How Do I Know if it is the Autism or “Just Behavior?" (page 2)
How do I know if it is the autism or just behavior? Restated, this question is, “How can I tell if a behavior is a result of autism or if it is a willful choice?” This is a very important question.
Consider Bob, a 10-year-old boy with Asperger Syndrome (AS). Every morning, as his classmates enter the room, he hits them. His teachers assumed that Bob was being aggressive. Knowing that communication challenges are a hallmark of all autism spectrum disorders (ASDs), including AS, Bob’s parents suggested that he was simply attempting to greet his classmates. In response, school staff taught him to greet his peers with a “high five.” Over time, he learned to give a high five as his classmates arrived. One student, however, would not give Bob a high five, so Bob persisted hitting only her every morning. The school was disturbed by this and sent Bob to the office. After lecturing him, the school resource officer wrote Bob a ticket for assaulting a peer. But there was something special about this situation. More on Bob later.
Young people with AS may choose to “misbehave” in the same way as any young person may. When this happens, a response that is designed to decrease the likelihood that the person will make the same choice in the future, punishment, may be logical and appropriate; however, what if “it is the autism?” What if the underlying autism has resulted in the behavior of concern? Punishing a person for having AS is never the correct choice.
Understanding Behavior with a Functional Behavior Assessment
Behavior is complex and may occur for multiple reasons. Examination of the visible aspects of behavior—antecedents, behavior and consequences (the ABCs)—may shed light on the purpose or function of the behavior. This is known as a Functional Behavior Assessment (FBA).
Events that precede behavior, including setting events and trigger stimuli, are known as antecedents. Setting events occur outside the immediate setting (e.g., missing breakfast, medical conditions). Triggers are discrete events that immediately precede a behavior and reliably predict that the behavior will occur.
In order to conduct an FBA, problem behaviors must be defined so that they can be measured and observed. Defining a behavior as “acting out” is too vague. Instead, it should be described as seen (e.g., he says “no” and leaves the classroom).
The term “consequence” is sometimes equated with “punishment,” which is not accurate. The term refers to events (desired or undesired) that follow a behavior. The chart below describes Bob’s behavior using the ABCs.
|Antecedent • Events that precede behavior: setting events, trigger stimuli||• Classroom, morning, proximity to classmates • One peer does not return high five|
|Behavior • Visible, observable, measurable||• Hitting one peer as she passes Bob|
|Consequence • Events that follow a behavior||• Teacher says, “Stop” • Sent to office • Peer cries • Issued ticket|
Examining the ABCs helps to determine a purpose or function of a behavior. Common functions of behavior include:
- Tangible item
- Preferred activity
- Sensory stimulation
When Bob’s parents were notified that he was ticketed for assault, they requested an FBA. Before conducting the FBA, school staff assumed that Bob was being mean to his classmate. After considering the ABCs, they concluded that Bob chose to hurt his peer in order to gain attention from her. Staff felt that this was “behavior” and not autism; therefore, they felt that punishing Bob was necessary.
The ABCs did not tell the whole story. Bob’s classmate was visually impaired and could not see Bob’s gesture. This amplified the staff’s interpretation of his behavior as “mean.” The autism consultant encouraged staff to consider Bob’s underlying autism.
Getting to the Bottom of It
The autism consultant suggested that Bob’s ASD resulted in an inability to understand his classmate’s thoughts and feelings. In the same way that his classmate was not able to see Bob’s gesture for a high five, Bob was not able to “see” the world from her perspective. He did not understand her inability to see him and was not able to interpret her facial expressions that showed distress after being hit. While her “blindness” was evident, without examining the underlying ASD, Bob’s “mind-blindness” was not.
The ABC Iceberg (ABC-I), a tool for better understanding the relationship between behavior and ASD, was created to answer the question, “Is it the autism or ‘just behavior’?” (Aspy & Grossman, 2007a). The tool was adapted from the iceberg metaphor developed by Schopler (1994). The top of the iceberg represents the visible aspects of behavior, the ABCs, while the bottom represents the underlying characteristics of autism identified with a special tool: The Underlying Characteristics Checklist (Aspy & Grossman, 2007b). Figure 1 depicts the ABC-I for Bob.
Figure 1. Bob’s ABC Iceberg
Once the underlying characteristics were considered, it was clear that Bob was being punished for his disorder. Bob needed to be taught to recognize the thoughts and feelings of his peer. Staff used video and role-play (blindfolding Bob) to help teach him these new skills. Each day, staff reminded him to, “Say ‘high five’ to Judy and wait for her raised hand.” He then received a reward for appropriately greeting Judy and his classmates.
Knowing the ABCs provides insight into possible ways to prevent a behavior; however, in the case of Bob, the ABCs are not meaningful without considering the underlying ASD. It is important to consider the impact of autism on behavior. Before concluding that a student is misbehaving, look at the patterns of behavior as well as the underlying characteristics of autism. When in doubt, it is always best to assume that a behavior is related to ASD and to take a therapeutic (skills- based) intervention approach instead of a punitive stance.
Aspy, R., & Grossman, B.G. (2007a). The Ziggurat Model: Designing Comprehensive Interventions for Individuals with High-Functioning Autism and Asperger Syndrome. Shawnee Mission, KS: Autism Asperger Publishing Company.
Aspy, R., & Grossman, B.G. (2007b). The Underlying Characteristics Checklist. Shawnee Mission, KS: Autism Asperger Publishing Company.
Schopler, E. (1994). Behavioral priorities for autism and related developmental disorders. In E. Schopler & G.B. Mesibov (Eds.), Behavioral Issues in Autism (pp. 55-75). New York: Plenum Press.
Reprinted with the permission of the Autism Society.