Autism & challenging behaviours in children

Katie hits herself on the head when someone tells her “no”. Morgan is unable to sit still in class and requires constant and direct supervision from teachers. Lucy screams and covers her ears when she hears a loud announcement at the train station. Timmy flaps his hands all the time. Sally only wants to eat a particular type of food and gets intensely upset when the food changes.

Challenging behaviours and autism

Children with autism often display challenging behaviours. These behaviours can serve as a potent source of stress and frustration amongst the children themselves, as well as parents and caregivers.

While parents may feel accountable or guilty for these behaviours, it’s important to not blame yourself or your child. These behaviours can be treated and managed.

What is autism?

Before we dive into understanding some of the behaviours of children with autism, it’s important for us to first understand what autism actually is.

Autism, or autism spectrum disorder (ASD), is a complex developmental condition. Autistic children often experience differences in social communication and interaction. The level of impairment varies significantly among individuals. This is why autism is considered to be a spectrum condition.

Signs of autism usually surface around the age of 2 or 3, though some developmental delays could be observed and be diagnosed even as early as 18 months.

Some common signs of autism can include:

• Differences in social communication and interaction across multiple settings, such as:
  • Aversion to maintaining eye contact with others
  • Does not respond to name when called
  • Differences in non-verbal communicative behaviours such as the limited use of non-verbal gestures or facial expressions
  • Does not initiate social interactions or sustain a back-and-forth conversation with others
  • Unable to develop and maintain social relationships, or uninterested in doing so
• • Restricted and repetitive patterns of interests, activities, and behaviours, such as:
    • Repetitive motor movements such as hand flapping, rocking one’s body back and forth, or spinning self in circles
    • Persistent repetition of selected words and phrases (also known as echolalia)
    • Insistence on playing with objects in a certain way every time or lining up toys in a fixed order and getting upset when order is changed
    • Inflexible adherence to routines and rituals such as needing to eat, dress or leave the house, in the same way, every time, drinking only from particular cups or asking the same questions repeatedly, and requiring the same answer every time
    • Restricted and obsessive interests, or an intense preoccupation with a narrow topic such as insects fighting

Common challenging behaviours in autism

Now that we understand the signs and symptoms of autism, we can then start to learn about the common challenging behaviours displayed by children with autism.

Common challenging behaviours may include:

• Non-compliance or the refusal to follow rules and instructions, either actively or passively.
• Inappropriate behaviours that interrupt the flow of their surroundings or environment such as causing a disruption in class or interrupting a caregiver’s conversation with others. These behaviours can include crying, tearing things, throwing objects, or knocking things over etc.
• Obsessions, compulsions, and rituals which result in an inflexibility to adapt and cope with change and transitions.
• Tantrums or meltdowns refer to emotional outbursts that often include behaviours such as crying, screaming, or yelling. The child loses control of their emotions and might even experience difficulties calming down even when they have achieved their desired goal.
• Physical aggression includes behaviours that harm others, such as kicking, biting, punching or hair-pulling.
• Self-injurious behaviour refers to behaviours that are harmful to self, which include head banging, hair pulling or wound picking etc.
• Sexual inappropriateness refers to a wide variety of behaviours including sexual touching or exposing of one’s genitals.

Understanding behaviour

Behaviour is a form of communication. Given that many children with autism face speech and language-related challenges, they are often unable to explicitly express their needs and wants to others. In this manner, challenging behaviours serve to be their way of communicating a desired outcome. Furthermore, children with autism often face difficulties and stressors in other areas of life, which can result in stress and frustration perpetuating these challenging behaviours.

It’s important for us to first understand the “why” of a behaviour in order to formulate an effective plan to manage it.

Challenging behaviours do four main things:

• They seek attention
  • The child behaves in a way to seek the attention of others. The child might not understand the difference between positive (e.g., compliment) and negative (e.g., scolding) attention. Therefore, the child might engage in behaviours such as hitting siblings or throwing objects to receive negative attention from caregivers.
• They seek access
  • The child wants access to a toy, or a preferred activity and the child learns that the challenging behaviour (e.g., having a tantrum) would help them obtain what they want.
• They seek to escape
  • The child wants to avoid or escape from a task or activity and the child learns that the challenging behaviour (e.g., deliberately urinating in pants during work time) would help them escape.
• They seek to feel good
  • The child engages in feel-good behaviours that are self-soothing, such as flapping hands or rocking themselves back and forth etc.

The antecedent-behaviour-consequence model

Now that we have a high-level understanding of some of the behaviours associated with autism, it’s time to go a little deeper.

It’s important for us to understand that challenging behaviours are situated in a context, and we cannot create successful intervention plans if we do not understand the context in which the behaviour occurs. Psychologists use the antecedent-behaviour-consequence model (the ABC model), which is a behavioural modification strategy.

Antecedent: the action, event or condition that triggers the onset of the behaviour, for instance, the presence of a teacher or hearing the word “no”.
Behaviour: the child’s response to the antecedent, such as crying or hitting of self. Consequence: the response of others following the child’s behaviour, which could be giving in to the child or ignoring the child etc.

Behaviour is often learned and maintained by the events that happen before and after the behaviour. Changing what happens before or after a behaviour can help reduce it and make it easier to manage.

Here are some questions for you to consider when it comes to challenging behaviours:

• Is this a sudden behaviour?
• Is my child trying to escape from something?
• Is my child feeling anxious or frustrated?
• What does my child gain from exhibiting this behaviour?
• Is this behaviour consistent and ongoing?
• If so, does it happen only in certain situations or with specific people?
• How do I and others react to my child’s behaviour?
• What is my child trying to tell me?
• Is there something in the surroundings or environment that is bothering my child?
• Does my child feel calmer and more regulated after exhibiting the behaviour?

It’s okay if you’re unsure of the answers to these questions. Often, understanding challenging behaviour takes time. Consider writing down your thoughts and observations and revisiting them when challenging behaviour arises.

If you'd like help making sense of your child's behaviour, our psychologists can assess what's driving it and build a plan with you. Call 1300 151 110.

Our page on behavioural assessments for children and teens explains how this works.