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    The 2-Step Approach to Preventing Disruptive Behaviors for Children With Autism

    Topics: Autism & Emotions, Autism Treatment Options, Infant/Toddler (0-3), Elementary (4-12)

    The 2-Step Approach to Preventing Disruptive Behaviors for Children With Autism

     

    Functions of Behavior and Antecedent Strategies 

    By understanding the function of problem behavior – what a child with autism is trying to communicate – we can then create appropriate antecedent strategies that support the child’s needs and reduce disruptive behaviors at the same time. 

    Professionals agree that behavior is functional: It serves a purpose. Although some forms might be more challenging to initially identify, investigative work can be done to pinpoint the function of a behavior, and behavior should be viewed as a form of communication. Take a child who begins throwing toy cars across the classroom, for instance… Is this a function of wanting to escape? Perhaps for gaining attention? Or maybe to get a different item or new toy? 

    Given these situations, behavior analysts seek to reliably identify – and appropriately disrupt – challenging behaviors by replacing them with new behaviors that serve the same function or purpose. This two-step approach can help prevent maladaptive behaviors, and sufficient opportunities should then be provided to help a child practice implementing new behaviors. It is essential that the replacement behaviors consistently result in the same desired outcome or functional goal that the maladaptive behaviors once did. 

    As the replacement behavior successfully produces a desired outcome over time, maladaptive behaviors can be placed on extinction – meaning that they no longer produce the same results as before. In other words, engaging in a challenging behavior no longer provides access to tangible items, attention, sensory stimuli, or the discontinuation of an aversive activity, situation, or event. Instead, a functional replacement behavior must be used in place of the maladaptive behavior, and antecedent interventions can be implemented to modify the learner’s environment to prevent challenging behaviors from occurring in the first place.   

     

    Behavior as a Form of Communication

    Importantly, behavior should be viewed as a form of communication – especially when working with children on the autism spectrum who may have limited language skills. Seeing behavior as a form of communication is essential when investigative work is being done to pinpoint the purpose or function of the behavior in question. Because challenging behaviors can become a child’s primary method for expressing their needs, wants, and desires, it is crucial to develop effective strategies for intervention that directly address these concerns – particularly among those with speech delays or limited verbal communication skills. 

    Disruptive behaviors can be replaced with adaptive behaviors that reliably, consistently, and successfully result in desired outcomes across multiple environments. To be effective, these replacement behaviors must dependably provide a functional outcome for the child in every context of life (e.g., at home, at school, in therapy, and in the community setting). Furthermore, maladaptive behaviors should be placed on extinction – meaning that they no longer receive reinforcement in any context, setting, or environment. Encouraging the use of positive replacement behaviors, rather than maladaptive ones, is an adaptive approach for improving communication among those on the spectrum.   

    girl with autism having tantrum in grocery store

     

    Describing the Functions of Behavior

    Professionals have determined that many autistic children display delayed speech or limited vocabularies, which can contribute to reduced functional communication skills as well as increased behavioral challenges. With this in mind, researchers and behavior analysts agree that the four primary functions of behavior include:


    • Escaping from an aversive activity or unpleasant situation… 

    For example, Sara throws her classroom worksheet on the floor to get out of a difficult assignment. 


    • Gaining attention from others… 

    James cries to get noticed by his parents, teachers, or adults who are nearby.

     

    • Accessing tangible items… 

    Gracie stomps her feet and repeatedly pulls on a cabinet door to get her favorite board game. 


    • Seeking or avoiding sensory stimulation… 

    Charlie rocks back and forth and aggressively bangs his head against the wall to self-soothe. He also covers his ears to avoid loud noises in overly stimulating environments. 

     

    Medical Considerations

    Additionally, medical considerations are a fifth and final function of behavior that some professionals include in the list. When a child is not going to the bathroom regularly, for instance, aggressive behavior or verbal outbursts might ensue as a result of the physical discomfort. In this case, it is crucial to obtain outside support from a medical professional to ensure that appropriate treatment is received and any underlying health issues are carefully and adequately addressed. Strategies that are suggested – such as taking scheduled bathroom breaks – may then be incorporated into behavioral treatment. It is always important to consider a number of possibilities that could be contributing to the behavior in question.

     

    Incorporating Antecedent Strategies 

    Once the function of behavior has been accurately determined, antecedent interventions can be implemented as part of the two-step approach to teaching functional replacement behaviors and adaptive forms of communication. The following chain of events is often used to identify appropriate interventions: 

     

    • (A): Antecedent

      A setting or environmental factor that impacts the likelihood of a behavior occurring 

    For example, Julie is given a difficult worksheet to complete during math class today.

     

    • (B): Behavior

      What happens as a result of an environmental change, proceeding event, or antecedent factor.

