˜belonging” to the child’s home environment, while the child is perfectly content and secure visiting the grandparent, aunt etc in that person’s ˜learned” home environment. The resolution of such a predicament is that the extended family member needs to continue coming to the child’s home environment(making the visits very brief at first), only leaving on their and the parents own terms, no matter what.

 

Similarly, many young children on the spectrum have difficulty defining themselves as˜student at school” when adjusting from the home environment to a new school. In order to cope, they need to ˜learn” the new school, staff and routine, overcoming their anxiety which is no easy feat. It often makes things more difficult if teachers bring the parent to school by mentioning “mummy” or daddy” while the child is still adjusting to the process of defining himself as a school student in the new setting. Some children can become quite upset if the parent who would not normally be the one to pick up the child at the end of the day, enters the school setting. It can be unsettling and difficult for children on the spectrum to have either parent in the school setting at all, as opposed to the home environment where they are seen to belong.

 

Similarly, some children have enormous difficulty seeing their mother/father or significant others dressed in uniforms or clothes outside of what is seen to be the norm in specific settings for that particular child. A parent can in effect be seen as two separate people and the child may have a separate “Self” for each version of the parent/other involved. Only when the child understands the continuity of the world and people/objects in it, will he/she develop a sense of Self that is multi-faceted. Only then will it be understood that a person can have different characteristics in different settings, but still be the same person.

 

Unfortunately there is no easy way to assist a young child on the spectrum in understanding that the world is continuous, other than provide them with structured and stable activities hand in hand with a standard communication system across all settings. Experience and intellect will be the determining factors in regard how successful the child will be in understanding the world. The higher the intellect, the greater the chance of success,but only if coupled with structured and consistent rules and routines.

 

There’s alot to be mastered in this life we are given. As painful as it may be to watch, autistic people have much that must be mastered by themselves and themselves alone. Above all else, we must learn to master our constant anxiety and learn self-control. Some do, others do not.

roaring

SELF INJURIOUS BEHAVIOUR

 

In the long-term, self-injurious behaviour develops incidentally/accidentally as a result of repeated patterns of responding to over-stressed children as they seek to escape from that stress. So, if and when for example, a child bangs his head on a window and finds that teaching staff respond consistently in a specific way, possibly removing him from the stressful situation for safety/first aide reasons, he will gradually learn that banging his head is a wonderful and effective form of communication that forces staff to release him from the stress. If the child is non-verbal, the situation is compounded further by his inability to communicate directly. In this case, it’s important to establish what it was that overstimulated the child. All children are meant to be under some structured and planned stress in schools and expected to adapt to that stress, in other words, to learn. It’s when stresses are excessive in intensity, duration or both and staff in busy classrooms fail to read the subtle signs of initial anxiety, that problem behaviour develops. Young autistic/AS children have neither the insight or communication to state “I’m anxious!”. Staff generally only realise there’s a problem for the over-stressed child when he/she explodes and hits, bites or runs etc. Invariably, the child is labelled “aggressive” and behaviour management is sought to “fix” the child. In reality, it is the awareness of staff in reading subtle indicators of anxiety, that must be trained.

 

With regard to hand biting, head-banging and other patterns of self-harm behaviour, the other issue is that there is the possibility that the child may start to stimulate the release of endorphins in the brain via the physical impact, producing a pleasant sensation.

 

It’s important to ascertain the background to any outbursts(head-banging, biting etc) that are indicative of stress. Awareness of the subtle signs of building stress(be it fidgeting, laying or banging head on desk, swearing etc) need to be recognized and removal to a calming room or quieter area/activity, before the explosion occurs is key. Note that taking the child to a calmer area/room only when he explodes, only reinforces explosive escape behaviour as escape behaviour.

