refocusing behavior

My child is an 8 year old girl with autism who is in a public education functional skills class.  We have had a huge problem with her hitting others, squeezing arms and pounding on objects when frustrated.  I have been working at redirecting the behavior into something acceptable for her to use when frustrated.  I have tied a sock into knots, tied it to a string and have a clip to place it on her belt loop so it is accessable.   I also feel that this is something that can grow with her as she gets older and needs to squeeze because she can place a cloth in her pocket or something along those lines.  We have only been doing this for 2 months although I found out that the school decided to discontinue its use because they had to keep reminding her to use it and she wasn't using it consistently on her own.  She will use it when reminded as well as on her own and I feel it is better for her to use this rather then squeeze an arm or pound on a computer or another child. When she uses the sock it does release the agression and the other behaviors do not happen.  I also don't feel that 2 months is long enough to make an accurate assessment or to change 8 years of aggressive behavior.  I have demanded that they re implement the device for now while we await her appointment at the children's hospital for a full assessment of her condition and their recommendations for occupational therapy.

My questions are:  Is the approach a good one to redirect the behavior?  How long should we wait after implementing a new therapy or technique before we assess the outcome?  I realize that times do very depending on the child and situation, but what is a good timeline to use when judging if a behavior change is permanent or not?

[Rachel Thompson, Ph.D., BCBA]

In most cases, we find that aggressive behavior displayed by children with autism and other developmental disabilities is a form of communication. Because aggressive behavior is often successful in producing some reaction from adults and peers, children learn that aggressive behavior may be an effective way to indicate that they want or need attention, a break from what is going on around them (e.g., challenging academics, too much social stimulation or noise), or a favorite toy or snack. One well researched and often very effective strategy is to attempt to teach the child an alternative way to communicate their wants and needs appropriately. Therefore, a first step would be to ensure that your child can communicate when she wants attention, a break, or a favorite toy or snack. It is important for teachers and caregivers to agree to a specific form of communication that is appropriate to your daughter’s skill level and to attempt to honor her requests as immediately and frequently as possible. Otherwise, she may find that aggression is a more efficient form of communication. At first, it would be best to give frequent reminders (before aggression occurs) for your child to communicate appropriately. Finally, teachers and caregivers (and peers to the extent possible) should attempt to respond as neutrally as possible to the aggression. When aggression occurs (a) avoid excessive attention for aggression, (b) attempt to continue ongoing interactions (e.g., academics), and (c) avoid presenting favorite toys or snacks immediately following aggression. If this approach is implemented very consistently, I would expect to see some improvement within about 2 weeks, but it is important to record your child’s behavior carefully so that you can have an accurate assessment of the effects of any intervention. A Board Certified Behavior Analyst should oversee the implementation of this type of strategy. Please visit the website of the Behavior Analysis Certification Board (http://www.bacb.com/) where you will find a directory of service providers.