    Julie throws the assignment on the floor and refuses to complete it because it is too difficult.

     

    • (C): Consequence

      What takes place immediately after a behavior as a result of the behavior.

    Julie gets out of – or escapes – the assigned worksheet.  

     

    Antecedent strategies are designed to prevent maladaptive behaviors from happening in the first place after a function of the behavior has been reliably pinpointed. Preventative measures like antecedent interventions are, therefore, used to alter the environment prior to a challenging behavior taking place. 

    In the case of Julie, a student who tears up difficult worksheets during math class, the teacher might modify the assignment or only give her a few problems to work on at a time. This antecedent strategy can make the classroom environment less aversive by providing a modified version of the assignment. While Julie is still completing the assignment, it is presented in a more manageable – and less aversive – manner, making her less likely to engage in challenging behaviors to escape the classwork. 

    The ARIS curriculum created by STAGES® Learning includes using a Daily Behavior Tracking Sheet to facilitate tracking of challenging behaviors and to help you determine under what circumstances those behaviors tend to surface. This data will help determine antecedents that trigger the behavior, as well as events that follow the behavior which may be reinforcing to the student. The Daily Behavior Tracking Sheet is available from STAGES as a free download.

    girl with autism crying during school worksheet

     

    Common Antecedent Strategies and Techniques 

    Several of the most common preventive strategies that are used as antecedent interventions include: (1) providing choices, (2) incorporating noncontingent reinforcement (NCR), (3) altering the environment, (4) capitalizing on motivating operations (MOs), and (5) using physical, gestural, verbal, or visual prompts as needed. Each of these seeks to modify the environment before any maladaptive behaviors occur. 


    1. Providing Choices

    Choices and self-directed goals play a key role in any effective treatment plan. Allowing students to decide which task to complete first, second, and third – for example – gives them the opportunity to think for themselves and make their own informed decisions when presented with a series of tasks. 

    Although it is not possible to provide students with choices for every decision that is made, presenting learners with options – and including them in the decision-making process whenever possible – is a critical component of success, and it prioritizes students’ rights and dignity. Offering options, choices, and potential solutions has also been shown to improve classroom learning outcomes among autistic students while increasing task effort, performance, and overall academic achievement. 


    2. Incorporating Noncontingent Reinforcement (NCR)

    Noncontingent reinforcement (NCR) strategies provide students on the autism spectrum with a predetermined schedule of reinforcement based on the average frequency at which challenging behaviors occur. An NCR approach for Sam – a fourth grader who engages in kicking, crying, screaming, and hitting approximately every hour after school to get the attention of his parents – might be giving Sam attention non-contingently every 45 minutes in the afternoon and evening. This means that, regardless of the behaviors that Sam engages in, his parents will consistently give him attention on a fixed 45-minute schedule each day after school. 

    By providing this level of attention regularly, Sam will receive it without having to kick, cry, scream, or hit his parents, and – over time – this should result in less disruptive behaviors. Other strategies can be used in combination with NCR interventions to teach children to effectively communicate their needs with others in adaptive, appropriate, and non-harmful ways. 


    3. Altering the environment

    It can often be beneficial to alter the classroom, therapy, and home environment to accommodate sensory sensitivities described by many on the autism spectrum. Consider reducing sounds, lights, smells, and the overall level of stimulation to the extent possible. In the therapy and school setting, it may be worthwhile to have a calm-down space where students who are overwhelmed or overstimulated can go. These rooms should have limited lighting, be soundproof to the extent possible, and provide calming items – like sensory chairs. 

    little girl with autism sitting with bear to calm down

     

    4. Capitalizing on Motivating Operations (MOs)

    Motivating operations (MOs) are vital to keep in mind when establishing antecedent interventions for those with autism. In short, motivating operations are variables that alter the value of an item or activity by either increasing or decreasing its level of reinforcement.

    For example, Sam, a child who just finished playing on the playground in the heat of the day, will be more likely to engage in behaviors to access water because he is experiencing a level of water deprivation to some extent. This makes behaviors that result in getting water (such as walking up to a water fountain) more motivating – or likely to occur – and increases the effectiveness of water as a reinforcer. Similarly, the value of water may also increase for a child who is eating a salty snack during therapy. As sodium levels rise, the body begins craving fluid to balance out the sodium-to-water ratio, and water becomes a more powerful reinforcer. 

    Each of the above are examples of establishing operations (EOs) because they increase the value of water as a reinforcer. However, motivating operations can also cause a stimulus to become less desirable by reducing its level of reinforcement – as in the case of abolishing operations (AOs). EOs and AOs both affect how much someone desires an object, item, or stimulus according to their relative level of deprivation from it.  


