Behaviour as Communication

The way that humans behave with each other often has communicative properties, even when they aren’t speaking. Even when humans are speaking, most of what they say to each other is non-verbal (tone, expression, etc.). In other words, we use our behaviour to ask others to help us with things we can’t do alone or by ourselves. 

Think of it this way. What could an infant having a tantrum in a store be communicating? It could be that they are hungry. It could be that they are ready to leave. It could even be that they don’t feel well and need comfort from someone else. This leads to one of the hard things about communicating, which is; others don’t always hear what we are trying to say.

What Are You Trying to Tell Me?

How can we tell what someone is trying to say if they can’t speak? Really, it isn’t very different from speaking, but it can be a lot harder to “hear” when others don’t speak. One trick is to look at the response that stops a person’s behaviour. 

That can be a bit confusing so let’s look at an example with speech. With typical, spoken communication, if someone calls your name and you respond, the person tends to stop calling your name, because you responded. Imagine if someone called your name and you didn’t respond. What might happen? The person might call your name more loudly, they may get nearer to you, and they may try to get your eye contact. If any of those other behaviours gets your attention, they will probably stop.

Let’s look at the same situation without speech. If someone starts to stomp and grunt they may be trying to get your attention. If you don’t respond, they may grunt and stomp more loudly, or they may get closer to you. They may try tapping you or grabbing you. If you finally look at the person and say, “What do you need?” and they stop, then they were probably trying to get your attention.

Let’s look at one more example without speech. You are talking to a friend and the person you are with starts to fidget and grab at your phone. If you just keep talking, they may become louder, more insistent, or just walk off. They probably aren’t trying to bug you, they may be bored or looking for something to do while you  talk.

A Very Brief Look at Functions

The trick to understanding what people are “saying” with their behaviour is to find out what the person is trying to get with their behaviour, what those in ABA call a “function”. In ABA, we look at what happens right after a behaviour to figure out why the behaviour happened. People have complex needs but they can all be fit into 4 broad categories of needs (or functions) and if one of these happens right after a behaviour, it might be why the behaviour happened. First, let's look at the things that can happen after a behaviour;

Accessing Items or Activities

The person is able to access something they can feel, eat, or use. An example is buying movie tickets so that you can access the activity of watching a movie. 

Accessing Social Attention

The person does something so that other people will engage with them. An example is telling a funny story or calling an old friend to chat.

Accessing a Sensation

The person does something because of the sensation it produces. An example is clicking a pen, tapping a foot, or twirling your hair

Escaping Something Unpleasant

The person does something to get out of, or avoid, something unpleasant to them. An example of this is driving the speed limit and following all traffic laws so that you do not get a ticket, which is unpleasant

When Words Fail Us

People we encounter do not always have the skills needed to communicate their needs. A person like this cannot tell you that they need to eat, or that they want some attention, or that they need help to do an activity they enjoy. So how do people that don’t speak learn to communicate? If there is no plan what often happens in cases like this is that the person does something (yells, cries, stomps, etc.) that ends with a need being met, so they become more likely to do the same thing again the next time they have that need. 

It can be confusing so here is an example. A child that cannot speak begins to stamp their foot and grunt loudly while standing in the kitchen. Their mother comes over and says “it’s okay, what is wrong?”, but the person can’t respond so they keep stomping and grunting, maybe even getting louder or more intense. The mother wants to stop the grunting and stomping so she gives the child some food and comfort. If the child was hungry, or wanted attention they would likely stop grunting and stomping when their mother gave them food and comfort, but they will be more likely to stand in the kitchen and stomp and grunt the next time they are hungry or want attention. 

So What Now?

So what do you do about it? Knowing what a person is trying to get, or “say” with their behaviour lets you make sure they get it only for doing what you want. Let’s look at it practically with our prior example. Since we see that the child grunting and stomping their feet results in food and attention, we can make a plan to teach the child how to ask for food and attention first thing in the morning and before meal times. 

This can look a lot of ways. You could have a small packet in the kitchen filled with pictures of different food items that the child can select and bring to you. You could teach the child sign language for “food” and “hug”. You could even teach the child to come and tap your arm a certain number of times to indicate food. The idea is to find out what the person wants and then teach them to ask for it in a way that they can easily do. 

