Challenging Behaviors in Individuals with Autism

By raluca.olariu@…, 1 September, 2022
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Behaviors that are challenging for people with ASD may include self-injury, aggressiveness, property destruction, tantrumming, disruptivity, noncompliance, and stereotypies. Approximately 59% of people with ASD experience these behaviors at some point in their lives.

Furthermore, a recent follow-up study by Laverty found that 44% of autistic individuals who engage in repetitive behavior exhibit similar patterns a decade later. Because of their larger bodies and greater physical abilities, these persistent behavioral patterns may worsen with time and affect the quality of life for people with ASD and their caregivers or parents.

Understand and address difficult behavior

Most challenging behavior can be traced back to either biological, social, or both.

Though the roots of challenging behavior may differ, the behavior itself is generally understood and addressed as a function of communication. Autism spectrum disorders (ASDs) are characterized by communication challenges; thus, these challenging behavioral issues are often associated with ASDs. Behavioral interventionists understand that these challenging behavioral patterns are learnable through teaching new skills and replacing old ones. When provided with appropriate support and interventions, these challenging behavioral problems can be modified and replaced with more effective responses.

Some challenging behaviors persist into adulthood because they unintentionally reinforce themselves. When an adult engages in a behavior that gets them what they want (e.g., avoiding toothpaste), they get reinforced. When an adult engages a behavior that causes harm (e.g., hitting their head against a wall), they get punished. However, without knowing why they behave the way they do, it can be hard to change.

Context, behavior, and consequence

Challenging behaviors do not happen in a void; they require an environment where they can thrive. Without such an environment, challenging behaviors simply won't exist. To understand why certain environments may be conducive to challenging behaviors, providers must consider the context in which these behaviors take place.

A provider who understands the context in which a child's challenging behaviors take place can then design interventions that address those specific needs. For example, if a parent reports that her son's challenging behaviors began after he was diagnosed with autism spectrum disorder, she might benefit from information about how ASD affects social communication and interaction. 

  • A contextual factor may be anything that makes something more or less likely to happen. For example, if you're hungry, then eating a sandwich might seem like a good idea. If you're not hungry, however, then eating a sandwich probably won't feel so appealing.
  • An antecedent is anything that might trigger a particular behavior. For example, if you want to get up earlier tomorrow morning, an antecedent would be something like, "I need to wake up early."
  • Consequences: the outcome or type of reinforcement provided by giving someone something they want or doing something unpleasant for them.

If we view challenging behaviors through this behavioral health care system, we have four different levels at which interventions can take place. But, for these interventions to be effective, they must be matched to the underlying causes of the problem.

Functional Behavior Analysis

Functional behavior analysis (FBA) is an evaluation technique used to identify the cause of problematic behavior. Functional behavior analysis helps determine what the problem behavior is doing and why it is occurring. By identifying the specific functions that are being performed, treatment can be tailored to meet the needs of the child.

For example, if a child is throwing things out of frustration because they cannot find their favorite toy, then a functional behavior analysis would show that the child is frustrated because they do not know where their toy is located. In order to resolve the issue, the teacher could teach the child how to locate toys so that they no longer feel frustrated.

  • Interviews - with the individual, their parents/guardians, and/or teachers (or anyone else who might be familiar with them).
  • Observation - Conducted across multiple settings, by different people, and at different times. These assessments help identify the reasons why someone engages in certain behaviors.
  • Experimenting to test whether the function of the behavior is working. For example, testing whether changing the consequence makes a difference to the behavior. Or testing whether changing the antecedent has an impact on the behavior.

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Treatment options

After conducting a thorough assessment, professionals can determine which treatment method(s) would be most effective for each individual exhibiting challenging behavior.

These treatments usually combine three approaches:

  • Preventive strategies focus on changing settings and antecedent events so that children don't get into trouble and treat any co-occurring medical conditions.
  • Replacement strategies focus on teaching people new ways to cope with their emotions.
  • Response strategies focus on making sure that the consequences for bad behaviors match up with the punishments for good behaviors.

Read also: Are Online Autism Tests Accurate?

Challenging behaviors in adults with autism

Aggressive behavior, destructive behavior, and self-injurious behavior are extremely difficult for people with ASD and their families. Each week, the Autistica­rity receives desperate communica­tions from caretakers who seek help for these challenging behaviors.

Studies show that using non-psychoactive cannabidiol (CBD) may be helpful for some individuals with autism There has been some recent research on the effectiveness of CBDV for treating irritable behavior in children with autism spectrum disorder.

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