    5. Using Prompts as Needed

    Finally, prompts, cues, reminders, and visual supports can be effectively implemented as antecedent interventions for those with autism. These strategies provide changes in a student’s learning environment before challenging behaviors occur. Posting signs on classroom doors to remind students to walk quietly in the hallway is one example of how visual reminders can be used as antecedent interventions to prevent problem behaviors. 

    Similarly, physical, gestural, verbal, and visual prompts might be used with autistic learners to help guide their responses during certain tasks and activities. When teaching writing skills to students with autism, for example, light hand-over-hand physical prompting can be useful as students learn to grasp the new writing techniques for themselves. With practice comes the improvement of the skill being taught, and prompts should be faded out (i.e., discontinued) over time as mastery is achieved. Be sure to start with the least intrusive prompt necessary and guide the child to independence so that prompting is no longer needed. 

     

    In Summary

    Identifying the primary aspects of behavior (e.g., what occurs before, during, and after a behavior in question) allows behavior analysts to pinpoint, examine, and directly target goals for student success. By breaking down a behavior into separate parts and identifying its function, effective interventions can be easily established, developed, and implemented. 

    Moreover, antecedent interventions tend to be used as a first-line approach for preventing challenging, disruptive, or harmful behaviors. Providing choices, incorporating noncontingent reinforcement (NCR), altering the environment, capitalizing on motivating operations (MOs), and using prompts as needed are the most common antecedent strategies that have been used successfully with those on the autism spectrum. 

    Generalization takes place as new skills are practiced, replacement behaviors are learned, and antecedent interventions are incorporated on a consistent basis. Any extra assistance or prompting should be faded out over time to a point where the individual can manage tasks on their own. As interventions are implemented consistently across multiple environments, autistic individuals will develop the skills they need to thrive

     

    Functions of Behavior and Antecedent Interventions 

    A Chart for Navigating Approaches to Support Those on the Spectrum 

    Making meaningful changes in behavior is often a primary goal when working with autistic children. Typically, challenging behaviors must be appropriately addressed and managed before other complementary skills can be taught. Considering this, it is important to identify the function of a child’s behavior prior to implementing a strategy or intervention to change it. 

    The primary functions of behavior–along with effective antecedent interventions–include: 

     

    The Function of the Behavior

    Example

    Antecedent Interventions

    Escaping an aversive activity or unpleasant situation

    • Throwing homework sheets on the floor to get out of a difficult assignment
    • The teacher provides a modified version of the assignment and requires the student to finish it before leaving the classroom.

    Gaining attention from others



    • Crying to get the attention of an adult, parent, or teacher
    • A noncontingent reinforcement (NCR) procedure is implemented that provides attention from adults on a consistent basis (e.g., every hour after school).

    Accessing tangible items



    • Stomping feet and repeatedly pulling on a locked cabinet door to get the bubbles inside
    • Functional communication skills are taught so that the child can appropriately request bubbles without engaging in challenging behaviors.

    Seeking or avoiding sensory stimulation



    • Rocking back and forth or aggressively banging one’s head against the wall to self-stimulate
    • Use a helmet to protect the child’s head until the behavior is better controlled; capitalize on the child’s motivation by playing with a favorite toy or distracting them with another activity. 

    Medical considerations (including underlying symptoms and physical causes)



    • Aggressive behavior or verbal outbursts may originate from physical discomfort of not going to the bathroom
    • Seek outside support from a trained medical professional to treat and address underlying medical concerns. Then, implement any strategies and suggestions that are given (such as taking scheduled bathroom breaks). 



    Join the conversation by sharing some ways you have used the function of behavior to develop effective antecedent strategies or taught replacement behaviors to a child on the autism spectrum.

     

    This article was based, in part, on the following sources:

    https://masteraba.com/functions-of-behavior/

    https://thinkpsych.com/blog/antecedent-interventions-to-reduce-challenging-behavior/

    https://www.southshorehealth.org/wellness/blog/sensory-seeking-in-children-how-to-treat-sensory-seeking-behavior 

    http://abaappliedbehavioranalysis.weebly.com/antecedent-interventions.html 

    https://www.n2y.com/blog/antecedent-interventions/ 

    https://www.edutopia.org/article/importance-student-choice-across-all-grade-levels

    https://www.bhwcares.com/motivating-operations/

    https://thinkpsych.com/blog/the-4-functions-of-behavior/ 

    http://coloradoabatherapy.com/the-abcs-of-behavior/

    Kenna McEvoy

    Written by Kenna McEvoy

    Kenna has a background working with children on the autism spectrum and enjoys supporting, encouraging, and motivating others to reach their full potential. She holds a bachelor's degree with graduate-level coursework in applied behavior analysis and autism spectrum disorders. During her experience as a direct therapist for children on the autism spectrum, she developed a passion for advocating for the health and well-being of those she serves in the areas of behavior change, parenting, education, and medical/mental health.

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