Practical antecedent strategies are described that can be used by therapists and teachers to prevent inappropriate behavior in students with Autism Spectrum Disorder (ASD). Helpful antecedent strategies for regular use by therapists and teachers include: engaging favorite activities, giving choices, introducing students to the materials and people they will be interacting with before learning tasks, a period of play with favorite toys before beginning challenging tasks, and alternating problems students already know with challenging new items (Newcomb & Hagopian, 2018; Rivera et al., 2019; Kelly et al., 2015).
Specific strategies that significantly reduce aggression in students with ASD who resist doing school assignments include: briefly removing demands when they are not aggressive, alternating new questions with ones they already know, non-contingent reinforcement that is independent of their responses, and functional communication training done with a speech/language pathologist. These strategies are described below (Newcomb & Hagopian, 2018; Rivera et al., 2019; Pagano, 2019).
- Engaging favorite activities- therapists and teachers know the student best are able to find the learning activities they enjoy most. A preference assessment can be used where two activities or items are placed out and you note the one the student uses, or place several items out and see which ones he engages with for the longest.
- Choices- Giving choices significantly improves behavior. Developmentally determine how many choices to provide.
- Priming- Especially helpful with students who have ASD you familiarize them with the setting, materials and people in there class before starting learning activities.
- Antecedent Pre-session Pairing- Interacting with student using a favorites activity (identified through a preference assessment) before challenging tasks. It can significantly reduce aggression in students with ASD that are done for attention or escape from doing tasks, even after this strategy is stopped (Kelly et al., 2015).
- Intersperse learned tasks- Intersperse known/favored items with new learning for improved behavior.
- Non-contingent Reinforcement (NCR)- Response independent reinforcement (that can match the proposed sensory qualities of repetitive problematic behavior)
- Functional Communication Training (FCT)- Develop an alternative way for student to get the thing that he is currently using inappropriate behavior to obtain, over 75% affective in improving behavior (Newcomb & Hagopian, 2018; Rivera et al., 2019). The strategies described above were found to significantly improve school behavior without a functional behavioral assessment. However, a functional assessment should always be done if these strategies are found to worsen or not improve behavior (Lydon et al., 2017) SEE CASE STUDY
My next blogpost will discuss when and how to use specific functional behavioral assessments. Therapists in conjunction with teachers can integrate behavioral with sensory and communication strategies to help students with ASD behave and participate more appropriately in school.
References
Kelly AN, Axe JB, Allen RF, Maguire RW. Effects of presession pairing on the challenging behavior and academic responding of children with autism. Behavioral Interventions. 2015 Apr;30(2):135-56.
Lydon H, Healy O, Grey I. Comparison of behavioral intervention and sensory integration therapy on challenging behavior of children with autism. Behavioral Interventions. 2017 Nov;32(4):297-310.
Newcomb ET, Hagopian LP. Treatment of severe problem behaviour in children with autism spectrum disorder and intellectual disabilities. International Review of Psychiatry. 2018 Jan 2;30(1):96-109.
Pagano, J. FAB functionaly alert behavior strategies: Integrated behavioral, developmental, sensory, mindfulness & massage treatment. Connecticut: Pagano FAB Strategies, LLC: 2019.
Rivera G, Gerow S, Kirkpatrick M. A review of school-based interventions to reduce challenging behavior for adolescents with ASD. Journal of developmental and physical disabilities. 2019 Feb;31(1):1-21.