behavior management that is consistent at home ,school, car...

Does anyone have a suggestion for behavior management for autistic 8 year old boy who reacts violently, or runs into the street when upset or angry. He does pretty well at school but when mom picks him up and at home he can be in a rage. He used his words one day at school when he was angry (something we have been practicing in therapy). I wonder if there is a "score card" or something that can travel with him to reinforce using control and other desirable behaviors - that everyone who deals with him uses to manage behavior - Is this reasonable?? Ideas??

Hi sarahoo, and welcome to IAN.

It is certainly true that making behavioral interventions consistent across settings can be very helpful -- while totally different systems or expectations can be very confusing for a child with autism (or any child). If a system in place at school is working, one possibility might be to schedule a meeting to be attended by parents/caregivers and teachers/therapists to see if it would be possible for all to use the same rules, responses, and interventions. Parents can request an IEP meeting or otherwise arrange to meet with school personnel with the goal of getting everyone "on the team" at school and home on the same page.

I hope others will share their experience with this issue. Has applying the same rules and behavioral interventions across settings worked? What barriers were there to making this happen?

My 6 year old grandson was diagnosed with autism in 3/09. Even being on 2 different medications, we have not been able to keep his aggressive behavior under control, especially at school. He is in kindergarten. The district hired an aide for him right before Thanksgiving last year. I'm looking for other ways to help him. I want to take him off the antipsychotic drugs.

Grandmother

Hi Grandmother, and welcome to IAN.

There are few difficulties more challenging for families than having a child on the autism spectrum with intense behavior problems. These are very common, and a huge struggle because they interfere with so much, especially school.

Of course, many times a family wants to avoid medication, if possible. Still, medication sometimes becomes part of the treatment picture.

What's most important is to start out by getting a handle on what is driving the child's behavior, however complex that picture may be. Some things to consider are:

* physical complaints (are behaviors due to any physical discomfort, like ear aches or GI issues?)
* sensory issues (is the child being driven to distraction by noise, lights, crowds, clutter in the classroom?)
* anxiety (is the child acting out just to get OUT of a situation that makes him or her really anxious?)
* behavior reenforcement (is the way adults respond to the child's outbursts actually encouraging them because they "pay off"? -- as in, the child gets sent home every time he blows up)
*bullying or teasing (is the child having an issue at school that adds to his discomfort and difficulties?)
* just plain neurochemistry (is the behavior less to do with the environment and more to do with brain chemistry?)

Sometimes the classroom situation is just too overwhelming; sometimes a "special" school with smaller classes and a staff more attuned to children with autism spectrum disorder can be a huge help. (Also helpful: staff that know how to effectively handle meltdowns so they don't send the child home -- reward! -- every time he has an issue.) Sometimes the school can make changes that will work in the regular school setting - like teaching the child to recognize when he is feeling overwhelmed, and giving him a place to go to calm himself before returning to class. Sometimes sensory issues play a big part, and addressing those can help.

Sometimes a child is so unable to regulate him or herself that medication can help. The tough part with meds is generally going through the trial and error of finding one that is really effective but doesn't have unacceptable side-effects.

You may want to read our article on when meds are usually considered, here: http://www.iancommunity.org/cs/therapies_treatments/child_psychiatry_and_autism

We also have an article on the type of medication you mentioned (antipsychotics) because they are so frequently used in treating behaviors in autism: http://www.iancommunity.org/cs/therapies_treatments/antipsychotics_malone

Also, we have a report on how many children participating in IAN are on what type of medication: http://www.iancommunity.org/cs/ian_treatment_reports/medication

And we have a write-up on meltdowns in general: http://www.iancommunity.org/cs/challenging_behavior/mood_instability_and_meltdown

There are also books available that deal with meltdowns and how to handle them. Just for one example: Smith Myles, B., & Southwick, J. (1999) Asperger syndrome and difficult moments: Practical solutions for tantrums, rage, and meltdowns. (Autism Asperger Publishing Company).

I hope this information proves helpful. I, too, have a child on the spectrum, and he, too, had issues like this, so I understand just how difficult it can be.