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AUTISM SPECTRUM DISORDERS

Updated: Dec 22, 2018

HOW STRUCTURE, UNDERSTANDING, AND CHOICES HELP





The first question most parents of a child with autism will ask me is “How do I best communicate with my child?”  My response is that we first have to take into account that children communicate through behavior, both the behavior they exhibit and the behavior they observe.  While true for most children, this is even more true with children of autism.


Understanding

Once we focus on behavior as the communication tool, we realize the question shifts.  “Why is that behavior occurring?” becomes the main question.  We shift our attitude toward the child to one of understanding, and perhaps even curiosity.   Your child will immediately appreciate your attempt at trying to see the world through their eyes, for their view is very different.If it is possible to use a sense of mindfulness and calm when a troubling behavior appears, more understanding is likely to develop.  This does not mean you will need to tolerate the behavior, but understanding it will help devise the solution.  It can be extremely difficult to not be reactive when faced with a troubling behavior (particularly a repetitive one!), but reactivity blocks understanding.  Reactivity is also the main communication the child “hears;” the words are likely lost.Behavior is “the response of an individual to it’s environment” (Merriam Webster).


Thinking of this formal definition of behavior provides a guideline to understanding as well as to devising solutions. A child with Autism interprets the world around him or her very differently than you or I.  For example, for a child who is hypersensitive to auditory stimulation, a classroom environment can be very difficult.  While a neurotypical student can focus on the topic at hand, a student who is hypersensitive to auditory stimulation can hear everything, including the buzzing of the fluorescent lights and the scratching of the pencil from the student sitting next to him.  This child may then exhibit behaviors such as yelling, covering his ears, or running out of the classroom.  This behavior is the child’s way of communicating that his perception of the world around him is causing him serious discomfort.


Once we know this about the child, we can make modifications that will in turn reduce the behaviors.  For example, we may consult an occupational therapist, so a “sensory diet” can be determined for the child.





Structure

Structure is very helpful for a child with autism as it relieves symptoms of anxiety.  This is one reason why behavior management plans are recommended for children with autism (actually, many children!).

The key to making modifications which can help the child change their behavior is structure.  “Behavior management plans” provide this structure.


What that means for a child with autism, or any behavioral difficulty for that matter, is that a concrete plan needs to be put into place based upon the difficulty the child is having.  The desired goal also needs to be factored in.  Furthermore, it is of utmost importance that all important individuals in the child’s life (parents, siblings, teachers, grandparents, babysitters, etc.) follow through with the plan that has been created.  Consistency is key!


Often children with autism act out as an attempt to gain some control in an environment where they feel they do not have any.  This can be extremely stressful for caregivers, as it appears the child is “wilful”  and purposely trying to manipulate the situation.


When the issue is related to control, structure can be most effective.  “What does that look like?” you may ask.   For example, let’s say that a young boy is having difficulties in the classroom.  His behaviors include not completing his classwork, ignoring teachers, and not following directions.  A plan could be made between his teachers and parents that for every day he completes his classwork and follows directions, he earns a preferred item at home (such as legos/TV/movies).  Consequently, these preferred items can be lost if the goal is not achieved.  Over time, the child will begin to make the connection that his behavior in school is resulting in the gain/loss of a preferred item at home.  This plan would show continuity of care between home and school because the same expectations and consequences are utilized.  It also develops a sense of mastery in the child because they realize they have an influence on what happens.  Over time, it increases their sense of control, although intially they may react against a perceived decrease in control.


In terms of devising the plan, we need to keep the focus on understanding the behavior.  Since reasons why specific behaviors take place are tenfold, proper evaluation by a professional is usually extremely helpful.





Choices

For many of our children with autism, a change in routine or transition can bring on a lot of feelings of uneasiness and panic.  In these instances, the best thing to do is let your child know, as often as you can, when there will be changes in routine, and to offer the child simple choices.  Offering choices helps a child with autism feel better about themselves because it gives them a stronger sense of self.  As previously stated, children with autism typically feel that they need to gain control in their environment since they usually do not have many instances where they are in the driver’s seat.  By offering choices, you give them the opportunity to gain some control, thus relieving their anxiety and related behaviors.


Understanding, structure and choices are all helpful and essential tools when raising and working with a child with autism.  It is always important to remember that each child with autism is unique.  What works for one child may not work for another, which is why understanding is so key.  There are many different tools and techniques that can benefit your child, so it may take a little trial and error to find the intervention strategy that works best; however a little patience and a lot of consistency go a long way for a recipe for success.


About the Author

Dana Carretta-Stein is a Licensed Mental Health Counselor and founder of Peaceful Living Mental Health Counseling, PLLC, in Scarsdale, NY.   She specializes in clinical psychotherapy to treat children, adolescents and adults with anxiety, behavior and trauma difficulties.




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