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Introduction

Is This Your Child?

Does your child engage in a behavior that just doesn’t seem to make any sense? For example, does his behavior hurt or disturb others, or appear to go against what your child wants for himself? Has your child been punished for the behavior, yet he keeps on doing it? Would you just give him what he seems to want if only he would use his words? As a parent or teacher of someone displaying these seemingly senseless behaviors, you might find yourself feeling frustrated and confused. You are not alone. Unfortunately, these perplexing behaviors are fairly common among individuals with autism spectrum disorders (ASD). Take a look at the four stories below and see if any of them sound like your story.

Grace Carmichael

By October, Ms. Brandt was ready to quit her job. While she had thoroughly enjoyed teaching her second grade class for the last several years, this year was different. Little Grace Carmichael was ruining her life. Grace was an eight-year-old girl with ASD who was included in Ms. Brandt’s regular education classroom. Grace was very interested in other children and repeatedly told her mother how excited she was to be in her new classroom and to make friends. Grace might go days with no problems at all, and then suddenly, she might stand up, pick up her chair, and smash it on the foot of the child seated next to her. While doing a crafts activity, she might bite the arm of a student working with her. While standing in line, she might slap the child in front of her.

Grace’s victims would yell at her or try to hit her back, but Grace persisted in her aggressive behavior. Grace had been sent to the principal’s office, lost her dessert at lunchtime, and had her mother called to come and pick her up—all to no avail; the behaviors persisted. Ms. Brandt wanted to help Grace, but she had virtually no experience with special education or behavior problems. The school psychologist had never worked with behavior problems this inconsistent or severe. Although Grace was making progress in her academics, socially her classroom placement was a failure. The other children had become afraid of her. Ms. Brandt hesitated to ask for Grace to be placed in a more restrictive setting because she felt that Grace had the potential to benefit from the inclusive setting, but she believed that these dangerous and disruptive behaviors were leaving her no choice.

Jamaal Brown

Four-year-old Jamaal Brown had been doing very well in his home-based discrete trial instruction program. In fact, his parents and teachers were starting to eye the inclusive kindergarten classroom as a possible placement for the upcoming school year. Not only was he flying through his academic, self-help, and motor programs, but his social skills programming was also going swimmingly. He could have entire conversations about various topics while using appropriate body language and intonation.

His parents and teachers were sure he was ready for typically developing peers, and enrolled Jamaal in a children’s gymnastics class to see how he would do. Much to their surprise, Jamaal did not interact well with the other children. Although he watched them closely and seemed interested in their activities, he did not go near them. When peers approached him, Jamaal would look right at them while making a strange face and adopting a crooked posture with his body. Sadly, the other children quickly stopped trying to play with Jamaal.

Darra Littman

If Darra Littman’s mother had told her once, she had told her a thousand times: no more discussion of the boy band One Direction (One-D). Darra had seen One-D on television and hadn’t stopped talking about them since. At first, Darra’s parents were excited—finally, their daughter with high functioning ASD was interested in an age-appropriate icon. The embarrassment of having a preteen who adored Sesame Street characters was at last at an end. And her peers noticed! They were very impressed with Darra’s knowledge of all things “One-D.”

Unfortunately, Darra’s interest in One-D continued to mushroom. She began to turn almost any conversation in the band’s direction, no matter how unrelated. These odd changes of topic made her peers uncomfortable and eventually resulted in them avoiding her. Nevertheless, Darra’s focus on One-D intensified. She could discuss nothing else. At this point, her mother decided to end the obsessive talk. She forbade any discussion of One-D. Furthermore, she made a rule that any mention of the group would cost Darra ten minutes of evening television time, which she treasured. Nevertheless, the “One-D” talk persisted. Last night, Darra lost all two hours of her allotted television time in the evening. The strange part was, this had no discernible impact on the “One-D” talk. Mrs. Littman could not understand why this behavior was so out of control.

Anthony Cappozolli

Mr. Cappozolli heard that familiar, unwelcome sound in the living room and went running. Just as he’d expected, he found Anthony, his nonverbal, fifteen-year-old son with ASD, banging his head against the windowpane. “Anthony!” he yelled, pulling him away. He sternly reminded him that head banging is dangerous and not allowed. Mr. Cappozolli then led Anthony over to a box of beads, off limits at other times, that the family used to distract him from continuing this perilous behavior.

Today, the Cappozollis were lucky—Anthony hadn’t broken the glass. Other times, they had not been so lucky. This behavior had cost them numerous trips to the emergency room and numerous windowpanes. More importantly, it had cost Anthony’s parents an untold amount of worry and grief, and had given them a sickening sense that they were helpless to protect their own son from himself. While grateful that he and his wife had the beads to interrupt the head banging, Mr. Cappozolli wished that he could understand where the head banging came from, and ultimately prevent it altogether.

