LESSONS LEARNED

TIPS FROM THE FIELD FOR UNDERSTANDING AND DISCUSSING CHALLENGING BEHAVIORS

BY RACHEL SCHWARTZ, PHD, BCBA-D

Challenging behaviors represent one of the most difficult and frustrating attributes of autism. While not every individual with autism displays challenging behaviors, those who do often struggle to gain access to opportunities and independence in their communities of choice1. In the face of challenging behaviors, many parents, caregivers, and prac titioners feel powerless in how to best respond. This article details my shift toward a better understanding of challenging behaviors and my ever-evolving perception of behavior. I hope my experiences will serve as a resource and guide for how to conceptualize challenging behaviors and promote productive behavior programming.

WHAT IS BEHAVIOR?

When I began in the field over 15 years ago, I worked with an adult named Daniel. Daniel had autism, no vocal verbal language, and engaged in significant aggression and elopement. On a particularly difficult day, my boss, Jon, pulled me aside to ask what I felt was going wrong. I lamented that I didn't know what Daniel wanted because he couldn't tell me. Jon looked at me for a moment, and then responded "Daniel is communicating very clearly with you. You just haven't been listening". Jon taught me the first tenant of behavior change – all behavior is communication.

Tip #1: Behavior is communication. An individual's behavior communicates to the environment his or her wants and needs. Listening to those needs will allow us as practitioners, parents, and caregivers to better understand and respond appropriately. Furthermore, understanding what an individual communicates will allow for teaching new, appropriate ways to communicate the same thing. For example, a child throws items when he or she needs help. Rather than providing help after a child throws, teaching the child to appropriately request help will build a new skill and reduce throwing.

HOW TO LISTEN TO BEHAVIOR

HOW TO LISTEN TO BEHAVIOR Jon's insight forever changed how I viewed challenging behaviors. From that moment on, I worked from the perspective that all challenging behavior serves as communication. The next stage in my growth toward changing challenging behaviors consisted of adapting how I described behavior. My experience with Daniel frustrated me. I didn't know what he wanted and I failed to listen or interpret his challenging behaviors as communication attempts. When describing him to my colleagues, I called him "noncompliant", "controlling", and "defiant". I tried to model and redirect, and yet he often ignored those instructions and prompts. It made me feel powerless, stressed, and anxious to work with him.

Jon helped to change my perception of challenging behaviors and consequently, shifted how I talk about behaviors. Using words like "noncompliant" did not facilitate problem-solving or help me analyze what Daniel needed. In fact, the language I used allowed me to convince myself that the problems lay solely within Daniel and represented his lack of skills or diagnosis. Unsurprisingly, that position provided no guidance, teaching, or cooperation. Over time, I came to realize that no individual bears all of the responsibility for change, especially not an individual exhibiting challenging behaviors.

I changed my approach by taking Jon's advice to "listen" to Daniel's behaviors. Rather than focusing on what he wasn't doing, I began to focus on what he did do. I examined his actions. I collected data on the environment, what he did, and what happened immediately after (ABC data)2. Upon analyzing the data, I began to modify the environment. I added in a visual schedule with supports, a countdown chart and timer, and modified all of our scheduled transitions to ensure Daniel always left early and missed crowded, unstructured times of day. The data I collected indicated Daniel's challenging behaviors occurred in order for him to access certain activities. Consequently, I began teaching him to appropriately request activities he wanted through a tactile communication system. Over the course of several weeks, Daniel and I learned to communicate efficiently with one another. He handed me a stick, we went for a walk. I handed him a plate, we went to go eat lunch. The days of aggression and elopement became less frequent, and Daniel's appropriate behavior progressed.

Tip #2: Isolate challenging behaviors as actions. What movement does the child make when he engages in the challenging behaviors? What actions do I see? Using actions words becomes a starting point for planning. Using action words keeps the focus on what the behavior communicates to the environment and how stakeholders can help change that behavior. Changing the lexicon of challenging behaviors from meltdown to movement may allow for more reflection, collaboration, and positive programming.

WHY DOES LANGUAGE MATTER?

My work with Daniel instilled a love of behavioral analysis and provided a new language for discussing challenging behaviors. Over a decade of further experience and personal reflection within my own career exposed how certain terms such as "noncompliance", "defiance", and "control" often used to describe challenging behaviors can lead to wasted time, fractured relationships, and depleted resources. Additionally, this language typically yields little helpful information when attempting to identify variables surrounding the behaviors of interest. Since Daniel, I have learned that these terms more often than not reflect the struggles of the adult and not the challenges of the individual.

In my career working with individuals with autism and challenging behaviors, I have not encountered an individual who is simply bad, defiant, noncompliant, or controlling. I have come across individuals who struggle to meet the demands of their environment and to adequately communicate and respond to the variables present3. Solving challenging behaviors begins with the mindset that the challenge doesn't begin and end with the child alone. Saying a child is "noncompliant" implies that there is something internal within that child that makes the child behave in a certain way. Rather, it helps to consider that the child responds to the environment in the way that he or she finds most effective. The environment plays a crucial role in setting up opportunities for challenging behaviors to occur. Similarly, the responses within the environment, including the actions of the persons present, serve to either reinforce or diminish the likelihood the behaviors will occur again. Challenging behaviors produce stressful circumstances for all involved, making the need for a productive and common vocabulary of challenging behavior all the more necessary. The language used to describe behaviors can help or hinder the problem-solving process. My work with Daniel initiated a complete reworking of how I conceived and connected Daniel's actions and my responses. I had lost hope that my work with Daniel would result in any change, and yet an alteration of my outlook resulted in positive, constructive outcomes.

Tip #3: Consider yourself a co-conspirator. Changing behavior involves reflecting on how the environment sets the stage for challenging behaviors and how we as stakeholders, caregivers, and parents, respond to those behaviors. Behavior doesn't occur in isolation; behavior happens as a response to the people and activities in an environment. Consider recording what occurs after an individual engages in a challenging behavior. Whatever occurs immediately following a challenging behavior serves to reinforce it and allow it to continue to occur. Learning how to adapt the environment can prevent challenging behaviors from occurring and promote more appropriate, positive behaviors. Changing challenging behaviors and ensuring that challenging behaviors do not stymie equal opportunities involves taking equal responsibility for the behaviors occurring.

FINAL THOUGHTS

My work in the field of special education continues to push my perception of challenging behaviors and presumed competence. I have met many more Daniel's over the past decade and each one has taught me new lessons of best practice and patience. One of the greatest lessons I have learned is that challenging behaviors do not change overnight. Behavior change occurs gradually over time, typically in fits and bursts. It takes persistence to work with and change challenging behaviors. Even more than that, it takes compassion and empathy. Incorporating both will build an environment of kindness, mutual respect, and trust for all involved.•

ABOUT THE AUTHOR:

Rachel Schwartz, PhD, BCBA-D, is a doctoral-level Board Certified Behavior Analyst (BCBA-D) who has worked internationally, creating and supervising programs for individuals with developmental disabilities. Rachel received her Master's degree in Teaching and Applied Behavior Analysis from the University of Georgia and her Ph.D. in Special Education from the University of Pittsburgh. Rachel's work interests include enhancing behavior analytic programming and exploring issues related to sexual education and quality of life. Rachel is an Educational and Behavior Consultant for the Watson Institute in Pittsburgh, and has published original research on these topics in special education journals as well as presented at national, state, and local conferences. When she isn't consulting, Rachel collaborates with the local medical community to promote resources for families with children with complex health needs.

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