Outcomes-Based Intervention Approaches: Supporting Children and Youth with ASD Who Exhibit Challenging Behavior
Patterns of challenging behavior have long been associated with the diagnosis of autism spectrum disorders (ASD). Anyone who has experience with such children has likely observed problems with toileting, sleep, excessive activity levels, intense tantrums, self-stimulatory or stereotypic movements (e.g., rocking, hand flapping), and more serious behaviors such as aggression towards others (e.g., hitting, kicking), destruction of materials and the physical environment, and self-injury (e.g., hand biting, head hitting and banging).
Consider Randall (pseudonym), a 7-year-old student diagnosed as having an ASD. Randall has been evaluated as also having severe intellectual disabilities, and does not exhibit any functional verbal communication. He displays a variety of challenging behaviors, including forcefully smacking the backs of his hands on table edges, dropping to his knees on hard floors, and a variety of aggressive behaviors such as hitting, pinching and scratching others. He spends most of his time in a self-contained classroom for students with disabilities, working on a variety of pre-academic and functional skill-training activities (e.g., toileting, dressing, communication skills). Randall’s problem behaviors can have a variety of negative physical, social, educational and economic consequences.
Problem behaviors exhibited by individuals with an ASD can result in significant pain, injury and emotional distress for children, families and teachers providing support to these individuals. Participation in educational and other community settings may be jeopardized, and there is an increased risk of admission to more restrictive public residential facilities. Providing necessary support for individuals in such facilities results in greatly increased costs (e.g., $100,000 or more per year for persons with severe self-injury [NIH, 1991]; see also Jacobson, Mulick, & Green, 1998). Challenging behaviors may place children with ASD at greater risk for abusive treatment by support staff (Bromley & Emerson, 1995). Without intervention, these students are at much greater risk for a variety of negative outcomes.
Reprinted with the permission of the Autism Society.
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