Fwd: February 2008 Autism E-news

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Thought this was relevent - dealing with behavior issues...

Training and Technical Assistance Centers

Virginia Department of Education

Autism E-News

Volume 6, Issue 1

February 2008 The Autism Priority Project is pleased to provide you with

articles by author and speaker, Kristi Sakai as well as Dubie, an

Educational Consultant at the Indiana Resource Center for Autism. Be sure to

check your email next week for a listing of upcoming

autism events.

Interdependence: Creating Community

Contributed by Kristi Sakai

As the mother of three children with ASD, one of the many challenges I share

with other families like ours is judgment by others over our children's

behavior- the assumption that our parenting falls short or that we merit blame

somehow because our kids have autism in the first place. When this kind of

judgment is placed upon parents, not only by random strangers but by the people

in our lives we wish would understand-such as our extended family, close

community or church-it is especially painful. Consequently, instead of seeking

support when they need it, many families withdraw into a self-protective cocoon.

We try to protect ourselves and our children from withering glances or sharp

words that hurt our feelings and tax our spirits. This can eventually become a

hard shell around our hearts that doesn't allow others in where they can hurt

us. We come to believe that no one wants to understand us. We struggle in

isolation despite our need for help. The truth of the matter

is that manypeople are willing to help if only given the opportunity. They

simply are notaware of our needs or how to meet them unless we ask. We must

reach outfirst and provide awareness in order to bridge that gap. Another reason

we may not seek help is that we secretly think we are unworthy; that we are too

needy, or that we havenothing to offer in return. My friend Lieberman, and

I recently discussed this subject. She reminded me, " Kristi, everyone has a need

to belong. " By explaining our needs and allowing others to meet them, we are

meeting a core need within them. Sharing our struggles together, asking for or

accepting help that is freely given creates a place of acceptance and belonging

for all. This is interdependence. Will others sometimes make clueless or even

hurtful comments because they lack awareness of the struggles people with

autism and their families face? Absolutely. Not everyone will understand,

despite careful explanations. Will our spirits

occasionally be beaten down by those who could care less about our needs? Yes,

of course. But if we take the risk of breaking out of our protective shell to

share our lives and allow ourselves to be mutually dependent, we will often

discover goodwill and intimacy among our fellow human beings. We will share the

gift of ourselves and see it reflected back by other open hearts. By doing so,

we create community. Everyone belongs.

Kristi Sakai lives on a farm in Oregon with her three children and husband,

all of whom have Asperger Syndrome. Kristi's article offers us a parent's

perspective on community and interdependence. Kristi Sakai will be a featured

presenter at the 5th Annual Autism Spectrum Disorders Conference on April

3rd-4th in Abingdon, VA. For more information about registering for this please

visit www.ttac.vt.edu/conference_autism.html.

Ever Had a Crisis Kind of Day?

Contributed by Dubie

Let's presume that you have already completed a functional behavioral assessment

(FBA) and are implementing a behavior support plan because a student on the

autism spectrum has continually displayed problematic behavior. Yet as you put

the plan into place, the

student's behavior still rises to the crisis level. This article will describe

behavior stages that any student in a crisis mode will escalate through when

displaying extreme emotions. The stages may include: anxiety, refusal, release,

and building rapport toward a resolution. In addition, helpful hints and

proactive strategies in each of the phases will be described particularly when

working with students on the autism spectrum.

When any student is in a crisis mode, his/her emotional state is high while

his/her quality of judgment is very low. It is also important to note for some

students', behavior starts with anxiety and escalates through phases while

others may come into your classroom

already in the crisis mode. As a result, it is imperative that the one primary

person that is trying to calm the student with ASD knows him/her well in order

to understand all of the characteristics of their personality. In all

circumstances, the goal is to recover from the crisis, work toward a safe

resolution, and ultimately teach self-management.

Anxiety Stage

Students on the autism spectrum may feel anxiety about social situations,

changes in

routines, overload of senses, and environment stressors. A warning sign may be

that he or she does things that are atypical. An example may be that the student

is trying to calm him/herself by doing repetitive movements faster (e.g.,

rocking, hand flapping, pacing) or counting and repeating words. As staff

members, our job is to be supportive. This means acknowledging the change in

behavior and offering the student with ASD assistance using positive behavioral

support strategies. Some of the ways may be to:

Allow more time to process information (e.g., may need 30 seconds to ten

minutes). Make sure everyone is clear about the time needed for the student to

process receptive information.

Try giving one direction; then waiting the

designated time before restating the information. If the time needed is long,

try

walking away from the student to help another child in class. Be patient. Then

watch to see if the student follows the direction given.

Model ways to express the need for a break (e.g., visual supports, sign

language

signal to signal break time). Many students with autism need to have periodic

breaks within the structure of their day to calm themselves. This time is

essential

and should not be thought of as a " reward time. "

Adjust the way the curriculum is presented to meet the student's low

frustration

level and allow for adaptations on how the student shows mastery of the skill.

