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Behavior Management and Autism

Every single child with autism spectrum disorder (ASD) needs a behavior management plan. Unfortunately, many school systems seem to write behavior management plans just for children with disruptive behavior, such as aggression, self-injury, property destruction and tantrums (collectively referred to as externalizing behaviors, because they are externally visible).

Equally important is to have a behavior management plan to address anxiety, perfectionism and cognitive rigidity (internalizing behaviors, which, as the name suggests, are not always visible on the outside.)

Children with internalizing behavior are not disruptive to classroom routine, which is why they often do not get the behavioral supports they need until they become so stressed that they begin to manifest externalizing behavior.

It would be much better to provide assistance early on, before that threshold is crossed. (My hunch is that girls on the spectrum are at greater risk than boys for having unaddressed internalizing behavior.)

Your child’s classroom needs to provide appropriate guidance for your child, at an appropriate stimulus level, with immediate, appropriate responses from staff. If your child is exhibiting disruptive, noncompliant or agitated behavior, is this because the classroom is too stimulating, because the demands on your child exceed his abilities, or perhaps because your child has mastered the art of using disruptive behavior as an escape mechanism?

If your child is anxious, perfectionistic or rigid about routines, do the staff take this into account, giving your child advance notice of transitions and reassuring your child that mistakes are just another part of learning? Does your child’s individualized education program (IEP) include the option for your child to take “stress breaks”?

The Incredible 5-Point Scale

The Incredible 5-Point Scale or a similar technique is useful as an adjunct to the Take a Break Cards, since it teaches the child how to recognize and label his stress level and helps him to avert meltdowns.

For more information, see The Incredible 5-Point Scale: Assisting Students with Autism Spectrum Disorders in Understanding Social Interactions and Controlling Their Emotional Responses by Kari Dunn Buron and Mitzi Curtis (Autism Asperger Publishing Co. $21.95).

I often suggest that children with ASD be issued three Take a Break Cards each day and that they be permitted to play these one at a time over the course of the day. A Take a Break Card would entitle the child access to a quiet area, or perhaps the occupational therapy gym. The flip side of the coin is that the child is expected to remain in class and toe the line at other times. Giving the child some ownership over when she can take a break is one step toward enabling the child to regulate her own behavior.

Excerpted from Making Sense of Autistic Spectrum Disorders: Create the Brightest Future for Your Child with the Best Treatment Options (Bantam, $25.50). Reprinted with permission. James Coplan, MD is in private practice at Neurodevelopmental Pediat­rics of the Main Line, Rosemont, PA, www.ndpeds.com

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