Disruptive Behavior and Autism Spectrum Disorder
Individuals diagnosed with autism often engage in disruptive behavior. Forms of disruptive behavior that can occur in individuals with autism include, self-injurious behavior (SIB, e.g., hand biting, head banging), aggression, and property destruction, among others.
Behavioral Treatment for Disruptive Behavior in children with Autism Spectrum Disorder
Programs utilizing the principles of Applied Behavioral Analysis (ABA) that focus on increasing skills in children with autism (e.g., academic skills, social skills, self-care skills) have become quite common. In addition to increasing adaptive skills, ABA can be used to decrease disruptive behavior. There is a large body of research that has shown ABA can be effective at assessing and treating disruptive behavior in individuals with autism and other developmental disabilities. It should be noted that ABA is a science rather than a specific treatment and it can be used to analyze a broad range of behaviors in individuals with and without autism.
Focus on Function. When using ABA to assess disruptive behavior in individuals with autism, the focus is on the “function” of disruptive behavior rather than topography (i.e., what the behavior looks like). For example, when assessing a child with autism who engages in aggression, the goal is to identify how the aggression serves the child (i.e., function) rather than on what the aggression looks like (e.g., hitting, biting).
Functional Behavioral Assessment. To identify the function of disruptive behavior, a behavior analyst uses a Functional Behavioral Assessment (FBA). There are a variety of techniques that can be implemented when conducting an FBA, ranging from indirect methods (e.g., questionnaires and interviews) to direct experimental analysis of the behavior where live behavioral data is recorded (i.e., functional analysis). Regardless of the specific techniques used, the goal of an FBA is to identify the “function” of the target behavior (note: indirect measures can only lead to hypotheses about function). Common functions associated with disruptive behavior include, access to adult or peer attention, access to preferred items/activities, or escape from nonpreferred tasks or environmental setting (e.g., noisy classroom). Gaining access to some type of internal sensory (automatic) reinforcement can also be the function of some forms of disruptive behavior such as SIB.
Function-Based Treatment. Once an FBA has identified the function of the disruptive behavior, a treatment plan targeting that function is developed. Common treatment goals are to teach an alternative behavior that allows the child to gain access to the same functional reinforcer that maintains the disruptive behavior. Simultaneously, reinforcement is discontinued for the disruptive behavior. For example, if an FBA indicated a child’s aggression occurred to gain access to attention, that child would be taught an alternative communicative behavior (e.g., touching a card, asking for attention) to gain the attention and aggression would be ignored. In addition to teaching an alternative behavior, other behavioral techniques are often used (e.g., timeout, reinforcing incompatible behavior, finding competing forms of reinforcement).
Disruptive Behaviors Treated with ABA
A variety of disruptive behaviors have been treated using ABA and include Aggression, SIB, property destruction, stereotypy, feeding difficulties, and Pica, among others.
Tips for Parents
- Think about function. When observing disruptive behavior engaged in by your child, attempt to identify the function. Does the behavior occur because your child wants to escape a nonpreferred task or situation? Does it occur because your child wants to gain access to a preferred item or activity? Does the behavior occur often when your child is not receiving attention?
- If your child engages in disruptive behavior to escape nonpreferred tasks, break those tasks down into smaller parts and provide a break to fun activities after completion of each small task. Simultaneously, do not allow a break if problem behavior occurs.
- If your child engages in disruptive behavior to gain access to attention (e.g., always engages in problem behavior when you are on the phone or otherwise diverting your attention), inform your child he/she can gain attention for asking appropriately. When your child uses an appropriate request, give your attention as quickly as you can. Simultaneously, ignore minor disruptive behavior.
- If your child engages in disruptive behavior to gain access to preferred items/activities, require your child to ask appropriately for the items and ignore disruptive behavior. Following an appropriate request, attempt to provide the item as quickly as possible.
- If a delay in providing attention or a preferred item is necessary, use a timer following the appropriate request to signal a “wait” period and give your child other preferred activities to engage in during the “wait” period.
- If a clear function is not apparent, the initial behavioral strategies are not effective, or the behavior is severe (e.g., significant aggression or SIB), obtain consultation from a Board Certified Behavior Analyst (BCBA) or a mental health provider that has experience using ABA to treat disruptive behavior.
Helpful Websites
- bacb.com (allows you to search for BCBAs in your area)
- Journal of Applied Behavior Analysis (allows you to search for ABA research on the treatment of disruptive behavior with individuals with autism, intellectual deficits, and other developmental disabilities)
- Organization for Autism Research
- Autism Speaks
- The Association of Professional Behavior Analysts (For more general information about behavior analysis and ABA)
- The Association for Behavior Analysis International
- Cambridge Center for Behavioral Studies
Although I appreciate that the understanding of autism behaviors has increased greatly, this breakdown nearly defeats the purpose of re-structuring our understanding of these behaviors.
Looking at the behaviors from the place of function is important because it returns humanity to this society. Historically, autistic behaviors were not granted the understanding of motivation, so this society was not deemed to be logical or reasonable. Now that we can see the functionality, we have returned the ability to understand cause and effect… the society has had it’s humanity restored.
This article grants that understanding, but it also trivializes the understanding. By describing disruptive behaviors as an escape from a “non-preferred task”, this article offers that the behaviors are the choice of a willful, spoiled intellect. For many autistic individuals, disruptive behaviors are based in fear or pain. A task may be unknown, and the pains it may provide are unable to be comprehended or managed until after they have been experienced. The individual fears these potential pains. The “non-preferred task” may be a known task that is painful or confusing, yet the people helping the individual have no understanding of the motivation. Ie. A child that melts down during morning preparations who has difficulty processing all of the changes quickly taking place in the morning and suffers great pain from the rub of his clothing against his body, both common autistic motivations. The description in this article offers an individual rejecting a task, not panicking in fear of it.
This distinguishing descriptor is important. While we have a generation of caretakers who see the behaviors as bad choices, we will not be able to help the children escape the motivation for those choices. All we are teaching these children to do is suffer the pain and fear in silence, with all of the damage that does, when we could be teaching them how to feel less afraid or less pain.
I have a child, It’s a hard time for me to control his behaviors. He is doing something very unusual things like hit his head on the wall. I felt sad about him.