Identify sensory needs or movement differences that exist. Then with the

occupational therapist, plan strategies to accommodate the student in the stated

areas.

Possibly review the daily schedule by using photographs, symbols or words

when

the student first arrives at school to relieve the student's anxiety.

Offer the student choices (e.g., first we'll do this, then we'll do that or

show me

which math papers you want to do first).

Consider any antecedents that the student with ASD may not have control

over

(e.g., changes in medication, weather, lack of sleep, poor nourishment).

Refusal Stage

When positive behavioral supports fail, the behavior may start to escalate. This

will look like refusal to do the task or follow through the directions given.

The student with ASD

may walk or run out of the classroom, hide under a desk, sit with arms folded or

refuse to talk. The staff needs to respond calmly by setting limits. Staff

members need to make sure the limits are:

Clear and simple – Many students with ASD learn best by being given short

phrases that are concrete (e.g., the bell to start class just rang, sit down at

your

desk). Don't keep rephrasing a direction in many different ways in a short

amount

of time. Are you using too many words or trying to use a long explanation to

reason with the student? Often the difficulty lies in our need to express a lot

of

information. Other students work better with choices or options. Always state

the

positive choice last so that if the student with ASD perseverates it will be on

the

positive option.

Reasonable – Remember that all behavior communicates a need and serves a

purpose from the student's point of view. Make sure the limitation that is

stated is

within the individual's capabilities. The limit that is set may need to be

flexible.

For example, staff requests the student to return to a specific location after

running out of the room. The student may move closer to the designated location

but need additional space. Ask the student if you can approach him/her. If

he/she

says " No, " respect their wishes by allowing some space. Then try again after a

period of time based on their processing time when agitated. Try to write a note

in order to use less verbal requests. This process may take some time. It is

important to wait. Listening to the student's needs is an important part of

setting reasonable limits.

Enforceable – When setting a limit, make sure that staff can follow through

with

the expectations. Do not overreact by grabbing or running after the student. The

appropriate response by staff should only include verbal or visual redirection.

Release Stage

If time is not allowed or a solution has not been discovered for the student to

calm down, then the behavior may escalate to releasing their anger by becoming

self-injurious (e.g., head banging, biting, slapping themselves, yelling,

crying, stomping feet, throwing

objects). The student may also be aggressive or intimidate others. It is

critical to realize

that our behaviors may further escalate the situation. Below are some reactions

to avoid:

Do not start setting firm limits after the student is calm.

Do not bring up past incidents that may have occurred on another day.

Do not judge the student or compare him/her to other students in class.

Do not lecture the student.

Do not make up consequences as the crisis escalates. State clearly the

boundary or rule that the student needs to learn from the crisis experience. If

a consequence must be applied, make sure it matches the function of the original

behavior. The consequence needs to be immediate, relevant, and natural if

possible.

Instead, solutions when students with ASD are at the release stage need to

include:

Calming the student. Use a soft voice and talk slowly.

Getting other students in the classroom out of the area. Have another staff

member take the class to an alternative setting (e.g., library, another

classroom) or stay with the class if the student runs out of the room.

Having an administrator involved in all levels of the crisis.

Making sure that everyone in the situation is safe. Students that are apt

to harm

themselves when they are frustrated or scared will continue this behavior until

they are taught another solution, and/or until the environment is altered

correctly for their needs.

Being aware of how you handle crisis. Ask yourself: Am I overreacting?

Under

reacting? There are some interventions that should be done cautiously. Make sure

you:

DO NOT physically intervene unless the student is being aggressive

towards others in an uncontrolled manner. This has to be used only as a

last resort. Remember some students with ASD crave deep pressure. As a

result, physically holding a student who needs deep pressure will reinforce

the inappropriate behavior.

DO NOT use any type of physical intervention (i.e. especially restraining

a student) unless staff has been trained with specific instructions in these

techniques. Also, consider the size and age of the student. The student

should never be taller or stronger than the staff member. If physical

intervention is essential, make sure that there are more than two people in

the area helping the staff member.

DO NOT physically restrain a student unless the person who is the leader

(one who is only talking) has considered whether the behavior can only be

controlled if he/she is restrained. Remember that usually when a student is

held, the behavior will escalate before the person calms down.

Ultimately the focus should still be on the student regaining control of

their behavior. Be sure to set realistic expectations for the specific

individual with ASD.

Building Rapport Stage

When rebuilding focus, the student should be calm. He/she may feel embarrassed,

show

no emotion, or laugh inappropriately. Often students with ASD show inappropriate

emotions in uncomfortable situations. The student may not know how they feel and

be

unaware of how the staff is feeling during or after the crisis. The focus should

be on re-

establishing rapport with the student by:

Evaluating if the student is able to reason through the situation? It is

important to

know the student's capabilities and respect how they process information even if

it is different from the needs of the staff members.

