There is a very popular ABC (Antecedent – Behavior – Consequence) approach when the carer is supposed to find the trigger (Antecedent), define the Behavior and provide the Consequence for this (often called inappropriate) behaviour – ignore/ time out/ etc. In autism this approach does not always work. Sometimes the antecedent cannot be easily identified, because it can be either ‘present but invisible’, or ‘possible future’, or ‘past’ antecedent. Let me explain.
Present but invisible antecedent
Sometimes we cannot see/ hear/ feel certain stimuli as our senses are too ‘normal’. For example, the child may be disturbed by the sound of the microwave oven two rooms away. As the carer cannot hear it, any ‘challenging behavior’ displayed by the child would be interpreted as ‘out of the blue’.
Possible future antecedents
Not only certain stimuli but also any sudden unpredictable stimuli can be painful. The fear of the stimulus that ‘hurts’ is often the cause of challenging behaviors. The antecedents cannot be easily identified because they are ‘possible future antecedents’. Some autistic children may try to break things (for example, telephone or alarm clock) that can produce unpredictable painful sound. They do it as a protective reaction. For instance, Alex, a 9-year-old child with classic autism could not tolerate the sound of babies crying. Even when a baby was asleep he would try to attack (hit or kick) it. The trigger (antecedent) was ‘in the future’. It was easier for Alex to tolerate the cry, when he was prepared for it and could see the source of it. This explains his ‘challenging’ behaviour – to initiate and be in control of the painful sounds, make them predictable, instead of jumping out of his skin when the baby starts crying and he does not expect it.
Sometimes any stimuli (not only sensory but also emotional ones) may bring memories of pain, or anger, or panic (happened in the past). As any memory brought to the surface (i.e. to consciousness) becomes very much ‘present’, the child may react the way he or she reacted in the past, when the bad experience happened. What can provoke anger, fear, anxiety, panic attack? Anything! From smell to emotionally colored intonations. For example, some smells can bring pleasurable memories, and other odors remind one of unhappy ones. Or take another trigger – an emotional aspect of the word. Some words have emotional coloring that can be negatively charged. In autism, the conventional interpretation often doesn’t matter. If something unpleasant happened when the child heard the word ‘sorry’, for example, he would connect this word with the experience. Any time the child hears ‘Sorry!’ he may react with rage – the experience repeats itself.
The ‘last straw’ antecedent
Sometimes there are no definite triggers whatsoever. The cause of the challenging may be overload, i.e. if the child has been struggling already, anything can be last straw. Their sensory perceptual inconsistencies and differences can make dealing with the environment very difficult. If they continue to try to process all the information coming in, despite their inability to keep up with it, it may result in hypersensitivity that eventually bring anxiety, confusion, frustration and stress, that in turn lead to tantrums and difficult behaviors.
T.O. Daria has been a SEN teacher for more than 20 years. She has a son with autism and a daughter with Asperger syndrome. She is the author of the book Dasha’s Journal: A Cat Reflects on Life, Catness and Autism, published by Jessica Kingsley Publishers.