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.
Repetitive Stereotyped Activities
Individuals with ASD are often engage in repetitive stereotyped activities. These activities may be simple or
complex. Children of higher levels of ability usually show more complex routines.
Simple stereotyped activities
Examples include: flicking fingers, objects, pieces of string, etc; spinning objects or staring at objects that spin;
tapping and scratching on surfaces; inspecting, walking along and tracing lines and angles; feeling particular
textures, cloths, etc; rocking, standing up and jumping; tapping, scratching or manipulating other parts of the body;
repetitive head banging or self-injury; teeth grinding; repetitive grunting, screaming or making of other noises.
Complex stereotyped activities involving objects
Examples include: intense attachment to particular objects for no apparent reason; a fascination with regular
repeated patterns of objects, sounds, etc.; repetitively arranging objects in lines or patterns; the collection of large
numbers of particular objects, such as plastic bottles, pebbles, or the tops for no apparent purpose.
Complex stereotyped activities involving routines
Examples include: insistence on following the identical route to certain places; insistence on carrying out a lengthy
bedtime ritual; repetition of a sequence of odd body movements.
Complex verbal or abstract repetitive activities
Examples include: fascination with certain topics, ex. astronomy, birds, train time-tables, even specific persons;
asking the same series of questions and demanding satisfying answers.
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.