Giving your undivided attention to the student by completely listening to

the real

message (e.g., using reflective listening, visuals).

Returning the student to a familiar setting. The student may need

reassurance

from a specific staff member before returning back to class.

Processing as a team after school or the next morning. The team of teachers

who

worked through this crisis need to individually write down what happened from

their point of view. Then everyone needs to talk about the situation from

his/her

report. This will allow everyone time to express concerns, provide feedback to

one another, and become more aware of the student's needs. A plan will need to

be developed (if not done already) and shared with the student and his/her

parents so that everyone can work together to prevent crisis situations from

occurring again.

Revising the original FBA and behavior support plan to re-identify the

function of

the behavior and the antecedents. An observation by an independent person (e.g.,

someone not involved daily) may be helpful to give more insights to the

behavior. Often when the original plan is created, it will need to be tweaked as

more

information is discovered.

Effective interventions for students with ASD must include the recognition

that all

behavior has a function and communicates a message. The staff must learn to

interpret

these behaviors and attempt to teach alternative strategies involving the

individual's

language processing time, learning style, sensory needs, social capabilities,

and cognitive ability. Any person working with individuals with ASD will need to

communicate with a

group of people to constantly investigate different patterns, antecedents

(triggers), and messages of the students' behavior. Here are some general rules

to keep in mind:

Students who engage in behavior that warrants a crisis approach, must have

a

behavioral support plan that is consistently followed.

Minimize your verbalizations in a crisis situation. Do not lecture the

student.

If you continue to spend the majority of your efforts with a student in a

crisis

mode, then redo the FBA and reexamine the behavior support plan.

Crisis management is a short-term intervention that has no long-term or

educational outcomes.

The outcome of a good behavior support plan is not that others can control

the

students in a crisis situation, but that the student can learn to self-manage or

self-control.

Remember as professionals that the way we frame our responses to the

student

impacts their behavior and attitudes, and may add to the problem situation.

Challenge yourself and your team members to be more proactive and positive.

Follow the lead of the student by listening, watching, and waiting for the

student

with ASD to " show " their needs and address these before the crisis arises again.

References

, Janice I. (1997). Autism P.D.D. More Creative Ideas From Age Eight to

Early Adulthood. Ontario, Canada: Publications.

, K. (1998). A Challenge to Reframe our Thinking about Behavior.

Retrieved February 2, 2004, from Indiana University, Indiana Resource Center for

Autism Website:

http://www.iidc.indiana.edu/irca/behavior/reframe.html

Buchmann, S., (2000). Concerning Consequences: What Do I Do When . . .?

Retrieved February 2, 2004, from Indiana University, Indiana Resource Center for

Autism Website:

http://www.iidc.indiana.edu/irca/behavior/consequ.html

Buchmann, S., & Pratt, C., (2000). Supporting Students with Asperger's

Syndrome Who Present Behavioral Challenges. Retrieved February 2, 2004, from

Indiana University, Indiana Resource Center for Autism Website:

http://www.iidc.indiana.edu/irca/behavior/supportiASP.html

Cole, S., Horvath, B., Chapman, C., Deschenes, C., Ebeling, D., & Sprague, J.

(2000). Adapting Curriculum & Instruction in Inclusive Classrooms: A Teacher's

Desk Reference Second Edition. Bloomington, IN.

Crisis Prevention Institute, Inc. (2002). Nonviolent Crisis Intervention.

Milwaukee, WI.

Gray, Carol (1994). Comic Strip Conversations. Arlington, TX: Future Horizons.

Pratt, C., & Buchmann, S. (2003). Ten Steps Towards Supporting Appropriate

Behaviors. Retrieved February 2, 2004, from Indiana University, Indiana Resource

Center for Autism Website:

http://www.iidc.indiana.edu/irca/behavior/TenSteps.html

Vicker, B. (1992). The Message of Behavior. Retrieved February 2, 2004, from

Indiana University, Indiana Resource Center for Autism Website:

www.iidc.indiana.edu/irca/communication/messagesbe.html

Dubie, M. (2004). Ever had a crisis kind of day? The Reporter, 9(2), 20-24.

Dubie is an Educational Consultant at the Indiana Resource Center

for Autism at the Indiana Institute on Disability and Community located at

Indiana University, Bloomington. worked in the public school system for

eighteen years as a teacher, coordinator, autism consultant and coach. In this

role, she worked to develop strategies to effectively educate students across

the autism spectrum. At IRCA she has provided training on developing positive

behavior support plans and crisis management,educating students across the

autism spectrum and to make the necessary accommodations needed,and on writing

measurable goals/objectives. In her article Ms. Dubie describes behavior stages

that any student in a crisis mode will escalate through when displaying extreme

emotions as well as helpful hints and proactive strategies to be used in each of

the phases.

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