Description of the video:
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Hello.
00:01
This is Dr.
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Cathy Pratt. I'm the Director of
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the Indiana Resource Center for Autism
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at Indiana University.
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And I'm also a board
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certified behavior analyst.
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And I'm going to be talking today
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about behavior
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this summer The Indiana Resource Center
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for Autism staff and
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our autism leaders and others are presenting
00:19
Parent Zooms for free
00:21
just to help you
00:22
during this difficult time.
00:23
And so hopefully you'll get
00:24
a few tips today from us.
00:26
If not, please visit
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our Facebook page and our website.
00:30
And you're also welcome to email
00:32
me at anytime with questions.
00:34
So tip one, know that there's
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not a categorical approach that says
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child has these disabilities
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and whatever it
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is on the autism spectrum,
00:44
anxiety, ADHD,
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and they have
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this behavior and this is what you do.
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There's really not a recipe for behavior.
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And in truth, we,
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we have to get to know each individual
00:56
in each situation.
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And so when I
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go in and do behavioral assessments,
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when I see children with behavior,
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I have to know
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the individual, their strengths,
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their skills, their challenges,
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interests, the context.
01:07
I have to know everything
01:09
that's going on and also
01:11
for us to understand that
01:12
we are part of this equation as well.
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So I have to look at the interaction
01:16
with the professionals, the family members,
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and the individual themselves,
01:20
behavior a dance and we are
01:22
engaged in that dance as well.
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So the question that we oftentimes
01:25
get is, What do we do when,
01:26
what do we do when a child is hitting or
01:28
kicking or putting their head down,
01:30
refusing to do things or
01:32
screaming, what do we do when?
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And there's a few things that
01:35
that question prompts from me. One is that
01:37
I know that there's always more going
01:40
on than what that initial question tells me.
01:43
And so again, I have to go and
01:45
see what really is going on with that child.
01:48
The other thing is that when
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I get asked that question,
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I know oftentimes that means that
01:52
family members or professionals
01:53
are in crisis with the child.
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And that means that the child
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is in danger of hurting
01:58
themselves or hurting other people
01:59
or doing property damage.
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So Crisis Management if the only reaction,
02:04
the only way that you interact
02:06
with behavior is when
02:07
behavior is happening in
02:09
the heat of the moment.
02:10
Understand that that is
02:11
only a short-term solution
02:13
to a problem behavior.
02:14
And it really doesn't
02:15
equate to long-term behavior change.
02:17
What we know is that the only way to
02:19
change behavior in the long-term is
02:21
to teach a child a different way of behaving
02:23
to teach an alternative skill
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I would also encourage that if
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you put together a crisis plan,
02:31
that that it needs to be written down.
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Part of the reason for that is that I
02:37
know that oftentimes
02:38
when plans have been developed,
02:39
they don't work because they're not followed.
02:41
So the people in the household need to have
02:44
some consensus about how do we
02:46
respond when this behavior happens.
02:48
You know, and there has to be
02:51
some consensus in terms of
02:52
that responds because otherwise,
02:54
the child is getting mixed messages about
02:56
what's going to happen
02:57
and that's never a good thing.
02:59
And then know the signs that
03:00
a behavior is escalating
03:03
You know, I know as a teacher,
03:04
oftentimes I could tell that
03:05
my students were starting to
03:08
Verbalize a little bit more.
03:10
They may be paced, sometimes
03:12
their facial expressions changed,
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sometimes their coloring changed,
03:16
sometimes they did more
03:17
self stimulatory behaviors.
03:19
So understand those signs
03:21
when the behavior is starting to escalate.
03:23
So understand that when
03:25
we interact with behavior,
03:27
anytime we interact around behavior,
03:28
we run the risk of strengthening
03:30
or reinforcing the negative behavior.
03:33
So this is a scene
03:34
that I've seen played out many times.
03:36
Child who loves attention
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and runs out of a house
03:40
or out of a building,
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and people chase after them
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and they were kind of excited by that.
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And so that actually
03:47
strengthens or reinforces
03:49
the negative behavior and it'll be
03:51
harder to suppress it in the long-term.
03:53
The main thing is, is that
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when a child is acting out,
03:56
and this is really hard,
03:58
is that you have to maintain your calm
04:00
You have to stay very neutral.
04:02
You have to not show how your,
04:04
what your emotional reaction is.
04:06
Because as soon as you respond,
04:08
as soon as you react,
04:09
as soon as you kind of
04:11
engage that child in a negative way.
04:12
Rather than behavior
04:14
You've told the child what you're,
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what you're hot buttons are,
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and they're going to probably push
04:18
those hot buttons in the future.
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So maintain your calm
04:22
I think the other way to look at it is,
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is that for our children who have
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this neurological disorder and have
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sensory processing challenges and
04:30
other things going on for us to
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not remain calm only throws
04:34
them and triggers them into more behavior.
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So stay as calm as possible.
04:39
Again, have a plan.
04:40
Don't yell or threaten empty threats.
04:43
If you do use the empty threats.
04:45
If you do that one more time,
04:47
you're going to go to your room.
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If you do that one more time,
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you're going to go to your room.
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What a child learns is how
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many times they can get away
04:53
with something before you
04:54
actually carry it out.
04:55
So be careful about empty threats.
04:58
And in
04:59
again this is really counterintuitive.
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But the worst time,
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the least effective time to address
05:04
behavior is
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when you're in the heat of the moment,
05:07
when that behavior is escalating.
05:09
At that moment, your only goal
05:11
is to de-escalate the child.
05:13
It's not to teach
05:14
the child a different we're responding.
05:16
It's not to teach them a lesson.
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It really is to kind of
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minimize the situation and get
05:21
everybody to a state of
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calm and choose your battles.
05:24
You know, know what you're hot buttons
05:25
are what triggers you.
05:26
For example, I have
05:27
a hard time with whinny behavior,
05:29
whinny behavior, is a challenge for me.
