Children with autism have a broad area of behavior impairments and apparently many of these
behaviors serve no useful purpose. The behaviors seem to relate to the constant rituals in their
activities. They exhibit repetitive and compulsive behaviors which are achieved daily in terms of their
nature or intensity. These are the extensive areas, which appear to have a specific relation to autism. In
addition to this oddity various other elements of behavior couple with basic cognitive process.
Repeated evidence offers descriptions of the behaviors common to autism. One of the most crucial
observations is the need for certain rituals and events. These seem to coexist with peculiar obsessions.
As well as this need for ‘obsession and ritual’ there is often a high level of repetition of activities, mostly
in communication or brief motor activity (such as hand-flapping or head-banging). When rituals and
structure is removed from the environment ‘challenging behaviors’ and ‘tantrums’ may be a
consequence. These make education and daily living very difficult and are one of the major causes of
stress for individuals with autism and their families.
In addition many individuals demonstrate ‘self-injurious behaviors’ (such as head-banging and self-
picking) in response to a need for communication, frustration, raised endorphin levels and many other
reasons. It is vital that the reasons for behaviors are understood, especially if the behavior has a
damaging effect on the individual or those around him or her. There are methods of managing the
behavior and interventions (such as time-out), but it is first necessary to understand the behaviors
common in autism and the way they are presented and what might be the underlying causes.
Obsession and Ritual
According to the diagnostic criteria for autism repetitive and stereotyped behavior, demonstrating
restricted interests and activities, is a basic expression of the condition. Children with autism may seem
to be puzzling obsessed with some non-functional object or part of a toy and may become very disturbed
when it is taken away from them. The strangest part of this behavior may be that the object or toy is not
used for any specific function or purpose. Other people with autism might be ‘obsessed’ with certain
figures, or with collecting particular objects, with water, with memorizing bus time tables or travel
destinations. These are all fairly typical ‘obsessions’ but where they differ is in the degree to which the
obsession consumes the individual, the control they have over the obsession, and the non-functional
nature of the particular interest.
Obsessive tendencies and restricted interests are not limited to a specific area they can be seen in most
of everyday life, from the arrangement of furniture to times at which dinner is served or people go to
bed. People with autism may have many routines which seem bizarre to their peers or family and will find
it hard to cope when these routines are disturbed. It is important to recognize the importance of these
behaviors and the role they play in the everyday lives of people with autism. Routine is a means by
which they understand and feel safe within our environment. It makes the world reliable and predictable.
Stereotyped Behavior
To people with autism the world might be somewhat confusing. Impairments in theory of mind might
make it difficult to understand other people, impairments in central logic might make it difficult to
understand objects and events in context and apply meaning to them. Therefore seemingly useless or
non-functional objects or interests might have specific significance to some people with autism whereas
some more generally accepted interest might be inadequate in meaning. There is great distinctness in
autism for example the areas which have little importance in meaning or significance maybe topics of
interest to people with autism. There are common obsessions like mechanisms (such as moving parts)
or numerical areas (such as bus routes or timetables). These are areas which avoid the difficulties which
people with autism experience (social interaction and understanding, the need for communication) and
concentrate on their skills (rote memory, spatial awareness etc.)
Whatever the source of interest or the area of routine they serve vital roles to people with autism. More
than for most people, for those with autism there is a need for security and to understand the world. This
is best achieved through familiar and comfortable objects and activities. When something has specific
meaning it is both a comfort and an expression of personal identity. It may also be escape from a world
which puts too many pressures and demands on the individual just through normal daily events. Simple
social interaction can be very tiring and cognitively draining for people with autism. It is perhaps
inevitable that when these obsessions and rituals are disrupted the response may be likely extreme and
excessive, especially where there is no clearly understood reason for the interruption.
There are various stereotypical behaviors which are commonly seen among people with autism. Some of
the most known are ‘body-rocking’, hand/limb ‘flapping’, ‘head-banging’ and ‘spinning’. These might be
engaged in at various times: when agitated, when aroused or active, when happy, when excited, when
angry and even when simply comfortable and relaxed. Where these behaviors are a problem (for
example ‘self-injurious behavior’) the reason for their presence must be carefully considered. These
behaviors can be simply automatic, they can be learned and copied, they can be exaggerations of
sporadic habits which nearly everyone has (foot-tapping for example), mostly they express or produce a
stimulating feeling or sensation.
Rhythmical motions are good ways of imposing order and control on one’s self and the environment and
this order is something most people with autism seem to both desire and need. There is a common
incidence of interest in spinning around and in watching spinning objects, the dizziness spinning evoke
may be enjoyable, as may be the elimination of other information.
Challenging Behavior and Tantrums
Unfortunately for individuals with autism and their families, ‘tantrums’ and destructive behaviors are
common, especially among children. The term ‘challenging behavior’ is a controversial one, but it is
intended to suggest that behaviors present a challenge to professionals and services. This is supposed
to prevent internalizing the cause of the behavior and ‘blaming’ the individual. This is very important in
autism, as it is unlikely that any behavior which causes difficulties for families and professionals is
intended maliciously or vindictively. There is virtually always some other, unidentified, cause which
provokes challenging behavior. It is worth noting that in most cases (although not all) individuals do not
enjoy ‘being challenging’. Unfortunately it would appear that the majority of cases of ‘challenging’
behaviors occur by children in the presence of their families. If such behavior is a challenge for
professionals then it can have a debilitating impact on parents and siblings. Therefore it’s very important
that behaviors are dealt with in way which allows both the secure functioning of the family, and the
opportunity for the individual to develop skills and communicate effectively.
