An Educational Aside
Over the course of my life, I have been surrounded by autism. Autistic kids have been some of my favorite companions and my twin brother was always willing to be my partner in crime, or allow me to be his. This being the case, I have developed an eye for what behaviors are associated with autism and what behaviors are not.
I do not know if this is because of my brother or just a part of my own upbringing, but 95% of the time I see no problems with autistic behavior. I am okay with students behaving differently than what might be considered normal, so long as the student is happy. For example, when I see autistic kids on playgrounds and at school flapping their hands and jumping, I giggle to myself, smile, and say, “flappy hands are happy hands,” and think nothing more of it.
There are of course exceptions. I consider the following behaviors problematic: self-injury, coprophilia, and highly restrictive food preferences that often lead to a refusal to eat. In all instances, I try to teach alternatives to these behaviors as these behaviors truly prevent the student from accessing the outside world. It is important to note that the vast majority of students I have known with these above behaviors were not autistic–despite these behaviors being labeled as “associated with autism”.
Do You Really Care?
When I have colleagues tell me that I need to make students stop doing something, I have a single question, “Do you REALLY care about that?” What amazes me is that most of the time, my co-workers have been trained explicitly that autistic behaviors are a huge deal and it is highly important that these behaviors be mitigated. This blows my mind.
Some concrete examples of behaviors I am okay with but others demanded I stop the child from doing immediately:
- Taking their sandwich apart to eat items individually
- Eating M&Ms in 3 bites rather than one
- Quietly pacing in the back of the classroom when stressed out
- Having a hitch in their left leg when they walk
- Toe walking
- Abnormal blinking pattern
- Popping their knuckles/neck during the day
- Rocking back and forth on their desk
- Bouncing their foot on the ground all day
- Running around making noises and flapping their hands at recess
- Walking around like a T-Rex at recess
- ONLY using the swings at recess
- Telling others about restricted interests during free time
- Drawing the same picture over and over
- Facial or other tics
- Looking at materials through one eye and cocking their head
- Sitting “wrong” in their chair
- Avoiding eye contact
…and so on
Some Behaviors DO Require Intervention
So to start off, I do not view behaviors as autistic or nonautistic. I believe that is a short-sighted and often toxic way to view a child and their behavior. My doctoral work and professional experience have shown me that anyone is capable of any behavior, because repetitive or odd behaviors arise when an individual is stressed or anxious. We all do it. I also do not simplify behavior as “wrong” or “right” as the same behavior may be wrong in one context and right in another.
I conceptualize behavior as adaptive or nonadaptive. I see behavior as expected or unexpected given the context.
Most importantly, I do not weigh any so-called social relevance in any way into my analysis of behavior. Applied Behavioral Analysis (ABA) has a focus on behaviors that are socially relevant, but I feel this is too floppy a definition and can be molded to include anything an autistic child does. In my approach, if any behavior has become a problem, I need to help the student choose another behavior – regardless social relevance of the behavior or diagnosis of the kid.
So when I approach a student (I usually say “autistic student” on this blog but this also applies to the kids with Tourette’s, Angelman’s syndrome, Down’s syndrome, Cerebral palsy, Fragile X Syndrome/Premutation, 22q11.2 deletion syndrome or 22q11 duplications, 46-XXYY, Borderline Personality Disorder, and any other developmental disability I have worked with), I look at them and try to determine if they understand the impact of their behaviors on other people.
If so, great. If not, then I teach.
To prevent bias from my having researched the neuroanatomy and neurochemistry underlying a lot of behavioral disorders, I have a few simple questions I ask myself every time I see a behavior. These questions keep me honest and allow me to quickly explain to others why a behavior is or is not a big deal and worthy of intervention.
My approach to “weird” behavior is to ask myself these questions based on a 1-hour observation:
- Does the child know they are doing the behavior
- Does the child have control over the behavior
- Is the child rewarded by or for the behavior
- Is the child themselves hurt by the behavior
- Are others hurt by the behavior
- Does the behavior prevent the student from participating in X
To me, these questions are all I need. I do not appeal to social relevance or behavioral expectations like CBT or ABA therapists. I want to dispassionately assess the behavior. Is it a problem? Is it not a problem?
Let’s go over these questions/rules in turn by addressing some examples for each.
Does the child know they are doing the behavior
This sounds dumb, but that is why it needs to be asked. It is a basic, low level question. I have seen teachers and therapists try to extinguish a behavior that the student did not know they were doing. In this case, the autistic boy made a hyper-annoying hiccup/snorting sound every 30 seconds or so. It sounded like momentarily he was choking.