The four children described above illustrate just a few of the behavior problems that children with an autism spectrum disorder may display. Your child may be challenging you with noncompliance, inattention, repetitive behaviors, or other problems. Some behaviors may be life-threatening, while others are just plain irritating. Some behaviors may lead to the destruction of property, while others may lead to the destruction of relationships with family or friends. For some parents, these behaviors are a constant, painful reminder of their child’s disability. For others, they may be a constant barrier to getting their child into the community and participating in the world.

While each type of behavior appears very different from the others, they do share a common thread. Each of the above behaviors does not seem to make any sense. The children engaging in these behaviors are losing things they value, ranging from television time to positive interactions with peers, but they are engaging in the behaviors anyway. Some behaviors, such as Anthony’s head banging, appear to be enormously painful, yet the behaviors persist.

For those who care about these children and desperately want them to be safe, happy individuals with a rich circle of friends and loved ones, these behaviors are enormously frustrating and are often the barriers between where these children are and where we want them to be. The purpose of this book is to help tear down these barriers. This book will help readers to identify how and why these troubling behaviors arise as well as to learn the basics of a strategy to eliminate them. Additionally, while this book cannot help with certain behaviors that require medication (such as tics), it can help you learn to distinguish behaviors that are part of underlying medical issues from those that will respond to behavioral intervention.

Over the years, research and experience have taught professionals who study behavior that making sense of a seemingly senseless behavior is an essential step to controlling it. This means that we must accept that these behaviors make perfect sense to the individuals engaging in them and then identify why. We must ask ourselves, “What purpose is this behavior serving?” and “How is this behavior benefiting my child?”

Well-established procedures have been developed to systematically identify the factors contributing to the occurrence of behavior problems in people with disabilities. Collectively, these procedures are referred to as “functional behavior assessment.” Results of functional behavior assessments are then ideally used to develop effective behavior intervention plans.

Study after study has shown that relying on a thorough functional behavior assessment is the most likely way to succeed in addressing an unwanted behavior (e.g., Repp, Felce & Barton, 1988). Behavior intervention plans based on functional behavior assessments work for individuals of all ages and all functioning levels (e.g., Crone, Hawken & Bergstrom, 2007; McLaren & Nelson, 2009; Wilder et al., 2009). This approach is relevant for individuals with the most severe developmental delays as well as for typically developing children and adults with no diagnosis at all. The research behind functional behavior assessment is so compelling that, legally, public schools in the United States must consider completing this type of assessment when addressing challenging behaviors (Individuals with Disabilities Education Act, 2004).

You do not have to be an expert in behavior analysis to understand and implement a functional behavior assessment. This book will teach readers how to complete comprehensive functional behavior assessments independently. In addition, this revised edition includes strategies that have been developed since the publication of our first edition that make it far easier to use these principles in home and school settings. The book has been written to help parents, grandparents, group home staff, and other caregivers, as well as teachers, school psychologists, and other professionals who may not have had access to specific training in this area. The methods described in this book can be used with toddlers, preschoolers, school-aged children, adolescents, and adults with any type of autism spectrum disorder, as well as other individuals with problem behaviors.

A general introduction to the principles of behavior will be provided in Chapters 1 and 2, including a discussion of how challenging behaviors arise and why individuals with autism spectrum disorders are more susceptible to developing them. Other foundation topics covered in these chapters will include an introduction to the principles of learning, a discussion of factors determining which behaviors will be performed in a given situation, and an overview of the types of consequences that may strengthen behaviors. Furthermore, Chapters 1 and 2 include an overview of functional behavior assessment and a discussion of how functional behavior assessment helps make sense of otherwise perplexing behaviors.

This background will equip readers for Chapters 3 through 8, which offer a practical, step-by-step guide to completing a functional assessment, including various forms of functional analysis—the “gold standard” in identifying the reasons why a behavior is occurring and informing effective intervention. These chapters also include “Keep it Simple Tips” to make the process more manageable, and handy tools to use when completing an assessment. This guide will help readers learn how to interpret assessment results, which are ultimately needed to develop an effective intervention. Chapter 9 summarizes the process, while Chapter 10 provides an overview of how to turn these assessment results into an effective plan. Finally, Chapter 11 addresses special topics such as adult issues, very infrequent but severe behaviors, and troubleshooting.

Armed with this combination of knowledge and skills, readers will be ready to make sense of those seemingly senseless behaviors and help their children or students tear down barriers to leading fuller and happier lives. If someone you care about is being held back by interfering behaviors, you can gain the skills to make a difference in his or her life. To begin empowering yourself to help, read on.