Tantrums are one of the most common problems in young children with autism. They may appear to go
into a state of rage, panic, anxiety or fear for no reason at all. Tantrums are normal behavior for most
children and there is no reason why children with autism should by-pass this stage of development. The
problem seems to be that it is more difficult for parents to prevent ‘tantrums’ in children with autism, the
child seems inconsolable during the ‘tantrum’, the episode might last a long time, and the reconciliation
that typically accompanies the end of the ‘tantrum’ rarely occurs.
Tantrums are just one example of challenging behavior. Similar episodes of panic, anxiety, rage or even
aggression might be seen all through childhood, adolescence and even adulthood. This might involve
screaming, crying, resisting contact with others, or pushing others away. On the other hand it might be
much less obvious, such as refusing to respond to interaction (especially in learning settings where this
might have a destructive effect), using others as objects and refusing to comply with daily activities.
These behaviors are not necessarily ‘challenging’ but in some cases they might cause disruption (for
example to a classroom engaged in a lesson, or a family outing or event).
What is the Cause?
As with such behavior in all children there may be any number of causes. There might be underlying
reasons (such as feeling upset, anxious or angry) and immediate triggers (such as being told to do
something). In autism however, there is also a specific pattern of behavior and of social interaction.
Understanding that can help us explain some ‘challenging’ behaviors.
People with autism often rely on ritual and structure. Structure is a method that helps define the world in
terms of constant rules and explanations and that helps the person function most effectively. Most
children with autism find their own methods of imposing structure and maintaining consistency. They
need this structure because the world is confusing. Other people are complex and almost impossible to
understand. The information they receive through their senses might be overwhelming and hard to bring
together into a purposeful whole, and there is likely to be an additional learning disability that makes it
hard to apply cognitive skills to all these areas at once.
Therefore when some form of structure or routine is disrupted the world becomes confusing and
overwhelming again. This disruption of structure might be obvious (having a collection of objects
disturbed, being made to go a different way to school, getting up at an unusual hour) or it might be
hidden (subtle changes in the environment which the child is used to for example). Some of these
triggers might be out of the control of the individual or his or her family members. Some might be
avoidable. Others might be necessary events, which can be slowly introduced so as to limit improper
reactions. It is important to remember that ‘tantrums’ and similar behaviors are not rejections.
They are not emotional blackmail or warfare aimed at those close to the individual. They are
the natural reactions to various stimuli. Natural if you have autism that is. Disruption of
structure is only one trigger of such behavior.
Communicative Needs
In more general terms one of the most significant of ‘challenging behavior’ is caused by communicative
need. For people with profound difficulties in understanding others and in communicating with them it is
hardly surprising for frustration, anger and anxiety to build up. It is also quite likely that ‘challenging
behaviors’ will directly serve as a form of communication. Natural ‘tantrums’, for example in response to
changes in routine or requests to do something the individual does not want to do, may well be
reinforced by the other people involved. For many professionals and parents it might be easier to let the
child ‘have their own’ way rather then help them to develop other means of communicating. In this way
the child will learn that ‘challenging behavior’ may be the most effective and immediate way of bringing
about a desired response from others. It is perhaps inevitable that this will be the case in home
environments where parents do not have the time, resources or knowledge to deal with this behavior
more constructively.
This might also be the case in educational settings where there is a compromise between offering
support for the individual with autism and ensuring that any ‘challenging behavior’ is not disruptive to
other students. This is where support is needed both in the form of direct interventions related to the
behaviors, and in advising and helping parents manage episodes in ways which can be applied at
home. It is important to intervene as early as possible so that behaviors are not reinforced and so that
other means of expression and communication are open to children with autism.
Interventions
In summary, it is important to recognize two major extent of ‘challenging behavior’. These include
recognizing that there are experiences and difficulties specific to individuals with autism that might
trigger or cause these behaviors. These include problems with understanding themselves, the world
around them (especially their social environment) and their relationship with it. They might have
cognitive difficulty in processing and applying meaning to the information they are given. They might
need rigid structure in order to function comfortably. They might not understand or require the typical
social interactions and comforting of other children (such as being hugged when crying). These
difficulties can be improved slowly through education and other interventions, but basic differences must
be respected and effort can be made to manage the environment so that the individual is more
comfortable (allowing some structure, avoiding distracting information when engaging in tasks, allowing
personal space where necessary).
The second major area is where ‘challenging behavior’ serves a communicative function. In this case
the function of the behavior must first be identified before teaching and developing other means of
communicating. Interventions looks at methods of providing support and mediation for people with
autism in order to help them overcome any difficulties they might experience as a result of their autism,
and so that they can make the most of the skills and characteristics they do have. This is divided into
four areas: Educational, Behavioral, Drug and other interventions. Other Interventions include those
which may be seen as behavioral or educational in terms of content, and those which are more
controversial such as (chelation therapy). Discussion of these interventions is based on the
characteristics they improve and the psychological and neurological theory which helps explain them.
Interventions can be the most effective when it involves the learning of new skills or abilities.