Tuesday, January 3, 2012

B is for Behaviour

Once upon a time my little Liam was a biter.




Still is but he has learned to bite his own hand* in order to stay out of trouble.

We didn't teach him to do this, but the consequences of biting other people taught him to try and stop himself, by putting his hand up to his mouth. He used to bite a lot of other people. A lot.

Biting is such an effective way to get someone out of your space, to elicit a reaction, and to get sensory input when you are angry, threatened or excited, that it comes naturally to many children, not just those on the autistic spectrum. It comes just as naturally for the victim to squawk or scream in an amusing fashion, back off and leave them alone with whatever they were doing before you got bitten. No wonder it works.

So, how do we put an end to it? Well the first thing is not to react. Very difficult when your beloved 3 year old has just nipped you on the c-section scar (a convenient height when you are 3) and you are in white hot pain meltdown. But stifle the scream, as it just increases the likelihood of a repeat.

At the time when biting first occurs, you will hopefully be stronger than the child so you can move them firmly but gently towards a pre-planned time out zone. A time out zone removes the biter from the situation and protects the recent victim from retaliation. It also helps everyone to cool off.
Please don't smack, hit or bite back. You are bigger so it's not fair and it will not solve the situation.

For reasons of compliance the time out zone has to be more than just the “naughty step."
A sophisticated child with ASD is just not going to stay there alone. You need a room with no toys visible, (lock toys in a cupboard or toy box when they are not in use) or the back porch if you have an enclosed yard with a glass back door. And you have to be within sight or sound of the biter. This is about separation, not isolation. Only a short time is needed so stay nearby and don't forget about them! You are pretending to ignore them. Pretending. So whatever space you come up with, make sure there is nothing there that they can wreck or tip over to create further mayhem and regain your attention.

You have to be able to leave them safely alone for a few minutes. The younger they are, the less time they need. If Liam bit his sister I would put him in the back garden and stay at the glass porch door while comforting Grace visibly. Liam soon learned that this was not a way to win friends and influence people, and the behavior ceased.
At the same time I started trying to teach him ways to get my positive attention.

Once you come up with a Zone you need to do an “A.B.C” (here's the science part)

Just get a piece of A4 paper and draw 3 columns, put it on a clipboard and attach a pen.
The first column stands for Antecedent; what happened before you observed the behaviour,
the next is the actual Behaviour, come up with a standard description so others can fill in the chart too, and the last is Consequence; what you or others did afterwards.

When a behavior happens, put them into the "time out" zone and grab the clipboard. It will help to calm you down if you're angry or hurt, and you are less likely to do anything unreasonable if you have to write it down. I am not judging you, we have all done it when pushed, and I'm prone to roar my head off when under pressure, but I regret it straight away.
Seriously, forget about threatening to smack too, as they will soon learn whether you mean it and it is pointless and unpleasant for all.

Make threats by all means, but make them about things you will do. I threaten Liam with putting his DVDs in a suitcase and taking them to St Vincent de Paul. As I did do this with all his VHS videos he believes me. (he no longer has a VCR player at home as a result)

Mean it, and Do it, if you have to. Once you have filled one side of an A4 page, I guarantee you will be able to see a pattern. In either the Antecedent or Consequence column there will be a row of similar activities.
It's a bit like writing down everything you eat and drink for a day - you will see very clearly why you cant zip up your jeans any more. Once you have an idea of what it is then you can have a go at changing it.

The ABC will teach you to take control and change the consequences which may be inadvertently rewarding the behaviour, and it will quickly show you which activities or situations make it most likely to occur.

Remember - your child might be finding something that you intend to be punishment as a good reason for repeating the behaviour again and again. Mums say to me: "but I give out to him and he still does it"
Unfortunately the sound you make when "giving out" might be hilarious to your child. I once witnessed an Asian friend reprimanding her son in Urdu after he tipped a bottle of washing up liquid on the carpet. The sound she made was so enchanting I was tempted to tip a bottle of honey on top of it just to hear it again!
So your yelling and gesturing might as well be in Babylonian for all the good it's doing. Just make a poker face and remove the child to their time out zone, then write the behaviour down.

If you find that the behaviour is happening in the same situations - the antecedent- take steps to change those situations and make them less challenging for your child. Communication strategies are usually the key although sensory issues may also need to be taken into account.

This is where we do a functional assessment of what the behaviour is achieving and then find a more appropriate way to get the same thing. A job for another day.

xx

*Liam's hand chewing has so many functions that it is the work of a team of behaviourists to try and reduce it and fortunately it's not doing too much harm, as after 14 years he has a hardened area of skin where he tends to chew.
If your child is hurting themselves badly in order to get a reaction then you need to advocate for professional help immediately. Contact your local area health services or advocacy group and ask for an urgent referral. The smaller they are, the easier it will be to do a structured professionally supervised behavioural intervention that will save them from long term harm.



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6 comments:

Petunia said...

Was good to read and refresh again as about to implement a behaviour plan for some new aggression that has emerged with Munchkin. Mostly verbal threats (she's chanting die, die, die right now) some physical threats, hits, pinches or brandishing items. She's small and not hurting us (yet) but she's growing so need to do my ABCs with her and nip this in the bud now. Thanks for the timely post refreshing what I need to do :) xx

Me said...

Lisa this is great. I'm going to put link on ABA FB group.

Looking for Blue Sky said...

Great and clear advice as usual. Btw both myself and aspie boys are hand biters, it doesn't seem to do either of us any harm, it's just a bit unsightly x

jazzygal said...

Great advice....again ;-)

xx Jazzy

Hammie aka lisadom said...

Delighted! I am enjoying the journey via a group that "Me" joined me up to on Aba nd it is reminding me to share what I learned.
Candi: that's interesting that you bite your hand, I pick my eyebrow when I'm stressed, actually causes ingrowns! But I guess there are rose things. Petunia: tht sounds like a bit of echoalia that has been inadvertently rewarded by someone. I doubt she knows what it means but I bet it gets a great reaction. You should join "Me" 's aba group too as a parent and past therapist I'm sure they would make you welcome.

Jazz: thans for sharing! Xx

Clive said...

Excellent advice!

Using an ABC plan got rid of constant non-stop hand-clapping in this house! Made such a huge difference when suddenly the non-stop clapping ceased!!!

It's a great plan to use and implement - really works!