Parents Can Invest In Treatment Strategies For Autistic Children

How can parents deal with the problem behaviors that many children with autism exhibit at home, such as screaming, hitting, throwing tantrums, destroying things and hurting themselves?

In a previous column, I discussed these and other problem behaviors and described some of the ways specialized educational programs use “functional analysis” to try to determine what might be causing these behaviors. Typical causes (also called functions) include: to get attention from other people, to get preferred food or toys, to escape from instructions or to obtain sensory stimulation.

Professionals trained in applied behavior analysis develop detailed comprehensive treatment plans to deal with problem behaviors within a program or school setting. Understandably, many parents have difficulty following these plans as consistently as do the therapists and teachers.
Parents must deal with many competing demands for their attention and time.

Siblings must be cared for, laundry must be done, meals must be prepared, telephones must be answered and time must be spent with one’s spouse.
Below are listed the typical components of a comprehensive plan, with suggestions for using them at home. Even so, it is likely that most parents will need some assistance from a school staff member or from a behavior specialist.

Define the problem behavior in simple, observable terms such that both parents can agree when the problem is occurring or not occurring. Begin by addressing only one or two behaviors. For example, screaming could be described as loud vocalizations that last for more than 15 seconds.
Use positive rewards for periods of time with no problem behaviors.
Choose one of the child’s preferred foods or toys and only let the child have access to the reward if there has been no problem behavior for a predetermined period of time, such as one hour. The hardest part of this procedure is for parents to not allow the child to have the item if he or she has demonstrated the problem behavior. Sometimes it is easier to give in or to make an excuse for the child; however, if the parents can follow through, it is more likely that, over time, the behavior will occur less frequently.

Identify one or two specific appropriate skills the child can learn as an alternative to the problem behavior, such as independent play. Start with a small amount of time, such as five minutes, and provide a reward at the end of the five-minute period. If possible, use a different reward than the one used for the absence of problem behavior.

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