How can a psychologist help?
Raising children is not an easy feat. One minute you will all be playing a fun family game of monopoly, and the next minute your children are leaning across the table pulling each other’s hair out, and you’re wondering who will be left with more hair on their head – them, or you!
Children’s emotions tend to escalate quickly, one reason being that they have not yet learnt strategies to regulate their own emotions. As a result, children behave in ways that test our patience time and time again.
Why do children with Autism Spectrum Disorder (ASD) typically engage in more behaviour that challenges us?
Children on the autism spectrum are more likely to exhibit behaviours that parents find challenging to manage for several reasons:
- They commonly have difficulty understanding what’s happening around them in the social world. Their lack of understanding around social cues and non-verbal communication often leads them to perceive people as unpredictable, and results in them feeling confused, frustrated, a lack of sense of control and vulnerable
- Their difficulty with communicating often extends to them struggling to communicate their own wants and needs effectively, leading to frustration
- They often live with high levels of anxiety
All behaviour is communication. As people with ASD have difficulty communicating through words, it makes sense that they use behaviours in an attempt to communicate and have their needs met.
Understanding and Managing Behaviours of Concern: How can a psychologist help?
Functional Behaviour Analysis
Before being able to change a child’s behaviour, you need to first understand what’s causing it and what function it is serving them. To do this, psychologists conduct an intensive ABC analysis to identify:
- Antecedents – these are the settings in which the behaviour is more likely to occur, and the things that switch the behaviour ‘on’ (or ‘trigger’ it)
- Behaviour – the way your child responds to the antecedent
- Consequences (AKA ‘rewards’ and ‘reinforcers’) – how does everyone respond? This is what your child gets from behaving this way, such as continuing on with their preferred activity, or leaving a stressful situation. This gives us an idea as to what the function of their behaviour is, and therefore, what need they are trying to have met.
Common triggers to look out for at home in children with Autism Spectrum Disorder include:
- Unpredictability, such as a change in routine e.g., driving a different route to school
- Transitions e.g., shifting from one activity to another
- Sensory overload e.g., too much noise, or bright light
- Discomfort e.g., being aversive to the feeling of clothes against skin
- Not having sensory needs met e.g., being told not to touch particular surfaces or objects
- Poor fine motor skills e.g., difficulty handwriting
- Not having the skills to do what is expected of them e.g., getting dressed by themself
- Comorbid ADHD, which is common in children with Autism
The function of most behaviour can typically be simplified down to an attempt to get or get away from:
- Attention (to themselves, another person or an item)
- Tangible (Object/Activity/Place)
- Sensory aspects
Positive Behaviour Support Plan
After conducting this analysis, psychologists begin to devise a support plan that outlines strategies to both reduce these behaviours of concern, and increase the use of more adaptive behaviours that serve the same function (i.e., meet the same need). These strategies typically fall under the category of either prevent, teach or reinforce (PTR model):
- Prevent strategies – these focus on removing the triggers, where possible.
e.g., providing noise-cancelling headphones to reduce the noise and prevent over stimulation
- Teach strategies – these focus on teaching the child new ways to the have their wants and needs met in a more constructive and socially appropriate manner. There is a heavy focus here on skills training, including social skills, communication skills, tolerance skills and emotion regulation skills.
e.g., when someone cheats in monopoly, the child could instead communicate “wait, that wasn’t fair. You need to give that $50 back to the bank.”
- Reinforce strategies – these focus on ensuring that the new behaviour we are trying to increase results in the child having their needs met, rather than the behaviour of concern we are trying to reduce.
e.g., they are given extra time to finish reading the chapter of their book when they ask politely, rather than kicking, screaming and locking themselves in their room to do so.
Implementing the Plan
Once a plan is created, it can be difficult for a parent to begin to apply it on their own. A psychologist can come into the home and community with the family and support workers to model how to use the strategies, observe the parents/carers implementation, and provide constructive feedback and re-modelling.
Psychologists use behaviour recording methods to monitor the effectiveness of the plan, and modify the strategies where necessary to ensure that forward progress ensues.
So how do I get started?
Revive Health and Happiness is now a registered National Disability Insurance Scheme (NDIS) provider. Having been a primary support worker for two young boys with Autism and ADHD, our in-house Clinical Psychologist (Registrar), Gemma Patton, is highly skilled in analysing and understanding behaviours of concern and tailoring strategies to the individual needs of your child.
Thankfully, the NDIS has a category of funding dedicated to this service, and it is recommended that you speak to your Local Area Co-ordinator about this being included in your funding package at your next planning meeting.
This article was written by Clinical Psychologist (Registrar), Gemma Patton.