Positive Behaviour Strategies

for
Students With Autism
 Aims
• To develop our understanding of the needs of students
with autism

• To explore the processes operating during episodes of

challenging behaviour

• To develop a range of proactive, active and reactive

strategies which will enable positive behaviour support
for students with autism

• To consider ways in which we can bring about positive

lifestyle changes for students who display challenging
behaviour
 Part One

Autism:
Developing Our Understanding
Autism is a part of who I am

Temple Grandin
 Kanner’s Key Features
• ‘the inability to relate themselves in the
ordinary way to people and situations’

• ‘the absence of spontaneous sentence

formation’

• ‘insistence on sameness’
 Asperger’s Key Features
• difficulties in interpreting non-verbal communication such
as facial expressions and body movements
• peculiar use of language
• obsessive interests in narrowly defined areas
• clumsiness and poor body awareness
• behavioural problems
• familial and gender patterns
Hans Asperger 1944
 APA Diagnostic Statistical Manual DSM-IV (1994)

‘Onset before three years of delayed or abnormal function

in at least one of: social interaction, language for social

communication, symbolic or imaginative play.’

 WHO’s International Classification of Diseases
ICD 10

‘Impaired or abnormal development must be present

before 3 years of age, manifesting the full triad of

impairments.’
 Autism: A definition

a behaviourally defined developmental

condition resulting from neurological

characteristics caused by

genetic factors
 Prevalence
• Estimated half a million people in the UK

• 1:100

• Gender bias:
Classical Autism = 4 boys to 1 girl
Asperger’s Syndrome = 9 boys to 1 girl

• Increasing prevalence
Better identification
Neo-natal care
 The Triad of Impairments

Social Understanding

Social Communication Imagination

 Mind-blindness
• People with autism lack a Theory of Mind

• Theory of Mind is the ability to appreciate the mental

states of other people

• Evident from about age four onwards

• Theory of Mind is essential for forming social groups

 Central Coherence
The ability to …

– see the bigger picture

– understand the context

– get the gist

 Executive Function

1. switch our attention from one thing to another

2. prioritise

3. make decisions

4. plan strategically
 The Senses
• Visual – what we see
• Auditory – what we hear
• Olfactory – what we smell
• Gustatory – what we taste
• Tactile – what we feel
• Vestibular – where we are in relation to the world (balance)
• Proprioceptory – where we are in relation to ourselves (co-
ordination)
 Sensory Processing
• Hyper- or hypo-sensitive – do not easily filter
information
• Mono-processing
• Difficulties with focusing on what neuro-typical
thinkers consider salient information
• Attention channel – incredible knowledge and
detail in this
 Part Two

Challenging Behaviour:
A Process and Not an Event
What is Challenging Behaviour?
 Definitions
‘… behaviour that challenges – whether it is
a challenge to our understanding, our own
well-being or a child’s or else to our ability to
carry out our responsibilities as parents or
professionals.’
(Whitaker 2001: 4)
 Definitions

‘… behaviours which involve significant risks

to people’s well-being or act to reduce
markedly access to community settings.’

(Emerson 2001: 3)
 Challenging Behaviour
A Working Definition

Episodes or patterns of behaviour which

present significant risk of harm or restriction
to an individual and the people around them
and are likely to be severely detrimental to the
quality of life experienced by those individuals
and the people around them.
 Domains of Challenging Behaviour
Violence Self-injury Destruction Disruption Excessive
self-stimulation
Behaviour directed at other Behaviour directed at Behaviour directed at Behaviour which Behaviour which is
people which is likely to cause themselves which is the environment interferes with generally repetitive in
injury likely to cause injury which is likely to cause organised activities nature and provides a
damage reinforcing stimulus

Attacking with objects Attacking with objects Arson Inciting others Eye-poking
Biting Biting Pushing items over Refusing to move Flapping objects
Hair-pulling Eye gouging Ripping furnishings Running away Hand-flapping
Head-butting Hair-pulling Smashing windows Screaming Masturbation
Kicking Head-banging Smearing faeces Shouting Rocking
Pinching Head-slapping Tearing resources Spinning
Punching Knee dropping
Pushing Pinching
Scratching Punching
Slapping Scratching
 Challenging Behaviour
• Functional
• It does something for the person

• Effective
• It works for them

• Learnt
• It is a consequence of previous experiences

• Ingrained
• It is part of the person’s repertoire

• Communicative
• It is telling us something
 Also …
• Subjectively defined
• A product of our personal histories

• Context specific
• Varies according to settings and situations

• Socio-culturally constructed
• May vary in impact from group to group
 Need

• All human behaviour is driven by needs

• Identify the need … understand the

behaviour

• Meet the need … address the behaviour

 Four Areas of Need
• Attention

• Escape

• Sensory

• Tangible
 Functional Assessment
• All behaviour is functional

• Remember, it is doing something for that person

• If you want to prevent or modify the behaviour you have

to find a way of doing that same something for the
person

• The person will find a way of meeting his or her needs

 Functional Behaviour and Autism
• Many people with autism have a limited range of
behaviour and a limited capacity to learn new skills

• Given this, they are likely to ‘stick with what works’

• Behaviour becomes deeply ingrained through repetition

• If ‘what works’ is inappropriate we need to replace it

 Challenging Behaviour
• Challenging behaviour serves a necessary purpose for a
person
• Challenging behaviours are learned through a history of
interactions between a person and the environment
• Problem behaviour may communicate something about
a person’s unmet wants or needs
• A single behaviour may be maintained by more than one
outcome and group of behaviours may be used to
achieve a single outcome
 Part Three

Proactive, Active and Reactive

Strategies
 Behaviour Support
• Emphasis on enabling individuals to develop behaviour patterns
which are positive and fulfilling

• Focus on developing an individual’s capacity to respond to

challenges and obstacles they face

• Endeavours to enhance an individual’s repertoire of skills via

proactive strategies
 Three Tiers of Strategy

• Proactive – things we teach

• Active – things we introduce to calm or distract

• Reactive – planned interventions

 Reactive

A
r
o
u
s
a
l
Proactive
Active Active

Proactive

Time
 Proactive Strategies
• Learning
• Delivered in optimum learning conditions
• Positive outcomes
• Enabling
• Address the need
 Active Strategies
• Palliative
• Temporary – not designed for deep effect
• Portable
• Quick thinking
• Return to proactive state
 Reactive Strategies
• Last resort
• Principles of least restriction
• Non-physical or physical
• BILD accredited physical interventions
• Critiqued – something is failing
• Recorded and evaluated
 Part Four

Positive Lifestyle Changes

 Improved Lifestyle Options

• Long term

• Enduring

• Trans-disciplinary audit

• Forward thinking

• Capacity assessment
 Areas for Improvement
• Diet
• Health
• Leisure
• Self-advocacy
• Sensory support
• Skills and knowledge
 Incident Specific Strategies

• Short term

• Instant pay off

• Not sustainable

• No deep effect

• Bridging strategy
 Categories of Strategy
• Avoidance

• Calming techniques

• Distraction

• Options