Problem behaviors remain one of the most troublesome factors affecting the development and health of people with autism. Unfortunately, many outsiders who see problem behaviors in children, teens or adults with autism do not realize the behaviors stem from cognitive difficulties. However, behavioral therapists have managed to help people regain control over problem behaviors through applied behavior analysis (ABA), but it is still far from perfect.
Information about how to properly use ABA varies, and educators or parents may be nervous about when to use its tools and techniques in caring for children or others with autism spectrum disorders (ASDs). Consequently, you must prepare to work on eliminating problem behaviors by understanding what constitutes a problem behavior and considering how other factors that may influence the type of behavioral therapies available.
Defining Problem Behaviors Among People with ASDs
Any behavior that inhibits a person's ability to control his or her action is a problem behavior. It is important to understand problem behaviors are not necessarily intentional. They result from changes in the brain's function in those with ASDs. From a parent's or educator's standpoint, problem behaviors may include the following:
- Disruptions during school or home.
- Refusal to communicate.
- Inappropriate actions, such as suddenly sitting down when walking between rooms.
- Refusal to complete homework or chores.
Unusual or excess vocalization make up one of the most common problem behaviors people with autism exhibit. However, vocalizations are not limited to yelling or crying. Instead, they may include making unusual sounds, such as snorting, explains Autism Speaks. Rather than immediately identifying any vocalization as a symptom of autism, parents, caregivers or therapists need to ensure the behavior is not the result of a medical problem first.
For example, excessive crying or snorting may be related to a problem with the throat, nose or sinuses.
Problem behaviors can also be more dangerous than many realize. Per the Centers for Disease Control and Prevention (CDC), problem behaviors may include physical and verbal aggression and self-injurious behavior (SIB). Furthermore, up to 78 percent of people with autism may exhibit aggression due to an undiagnosed, co-occurring mood disorder. Similarly, up to 50 percent of children with autism may exhibit SIB.
Unfortunately, there is not a one-size-fits-all means of managing aggression or SIB. As a result, any means of reducing problem behaviors must adapt to different causes and specific behaviors. This is part of what makes behavior analysis an effective tool in reducing problem behaviors.
Other Considerations in Reducing Problem Behaviors
Reducing problem behaviors through ABA must involve more people than just a behavioral therapist. Teachers, family members and peers can benefit from understanding simple ways of applying ABA interventions, especially for those in a state of crisis.
For example, simple training sessions on the use of non-contingent reinforcement have been shown to reduce problematic behaviors in after-school settings, reports a study published the U.S. National Library of Medicine. In other words, a person with autism already has what may be typically driving vocalizations or problem behaviors, such as the desire for attention. Meanwhile, the use of telehealth and mobile-learning platforms has helped parents in remote areas learn how to reduce problem behaviors in their children.
There are many benefits associated with the use of telehealth or mobile-learning to reduce problem behaviors among individuals with autism. Initially, the greatest benefit is the ability to reach more people with limited resources.
For example, parents that are unable to take children to therapy due to work or other responsibilities can use telehealth to ensure missed appointments do not transition in a recurrence of problem behaviors.
Additionally, mobile-learning platforms directly lower the costs associated with traditional behavioral therapies. In other words, mobile learning can teach parents and other caregivers how to continue behavioral analysis without the intervention of a licensed therapist specifically. In fact, parents who used mobile-learning platforms to continue and analyze behavioral improvements were able to reduce problem behaviors in more than 90 percent of their children with autism.
The cost of behavioral therapies is the final cornerstone of treatment and intervention for autism. In the study, researchers analyzed the results of three service delivery models, including in-home therapy, clinic-based telehealth and home-based telehealth. The findings suggest parents who are unable to meet insurance deductibles or copays may be able to access other forms of therapy, including conducting ABA within the home themselves, without the added costs of a behavioral therapist.
Of course, families seeking any of these three types of therapies must have internet access available. Consequently, the next phase of funding for reducing problem behavior through behavioral analysis of those with autism may place more focus on providing internet access than actual in-person therapy sessions. While this may seem unusual, it reflects an expansion of the role of parents or caregivers in helping therapists eliminate problem behaviors.
Meanwhile, the lower costs and quantifiable results from the study suggest in-person therapy may only be needed for the most severe of problem behaviors. Therefore, the financial burden on the health care industry can be lessened, making way for newer, more innovative treatment approaches.
Problem behaviors can influence a person’s ability to engage in social settings appropriately, overcome emotional challenges and become a productive member of society. However, eliminating problem behaviors in people with autism is not as simple as explaining consequences. Behavioral therapists, caregivers or parents need to understand how to define problem behaviors, their possible impact on quality of life and how new technologies are becoming central to successfully exterminating them.
Ultimately, the goal of eliminating problem behaviors begins with understanding, and the next section will dive into specific steps to eliminate problem behaviors permanently.