Looking for triggers of ‘challenging behaviours’ in autism.

It is not as simple as ABC

When we come across a behaviour that’s difficult, there’s a popular method that’s used to help parents and carers to analyse what’s happening and do something about it. You may have heard about it – or even used it. It’s called the ABC approach the idea of which is that you find a trigger for the behaviour (Antecedent), define the Behaviour and provide the ‘Consequence’ (for example, ignore/ time out) for this (often deemed ‘inappropriate’) behaviour.

However, to find the trigger is not as simple as ABC. From my experience, in autism this approach doesn’t always work for a number of reasons. Sometimes the antecedent cannot be easily identified. Let me explain.

Present but invisible antecedent

Sometimes we cannot see/ hear/ smell / 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 or a fridge in the kitchen, or a car outside. As the carer cannot hear it, any ‘challenging behaviour’ displayed by the child would be interpreted as ‘out of the blue’.

Possible future antecedent

How do you identify an antecedent when it hasn’t happened yet? Since any sudden unpredictable stimuli (such as a noise, for example) can be painful to a child with autism, sometimes it’s fear alone that can cause a behaviour, in anticipation of something unpleasant.

Some autistic children may try to break things (e.g., telephone or alarm clock) that can produce unpredictable painful sound. They do it as a protective reaction. For instance, my son (until he was 9-10 years old), could not tolerate the sound of babies crying. Even when a baby was asleep, he would try to ‘attack’ the poor infant. The trigger (antecedent) was not the baby itself but its noise potential! It was easier for Alyosha 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 and make them predictable, instead of jumping out of his skin when the baby started crying and he didn’t expect it.

There are a multitude of environmental threats like this - school bells, fire alarms, fans, dogs barking and vacuum cleaners are all common ones. So, always warn a child about the possibility of the noise they are fearful of and show where it is coming from. Showing them a hairdryer or vacuum cleaner for a few minutes and letting them control the switch themselves is one way to help.

Past antecedent

Sometimes any stimuli (not only sensory but also emotional ones) may be associated with painful memories of pain, anger, or panic. As any memory brought to the surface becomes very much present, the child may react in the way he reacted in the past, when the bad experience happened for real.

What can provoke anger, fear, anxiety or a panic attack? Anything! From smell to what can be called ‘emotionally coloured intonations’. For example, some smells can bring pleasurable memories and other odours remind children of unhappy ones – and some words have ‘emotional colouring’ 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, they 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 behaviour may be overload, i.e., if the child has been struggling already, anything can be the ‘last straw’. 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 meltdowns.

Some synaesthetic experiences

In some autistic children who has synaesthesia, the triggers can be some unpleasant (or even painful) synaesthetic experiences; for example, the sound which is perceived as the colour the child cannot tolerate: ‘I was scared, I saw a yellow “z-z-z” sound’ (sensory synaesthesia) or ‘I heard black than the word broke down into pieces and they entered my eye. I became blind because everything was black’ (cognitive synaesthesia). If the child cannot explain what’s happened, it’s impossible to find the trigger.

The emotional state of the carer/teacher as an antecedent

As most autistic children’s senses work in ‘hyper’, and feelings start as sensations (either conscious or unconscious), it is no wonder that many autistic people are emotionally hypersensitive, too. Some resonate with the emotional states of those around them.

Sometimes the carers themselves (or rather their emotional states) trigger the 'challenging' behaviours in these children. They may feel the negative emotions of their carers but cannot interpret what (and why) they are feeling.

If you feel under the weather, don’t think that you can pretend everything is fine and the children won’t notice. They won’t understand what is wrong but they will sense the negative signals you’re emitting and physically feel them in their body. It’s terrifying, isn’t it? So we all who live and/or work with these hypersensitive children should remember that sometimes it’s us who are the triggers of ‘challenging’ behaviours.