05:32
And, and so now
05:35
that's not an extreme behavior,
05:37
but I know that that's a hot button for me.
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And so I kind of joke with with
05:42
my grandkids and with my family members that,
05:44
you know, that whining
05:46
is not a good behavior to use around me.
05:48
So understand what triggers you.
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What are the things that challenge
05:51
you a little bit as well?
05:53
So behaviors, typically,
05:56
an indicator of
05:57
other things in a person's life.
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And it may be an indicator
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of all sorts of things.
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And so we have this process
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called functional behavioral assessment
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that we use in schools.
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And so I kind of think
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about it in terms of a medical diagnosis.
06:14
So if an individual goes to
06:17
the doctor and there
06:18
they have all kinds of symptoms,
06:20
losing weight, chronic headaches,
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whatever those symptoms are.
06:24
And they go to the doctor and
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the doctor only treat the symptoms
06:27
and doesn't look for the
06:29
underlying cause of those symptoms,
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that disease will never go away.
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And I think too often we
06:36
treat the symptoms of
06:38
a behavior and we don't
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really look at the underlying conditions.
06:41
What is the why, why is the child doing this
06:44
coming to some understanding about
06:46
what's really going on in that child's life.
06:48
And I'm not going to lie to you.
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Some types, it's a very difficult process.
06:51
So in that behavioral assessment process,
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we know that there's
06:55
two different kinds of antecedents.
06:56
And for children on
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the spectrum, we see triggers,
07:00
slow triggers, or setting events are
07:02
often the antecedents that are the
07:04
most important to understand.
07:05
So let me explain it this way.
07:07
When we look at behavior,
07:08
we look at behavior in terms of what comes
07:11
before the behavior and what comes after.
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And so we have
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kind of two categories of antecedents.
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One is the setting events and
07:19
the other one are the immediate antecedents.
07:22
This so the setting events or
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things that you may or may not
07:25
see but that increase
07:26
the likelihood that a behavior will occur.
07:29
So for example, you get up in the morning
07:31
and you've got a busy day ahead
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and you go to get
07:36
dressed and the clothes that you were
07:38
planning to where or at the dry cleaners.
07:40
And then you go to get a cup of coffee
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and there's no coffee in the house.
07:45
And then you go in to get in your car to
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go to work and your gas tank is on
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empty because a family member
07:52
use the car and forgot to fill up
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the gas by the time that you get to
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work and all these things
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have happened in the morning,
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you may be a little bit more agitated.
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So for our folks on the spectrum,
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understand that there's things
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in their life that are
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setting them up for
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having behavior difficulties.
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We know that anxiety is major for our kids.
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And with anxiety goes depression.
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We also know that there are biological issues.
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And, you know, when I'm looking at a child
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I will look to ask about the health.
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because we know that many of
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our kids have gastrointestinal issues.
08:23
We know that they may
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have allergies or asthma or seizures.
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And so we have to understand kind of
08:29
the biological things that are
08:30
going on within individual.
08:32
We also know that schedule and
08:34
staff changes can have an impact.
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And all the schedule changes that
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children have been through
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this year and have been really tough
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for them and for you as well.
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Medications that are changed or missed.
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I'm not a physician,
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so I'm not going to recommend a medication.
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But I know that medicating a child
08:49
is more of an art form than a science.
08:51
And finding psychiatrists who have
08:53
a good understanding of children on
08:55
the autism spectrum is really rare.
08:57
And fortunately we do have
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some good psychiatrists in
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the state and so
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But more is not always better.
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And, you know, it's important
09:06
that you understand how
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the dosing is done and
09:09
and the consistency and dosing.
09:11
Irregular sleep patterns.
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You know, many of
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our kids have difficulties with
09:15
sleep and if they don't sleep at night,
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they may be more challenged the next day.
09:21
We also know that
09:22
illness or an impending illness.
09:24
So often as a teacher,
09:25
I would have a child who would act out
09:27
and then a couple days later would
09:28
become ill. Missed meals can be setting events,
09:32
excessive hot and cold temperatures,
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because we know that our children
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with these sensory issues
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don't process temperatures the
09:38
same way that others do.
09:39
Arguments or fights with
09:41
classmates, parents, teachers,
09:42
siblings are all setting events for
09:44
these kids when they
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ride the bus, when they go to school.
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If there's difficulties on the bus,
09:49
skill deficits and the skill deficits
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are the ones that I really,
09:52
we're going to talk about a little bit more.
09:54
And that to me is the most important one.
09:56
There is this fabulous professional,
10:00
Ross Greene, who has the saying
10:03
If they knew better, they would do better.
10:05
And I think again, for our kids,
10:06
oftentimes behaviors are really
10:08
related to those skill deficits.
10:10
A lack of communication
10:12
system our individuals
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need to have a way of
10:14
telling us what they're thinking and feeling.
10:16
Sensory issues are a setting event.
10:19
Trauma in a child's life
10:20
can be a setting event.
10:22
And so these things set them up for
10:24
having more challenges and difficulties.
10:26
So consequences,
10:28
I think it's important
10:32
to understand consequences from
10:33
the perspective of the individual.
10:35
And again, to realize that we
10:38
may intentionally or
10:39
unintentionally reinforce behavior.
10:41
I know working with
10:43
students through the years,
10:44
I've worked with individuals who engage
10:45
in self-injurious behavior and,
10:49
and found out that
10:51
the reason that they engage in
10:52
self-injurious behavior was that
10:54
it was fulfilling a Sensory Need for them.
10:56
It doesn't make sense to me,
10:58
but from their perspective,
11:00
they were getting a need met.
11:02
And so in that individual's programming
11:05
in previous years when
11:07
people were restraining them,
11:09
they were giving them sensory input.
11:11
And so that was only reinforcing
11:13
and increasing the behavior.
11:15
So you have to look at it
11:16
from the individual's perspective.
11:18
What is the payoff?