Hopefully this article will give you some ideas about communication and some strategies for figuring out what others are trying to tell you. Look at what happens right after a behaviour for help in figuring out why it happens and remember that knowledge is power; the more you know about a person, their strengths, weakness, likes and dislikes, the better you can help them. 

The 4 Functions of Behavior series: Escape

The other function of a behavior is escape. Escape refers to negative socially mediated reinforcement. This involves escaping from an aversive experience, involving another person, in the outside environment (e.g., noisy classroom, difficult task, etc.).

Most children with Autism often resort to challenging behaviors to get out of work. They may display various types of behaviors, for instance, throwing into tantrums, self-injurious behaviors, property destructions, and at times self-stimulatory behaviors (e.g., hand flapping, body rocking, etc.) to escape a difficult task.

 These inappropriate behaviors can last for a long time because they are effective. They work. When a child cries, and tears the paper at school when presented with a math worksheet activity, and is brought outside for time out – the child stops doing the work. This is exactly what the child wants; to escape from the task. Teachers may think that they are teaching the child a lesson and hoping that the child would learn to comply next time. But no, they are just teaching the child to continue engaging in those types of behaviors to escape from the task. They are just reinforcing the escape behavior of the child.

 Parents encounter these types of situations as well at home. They also struggle on how to have their children comply with simple instructions without the child resorting into challenging behaviors (e.g., brushing teeth, wearing clothes, putting away their toys, etc.) The main key is to figure out some ways to stop these behaviors and have the child comply to have the task done.

 There are some effective strategies like enriching the environment, using high probability sequence (e.g., easy task, difficult task, then easy task), giving the child choices of activities, setting up schedules, being creative in presenting the activities, using a token economy system, FCT (Functional Communication Training), using the Premack principle – First and then, and more other techniques for the child to be more motivated in completing a certain task and not resort to escape it.

 In addition to those strategies, don’t forget to use highly preferred items/activities as reinforcers. You can easily see which items or activities are reinforcing to the child as those are the items they choose to play with or activities they engage in most if not all the time at home. Simple tips. After finding out those reinforcements, try to keep them and just have the child access to them after completing a certain task or demand. In presenting the task, make it enticing and fun for the child. You can do this by knowing what your child enjoys doing (e.g., flying him like a superman or like an airplane or moving like his preferred animal - hop like a bunny to go to a room in your house where you planned on doing the activity, etc). 

 Let’s go back to the strategies. As you can see, there are lots of different strategies to motivate the child to complete a task. But keep in mind that one child is different from another. We can actually just use one strategy or combine some strategies, whichever fits the child’s needs. For now, let’s learn how to use three strategies together like using FCT (Functional Communication Training), giving the child choices of preferred activities, and the use of the Premack principle that parents can use easily and effectively at home to teach their children to comply, stay on task and use more appropriate behaviors in escaping a demand. 

Functional Communication Training (FCT)

 We have already learned how to teach the child to communicate to gain attention and to access a preferred item/activity. This time, teach the child a replacement behavior for escape. Teach the child to ask for a break, go or I want to go. Why do we need to teach the child to ask for a break or ask to go? Because we much rather have the child verbally imitate us to say ‘Break or I need a break, I want to go, or get handed a ‘break or go ’ card than a child slap you on the face, or throw into tantrums for an extended period of time. So let’s replace it with an appropriate behavior because if we don’t teach them a replacement behavior to get what they want, they will continue to engage in those inappropriate behaviors to escape.

 We have to remember that the child can be escaping a social situation, a specific environment or a person, and not just from a task or demand. There are different techniques to teach the child how to request appropriately to escape from a demand. The strategies can be tailored to their language skill level and the severity level of their behaviors. You can use break/go cards, verbal prompts, visual cues, social stories, scripts and more. You just need to be creative and make sure to match it to your child’s needs and abilities.

Giving Choices

Knowing the child is the key here. You can start with simple preferred activities that you think are easy for the child to do it to completion. Present two preferred activities (e.g., inset puzzles, sorting colored toys, matching colored cars, or any activities that you see the child engage in most of the time). In this technique, the child will have a higher probability of complying and completing the task.  So for instance, ask the child ‘Which one do you want? The puzzle or the cars?’ as you present the two preferred items in front of the child. The child can either respond verbally or use gestures (e.g., pointing or touching the chosen item).

