BEHAVIOR MANAGEMENT 

The following scenarios exemplify strategies used by the TEACCH program as part of their overall Behavior Management approach.  When challenging behaviors occur, We first ask why are they happening , assessing all aspects of the situation where we are seeing the behavior.  By tweaking some aspect of the support system that is in place or adding structure when needed  we can eliminate a great percentage of behaviors that are interfering with the individual's success.

Scenario 1: Interests Opening Doors

I worked for several years in a TEACCH preschool program, working with children with autism, between the ages of 2 � to 5 years of age. Although for many of these students, work itself was motivating, for others, work activities were of no apparent interest at all.  One young man, named Chris, presented quite a challenge upon first entering the program, since he showed very little interest in anything.  When so little interest is shown, how does one begin to motivate the young person to begin the journey on the educational highway?

After assessing how Chris worked with a variety of different materials and how he handled himself in different situations, we observed that his most sustained attention and interest was when he had his hands in water at the sink.  His mother confirmed that since he was a baby, water was about the only thing that would comfort him during an upset. We used this information during his next work session in the classroom. 

Red Buttons in Water is a ShoeboxTask where a student drops large red buttons into the top of a clear plastic container that is filled with water. The buttons are set on edge in slots on the shoebox lid, while the tube is set down into the lid. Once dropped into the tube, the button floats gently down, disappearing into the bottom of the shoebox.  We set "Red Buttons in Water" in front of Chris and demonstrated how to take one button and drop it into the slot in the top of tube. With great interest he watched the button floating gently down out of sight, and then reached immediately for another button in order to make it happen again. This was the first time Chris had worked on something independently and with sustained interest. We then took another simple activity that he had previously resisted doing. This ShoeboxTask involved moving blocks off of a strip of Velcro and placing them into a container. At his worktable, we placed the Blocks on Velcro activity in front of Chris, and we placed Red Buttons in Water in the uppermost right hand corner, within Chris' sight, but out of his reach. We established a visual connection between the Blocks on Velcro activity and the Red Buttons activity, saying, "First work" (gesturing to the activity in front of him), "Then play," gesturing towards Red Buttons. At first, we only required Chris to move one block into the container before allowing him to do the Red Buttons. Over time, we increased the number of blocks to 10 and, once he was successful with that, we began adding a second activity that had to be "finished" before he could experience the Red Buttons again. The rate at which one can increase the amount of work, before play, will vary from child to child. Let success and comfort levels be your guide.

Scenario 2: Processing Communication Through Visuals   

Sometimes challenging behaviors occur when an individual is just not feeling well, and has no other way of expressing. Adam, a young man working in our ShoeboxTasks workshop, is not verbal; however, he communicates with some signs and is able to follow visual picture/word schedules very well.
 
Several weeks ago, Adam was upset when he came to work and his job coach could not figure out why.  The upset began as they approached our shop, which is unusual, because he really likes coming to work. He responds well to the structure and, if anything, the repetitive work has a calming effect upon him. Despite our encouragement for him to begin working on packaging some of the activities, Adam did not calm down. His job coach decided that maybe they should leave and go back to his other work location where he has a quiet room. She took out a pencil and paper and quickly drew a picture of her vehicle and also a picture of Adam in his quiet room. Once these pictures were presented to him with the message, "Go in van, have quiet time", his tantrums stopped.  He and his job coach gathered their belongings and they were gone. On the following day, I learned that Adam had come down with the flu. In retrospect, his upset behavior makes perfect sense, but at the time, we could only speculate on the reasons for it.

Scenario 3: The Power of the Visual

Not being able to anticipate what is happening next can create some very strong reactions from individuals with autism.  We tend to say how inflexible they can be, however, it has been my experience that if they have some advance notice on a change or what is expected in certain situations, they can show great flexibility. The following example points this out.

For several consecutive summers, I worked as a TEACCH consultant/trainer at the NC Autism Society's (ASNC) summer camp. Since many of the summer staff had no prior experience working with individuals with autism, it was my job to help train and teach them as coaches for the campers who came for one week.  I worked with a young boy named Derek, modeling the kind of structure that would help him to be successful during his camp experience. Derek was very large and strong for his age (he was 13, the last year I worked with him). He used some words and signs for communication. As sweet as Derek could be, when he became overwhelmed, he was prone to fits of aggression. During these times he would grab at his coach's shirt and pull, usually tearing it. Or if one had long hair he would grab for it and pull hard. Essentially, my work was to structure Derek's time in such a way that he would have a good, productive day with a minimum of overwhelm. If Derek did begin to act out, I then had the opportunity to demonstrate to staff in training a good way of handling him until he had calmed down.  

Towards the end of each camp week, the campers have a bonfire, where everyone gets to toast and eat marshmallows. Jill, a personable coach in training was passing out the marshmallows to each of the campers. Derek, who loves to eat, had 3 marshmallows, at which point the staffers agreed that he should stop and return to his seat. Upon being told that the marshmallows were finished, he became very upset and went first for the marshmallows and then for the person holding them. He grabbed Jill's long ponytail and with some effort I eased his hand off of her and helped him away from the circle of people to a secluded spot where he sat down and began to cry. By reducing any further demands on Derek, he became calmer and we were soon able to proceed on with our day as scheduled.

A year has passed and I am once again working with Derek and it is time for toasting marshmallows at the bonfire. Despite the passage of a year, the previous bonfire experience was still fresh in my mind. This time, we created a checklist for Derek, showing him visually, through drawings, that he would be eating 3 marshmallows. After eating each marshmallow he would cross out that line and after the 3rd marshmallow, there was a chair pictured, indicating a return to his seat. Despite having seen similar visuals work with so many others that I had worked with over the years, I was still nervous as I handed Derek the checklist and showed him what he was going to do. He still liked to eat and was still  to aggressive outbursts, but now he was bigger and stronger than the year before. Derek looked at the checklist, took a marshmallow from the young woman staff, crossed it out on his checklist, took another and crossed it out, took the third, crossed it out and returned to his seat very calmly and happily. Looking back, I probably could have avoided the meltdown that took place the previous year had I anticipated the event by using a visual tool such as the checklist. For me, this experience strongly supports the power of the visual (in this case a checklist) in allowing an individual with autism to understand the totality of an event that is about to take place. It also affirms that, for someone who does not inherently have the ability to understand an event in context, expressing their objection through behavior may be the only option.