11:19
What do you think getting
11:19
from this behavior, people
11:21
continued doing behavior because
11:23
they get something from it.
11:25
There was a payoff from it.
11:26
So, so
11:28
behavior support plans should kind of
11:29
logically evolved
11:30
from the hypothesis we develop.
11:33
And I encourage you to work
11:34
with your school team on that.
11:36
But I just want to show you kind of a grid
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that I use oftentimes when I'm looking
11:40
at behavior because I
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go into schools and I hear about
11:43
behaviors and people will
11:45
tell me all kinds of
11:46
things that are going on.
11:47
And, and so
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this is a very simplified version.
11:51
This was a student who
11:52
would yell and
11:53
publicly chastise other students.
11:56
She would see students
11:57
who were violating rules.
11:59
in the school.
12:00
She had some biological problems.
12:02
She had some gastrointestinal difficulty.
12:04
She had anxiety and she had depression.
12:07
She also had social skills deficits.
12:10
And so when she
12:13
would see students violating rules,
12:15
she would have these behaviors.
12:16
And what she got out of it
12:18
was a small release
12:19
of kind of tension and anxiety.
12:22
She got some staff attention.
12:24
She got the student to get
12:25
students to get away from her.
12:27
So the, the question that was given to me is,
12:30
what is the consequence?
12:32
What is the punishment that we
12:33
deliver to make sure
12:36
this child quits doing this,
12:37
but understand that this child
12:39
does not have the social skills.
12:42
Be able to know how to interact with kids in
12:44
an appropriate fashion and punishing her,
12:47
telling her no being punitive
12:49
with her is not going to
12:50
give her those skills.
12:51
So we also want to make sure again,
12:54
that we are very
12:56
specific about what
12:57
the alternative behavior is.
12:59
And the idea is that you have to
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make that alternative behavior as
13:02
efficient and as effective
13:04
as the problem behavior is.
13:06
So for example, if you know that your child
13:09
uses their behavior to
13:10
communicate stuff to you,
13:12
they will need a communication system.
13:14
But then we need to listen to
13:16
that communication system and
13:17
use it, you know,
13:18
so think about and this is
13:21
a challenge as you're working
13:22
with other professionals,
13:24
you should always be thinking about what
13:26
do you want your child to do instead.
13:28
So these are just some of
13:29
the alternative skills that we know that
13:32
many of our students on the spectrum are
13:33
challenged by problem-solving skills,
13:36
choice making skills, anger control,
13:38
relaxation training,
13:39
self-management, and control, communication.
13:42
But let me just
13:43
say something about communication.
13:45
If I were the parent of a child with
13:46
autism and my child
13:48
had speech therapy for
13:50
30 minutes a day or once a week.
13:52
I would be furious if they had
13:55
speech therapy for 30 minutes twice a week.
13:58
I would be angry if they had
14:00
speech therapy for
14:01
30 minutes, five days a week,
14:03
I'd be still livid
14:04
because really
14:05
a good communication program is
14:07
not solely about the individual having
14:10
speech therapy services through an SLP.
14:13
What it is is how does
14:15
everybody use that communication system?
14:17
So we asked the wrong question.
14:18
We asked the question
14:20
how many minutes of speech therapy
14:22
does my child yet a week?
14:23
Instead, we should be asking How does
14:25
my child communicate at all times?
14:28
We think about social skills.
14:30
We know that if individuals
14:31
are going to be successful in the long run,
14:33
that we really have to look at
14:35
the importance of resilience.
14:36
And resilience is very
14:39
critical for individuals and kind of
14:41
means that sometimes we
14:43
have to push our folks to
14:44
a little bit of discomfort and,
14:47
you know, people build
14:48
resilience through failure.
14:50
And I know that that's really hard,
14:51
but sometimes we protect our individual so
14:53
much that we don't set them
14:55
up for adult life.
14:56
And then self-regulation.
14:58
So know what to do,
15:00
tip nine and support,
15:03
but do not overly support.
15:05
So, we look at in autism,
15:09
we talk about kind of
15:10
this dichotomy
15:12
between accommodation and assimulation.
15:15
And so there are
15:16
those who believe that our job is just
15:19
to accept the person's autism and
15:20
to accommodate them in every way,
15:22
in every shape and form.
15:24
And then there are
15:25
those on the other side who
15:26
believe that the person with autism
15:29
just be like everybody else and be as normal
15:32
as possible and get
15:34
rid of those autism behaviors.
15:36
And the reality of it is,
15:37
is that individuals on the spectrum,
15:39
like all of us, are somewhere in
15:41
the middle accommodation and assimilation.
15:43
But what I do know is if we
15:45
accommodate too much
15:47
We will accommodate people right
15:49
out of possibilities in the future.
15:51
So again, creating that discomfort
15:54
Sometimes, you know,
15:56
kids need to understand they're
15:58
not always going to be first in line.
16:00
They're not always going to win the games.
16:01
And again, these are going to be
16:03
individual choices that you make.
16:04
And I know that family members,
16:05
you need to choose your battles.
16:07
But my goal is,
16:09
is that your child is ready for life.
16:11
And we know that the unemployment rate is
16:13
very high for
16:14
our individuals on the spectrum.
16:15
So as much as we can do to kind of set
16:18
the individual up for more success,
16:19
I think is important.
16:21
I think also getting
16:22
engaging the individual in
16:24
meaningful and motivating activities.
16:26
Our folks tell us a lot of
16:27
times what motivates them.
16:29
It's their facinations or fixations.
16:32
But individuals are going
16:33
to be more willing to be
16:34
engaged in things that they
16:36
find meaningful to them.
16:38
Know how your child learns.
16:39
Many of our kids are visual learners,
16:41
or does your child learn best
16:43
by being shown something?
16:44
Do they learn best by being
16:46
actually physically
16:47
assisted in doing something?
16:49
So now how your child learns
16:50
the very best way and then build in choice.
16:53
And there's a lot of literature that says
16:54
that when children are given choices,
16:56
that participation increases
16:58
and behavior goes down.
