“No Aiden you cant have the computer. You get the iPhone” I said as He immediately began screaming and bit into his own hand so hard that his head was shaking with an intense look of anger on his face. I lunged at him to stop him and grabbed his arms as he continued screaming. as i held his hands restrained from his face he proceeded to dig his nails into my arms and look at me with this wild look in his eyes.
Many of those care taking an individual with Autism will read this story and relate. It’s something that happens more often that we would like to admit and yet its something that we rarely get help with. In the autism world we call this form of behavior Sibbing, A term adopted by those in the special needs community to refer to “Self injurious behaviors” has become a topic of interest for those both on the severe and mild sides of the autism spectrum. This can present in may forms including biting ones self, hitting ones self, banging their head against walls or anything that presents pain. I have taken a slight interest into this aspect of autism as my son approaches his teenage years and has been engaging in hand biting and hitting himself in the head whenever things become frustrating for him. I have been researching approaches to this behavior and here are just a few things that I have learned.
1. The general rule of ABA states that in order for an undesired behavior to be extinguished a new more desired behavior must occur in its place. To accomplish this for instance, we began to immediately stop aiden from biting his hand and hand him something he could bite on such as a rubber chew necklace or a shirt i had cut into strips and braided. It must be a behavior that fills whatever behavior is trying to be extinguished. For instance, feel the texture of your hand… it is soft, almost rubber like therefore we replaced hand biting for a rubber chew toy.
2. Grabbing their hands to hold them away from their mouths is a good restraint to protect the individual engaging in Sibing behavior but remember your vulnerabilities. When a child who is struggling to regulate a strong emotion does not have the correct internal coping mechanisms or a lack of an out let for those emotions they will often respond to restraint by verbally (i.e yelling out or screaming)or physically, grabbing your arms strongly or trying to bite you instead of themselves.
3. NEVER. AND I MEAN NEVER! GIVE INTO THE BEHAVIOR IT ONLY ENHANCES IT! If the individual acting out is acting out because they want, say, the ipad and you have said no DO NOT GIVE THE IPAD TO STOP THE BEHAVIOR. While giving the desired object to the individual to stop the behavior stops the behavior it also tells the individual that this unwanted behavior results in their getting their way you are only setting yourself up for bigger battles later. remember this line “through the tears and the tantrum there IS progress”.
4. Meet chaos with calm, these children are depending on you. It is important to remain in control when any situation while a sibing behavior is occurring. The individual is acting out because there is chaos inside of them. Yelling out or being angry at them (though sometimes your very being is so angry its hard to restrain) will only add to the behavior and their inner chaos causing the unwanted behavior to increase in both intensity and length.
5. Have a plan. It is important, especially as children grow older to have a plan already in place just in case the sibbing behavior is not easily stopped. This can include having a safe room to place the child until the behavior subsides or having a few of their most calming items in an access able place. these items must be safe. Nothing with sharp edges and preferably nothing with a hard surface.
Note* if your child is engaging in a behavior such as head pounding its is vital that the child not be left alone. It is vital that any individual engaging in any behavior that can harm either them self or someone else not be left alone. If the behavior cannot be calmed safely with one person present call someone for help. Whether a first responder, a friend or neighbor that you trust.
6. Once the Situation is calm take notes. Take a moment to write down everything that happened. write the time it happened what happened prior to the behavior, what happened during and what happened after. They call this ABC data and remember the more you take notes the more able you and your therapists will be able to see patterns in the behavior. Note also how you felt during the incident. always remember that you are an active member of your child’s team and sometimes these situations can be harder on you emotionally than the individual and don’t down play that.
7. Hold a meeting. If your child is higher functioning it is beneficial to hold whats called a debriefing. Talk to the child and ask them how they felt during and after the situation. It helps to form a plan with your child or the individual to ask them what could have helped the situation to be avoided or what steps could have been taken to alleviate some of the stress in the situation.
If your child is lower functioning. Have a sit down with the team and form a social story about what happened. Remember, just because your child is nonverbal this does not mean that they cant understand. The trick is to keep it simple.
8. Take a breath. These situations are extremely emotional Take a moment to regroup. Take a walk around the block. Take a drive. Sometimes, something as simple as calling a friend to “vent” can help.
Caring for an individual with autism can be overwhelming and there’s a lot that goes into it. I don’t claim to be a professional. I’m actually pretty far from it. This is a list of things that I personally have learned just in my experiences of working my son and his own ABA team and thought I would share it. I hope it helps because Lord knows every little tid bit I learn that helps makes a huge difference. To all of you out there in the field, I’m thinking of you and Godspeed my friends.