Premack Principle – First and Then

 The Premack principle is a principle of reinforcement, which states that an opportunity to engage in more probable behaviors (or activities) will reinforce less probable behaviors (or activities). For example, if a child enjoys playing games or listening and watching nursery songs on the iPad (more probable) and avoids putting away toys (less probable), we might allow the child to play with the iPad after (contingent upon) finishing putting away the toys. 

 This principle is often referred to as “grandma’s rule” because grandmothers (or any caregivers) often apply this principle: “First, you clean your room (less probable) then you can play with your computer (more probable).” This strategy is effective in teaching children with autism as it gives them a clear view of all the expectations.

 Contriving teaching situations at home

Now, let’s learn how to combine these three strategies in teaching your child to comply and learn to escape from a task more appropriately. During your free time, set at least 10-15 minutes to contrive situations in teaching your child. Let's say that you’ve already chosen two preferred activities (e.g., 3 piece inset puzzle and matching superheroes card game) for the child to choose from. Present the two activities and ask the child “Which do you want? The puzzle of the Superheroes card? Let’s say the child chose the puzzle. Then, present the instruction ‘First do the puzzle then you can play with your iPad (highly preferred item). For starters, just ask the child to fit in one piece of the puzzle. Provide a physical prompt if needed to complete the task then gradually fade the prompt as the child learns to do it more independently. Upon completing the task, immediately prompt the child to say ‘break, I want a break, go or I want to go’ or physically prompt the child to hand you a break / go card. Then reinforce heavily for using his words. Give the child 5 minutes to play and repeat the process. So, one instruction, then break. This process may vary depending on the skill and severity level of the child. I was just setting an example.

 You are maybe wondering why you just ask a child to fit in one piece of the puzzle and he/she gets a break for five minutes. One technique to avoid any challenging behaviors in presenting a task is to start from a quick, easy, and simple activity that ensures success. In this example, we are just teaching the child to learn how to complete a simple task and use his/her words ‘Break or I want a break or I want to go.’ to escape from a task rather than a child punching you in the face.

 You can build up the difficulty level of certain demands at home from simple putting away toys, dressing up, or brushing then give the child time to play. Let’s say, for example, you presented two pictures (e.g., brushing teeth and putting away toys in the box), then ask “Which do you want to do? After choosing one of the activities, then present the instruction ‘First brush your teeth then iPad.’ You can have the child play for a certain period of time (e.g., five minutes) after teaching him/her to ask for a break / or to go appropriately and then present another demand. You can only present more difficult tasks once the child learns to escape more appropriately. 

During the occurrence of challenging behaviors

 When the behavior occurs upon presenting a demand, don’t let the child escape from the demand. Let’s go back to our example. When giving an instruction to fit in the one piece of the puzzle but the child starts crying, kicking, and throwing; physically prompt the child to fit in the puzzle if you still can and verbally prompt him to say ‘Break or go.’ Even if the child didn’t imitate you for a break, let the child go. You have already successfully had him fit in the puzzle even if it was with a physical prompt.

But if you can’t physically prompt him anymore because it was too late and the child is already in a full-blown tantrum, then disengage with the child.  Do not continue giving the child a demand. Let the child calm down and keep him safe from hurting himself. Make sure not to attend to the child (e.g., don’t talk to the child and try to calm him down) and clear the room by removing all the toys or other things that could probably harm you and the child. Once the child calms down, allow a few minutes (e.g., 5 minutes) before you give the same demand. 

We may or may not present another demand after the tantrums. It would depend on the situation. It is essential to present again the same demand after the tantrum so that the child would learn to complete a task calmly and ask for a break more appropriately. We don’t want the child to learn the pattern of throwing into tantrums, get prompted for a break then he can go and play. Children with autism can easily pick up a pattern of behaviors. We want to avoid having them learn a pattern of engaging in inappropriate behavior first and then end with a prompted response.

