Recently we brought you Scoop Essentials: Behavior, Taming The 800-Pound Gorilla, a conversation about tantrums, meltdowns and how to regain control with behavior specialist Deborah Lipsky. And boy did you respond. Our inbox was flooded with questions on everything from countering manipulation to dealing with aggression, establishing communication and more.
Now, Lipsky, who has autism herself, answers the first round of your queries. Check back in the coming weeks to find more insider advice on the behaviors affecting your everyday life.
I teach a 10-year-old higher functioning autistic male with severe behavior issues. He can be the most mannerly well-behaved student in the school. But fairly regularly he goes into a full-blown tantrum. Because these tantrums are severe — he uses profanities and threatens others — he is then picked up by his mother. How can we eliminate or modify his actions, which I believe are an attempt to go home? — Wendy Thomas, 41
Deborah Lipsky: This young man is definitely manipulating the system to go home. He has been rewarded for using verbal threats by getting picked up by his mother. The only solution I can see here is to not reward him. When he threatens, he needs a “quiet space” or room where he can go to de-stress. He must be warned that going home is no longer an option and if he continues to misbehave then he will either have to stay five minutes longer at the end of the day or lose a reward.
Of course he will tantrum even worse at first. But if everyone holds firm and keeps him in a place where he is safe and others are out of his way until he calms down no matter how long it takes, he will learn that tantrums will not be rewarded.
Institute a point system or reward system where he can earn something he really wants and take points away for bad behavior. I am also curious where he learned profanities because children tend to model behavior they see in adults or other children, especially if that child receives attention for that bad behavior.
I have a 12-year-old boy, Michael who is autistic. He is developing a lot of anger. He screams and yells at me and school staff. He is now hitting. He is very manipulative. He will comply with preferred tasks. But when it is a non-preferred task he tries to manipulate it and when that doesn’t work, he tantrums and then it escalates into a meltdown because you have many people in his face trying to get him to attend to task. I believe it could partly be a sign of puberty. I’m very concerned and confused on what step to take first in dealing with my son. Please help. — Paula A. Mueller, 51, Florida
Deborah Lipsky: Your situation is complex and involves many issues. First off puberty is a big factor in anger. Another factor is that there are too many people in his face when he doesn’t comply and that will definitely herald a meltdown. Forcing eye contact when in an agitated state also can be extremely stressful and elicit an aggressive response, so if eye contact is required of him, I would immediately discontinue that.
Hitting is never autism, but poor anger management and must be dealt with harshly no matter how much Michael protests. Use an ABA behavioral management plan that has consequences and rewards. He will escalate at first, but once he realizes no one will give in, it will hopefully subside.
All children will try manipulation — whether autistic or not. It is natural and kids with autism can do it just as good as any other if they want to. It sounds like there has been a lack of consistency in his behavioral and learning approach over time. I always recommend that parents and the school system get on the same track and follow the same behavioral protocols in school as at home. Michael needs routine and structure. When he escalates stay firm with a “no” and a consequence and walk away when he tantrums.
You may consider restructuring Michael’s day so that he knows exactly what activities and tasks are coming up next and also sees an opportunity to earn down time to do something comforting for him. Maybe he needs sessions with more short breaks to just stretch, stim, take a drink etc. Also consider his environment. Many issues that seem like nothing to non-autistic people are major stumbling blocks to us such as fluorescent lights, colors and textures, noises, unpredictability or changes in routine like a substitute teacher.
I really recommend that you and everyone who works with him read my manual on managing meltdowns. It gives the responder an inside look at why things are stressful and what to do to ease tension and calm the individual.
My autistic son is 40-years-old. He refuses to go to mental health counseling. He has anger management issues and needs counseling. How can I convince him to go? — Linda, 62
Deborah Lipsky: Your son is an adult so there is nothing you can do to “convince” him to seek counseling. Instead I recommend that a friend, mentor or peer discuss the issue of anger management in a positive frame of mind as opposed to “you need counseling,” which quickly sets anyone on the defensive side. Try talking about how different techniques could help ease some of the frustrations. Your son really needs someone he can trust other than close relatives who he will feel aren’t “forcing” something down his throat.
Keep in mind that with autistic people, counseling isn’t always effective because it requires “talking about feelings” which many of us are out of touch with. We want answers, not group hugs. Counseling sessions that are task orientated with specific goals to help decrease a certain behavior can be more effective.
A big issue here too is that at age 40 your son has a history of all sorts of other issues compounding his autism. Beyond counseling, he may need training in skills to handle daily living, especially if he is working or living on his own.
As a last resort, if he takes out his anger on you, I would not allow him to visit or be in your presence when he is angry. Walk away and don’t let him use you as the proverbial punching bag. Trying to reason or make suggestions in front of an angry person only escalates the bad behaviors and makes you more of a mark for the next time he feels anger.
If a child says “want to hit you” then hits you, then says, “hitting is bad,” how would you extinguish this behavior? — Mich, 40
Deborah Lipsky: This will depend on a lot of things. First, I would need to find out if the child truly understands the concept of “hitting is bad.” I would then also rule out observed behavior where the child has witnessed others being hit and is then duplicating that behavior or if that child himself has been the recipient of hitting for a variety of infractions.
After ruling all of those out, I would focus on breaking a very predictable sequence of events. As soon as he says he wants to hit you, put up some sort of “roadblock.” Say “no” sternly or get out of his way. I would make sure he understands that hitting is not allowed. Then, if he disobeys the rule, implement a consequence that he will notice like taking away a privilege.
Institute a simple reward for him when he does not follow through with hitting. Or at least add a small reward for his efforts to try to show restraint and add a bigger one when he doesn’t hit. The reward could be in the form of verbal praise or doing an activity he likes. Try to avoid a physical reward like a toy or candy as that may create a dependency or manipulation on his part to do things only if a physical reward is present or until he loses his interest in that object.
Expect that the behavior will escalate at first, but stay firm and always follow through. Eventually he will see that the reward for good behavior is better than the consequence of losing something.
You said that people with autism are disconnected from their feelings and don’t want to talk about them. So how would a person go about identifying those feelings and getting someone with autism to talk about them? Let’s say a child comes to school and seems to be very upset about something (beyond their typical reaction). Is there a way to get to the bottom of it if no one knows what set the child off? — Venus, 34, Palm Bay, Fla.
Deborah Lipsky: I recommend using a list of words to succinctly describe an emotion or feeling and have the child pick which one best describes them at that moment. Some of the books out there that deal with post-traumatic stress disorder have lists of emotions for people to help identify pent up feelings. It is a great way to help an autistic person begin to recognize what emotion they are experiencing.
Do this as a simple exercise often during good times — don’t wait until they are in distress — so it becomes second nature to them. In time they may be able to approach you with what word they are feeling instead of the usual frustration or emotional outbursts because they don’t have a word to describe what they are experiencing.
Be aware that you may get an accurate word response letting you know their state of mind, but for us to talk about our feelings beyond that is foreign. We don’t want to vent. Rather, we want to find an answer or solution to the problem.