Effective Management of Problem Behaviour in Autism
By Dr. Anna Saito, Psychiatrist and Psychotherapist at the Santa Croce Clinic.
Specialist in Autism Spectrum Disorder treatment.
Source: https://santacroce.ch/la-gestione-dei-comportamenti-problema-nellautismo-della-dr-ssa-anna-saito/
Autism is a neurodevelopmental disorder that interferes with the acquisition, retention or application of specific and social skills. It is a very difficult concept to explain and understand, so much so that a child’s point of view could help us understand the implications of this condition.
The testimony of this little sister opens our eyes, albeit in a naive and innocent way, to the characteristics of her little brother ‘from the Moon’. From bizarre and repetitive behaviours, loneliness, inability to understand or respond, difficulty in relating to and being among others, to behaviours defined as ‘problematic’.
Dysfunctional behaviours, or otherwise defined as problem behaviours, represent a varied and multifaceted complex of behaviours that have at least three characteristics in common: they can be dangerous for the person exhibiting them and/or for others, and they affect the progression and evolution of the individual with autism. Not all behaviours, even if bizarre and unconventional, are to be considered problematic or dysfunctional.
In order to address them in such a way as to reduce or eliminate them in individuals with autism who exhibit them in an uncontrolled and difficult-to-manage manner, it is first necessary to understand their function.
Every behaviour has a function, which can be deduced from the effect that a given behaviour has on the surrounding environment. It is therefore essential to observe and describe what happens before, during and after the problem behaviour occurs.
This functional analysis requires careful and methodical observation, in which even details that may seem insignificant or of marginal importance play a part in the onset and maintenance of a problem behaviour.
There are many types of behaviour, and they vary from individual to individual, although their functions can be grouped into broad categories.
The most frequent function is linked to a contextual response of attention that reinforces the behaviour, which, although dysfunctional, will still have elicited a response.
A second and frequent function is to avoid a task or request that elicits an inappropriate refusal from the subject.
The third function is usually linked to an inability to entertain oneself with rewarding activities, resulting in behaviours that are self-perpetuating because the aspect that reinforces them is linked to self-stimulation of various types and kinds.
The ability to communicate verbally in individuals with autism allows them to be self-determined, and this ability also underlies the frequency and severity of problem behaviours: the lower the ability to communicate, the greater the frequency and severity of problem behaviours.
Functional behaviour analysis is based on the description of contingent factors, i.e. it is necessary to pay attention to variables preceding the behaviour, the description of the type of behaviour exhibited and the consequences of the environmental context, i.e. the environmental response.
Example: Mario is at the table.
Behaviour: he takes bread from the table, licks it and puts it back in the basket.
Environmental response: he is verbally reprimanded.
If such behaviour is recorded with regular frequency and verified over time, it is possible that its function is to respond to a need for attention that is not communicated in an adequate and functional way.
For this reason, it will be essential and beneficial to report a well-done functional analysis to a specialist who knows how to analyse such behaviour and establish its function in order to provide everyone involved, including the family, with the appropriate tools to achieve that specific function.