16:59
So not everything has a choice.
17:01
It's not a choice about whether
17:02
you go to bed or not,
17:03
but it is a choice
17:04
about what kind of pajamas you wear
17:06
whether there's a light on
17:07
or not if somebody reads to you.
17:09
So think about how you build
17:10
in little choices and teaching children what
17:13
are choices and what are not
17:14
choices are also is
17:16
also a really good skill
17:17
I think just being present, you know,
17:19
spending time with your child,
17:21
is a really great strategy.
17:22
And then we have
17:24
to address the sensory needs.
17:25
with our individuals having
17:27
fidgets and other things around for
17:29
the child and hopefully working with
17:31
the occupational therapist who
17:33
understands and some things about sensory.
17:35
And then for some of our individuals,
17:37
having a safe area in
17:38
the house or a calming area so they know
17:40
when they get overwhelmed that there's
17:42
a place that they could go to be safe.
17:44
We'll look at task analysis as a strategy.
17:47
And, and the reason that I
17:49
bring a task analysis is to
17:50
understand that when we do something in life,
17:53
it seems like
17:55
a seamless activity and
17:57
is oftentimes very simple.
17:59
But oftentimes for individuals who
18:03
are on the autism spectrum,
18:04
what you will see are things
18:06
that you and I perceived to be
18:07
very simple from
18:08
their perspective is challenging.
18:10
And we have to know and teach
18:12
every step that's
18:13
involved with that oftentimes.
18:14
So understand what's part
18:16
of any routine that you're doing.
18:18
We use a lot of
18:19
visual supports with our folks.
18:20
And the Indiana Resource Center for Autism has
18:23
a full catalog of visual supports for free.
18:26
We have them on Pinterest as well.
18:27
So know what visual supports work
18:29
for your child, I think for your child to
18:31
Understand rules, having routines
18:33
during the day, making
18:35
sure that they understand the expectations.
18:37
And again, working with
18:39
people in the household to
18:40
kind of develop those routines
18:41
and the expectations.
18:43
Having a calm, safe,
18:44
and predictable environment, again,
18:47
with our individuals who have
18:48
this neurological disorder that oftentimes
18:50
makes the world overwhelming.
18:52
Having a calm, safe,
18:54
and predictable environment
18:55
will help calm them as well
18:57
We also know that brain intervals,
19:00
or what we call brain intervals or building
19:02
a movement into the day
19:03
is critical for our folks.
19:05
Making sure that they're getting
19:06
up and they're moving around,
19:07
building in some reinforcement for them.
19:10
And for example, if you do this,
19:12
then you can have access to this.
19:14
Again, things that we know are
19:16
really reinforcement builders for them.
19:19
And then I think, if I
19:21
think about the strategy that is the
19:22
most important in terms of working
19:24
with children on the autism spectrum.
19:26
I think rapport is
19:27
critical If the child trusts you
19:30
And if you've built a relationship,
19:33
you spend time really
19:34
building that relationship with them.
19:36
They will do more for you and learning
19:40
doing things differently is scary,
19:42
if you don't trust the people
19:44
who are guiding you on this journey,
19:46
then it's not going to be as effective.
19:48
So building that trust
19:50
and really spending time with the
19:51
individual and establishing that rapport and
19:54
finding out what interests
19:55
them is going to be really critical.
19:57
I think the other thing is,
19:59
is that I realized
20:00
that living with a child
20:03
on the autism spectrum and I'm sure
20:05
especially during this time,
20:06
can be very challenging
20:08
for all of you as well.
20:10
And so I'm going to also really
20:12
encourage you to practice some self-care.
20:14
And I know that that seems
20:15
impossible at times,
20:16
but it's kind of like that analogy
20:18
about being on an airplane
20:20
And if the airplane goes down,
20:22
you have to put the mask on
20:23
yourself first before you
20:25
put it on your child.
20:26
And I'm asking you please put
20:27
the mask on yourself first, You know,
20:29
so exercise when you can,
20:32
you know, eating or
20:33
eating habits have an impact.
20:35
Meditating or just having
20:36
some quiet moments can be really helpful.
20:39
I know in these days I'm really
20:41
reducing access to news to kinda
20:43
keep myself part of
20:45
what's going on and calmer about all of this,
20:48
connecting socially with family and friends.
20:50
And even if it's via Zoom,
20:52
or whatever and know
20:53
where your support comes from.
20:55
And I know that I've worked in this field
20:57
for many years and I know
20:58
for many families that,
20:59
autism becomes
21:01
a very isolating disability for
21:02
the family know that
21:04
their is support out there get connected
21:06
We have a lot of
21:06
parent support groups in the state of
21:08
Indiana be around positive people.
21:11
Laughter is a great medicine.
21:13
As a teacher, I was very blessed
21:15
that I got along very
21:17
well with the parents of my students
21:18
and was very involved
21:19
with the Autism Society.
21:21
In those meetings, we would
21:22
go get together and I have to tell you,
21:25
we would just laugh and tell stories.
21:26
And it was so medicinal for us
21:28
It was great.
21:29
And then I think also
21:31
in all of this is establishing
21:33
routines and setting goals for
21:34
yourself is going to be really important.
21:37
So we're here for you.
21:38
Feel free to reach out to the Indiana
21:41
Resource Center for Autism.
21:42
We know these are difficult times,
21:44
but we really want to help.
21:45
Thank you for your time.
English (United States)
00:00
Hello.
00:01
This is Dr.
00:02
Cathy Pratt. I'm the Director of
00:04
the Indiana Resource Center for Autism
00:05
at Indiana University.
00:07
And I'm also a board
00:08
certified behavior analyst.
00:09
And I'm going to be talking today
00:11
about behavior
00:13
this summer The Indiana Resource Center
00:15
for Autism staff and
00:16
our autism leaders and others are presenting
00:19
Parent Zooms for free
00:21
just to help you
00:22
during this difficult time.
