Working with Parents of a Newly Diagnosed Child with an Autism Spectrum Disorder by Deb Keen & Sylvia Rodger

Author:Deb Keen & Sylvia Rodger [Deb Keen and Sylvia Rodger]
Language: eng
Format: epub
Publisher: xx
Published: 2013-06-28T16:00:00+00:00

Figure 7.4 A visual schedule

So far in this chapter we have considered the impact of ASD on communication, and ways of using different strategies and techniques to enhance communication skills of children with ASD. In the process, we have looked at the use of the IPCA to identify communicative behaviours, and the introduction of visual supports to teach children more symbolic forms of communication. In the next section, we discuss some communicative forms that can be problematic, and how the strategies we have already discussed can help in addressing these problem behaviours.

MANAGING PROBLEM BEHAVIOURS

One of the most significant challenges facing parents of children with ASD is the high rates of problem behaviour evident in this group of children. They exhibit higher rates of problem behaviour than children with other types of developmental disabilities (Dunlap et al., 1994). These problem behaviours can have a significant impact on the quality of life of the child and his or her family (Lucyshyn et al., 2002). Problem behaviours can vary significantly within and between children and may range from mild behaviours that can be disruptive, such as spitting and screaming, to severe and seriously concerning behaviours, such as self-injury, aggression, and property destruction.

Sigafoos et al. (2006), have outlined various reasons why problem behaviours may occur among individuals with developmental and physical disabilities:

•biological factors (certain syndromes are associated with particular behaviours, e.g., stereotypic handwringing in children with Rett’s Disorder)

•psychological factors (psychiatric or mental health disorders which may increase frequency or intensity of problem behaviour)

•medical factors (certain types of epilepsy, illness)

•environmental factors (e.g., an impoverished environment)

•learning factors (reinforcement of problem behaviour, increasing the likelihood that it will recur).

In dealing with problem behaviours, a multi-component approach is recommended which combines the teaching of new skills, making changes to the environment, and modifying the consequences for positive and negative behaviours (Carr and Carlson, 1993). For parents, this will generally involve structuring child and family routines at home and in the community, and enhancing the child’s communication skills using approaches discussed in this chapter. A psychologist who specialises in ASD can make a valuable contribution here, being trained to assess the behaviour and then use the assessment data to develop a suitable, individualised, multi-component intervention.

It is important to consider that many problem behaviours may serve a communicative function. Problem behaviours that are a form of communication can potentially be replaced with communicative forms that are more appropriate or acceptable but serve the same function as the problem behaviour. This approach to problem behaviour is known as functional communication training (FCT) and has been shown to be effective for children with problem behaviours (Donnellan et al., 1984; Mirenda, 1997). The effectiveness of FCT relies on accurate assessment of the underlying communicative function being served by the problem behaviour. A functional assessment must inform the intervention.

Let’s consider a child with ASD (Sandra) who screams when prompted to use a fork to eat her dinner. There may be many reasons for Sandra’s behaviour, but for this example we will consider only two.

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