The assumption was made by the adults that this 1st-grade kid was trying to seek attention by being annoying since the annoying behavior was resulting in attention. So they put the behavior on extinction by not interacting with the student and nothing about the behavior changed. Absolutely nothing. No changes in amplitude, no changes in frequency. Nothing.
Well, be fair, something changed. The child thought he was in trouble because the teachers were avoiding him.
When I came in and looked at the kid, I did a very simple thing. I asked him if he knew he was making noise. He looked at me funny, so I assumed he did not. I did not shame him, I did not lecture him. I did not draw any attention to him other than when I was asking him a question. I sat down and collected data on the behavior.
My solution was to get parent permission to record this student in class and show him the video recording. I did not tell him why I was recording or what I was looking for. I recorded 10 minutes of footage and took the student to another room to watch the recording.
He asked me why he was bouncing in his seat and making a weird noise. He had no idea. He had always done this so it was so normal to him. He really did not know he was doing it. He then asked a series of questions about how people treat him and if his noises were a problem. He had a realization.
In the end, this student actually needed to visit a pediatrician with a parent to elucidate the origin of the tic. With the pediatrician and a pediatric psychiatrist, the family developed a strategy to get these behaviors under control that involved some cognitive-behavioral-therapy (CBT) and medication. As a result of this intervention, the student received an additional diagnosis of Tourette’s syndrome and CBT-based interventions for this disorder helped him immensely.
Now, this student was being annoying and the behavior was a problem because it was disruptive. BUT, if the kid does not know they are doing something, no amount of intervention will stop it. The kid will just learn adults are jerks and unfair. Not the lesson we want to teach them.
Does the child have control over the behavior
This is a classic Tourette’s syndrome issue. In this particular case, there was a student I was working with that had rather extreme motor stereotypies. He made a high pitched, staccato squeaking noise, had head rotation tics, and at the most extreme his full trunk lowering to his knees and 90-degree rotation. When at rest his feet were always very active and stomping on the floor.
He was moved at my behest from a self-contained academic classroom to a general education classroom since he had the highest reading scores in the school and was only two chapters behind in math and would never catch up in the special education classroom. I figured his “weird” behaviors could only be helped by challenging him academically as he was bored and becoming intentionally disruptive in the special education classroom.
Within a week, I was getting reports of his “disruptive” behavior in the classroom. I was being told he was getting up without permission, making peers laugh at him, and not following directions. Now, knowing this student, all three of these were totally possible. He well could have been disrupting the class on purpose for attention, so I went in to observe.
He was working as hard as possible to stay in place during class. He was trying to hold in his noises. He was trying to keep his feet still. After 10-15 minutes, all his tics would almost simultaneously overtake him and he “went a little bit crazy” as he called it for 10 seconds and then went back to control himself.
He told me he was working hard to not look weird in class and wanted to stop his “going crazy” episodes. However, little did he know that fighting tics rarely works. With lots of work, they can be redirected, but not suppressed. This did not stop this student. He kept trying to mind-over-matter his tics. It was at this time he started talking to his mom more about school and she took him to a neuropsychologist that diagnosed him with Tourette’s syndrome.
I worked with him and his teacher to develop a system whereby he could stand up and walk to the back of the classroom to get a drink of water when he needed to get his “wiggles out”. He also would leave the room to use the restroom when he felt a “big one” coming. He joked with me that his teacher had given him permission to break dance in the hallways. I told him she had, but he could not abuse that privilege.
He struggled the rest of that year with the teacher as his tics worsened with stress, but they both survived (if only barely). He went to his neighborhood school the next year and having to walk to school rather than take a bus helped him greatly. His mother also put him in Tae Kwon Do after school to help him learn how to direct his movements.
Last I heard he still has to break dance in the hall, but he is a straight-A student. The only time he annoys the teachers now is when he is being a little snot and is trying to get their goat by playing practical jokes or being intentionally disruptive.
Is the child rewarded by or for the behavior
For self-rewarding behaviors, I tend to focus on behaviors that are directly rewarding. In elementary schools. the most common behavior is stimming-related behaviors, which involves the student dangling their fingers in front of their eyes or else moving their fingers in and out of their field of vision. As a person who does not use visual stimming, I find this highly distracting and annoying. It makes me feel dizzy when I watch kids do this for an extended amount of time. My solution is that I do not watch them stim for a long amount of time.