00:23
And so hopefully you'll get
00:24
a few tips today from us.
00:26
If not, please visit
00:28
our Facebook page and our website.
00:30
And you're also welcome to email
00:32
me at anytime with questions.
00:34
So tip one, know that there's
00:36
not a categorical approach that says
00:38
child has these disabilities
00:41
and whatever it
00:42
is on the autism spectrum,
00:44
anxiety, ADHD,
00:47
and they have
00:48
this behavior and this is what you do.
00:50
There's really not a recipe for behavior.
00:52
And in truth, we,
00:54
we have to get to know each individual
00:56
in each situation.
00:57
And so when I
00:59
go in and do behavioral assessments,
01:00
when I see children with behavior,
01:02
I have to know
01:02
the individual, their strengths,
01:04
their skills, their challenges,
01:06
interests, the context.
01:07
I have to know everything
01:09
that's going on and also
01:11
for us to understand that
01:12
we are part of this equation as well.
01:14
So I have to look at the interaction
01:16
with the professionals, the family members,
01:18
and the individual themselves,
01:20
behavior a dance and we are
01:22
engaged in that dance as well.
01:23
So the question that we oftentimes
01:25
get is, What do we do when,
01:26
what do we do when a child is hitting or
01:28
kicking or putting their head down,
01:30
refusing to do things or
01:32
screaming, what do we do when?
01:33
And there's a few things that
01:35
that question prompts from me. One is that
01:37
I know that there's always more going
01:40
on than what that initial question tells me.
01:43
And so again, I have to go and
01:45
see what really is going on with that child.
01:48
The other thing is that when
01:49
I get asked that question,
01:50
I know oftentimes that means that
01:52
family members or professionals
01:53
are in crisis with the child.
01:55
And that means that the child
01:57
is in danger of hurting
01:58
themselves or hurting other people
01:59
or doing property damage.
02:01
So Crisis Management if the only reaction,
02:04
the only way that you interact
02:06
with behavior is when
02:07
behavior is happening in
02:09
the heat of the moment.
02:10
Understand that that is
02:11
only a short-term solution
02:13
to a problem behavior.
02:14
And it really doesn't
02:15
equate to long-term behavior change.
02:17
What we know is that the only way to
02:19
change behavior in the long-term is
02:21
to teach a child a different way of behaving
02:23
to teach an alternative skill
02:27
I would also encourage that if
02:29
you put together a crisis plan,
02:31
that that it needs to be written down.
02:35
Part of the reason for that is that I
02:37
know that oftentimes
02:38
when plans have been developed,
02:39
they don't work because they're not followed.
02:41
So the people in the household need to have
02:44
some consensus about how do we
02:46
respond when this behavior happens.
02:48
You know, and there has to be
02:51
some consensus in terms of
02:52
that responds because otherwise,
02:54
the child is getting mixed messages about
02:56
what's going to happen
02:57
and that's never a good thing.
02:59
And then know the signs that
03:00
a behavior is escalating
03:03
You know, I know as a teacher,
03:04
oftentimes I could tell that
03:05
my students were starting to
03:08
Verbalize a little bit more.
03:10
They may be paced, sometimes
03:12
their facial expressions changed,
03:14
sometimes their coloring changed,
03:16
sometimes they did more
03:17
self stimulatory behaviors.
03:19
So understand those signs
03:21
when the behavior is starting to escalate.
03:23
So understand that when
03:25
we interact with behavior,
03:27
anytime we interact around behavior,
03:28
we run the risk of strengthening
03:30
or reinforcing the negative behavior.
03:33
So this is a scene
03:34
that I've seen played out many times.
03:36
Child who loves attention
03:38
and runs out of a house
03:40
or out of a building,
03:41
and people chase after them
03:44
and they were kind of excited by that.
03:46
And so that actually
03:47
strengthens or reinforces
03:49
the negative behavior and it'll be
03:51
harder to suppress it in the long-term.
03:53
The main thing is, is that
03:54
when a child is acting out,
03:56
and this is really hard,
03:58
is that you have to maintain your calm
04:00
You have to stay very neutral.
04:02
You have to not show how your,
04:04
what your emotional reaction is.
04:06
Because as soon as you respond,
04:08
as soon as you react,
04:09
as soon as you kind of
04:11
engage that child in a negative way.
04:12
Rather than behavior
04:14
You've told the child what you're,
04:15
what you're hot buttons are,
04:17
and they're going to probably push
04:18
those hot buttons in the future.
04:20
So maintain your calm
04:22
I think the other way to look at it is,
04:24
is that for our children who have
04:26
this neurological disorder and have
04:28
sensory processing challenges and
04:30
other things going on for us to
04:32
not remain calm only throws
04:34
them and triggers them into more behavior.
04:36
So stay as calm as possible.
04:39
Again, have a plan.
04:40
Don't yell or threaten empty threats.
04:43
If you do use the empty threats.
04:45
If you do that one more time,
04:47
you're going to go to your room.
04:48
If you do that one more time,
04:49
you're going to go to your room.
04:50
What a child learns is how
04:52
many times they can get away
04:53
with something before you
04:54
actually carry it out.
04:55
So be careful about empty threats.
04:58
And in
04:59
again this is really counterintuitive.
05:01
But the worst time,
05:03
the least effective time to address
05:04
behavior is
05:05
when you're in the heat of the moment,
05:07
when that behavior is escalating.
05:09
At that moment, your only goal
05:11
is to de-escalate the child.
05:13
It's not to teach
05:14
the child a different we're responding.
05:16
It's not to teach them a lesson.
05:18
It really is to kind of
05:19
minimize the situation and get
05:21
everybody to a state of
05:22
calm and choose your battles.
05:24
You know, know what you're hot buttons
05:25
are what triggers you.
05:26
For example, I have
05:27
a hard time with whinny behavior,
05:29
whinny behavior, is a challenge for me.