 

Ultimately, it’s all about clear communication between autistic/AS child and teachers. The problem is that most teachers cannot speak or understand autistic communication through behaviour, even in special schools.

incoming waves

MANAGING MELTDOWNS

 

It’s important to recognize that anger is not a universal feature of autism/AS. There are many on the spectrum who seem almost devoid of anger, even under intense provocation. Those who fall under this umbrella, tend to be far more vulnerable to physical abuse and exploitation.

 

Stress can manifest itself in different ways for those on the spectrum. Some internalise their feelings, becoming withdrawn and depressed, even ill. Others may react by becoming increasingly anxious, yet managing to maintain self control. Others seemingly erupt out of the blue(be aware that spontaneous and unpredicatble episodes may be related to neuorological factors, especially complex partial seizures(Baron-Cohen 1988). But for some, the brewing storm turns to tremendous rage and both the meltdownee and those present can be left feeling quite traumatized, exhausted, even confused after the event. While in a blind fury, autistic/AS children and adults may lack sufficient empathy and self control to moderate the degree of injury/damage.

 

There are many strategies designed to help children understand and express their anger and other emotions in appropriate ways, and children can learn˜self control” over time. Music can be a great de-stresser as can vigorous exercise. Channelling aggression into constructive activities and teaching relaxation techniques designed to remove angry thoughts may also be helpful. Sometimes focusing on the cause can precipitate more anger.

sanctuary

Daniel Woodhouse wrote:


My Greatest Fear is Myself

 

My greatest fear is myself.

Control is not absolute: a constant struggle to maintain

it drains my strength.

I am always tired: I never get enough sleep.

Events beyond my control happen around me: I do

things that scare me. If I’m confused or angry or tired,

I slip up and my body takes over.

Watching your life like a void is scary. It takes an

effort of will to take control again and not just let it happen.

I’m afraid of what I feel. Emotion weakens my control,

making its grip easier to break.

When I think, I sometimes think of letting go, just

letting it all slip away. It hurts fighting all the time.

I just want peace and rest.


As Daniel so clearly expressed in his poem, our tolerance decreases as we fatigue. This is another reason to maintain the regularity of structure: routines, rules etc. When we are in a routine, we can relax a little and function on auto-pilot for a bit. Otherwise, we are always hyper-vigilant, watching and checking everything and everybody, and then trying to sort out meanings. When a child is confused, anxious, angry to the point of meltdown, their only concern is that you make them feel safe once more.

 

The escalation cycle can be smoothly diffused if managed carefully and calmly. If the signs of ensuing meltdown are missed and a rage has erupted, safety is paramount. Remain calm, maintaining confidence and control(your child will sense if you are not in control). Remove people to safety. Do not add fuel to the fire by raising your voice, adding angry or negative tone  –  think “emotionally neutral”.  Provided child/adult is in no immediate danger, do not seek to touch or engage/stimulate them further. Allow them time and solitude to work through the storm, observing covertly from a distance. Allow them to come to you when they are calm once more. Provide a known, calming activity to restore stability. Do not mention the storm. The child/adult who experiences meltdown has in effect experienced a total disintegration of their sense of Self. Their sense of safety and security is regained once more through engaging in known, calming activities and familiar routine.(Please refer to Behaviour Management Part 1 for clearer understanding and explanation of genuine meltdown as opposed to childish tantrum behaviour).

 

In closing, each and every child that enters this world is unique, complex and so very vulnerable.  They are a blessing and a gift.  Love and nurture, care for and guide them.  Should you require support, please don’t hesitate to seek it. They depend on you.  When the going gets tough, just take it one day at a time.  Take good care of yourself and your children. The best things in life truly are free.

solitary calm

For further reading :

“How to manage when someone on the autism spectrum is experiencing a meltdown”

Dr Tony Attwood

Click to access Adults-with-Aspergers-Tony-Attwoods-Anger-Management-Plan.pdf

Useful Resources:

Minds & Hearts:

Home Page

The Best Strategies for Calming Autistic Tantrums & Meltdowns:

https://harkla.co/blogs/special-needs/autism-tantrums-meltdown-strategies