173: Autism: Overview
and Treatment Debbie Laffranchini, Professor
Chapter 7: Comprehensive Behavior Interventions for Individuals with ASD
From “Autism Spectrum Disorders: Foundations, Characteristics, and Effective Strategies”
Boutot and Myles
Functional Behavior Assessment
• What happens before a challenging behavior is important
• What happens after a challenging behavior is important
• Before behavior: antecedent
• After behavior: consequence
• Consequence doesn’t mean what a person does to punish a behavior
Functional Behavior Assessment
• Assess behavior, where did it come from?
• If all behavior communicates, what is the child communicating?
• What purpose (function) is the behavior accomplishing?
• How can you support a positive outcome?
Behavioral Triggers
• Time of day
• Presence of specific people
• Specific classroom subject
• Transition
• Change in routine
• Settings with too much/too little structure
• Request or demand to stop a behavior
• Why would you do that?
• Punishment
• Medication changes
• Family circumstances
Intervention Based on Functional Behavior
Assessment
• If you understand the “pattern” (ABC) of behavior, your intervention is strengthened
• Antecedent intervention:
• Anticipate and prevent!
• Behavior intervention:
• Replace the behavior
• Consequence intervention:
• Reinforce what you want to encourage
• Allow for recovery
Beyond Functional Assessment: Address the
Underlying Need
• If you interpret a child’s misbehavior
as being “willful” when they are not, it
can have great risks
• Low self-esteem
• Hopelessness
• Depression
• Lack of opportunity to learn alternative
behaviors
Beyond Functional Assessment: Addressing
Underlying Needs
• Address the underlying needs of autism, not just what you see (behaviors)
• Target underlying needs
• Be proactive
• Don’t just address the consequence
• If you only address “what you see”, it will not be effective and won’t have a sustainable change
Beyond Function Assessment: Addressing
Underlying Needs
• Intervention plans must be comprehensive
• Thorough analysis of biological events
• Antecedent events
• Consequence events
• Intervention plans must involve multiple strategies
• Strategies are informed by functional assessment
Positive Behavioral Support (PBS)
• Research-based strategies used to increase quality of life
• Decreases problem behavior by teaching new skills
• Decreases problem behavior by changing the environment
“If it’s not working, change the environment”
Critical Features of
Positive Behavioral Supports (PBS)
• Comprehensive lifestyle change and quality of life
• Life span perspective
• Ecological validity (real life applicability)
• Stakeholder participation (parents as experts, professionals)
• Social validity (are interventions practical, effective?)
• Systems change
• Multi-component intervention
• Emphasis on prevention
• Flexibility with respect to scientific practices (appreciate and use other practices)
• Multiple theoretical perspectives
Characteristics of Autism that May Be Related
to Off-task Behavior
• Individual has difficulty imitating actions or words of others
• Chooses or prefers solitary activities
• Appears to be in their “own world”
• Seems to be unmotivated by customary rewards
• Has little or no speech
• Has problems handling transition and change
• Has difficulty following instructions
• Seeks activities that provide touch, pressure, or movement
• Swinging, hugging, pacing)
• Appears to be unresponsive to others (their own name)
• Displays atypical activity level
Comprehensive Planning: Moving Beyond
Functional Behavior Assessment
• Must understand:
• Characteristics of ASD
• What causes and maintains behavior
• Plan must be
• Multi faceted
• Implemented across all of child’s day
• Responsive to unique needs and strengths
• Ziggurat Model is framework for designing comprehensive interventions, consistent with principles above
In-Class Activity
• What are antecedent interventions? (1 - 2 sentences)
• What three levels of the Intervention Ziggurat consist primarily of antecedent strategies?
• Looking at the first level of the Intervention Ziggurat, sensory and biological interventions, summarize in one paragraph the antecedent interventions.
• What are the three levels of task demands? For each level, identify what makes the task a particular level?
• Looking at task demands, the fourth level of the Intervention Ziggurat, summarize in one paragraph.
• Looking at structure and visual/tactile supports, the third level of the Intervention Ziggurat, summarize in one paragraph.
• What is the goal of antecedent interventions?
• Summarize “skills to teach” in 2 – 3 sentences.
• What do “reinforcers” do according to your book, page 174?
• Summarize “reinforcement” in 1 – 2 sentences.
Antecedent Interventions (Prevent Behaviors)
• Prevent behaviors by changing the environmental factors
• Be proactive, not reactive
• Interventions that are responsive to individual needs:
• Sensory differences and biological needs
• Task demands
• Structure, visual supports and tactile supports
Antecedent Interventions
I don’t manipulate
others; just their environment!
• Prevent triggers
• Teach replacement behavior
• Improve environment
• Change difficulty of task
• Give REAL choices
Sensory and Biological Interventions
• Unmet sensory and biological needs will result in changes in behavior
• Crying
• Running away
• Withdrawing/failing to participate
• Becoming easily distracted
• Noise making
• Tantruming
• Hypersensitivity
Task Demands
• Conversation and play:
• Social skills
• Communications skills
• Levels of demand
• Easy
• Challenging/emerging
• (zone of proximal development
• Too demanding
Task Demands (cont)
• Zone of proximal development
• Not yet mastered but can do with
support
Structure and Visual/Tactile Supports
• Spoken instructions and information are often lost for child with ASD
• Visual supports
• Pictures
• Written schedules
• Task strips
• Social stories
• Video modeling
Video Modeling
• https://www.youtube.com/results?
search_query=video+modeling
Behavior
• Prevent many problem behaviors using antecedent interventions
• Antecedent interventions based on three levels of Intervention Ziggurat (sensory/biological, task demand, structure and visual/tactile supports)
• Visual supports
• Shorten length of circle time
• Something to hold
• Build activities that provide movement
• Use a first-then visual chart
• Provide optimal location on floor
Skills to Teach
• Behavior is communicative
• Non-compliance and aggression is communication
• Behavior problems may communicate hidden skill deficits
• The child with autism is not the problem
• Ask, “What skill is missing?”
Hidden Curriculum
• Standards and rules that are
assumed to be known by everyone
and must be learned through
observation
Consequence
• Reinforcer increases the likelihood that
a behavior will recur
• Be creative when arriving at an
appropriate reinforcer
• Create social reinforcers when possible
• Objects or activities related to
obsessions are often more effective
than food