When I see a student stimming or engaging in any other behavior that self-reinforces, but does not impact other students, I try to figure out how the behavior is reinforcing and if the student can still do work despite the stim.
Sometimes young autistics can develop a tendency to stim too often (meaning stimming gets in the way of daily functions of life), but this is most often not the case. When stimming gets in the way of schoolwork I come up with two options. First, set up a system that asks the student to work for 10 minutes and then go to a special place where they can actively stim for 5 minutes. Then increase work and fade active stim times until the student can use recess as the time to stim. This does not always work. If a student needs a sensory diet, they cannot control the stim. So I move to option two.
Secondly, I try to help the student develop a new stim that is less disruptive to their academic progress. Often times this involves trying to switch a visual stim to a tactile one that requires only one hand. In no cases do I ever try to extinguish “stimming” by suppressing it without a replacement behavior that fulfills the same need. I consider that mean.
My brother Kyle was an avid stimmer right up until the end. He had a string he would twirl and he would blur his eyes and focus beyond the point that the string hit his fingers and fluttered. He would also hum rhythmically while doing this. With time in school, my mother shaped his behavior so he would work and then go to a “stimming” square to stim and then return to work. With time Kyle stopped taking a string to school. He left it in a specific place in the house before he left for school. When we would get home, he would immediately go to his spot, pick up his string, and stim. He needed to stim, but he learned how to regulate himself to only engage in stimming behaviors at certain times and places.
For situations when behaviors are rewarded by attention, escape, or any kind of external stimulus the child finds pleasing, the behavior will continue and increase in both frequency and intensity. When this is present I do an A-B-C analysis and program the adults in the room to stop rewarding the student. I do this because if the adults are providing accidental rewards for problem behavior, the “naughty” behavior from the student is the adult’s fault.
Is the child hurt by the behavior
If the child is hurt by their own behavior, call your behavioral specialist and the parents immediately and work on a plan to stop the behavior. Hurting one’s self is never a good thing and we do not want any self-injury to increase in intensity. When in doubt, call someone with expertise.
On the internet, you will find numerous ABA plans using aversive stimuli to curb the self-injurious behavior. Do not use these methods,. They are abusive and only drive behaviors underground. Please discuss self-injury with a medical professional or therapist prior to intervening using plans found on the internet
There are ZERO appropriate planned ignore protocols for self-injury. Doing so can be extremely dangerous and irresponsible. The only thing to look out for is pseudo-injurious behavior. I had a student that I worked with that would throw himself on the ground and bang his head. However, when I observed closely, he always seemed to be banging his head on soft things. His backpack, a stuffed animal, etc. He also would hit his head with closed fists, but never hard enough to leave even a red mark.
One time I intervened to see what it would take to manually stop this behavior. The student only banged their head as hard as I resisted. If I used a feather touch they would scream and barely push into my hand. If I held his head rigidly they would push into my hand with their forehead quite hard. Same went for the fists toward his head.
In working with him, I extinguished his “self-injury” by ignoring him. One time (with parent permission) I tried to motivate him to hit harder. As I predicted, he stopped and looked at me very confusedly, as this was opposite to the nurturing behaviors he was seeking. This student was using fake self-injury to get teachers that did not like him to nurture him. It also got him trips to McDonald’s to soothe him.
Are others hurt by the behavior
If other children are hurt by a student’s behavior, call your behavioral specialist and the parents and work on a plan to stop the behavior. Hurting others never a good thing and we do not want any harm to others to increase in intensity. When in doubt, call someone with expertise.
Physical restraint may seem like the right call because it protects others, but you risk hurting yourself and the child you are restraining. Don’t do it.
I put this above similar to the self-injury section as I feel far too often as special educators we forget that all the students in a classroom have to be programmed for, not just the student with the aggressive behavior. I have been in situations where a student punches peers or kicks them to be rewarded by hearing the scream. The teachers correctly developed a plan to reward behaviors that are mutually exclusive to hurting others. However, they did not provide any kind of a consequence for hurting others.
While the teachers were rewarding the student for not attacking others, any attacks on other students were ignored/not rewarded. This was a major problem because all of these other students had a right to not be hurt in school. Yes, we should teach kids how to behave and not punish them unless necessary, but do not ever let a student hurt others.