05:32
And, and so now
05:35
that's not an extreme behavior,
05:37
but I know that that's a hot button for me.
05:39
And so I kind of joke with with
05:42
my grandkids and with my family members that,
05:44
you know, that whining
05:46
is not a good behavior to use around me.
05:48
So understand what triggers you.
05:49
What are the things that challenge
05:51
you a little bit as well?
05:53
So behaviors, typically,
05:56
an indicator of
05:57
other things in a person's life.
06:00
And it may be an indicator
06:02
of all sorts of things.
06:04
And so we have this process
06:06
called functional behavioral assessment
06:08
that we use in schools.
06:10
And so I kind of think
06:12
about it in terms of a medical diagnosis.
06:14
So if an individual goes to
06:17
the doctor and there
06:18
they have all kinds of symptoms,
06:20
losing weight, chronic headaches,
06:23
whatever those symptoms are.
06:24
And they go to the doctor and
06:25
the doctor only treat the symptoms
06:27
and doesn't look for the
06:29
underlying cause of those symptoms,
06:32
that disease will never go away.
06:34
And I think too often we
06:36
treat the symptoms of
06:38
a behavior and we don't
06:39
really look at the underlying conditions.
06:41
What is the why, why is the child doing this
06:44
coming to some understanding about
06:46
what's really going on in that child's life.
06:48
And I'm not going to lie to you.
06:49
Some types, it's a very difficult process.
06:51
So in that behavioral assessment process,
06:54
we know that there's
06:55
two different kinds of antecedents.
06:56
And for children on
06:58
the spectrum, we see triggers,
07:00
slow triggers, or setting events are
07:02
often the antecedents that are the
07:04
most important to understand.
07:05
So let me explain it this way.
07:07
When we look at behavior,
07:08
we look at behavior in terms of what comes
07:11
before the behavior and what comes after.
07:14
And so we have
07:15
kind of two categories of antecedents.
07:17
One is the setting events and
07:19
the other one are the immediate antecedents.
07:22
This so the setting events or
07:23
things that you may or may not
07:25
see but that increase
07:26
the likelihood that a behavior will occur.
07:29
So for example, you get up in the morning
07:31
and you've got a busy day ahead
07:33
and you go to get
07:36
dressed and the clothes that you were
07:38
planning to where or at the dry cleaners.
07:40
And then you go to get a cup of coffee
07:42
and there's no coffee in the house.
07:45
And then you go in to get in your car to
07:48
go to work and your gas tank is on
07:50
empty because a family member
07:52
use the car and forgot to fill up
07:53
the gas by the time that you get to
07:56
work and all these things
07:57
have happened in the morning,
07:58
you may be a little bit more agitated.
08:00
So for our folks on the spectrum,
08:02
understand that there's things
08:04
in their life that are
08:05
setting them up for
08:06
having behavior difficulties.
08:08
We know that anxiety is major for our kids.
08:10
And with anxiety goes depression.
08:12
We also know that there are biological issues.
08:15
And, you know, when I'm looking at a child
08:17
I will look to ask about the health.
08:19
because we know that many of
08:21
our kids have gastrointestinal issues.
08:23
We know that they may
08:25
have allergies or asthma or seizures.
08:27
And so we have to understand kind of
08:29
the biological things that are
08:30
going on within individual.
08:32
We also know that schedule and
08:34
staff changes can have an impact.
08:35
And all the schedule changes that
08:38
children have been through
08:39
this year and have been really tough
08:40
for them and for you as well.
08:42
Medications that are changed or missed.
08:44
I'm not a physician,
08:45
so I'm not going to recommend a medication.
08:47
But I know that medicating a child
08:49
is more of an art form than a science.
08:51
And finding psychiatrists who have
08:53
a good understanding of children on
08:55
the autism spectrum is really rare.
08:57
And fortunately we do have
08:59
some good psychiatrists in
09:01
the state and so
09:02
But more is not always better.
09:04
And, you know, it's important
09:06
that you understand how
09:08
the dosing is done and
09:09
and the consistency and dosing.
09:11
Irregular sleep patterns.
09:13
You know, many of
09:14
our kids have difficulties with
09:15
sleep and if they don't sleep at night,
09:18
they may be more challenged the next day.
09:21
We also know that
09:22
illness or an impending illness.
09:24
So often as a teacher,
09:25
I would have a child who would act out
09:27
and then a couple days later would
09:28
become ill. Missed meals can be setting events,
09:32
excessive hot and cold temperatures,
09:34
because we know that our children
09:35
with these sensory issues
09:36
don't process temperatures the
09:38
same way that others do.
09:39
Arguments or fights with
09:41
classmates, parents, teachers,
09:42
siblings are all setting events for
09:44
these kids when they
09:45
ride the bus, when they go to school.
09:47
If there's difficulties on the bus,
09:49
skill deficits and the skill deficits
09:51
are the ones that I really,
09:52
we're going to talk about a little bit more.
09:54
And that to me is the most important one.
09:56
There is this fabulous professional,
10:00
Ross Greene, who has the saying
10:03
If they knew better, they would do better.
10:05
And I think again, for our kids,
10:06
oftentimes behaviors are really
10:08
related to those skill deficits.
10:10
A lack of communication
10:12
system our individuals
10:13
need to have a way of
10:14
telling us what they're thinking and feeling.
10:16
Sensory issues are a setting event.
10:19
Trauma in a child's life
10:20
can be a setting event.
10:22
And so these things set them up for
10:24
having more challenges and difficulties.
10:26
So consequences,
10:28
I think it's important
10:32
to understand consequences from
10:33
the perspective of the individual.
10:35
And again, to realize that we
10:38
may intentionally or
10:39
unintentionally reinforce behavior.
10:41
I know working with
10:43
students through the years,
10:44
I've worked with individuals who engage
10:45
in self-injurious behavior and,
10:49
and found out that
10:51
the reason that they engage in
10:52
self-injurious behavior was that
10:54
it was fulfilling a Sensory Need for them.
