Complexities of Problem Behaviors in Children with Special Needs
By Alan Harchik, Ph.D., BCBA
behaviors in children often present challenges to parents and other
caregivers. For parents of children with autism and other developmental
disabilities, these behaviors can pose a unique and complex set
with autism and other developmental disabilities often exhibit severe
behavior problems including screaming, hitting, kicking, throwing
tantrums, destroying things, rocking back and forth, flapping their
hands, and bolting away from parents or teachers. These children
may also engage in self-injurious behaviors such as punching, hitting,
or biting themselves.
can parents do about these baffling behaviors? The child can't help,
because language problems typically prevent him or her from describing
what is wrong. Consequently, parents are left to guess, and they
may assume that something mysterious must be wrong inside their
child's body. This often leads them to try experimental treatments
(such as skin brushing or swinging activities) designed to "fix"
the child's sensory system, or diets and pills to "modify"
the child's vitamin and mineral status. There is, however, little
research to support these treatments.
than trying to treat internal systems we cannot see, my colleagues
and I have found that we are most successful when we treat what
we can see - observable behavior that we can clearly describe and
consider what might cause and contribute to the continuation of
a problem behavior. In general, a child behaves in a certain way
to get something he or she wants or to avoid or escape something
he or she doesn't want. For example, the child might rock back and
forth because it feels good, or throw a tantrum because it results
in extra attention or in escaping an unpleasant task. Some children
engage in self-injurious behavior to receive a hug or a massage.
For other children, hurting themselves might result in the removal
of undesired items, such as food, toys, or people. Although these
children may initially stop acting out, they are likely to repeat
their problem behavior frequently because it gets them what they
my opinion, the best way to determine the cause of problem behavior
is with a functional assessment or functional analysis. We use these
methods to determine what "function" the behavior serves
for the child. In other words, what does the behavior help the child
obtain or avoid?
out a functional assessment is very complicated and should be done
by a trained and experienced professional. At May Institute schools
for children with autism and other developmental disabilities, we
begin by checking on medical conditions to rule out things like
ear infections, bowel impactions, allergies, and so on. Next, we
write a clear definition and description of the behavior. Then,
there are three methods we use to try to determine the function
of a problem behavior:
Conduct interviews with the child's parents and teachers, using
standardized information-gathering tools. While the resulting information
may not be completely objective, it is important because it comes
from the people who are most familiar with the child and the behaviors.
Observe the child during regularly occurring activities at school
and at home, and record what happens before and after the problem
behavior occurs. Over time, direct observations can help to identify
certain consistent adult responses to behavior problems.
Put the child in situations where we can control the response to
the problem behavior. If behavior worsens each time attention is
given, for example, we might learn that the behavior is maintained
by adult attention. Studying behaviors in these controlled situations
can be extremely helpful in determining what causes them.
third method requires further comment. By altering the way we respond
to the behavior, we can get a good idea of what might be maintaining
it. Setting up these situations, however, can be problematic because
we are making it likely that the behavior problem will occur. Therefore,
it is very important to obtain parental consent, have a plan to
ensure safety, include multiple observers, and make certain that
the entire process is supervised by an experienced professional.
primary purpose of the assessment is to help us develop effective
treatment based upon the findings. I will discuss this in a future
Institute operates schools for children and adolescents with autism
and other developmental disabilities in Chatham, Randolph, West
Springfield, and Woburn, Mass., and in Freeport, Maine. The Institute
also provides residential and day services for adults. For more
information, call 800-778-7601, or visit www.mayinstitute.org.
Harchik can be contacted in West Springfield at 413-734-0300, or
information presented on this site is intended solely as a general
educational aid, and is neither medical nor healthcare advice for
any individual problem, nor a substitute for medical or other professional
advice and services from a qualified healthcare provider familiar
with your unique circumstances. Always seek the advice of your physician
or other qualified healthcare professional regarding any medical
condition and before starting any new treatment.