Recently I had a student that would throw items at other students to get a response from the teachers. So the student would chuck a toy train at another student and the teacher would intervene. Like clockwork. The initial plan was to have the teacher engage in a planned ignore for the throwing behavior. They were not going to give attention to the student for being naughty.
See the problem yet?
As one would predict, throwing behaviors went up 10-fold and larger things were being thrown; all because the kid was not getting rewarded. I was brought in to stop the behavior. So I just did something much easier than the other interventionist had done. I did not let the student play with items that could be thrown. I explained to him why the ban was in place and that he could earn the right to other toys by being good and not throwing anything. I also had the teacher work 1:1 with this student during play time so long as he was not throwing items or engaging in maladaptive behaviors, so he got the rewarding attention without the behavior. After a week the student would just grab the teacher to play and get attention rather than using negative behaviors to get attention.
I instructed the teacher to assign someone to play in the group with this student so that he never felt the need to throw things at other students to get the attention of the adults.
Does the behavior prevent the student from participating in X
The biggie. This is the question most people fail to answer when working with students with ADHD and autistic kids. Teachers are taught to always assume the behaviors that appear off task are competing with task completion. Many times they aren’t. They just annoy the teacher because they look inattentive.
I will be my own first example here. I have a fidget that can drive people nuts. If I am required to stay put, I twiddle pens and markers in my right hand. I can do this all day. I also move around in my chair…a lot. Chairs are uncomfortable and I just cannot conform to the chair. So I wiggle. Teacher trainers have commented I do not look like I am paying attention because of it, until I answer their questions insightfully because I was, in fact, listening and engaged. In actuality, I was much more engaged than I would have been had I been forced to stay still.
Well, one time, the reading coaches made the mistake of gave everyone a slinky to visualize “stretching words” in reading. Well, I love slinkies because they let me get my fidget on. I was playing with that stupid thing all day long. But I was always 100% on task and participating. I just needed to keep my body busy, so I used what they gave me to fulfill that need.
I had a student that was always drawing sharks or dinosaurs in class while the teacher was talking. It did look like he was not paying attention. He was drawing and coloring inside his own lines and his art was quite good.
I did an experiment with him. I prevented him from drawing while the teacher was talking. The first day I had a desk flipped on me and a waste paper basket thrown at me. A chair was lobbed my way the next day. Then he just sat and listened for the rest of the week without fighting.
After this part of the experiment, I let him draw freely during class, in fact, as an apology for our fighting the week before, I had given him a sketchbook and a few fun pens he could use.
Guess during which part of the experiment he retained information. When he sat and listened to the teacher without drawing, his memory was terrible. Importantly, by the end of the week, the student and I were no longer fighting. He just was not retaining what the teacher was saying. When he was drawing, however, he had a memory like a steel trap. Drawing let him focus in such a way he was able to listen and remember.
When I debriefed him he said that it is hard to listen because it is stressful. But then he draws he can hear and remember stuff.
“Autistic Behaviors” – Interventions are NOT Necessary
Lack of Eye Contact
In line with my last point above, I will use an example of eye contact. Many people consider the fact that autistics (and many other nonautistic disabled people by the way) have a difficult time maintaining eye contact. Adult autistics describe this difficulty as eye contact being too salient and drowning out everything else, overwhelming, or stressful.
I have never taught or even suggested to a student to make eye contact. Frankly, I do not care where you are looking so long as you can do the task I give you. This drives other people in the room bonkers. Adults perseverate on the fact that that see a student looking around while I am talking. They forget to notice if the student is completing their work correctly-most often they are. I do require the student look in the general direction of my side of the table or room. If they are looking a full 90-degrees off to the right or left or me the likelihood of distraction is too great.
What I see in classrooms is hard for me to watch. Kids are required to look a teacher in the eye while the teacher talks. Not the mouth. The eyes. I have seen student’s faces grabbed and turned to look the teacher in the eye. When teachers are punishing students they want eye contact. Any time there is an interaction the teacher demands eye contact. From the autistic kid. The nonautistic kid has no such expectations.
An autistic kid once asked me why nationalistic want them to look in the eyes instead of the mouth. Since the mouth is doing the talking he wanted to focus there. I agreed. He was rather angry that he had to look in eyes because if he was looking in eyes then learning was harder than if he was looking at his desk
Now, if a student has their head constantly looking and they are scanning the room while the teacher is talking, I redirect that. Having difficulty with eye contact does not mean I am giving them carte blanche to read the chart on the back wall while I am talking. It just means I do not care if you look right at me or just in the general vicinity of the teacher. My redirection usually involves teaching them to look within 45-degrees of the teacher but never at the teacher’s or face unless they want to. I tell them why I am teaching them this and I tend to be overabundant with rewards to help them understand I really want them to learn what I am teaching.