10:56
It doesn't make sense to me,
10:58
but from their perspective,
11:00
they were getting a need met.
11:02
And so in that individual's programming
11:05
in previous years when
11:07
people were restraining them,
11:09
they were giving them sensory input.
11:11
And so that was only reinforcing
11:13
and increasing the behavior.
11:15
So you have to look at it
11:16
from the individual's perspective.
11:18
What is the payoff?
11:19
What do you think getting
11:19
from this behavior, people
11:21
continued doing behavior because
11:23
they get something from it.
11:25
There was a payoff from it.
11:26
So, so
11:28
behavior support plans should kind of
11:29
logically evolved
11:30
from the hypothesis we develop.
11:33
And I encourage you to work
11:34
with your school team on that.
11:36
But I just want to show you kind of a grid
11:38
that I use oftentimes when I'm looking
11:40
at behavior because I
11:42
go into schools and I hear about
11:43
behaviors and people will
11:45
tell me all kinds of
11:46
things that are going on.
11:47
And, and so
11:49
this is a very simplified version.
11:51
This was a student who
11:52
would yell and
11:53
publicly chastise other students.
11:56
She would see students
11:57
who were violating rules.
11:59
in the school.
12:00
She had some biological problems.
12:02
She had some gastrointestinal difficulty.
12:04
She had anxiety and she had depression.
12:07
She also had social skills deficits.
12:10
And so when she
12:13
would see students violating rules,
12:15
she would have these behaviors.
12:16
And what she got out of it
12:18
was a small release
12:19
of kind of tension and anxiety.
12:22
She got some staff attention.
12:24
She got the student to get
12:25
students to get away from her.
12:27
So the, the question that was given to me is,
12:30
what is the consequence?
12:32
What is the punishment that we
12:33
deliver to make sure
12:36
this child quits doing this,
12:37
but understand that this child
12:39
does not have the social skills.
12:42
Be able to know how to interact with kids in
12:44
an appropriate fashion and punishing her,
12:47
telling her no being punitive
12:49
with her is not going to
12:50
give her those skills.
12:51
So we also want to make sure again,
12:54
that we are very
12:56
specific about what
12:57
the alternative behavior is.
12:59
And the idea is that you have to
13:01
make that alternative behavior as
13:02
efficient and as effective
13:04
as the problem behavior is.
13:06
So for example, if you know that your child
13:09
uses their behavior to
13:10
communicate stuff to you,
13:12
they will need a communication system.
13:14
But then we need to listen to
13:16
that communication system and
13:17
use it, you know,
13:18
so think about and this is
13:21
a challenge as you're working
13:22
with other professionals,
13:24
you should always be thinking about what
13:26
do you want your child to do instead.
13:28
So these are just some of
13:29
the alternative skills that we know that
13:32
many of our students on the spectrum are
13:33
challenged by problem-solving skills,
13:36
choice making skills, anger control,
13:38
relaxation training,
13:39
self-management, and control, communication.
13:42
But let me just
13:43
say something about communication.
13:45
If I were the parent of a child with
13:46
autism and my child
13:48
had speech therapy for
13:50
30 minutes a day or once a week.
13:52
I would be furious if they had
13:55
speech therapy for 30 minutes twice a week.
13:58
I would be angry if they had
14:00
speech therapy for
14:01
30 minutes, five days a week,
14:03
I'd be still livid
14:04
because really
14:05
a good communication program is
14:07
not solely about the individual having
14:10
speech therapy services through an SLP.
14:13
What it is is how does
14:15
everybody use that communication system?
14:17
So we asked the wrong question.
14:18
We asked the question
14:20
how many minutes of speech therapy
14:22
does my child yet a week?
14:23
Instead, we should be asking How does
14:25
my child communicate at all times?
14:28
We think about social skills.
14:30
We know that if individuals
14:31
are going to be successful in the long run,
14:33
that we really have to look at
14:35
the importance of resilience.
14:36
And resilience is very
14:39
critical for individuals and kind of
14:41
means that sometimes we
14:43
have to push our folks to
14:44
a little bit of discomfort and,
14:47
you know, people build
14:48
resilience through failure.
14:50
And I know that that's really hard,
14:51
but sometimes we protect our individual so
14:53
much that we don't set them
14:55
up for adult life.
14:56
And then self-regulation.
14:58
So know what to do,
15:00
tip nine and support,
15:03
but do not overly support.
15:05
So, we look at in autism,
15:09
we talk about kind of
15:10
this dichotomy
15:12
between accommodation and assimulation.
15:15
And so there are
15:16
those who believe that our job is just
15:19
to accept the person's autism and
15:20
to accommodate them in every way,
15:22
in every shape and form.
15:24
And then there are
15:25
those on the other side who
15:26
believe that the person with autism
15:29
just be like everybody else and be as normal
15:32
as possible and get
15:34
rid of those autism behaviors.
15:36
And the reality of it is,
15:37
is that individuals on the spectrum,
15:39
like all of us, are somewhere in
15:41
the middle accommodation and assimilation.
15:43
But what I do know is if we
15:45
accommodate too much
15:47
We will accommodate people right
15:49
out of possibilities in the future.
15:51
So again, creating that discomfort
15:54
Sometimes, you know,
15:56
kids need to understand they're
15:58
not always going to be first in line.
16:00
They're not always going to win the games.
16:01
And again, these are going to be
16:03
individual choices that you make.
16:04
And I know that family members,
16:05
you need to choose your battles.
16:07
But my goal is,
16:09
is that your child is ready for life.
16:11
And we know that the unemployment rate is
16:13
very high for
16:14
our individuals on the spectrum.
16:15
So as much as we can do to kind of set
16:18
the individual up for more success,
16:19
I think is important.
16:21
I think also getting
16:22
engaging the individual in
16:24
meaningful and motivating activities.
16:26
Our folks tell us a lot of
16:27
times what motivates them.
16:29
It's their facinations or fixations.