 These are just some of the strategies in dealing with escape behaviors. Parents must learn just simple ways of addressing problem behaviors at home that are doable and easy to implement. Learning simple techniques at a time. Again, just remember to be consistent in dealing with the behavior.

How Can I Support my Child at Home?

It can be alarming and overwhelming hearing from your Doctor that your child has autism. An autism diagnosis can be difficult to accept and come to terms with. This is maybe a new thing for you and you may have a hard time coping with this type of condition that you don’t know much about. You may try to find new ways for everyone in the family to live together and cope with your new situation but you end up finding it challenging and depressing in spite of all your efforts.

After the shocking news of your child having been diagnosed with autism, you may feel lost and feel like not given help or guidance on what to do next. Moving on from the diagnosis can be frightening, but there are many things you can do to overcome the challenges that you may encounter with having a child diagnosed with Autism Spectrum Disorder (ASD).

 

Learn about Autism

Learning about the condition of your child will help you to be better equipped and more ready in making good decisions for your child. Educate yourself (e.g., reading books, articles, research studies about autism, joining seminars about autism, joining ASD support group, etc.) and seek a variety of possible treatment options (e.g., ABA Therapy, Occupational Therapy, Speech Therapy, etc.), ask some experts (e.g., asking BCBAs, Doctors, teachers, etc.) or other parents (e.g., joining parents group, etc.) questions, and have yourself be ready to participate in all treatment decisions.

Accept your child

You may observe that your child may be different from other children but learn and practice to accept your child rather than focusing on what is ‘missing.’ Enjoy your child’s special skills and abilities, rejoice in every small step of improvements and successes, and try to stop comparing your child to others. The gift of unconditional love, acceptance and not giving up are the things that your child needs to cope with and enjoy life.

Observe your child

Learn everything about your child. This simply means that you have to observe your child and find out the things that trigger your child to engage in challenging or disruptive behaviors or the things that will elicit more appropriate behaviors. Try to find the things that will make your child feel calmer, comfortable or what makes him/her enjoyable. In addition, try to check the things that can be stressful or frightening to your child. Understanding your child will help you to become better at solving or finding out solutions to the problems or at modifying challenging situations that you may encounter at home.

Provide a structure at home

Setting up a structure at home will help you and your child cope in any challenging situations that you may face every day. One way of creating a structure is to set up a routine using a daily schedule. A daily schedule can consist of a list of activities from morning until bedtime. You can use visual support (e.g., pictures/images, written words, etc.) on your schedule to help your child to have a clear view of what is going to happen throughout the day. In going through each activity on the schedule, as parents, you have to be consistent, be predictable and you must follow through with all your instructions or activities that you want your child to comply with. Please refer to our previous blog about setting up a structure at home.

Be part of the treatment team

 Having a child with autism can be challenging and that you need support from other professionals who are experts in helping your child reach their full potential and learn to overcome their challenges. Knowing and learning everything about autism and participating in the treatment plan are essential keys to understanding and helping your child. You may have your child receive all the therapy treatment that he/she needs (e.g., behavioral therapy, occupational therapy, speech therapy, etc.) but your child will only have a few hours of learning opportunity with them and have more time at home with his/her family.

 As parents, it is important to collaborate with your therapy team. Treatment will not end at the therapy clinic. You may feel relaxed and comfortable knowing that your child is receiving all the needed help but it doesn’t end there. The biggest part and the most important part of your child’s life is his/her home. It is the place where the child spends most of his/her time and the place where he/she starts and ends day-to-day activities.

 It is very important for you and your family to learn how to deal with your child’s behaviors at home. The key is consistency. Try to seek help or training from your therapy team (e.g., joining parent training, observing actual therapy sessions, etc.) on how to implement the behavior modification techniques in place. Being consistent means doing the same thing in the same way over and over again in dealing with your child’s behavior at home, to different environments and across people. You have to follow through at home with whatever way your therapy team handles your child’s behavior. This can include learning how to reinforce appropriate behaviors and not to reinforce disruptive behaviors.

These are just a few of the most important and basic things you need to know to help you and your family on how to support your child at home. Having a child diagnosed with autism can be very alarming and overwhelming at first. But as you journey through the challenges and enjoyable moments with your child while applying everything that you learned, life gets easier.