Sandwiches. I see this all the time. Kids deconstruct sandwiches to eat them. They carefully eat the meat, then the cheese, put lettuce off to the side (eew, green food), and then enjoy a Mayo and bread sandwich. They pull a PB&J apart and gnaw at the peanut butter off one side and lick the jelly off the other. Then eat the bread.
Kyle did this with pizza. He would eat all the toppings off the pizza item by item. Meat first, then mushrooms and pineapple if there was any. Then he would eat the bread, leaving the crusty edge for me.
Who does this hurt?
I blame parents for this one. If they cannot stand their child destroying a sandwich, send them a Lunchable or just meat, cheese, and crackers. Spare them the empty carbs associated with Wonderbread.
Flappy Hands are Happy Hands
This one is a bit more nuanced. I can understand that parents do not want their child to be the only one stop-start running while humming and flapping their hands. It looks weird and no one else is doing it.
However, other than looking weird there is literally nothing wrong with this behavior. If a student chooses to pace the playground and stim/flap, who does it involve? If the student has goals to play with other students at recess then I would give them time for both.
The one exception is a story from my mother and I have done the same thing. She had a student that really wanted friends, but at recess, he would walk around the field flapping and stimming. So mom asked him if he knew that he looked a bit weird doing that and that maybe if he played with other kids at recess instead he might have friends.
Now at no point does my mother care if a kid flaps. The student’s flapping was getting in the way of a goal he had – friends. So HE made a change and started to play with other kids.
I have had the same experience but when I asked the student if he knew what he looked like and others may think he was being a bit weird, he had a different answer. He said (honestly), “I don’t care” and flapped with more intensity and glee than I had ever seen. So I let him. I just reminded him whenever he complained of not having friends that he needed to play with people at recess if he wanted friends.
Student ONLY swinging or hanging upside down from monkey bars at recess
This is brilliant vestibular stimulation and often serves to calm anxiety. Let them do it. Forcing them to do something else is just mean, but also is depriving them of a calming input, so redirecting them is a punishment. Stop that. Also, nonautistic kids do this.
Student telling others about restricted interests during free time
Honestly, I hear more about firetrucks and dinosaurs from nonautistic kids than autistic ones. We just get annoyed by the autistic ones because their autism gives us an excuse to shut them down. My solution is that I actually demand the students learn new facts and information about the topic before they can tell me about it again. That gets them learning and that is all I want in the end.
I do not care if the kid has 1 or 57 interests. So long as the interests are appropriate I leverage it for their educational benefit. I cannot describe how many times a T-Rex has participated in my math worksheets.
Student drawing the same picture over and over
If it is an assignment to draw one thing they draw their interest, correct them and make them do what they are told. Otherwise, if it is their free time, stop intervening. Let them practice.
This one is hard because the behavior of one student will influence all the others. But overall, my guiding question for kids and chairs is: Can they learn/work sitting like that? If the answer is yes, I leave them be. If no, I ask them to put themselves in a position they can work from.
My office chair is the one in the image below. This is because neither myself nor my wife sits correctly in chairs (and neither of us is autistic).
I also love seeing this youtube video of Commander Riker on Star Trek the Next Generation sitting oddly. Funny enough people think it is cool rather than inappropriate given his context as second in command on the show.
And one last piece of information. Many kids cannot sit cross-legged (criss-cross applesauce) on the floor. Forcing them to causes pain and is not going to end well. My brother Kyle was one of these. Even as a small boy cross-legged was not a position he was able to accomplish.
He would gladly sit, just not criss-cross applesauce. No amount of coaxing or punishing was going to make that happen.
My solution is to simply side step the problem by getting rid of chairs (I explain it here)
Most often we judge behavior from a student or child based on a biased perspective. Any behavior other than raw perfection from an autistic is a behavior that must be fixed. The same thing from a nonautistic kid is just a quirk. A tic from a Tourette’s kid has to be medicated, but am identical tic from a neurotypical kid is ignored and met with compassion.
We need to ask ourselves about all behaviors, not just those related to autism, Does it matter? Do I really care enough to do something about it? Should I? Would I want someone to stop me if I did that?