16:32
But individuals are going
16:33
to be more willing to be
16:34
engaged in things that they
16:36
find meaningful to them.
16:38
Know how your child learns.
16:39
Many of our kids are visual learners,
16:41
or does your child learn best
16:43
by being shown something?
16:44
Do they learn best by being
16:46
actually physically
16:47
assisted in doing something?
16:49
So now how your child learns
16:50
the very best way and then build in choice.
16:53
And there's a lot of literature that says
16:54
that when children are given choices,
16:56
that participation increases
16:58
and behavior goes down.
16:59
So not everything has a choice.
17:01
It's not a choice about whether
17:02
you go to bed or not,
17:03
but it is a choice
17:04
about what kind of pajamas you wear
17:06
whether there's a light on
17:07
or not if somebody reads to you.
17:09
So think about how you build
17:10
in little choices and teaching children what
17:13
are choices and what are not
17:14
choices are also is
17:16
also a really good skill
17:17
I think just being present, you know,
17:19
spending time with your child,
17:21
is a really great strategy.
17:22
And then we have
17:24
to address the sensory needs.
17:25
with our individuals having
17:27
fidgets and other things around for
17:29
the child and hopefully working with
17:31
the occupational therapist who
17:33
understands and some things about sensory.
17:35
And then for some of our individuals,
17:37
having a safe area in
17:38
the house or a calming area so they know
17:40
when they get overwhelmed that there's
17:42
a place that they could go to be safe.
17:44
We'll look at task analysis as a strategy.
17:47
And, and the reason that I
17:49
bring a task analysis is to
17:50
understand that when we do something in life,
17:53
it seems like
17:55
a seamless activity and
17:57
is oftentimes very simple.
17:59
But oftentimes for individuals who
18:03
are on the autism spectrum,
18:04
what you will see are things
18:06
that you and I perceived to be
18:07
very simple from
18:08
their perspective is challenging.
18:10
And we have to know and teach
18:12
every step that's
18:13
involved with that oftentimes.
18:14
So understand what's part
18:16
of any routine that you're doing.
18:18
We use a lot of
18:19
visual supports with our folks.
18:20
And the Indiana Resource Center for Autism has
18:23
a full catalog of visual supports for free.
18:26
We have them on Pinterest as well.
18:27
So know what visual supports work
18:29
for your child, I think for your child to
18:31
Understand rules, having routines
18:33
during the day, making
18:35
sure that they understand the expectations.
18:37
And again, working with
18:39
people in the household to
18:40
kind of develop those routines
18:41
and the expectations.
18:43
Having a calm, safe,
18:44
and predictable environment, again,
18:47
with our individuals who have
18:48
this neurological disorder that oftentimes
18:50
makes the world overwhelming.
18:52
Having a calm, safe,
18:54
and predictable environment
18:55
will help calm them as well
18:57
We also know that brain intervals,
19:00
or what we call brain intervals or building
19:02
a movement into the day
19:03
is critical for our folks.
19:05
Making sure that they're getting
19:06
up and they're moving around,
19:07
building in some reinforcement for them.
19:10
And for example, if you do this,
19:12
then you can have access to this.
19:14
Again, things that we know are
19:16
really reinforcement builders for them.
19:19
And then I think, if I
19:21
think about the strategy that is the
19:22
most important in terms of working
19:24
with children on the autism spectrum.
19:26
I think rapport is
19:27
critical If the child trusts you
19:30
And if you've built a relationship,
19:33
you spend time really
19:34
building that relationship with them.
19:36
They will do more for you and learning
19:40
doing things differently is scary,
19:42
if you don't trust the people
19:44
who are guiding you on this journey,
19:46
then it's not going to be as effective.
19:48
So building that trust
19:50
and really spending time with the
19:51
individual and establishing that rapport and
19:54
finding out what interests
19:55
them is going to be really critical.
19:57
I think the other thing is,
19:59
is that I realized
20:00
that living with a child
20:03
on the autism spectrum and I'm sure
20:05
especially during this time,
20:06
can be very challenging
20:08
for all of you as well.
20:10
And so I'm going to also really
20:12
encourage you to practice some self-care.
20:14
And I know that that seems
20:15
impossible at times,
20:16
but it's kind of like that analogy
20:18
about being on an airplane
20:20
And if the airplane goes down,
20:22
you have to put the mask on
20:23
yourself first before you
20:25
put it on your child.
20:26
And I'm asking you please put
20:27
the mask on yourself first, You know,
20:29
so exercise when you can,
20:32
you know, eating or
20:33
eating habits have an impact.
20:35
Meditating or just having
20:36
some quiet moments can be really helpful.
20:39
I know in these days I'm really
20:41
reducing access to news to kinda
20:43
keep myself part of
20:45
what's going on and calmer about all of this,
20:48
connecting socially with family and friends.
20:50
And even if it's via Zoom,
20:52
or whatever and know
20:53
where your support comes from.
20:55
And I know that I've worked in this field
20:57
for many years and I know
20:58
for many families that,
20:59
autism becomes
21:01
a very isolating disability for
21:02
the family know that
21:04
their is support out there get connected
21:06
We have a lot of
21:06
parent support groups in the state of
21:08
Indiana be around positive people.
21:11
Laughter is a great medicine.
21:13
As a teacher, I was very blessed
21:15
that I got along very
21:17
well with the parents of my students
21:18
and was very involved
21:19
with the Autism Society.
21:21
In those meetings, we would
21:22
go get together and I have to tell you,
21:25
we would just laugh and tell stories.
21:26
And it was so medicinal for us
21:28
It was great.
21:29
And then I think also
21:31
in all of this is establishing
21:33
routines and setting goals for
21:34
yourself is going to be really important.
21:37
So we're here for you.
21:38
Feel free to reach out to the Indiana
21:41
Resource Center for Autism.
21:42
We know these are difficult times,
21:44
but we really want to help.
21:45
Thank you for your time.
English (United States)
