How Should Providers Handle Challenging Behaviors?
O One of the biggest concerns about respite care is shared by both families and providers: what will happen if the individual with ASD exhibits any challenging behavior? Because of the social, communication, and behavioral difficulties, individuals may resort to inappropriate behavior to communicate, express frustration, or get what they want. This will not apply to everyone, but some may engage in aggression, self-injury, or other dangerous actions. When patterns emerge that predict when challenging behaviors are likely to occur, families and providers can take steps to minimize or even prevent them from happening at all. This proactive approach is a great way to reduce their likelihood, but it is also important to have a plan in place if they do happen. Families should explain these strategies to providers in advance of the scheduled respite.
For example, when Anthony is told to clean his room, he runs into the bathroom and slams the door. His parents allow him to stay in the bathroom, time passes, and he never ends up cleaning the mess. The next time he is told to clean his room, he is likely to hide again. Although not an appropriate response to his parents’ direction, this behavior was effective because it enabled him to avoid the task. By analyzing these consequences, the family can try alternate ways to handle the situation, such as initially starting with a smaller task (asking to just make the bed), planning positive reinforcement, and exploring other proven strategies to motivate Anthony to follow that instruction. Although many challenging behaviors can be prevented, the following are general tips to keep in mind if they do occur. Instead of reacting in frustration, take some time to consider why the individual may be having difficulty. For example, if Emma wants to go outside at a time it’s not allowed, let her know when she can and suggest other activities she enjoys. If Caleb throws away his homework and refuses to work on it, consider why he may be trying to escape the task; maybe he needs help or would like to take a brief break every ten minutes, choose the order in which he completes the assignments, or have quiet music on while he works. If Ben misbehaves to get attention, be sure to give plenty of attention to his appropriate behaviors and demonstrate better options. If these types of responses don’t help and the individual’s agitation becomes a safety concern, the provider should follow the guidelines set by the family as to who to contact. Safety is always the number one priority.
Addressing challenging behaviors is best accomplished through a functional behavior assessment (FBA), often conducted by a Board Certified Behavior Analyst (BCBA). This includes documenting what happens right before and after the behavior so the team can look for patterns to suggest why it is happening. Although it can be difficult to determine in some situations, providers must understand that behavior serves a function, or purpose, for an individual. If new challenging behaviors develop suddenly, a medical evaluation may be necessary since the individual may not be able to communicate that he or she is in pain. Other simplified functions are to get something (an item, activity, or attention), to avoid something (a task or location), or for sensory stimulation or relief. Once the reason for the behavior is understood, everyone involved can begin the process of teaching safer alternatives.
• • • • • Providers must understand that behavior serves a purpose for an individual...once this reason is understood, everyone involved can begin the process of teaching safer alternatives.
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