Treating Tantrums in Children with Autism

By Mary Barbera, PhD, RN, BCBA-D

I did a survey a few years ago and asked both autism parents and professionals about their #1 Autism ABA struggle and the top response was dealing with challenging behaviors.

I often get questions like this: What should I do if my child or client displays problem behavior (screams/argues/bites/kicks/flops to the ground) when a demand is placed (take a bath/do homework/go to bed)?

The answer to the question is similar regardless of the functioning level of the child, the type of problem behavior or the demand. Whenever problem behaviors occur, I believe the demands are usually too high, the reinforcement is too low and/or we don’t have adequate control of the reinforcement.

Before we can treat problem behavior, we need to accurately define what the behavior of concern looks like. Many people throw out vague words to describe problem behaviors displayed by their children or clients with autism.  They might say Billy was “very off” today, “he was anxious” and/or “had a complete meltdown.” Even the word “tantrum,” which many professionals (including me) use routinely, doesn’t describe what exactly the behavior looks like.

In order to help parents or non-ABA professionals describe problem behavior more accurately, when a parent or professional says “he was anxious,” I ask, “What did that look like, was he pacing, tapping his fingers, taking short/shallow breaths?” Likewise, if they say, “He had a tantrum,” I would ask what that looked like. Did the child fall to the floor, kick adults, hit the sides of his head with his fists? While I can’t count anxiety or tantrums easily, I can count more specific behaviors.

Once you better define the behavior and decide which behaviors you are going to target first, I would recommend you take some data (how many times the behavior occurs per hour or per day).

Next I would look at activities when the problem behavior almost always occurs (when it is time to take a bath) and when the behaviors of concern never occur (while your child is playing on the computer).

You then should look at ways to “re-pair” activity that is resulting in problem behaviors such as the bathing routine. Some pairing techniques for bath time might be to get foam for the tub or bath paint/toys for instance and try to sandwich harder activities with fun activities (first bath then computer). A heavy focus on pairing and manding as well as an 8 to 1 ratio for positive to negative comments is usually helpful too.  In fact, the key to controlling problem behavior in general is to spend 95% of your time preventing problem behaviors, not reacting to them.

If problem behaviors persist or are severe you will need a Board Certified Behavior Analyst (BCBA) or a related professional to help you since applying the principles of Applied Behavior Analysis is extremely complex and treating severe problem behaviors is outside of the scope of this short blog.

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