173: Autism: Overview and Treatment

Transcription

1 173: Autism: Overview and Treatment Debbie Laffranchini, Professor Chapter 7: Comprehensive Behavior Interventions for Individuals with ASD From Autism Spectrum Disorders: Foundations, Characteristics, and Effective Strategies Boutot and Myles

2 Functional Behavior Assessment What happens before a challenging behavior is important What happens after a challenging behavior is important Before behavior: antecedent After behavior: consequence Consequence doesn t mean what a person does to punish a behavior

3 Functional Behavior Assessment Assess behavior, where did it come from? If all behavior communicates, what is the child communicating? What purpose (function) is the behavior accomplishing? How can you support a positive outcome?

4 Behavioral Triggers Time of day Presence of specific people Specific classroom subject Transition Change in routine Settings with too much/too little structure Request or demand to stop a behavior Why would you do that? Punishment Medication changes Family circumstances

5 Intervention Based on Functional Behavior If you understand the pattern (ABC) of behavior, your intervention is strengthened Antecedent intervention: Anticipate and prevent! Behavior intervention: Replace the behavior Consequence intervention: Reinforce what you want to encourage Allow for recovery Assessment

6 Beyond Functional Assessment: Address the Underlying Need If you interpret a child s misbehavior as being willful when they are not, it can have great risks Low self-esteem Hopelessness Depression Lack of opportunity to learn alternative behaviors

7 Beyond Functional Assessment: Addressing Underlying Needs Address the underlying needs of autism, not just what you see (behaviors) Target underlying needs Be proactive Don t just address the consequence If you only address what you see, it will not be effective and won t have a sustainable change

8 Beyond Function Assessment: Addressing Underlying Needs Intervention plans must be comprehensive Thorough analysis of biological events Antecedent events Consequence events Intervention plans must involve multiple strategies Strategies are informed by functional assessment

9 Positive Behavioral Support (PBS) Research-based strategies used to increase quality of life Decreases problem behavior by teaching new skills Decreases problem behavior by changing the environment If it s not working, change the environment

10 Critical Features of Positive Behavioral Supports (PBS) Comprehensive lifestyle change and quality of life Life span perspective Ecological validity (real life applicability) Stakeholder participation (parents as experts, professionals) Social validity (are interventions practical, effective?) Systems change Multi-component intervention Emphasis on prevention Flexibility with respect to scientific practices (appreciate and use other practices) Multiple theoretical perspectives

11 Characteristics of Autism that May Be Related to Off-task Behavior Individual has difficulty imitating actions or words of others Chooses or prefers solitary activities Appears to be in their own world Seems to be unmotivated by customary rewards Has little or no speech Has problems handling transition and change Has difficulty following instructions Seeks activities that provide touch, pressure, or movement Swinging, hugging, pacing) Appears to be unresponsive to others (their own name) Displays atypical activity level

12 Comprehensive Planning: Moving Beyond Functional Behavior Assessment Must understand: Characteristics of ASD What causes and maintains behavior Plan must be Multi faceted Implemented across all of child s day Responsive to unique needs and strengths Ziggurat Model is framework for designing comprehensive interventions, consistent with principles above

13 In-Class Activity What are antecedent interventions? (1-2 sentences) What three levels of the Intervention Ziggurat consist primarily of antecedent strategies? Looking at structure and visual/tactile supports, the third level of the Intervention Ziggurat, summarize in one paragraph. What is the goal of antecedent interventions? Looking at the first level of the Intervention Ziggurat, sensory and biological interventions, summarize in one paragraph the antecedent interventions. What are the three levels of task demands? For each level, identify what makes the task a particular level? Summarize skills to teach in 2 3 sentences. What do reinforcers do according to your book, page 174? Summarize reinforcement in 1 2 sentences. Looking at task demands, the fourth level of the Intervention Ziggurat, summarize in one paragraph.

14 Antecedent Interventions (Prevent Behaviors) Prevent behaviors by changing the environmental factors Be proactive, not reactive Interventions that are responsive to individual needs: Sensory differences and biological needs Task demands Structure, visual supports and tactile supports

15 Antecedent Interventions I don t manipulate others; just their environment! Prevent triggers Teach replacement behavior Improve environment Change difficulty of task Give REAL choices

16 Sensory and Biological Interventions Unmet sensory and biological needs will result in changes in behavior Crying Running away Withdrawing/failing to participate Becoming easily distracted Noise making Tantruming Hypersensitivity

17 Task Demands Conversation and play: Social skills Communications skills Levels of demand Easy Challenging/emerging (zone of proximal development Too demanding

18 Task Demands (cont) Zone of proximal development Not yet mastered but can do with support

19 Structure and Visual/Tactile Supports Spoken instructions and information are often lost for child with ASD Visual supports Pictures Written schedules Task strips Social stories Video modeling

20 search_query=video+modeling Video Modeling

21 Behavior Prevent many problem behaviors using antecedent interventions Antecedent interventions based on three levels of Intervention Ziggurat (sensory/biological, task demand, structure and visual/tactile supports) Visual supports Shorten length of circle time Something to hold Build activities that provide movement Use a first-then visual chart Provide optimal location on floor

22 Behavior is communicative Non-compliance and aggression is communication Behavior problems may communicate hidden skill deficits The child with autism is not the problem Ask, What skill is missing? Skills to Teach

23 Hidden Curriculum Standards and rules that are assumed to be known by everyone and must be learned through observation

24 Consequence Reinforcer increases the likelihood that a behavior will recur Be creative when arriving at an appropriate reinforcer Create social reinforcers when possible Objects or activities related to obsessions are often more effective than food

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