When addressing challenging behaviors, specifically when it comes to aggressive behaviors and self-injury, it’s important to understand the reason as to why these behaviors are occurring before determining a solution. The behavior of all living organisms serves specific purposes; and the reason behavior occurs varies depending on an individual’s need in a given moment. Dependent on the circumstances, one behavior can serve multiple functions or multiple behaviors can serve one purpose.
Understanding the basic function of behavior is pertinent when dealing with the behaviors related to individuals on the autism spectrum. Research indicates that individuals with greater skill deficits often engage in higher rates of aggressive behaviors. This is likely due to inefficient communication abilities, reduced socials skills and social supports, as well as a greater degree of intellectual disabilities (Sturmey, n.d.). Aggressive behaviors tend to be more prevalent during the younger years of a person’s life and appear to be directed toward familiar people and caregivers as opposed to strangers (Autism Speaks, 2012). Further, some studies suggest that self-injurious and aggressive behaviors can be a result of biological or biochemical components leading to compulsive type behaviors that are difficult to treat (Autism Speaks, 2012). However, in general, most behaviors are learned and reinforced over time.
At the very core of most human behavior is the inherent need to satisfy primary needs. The primary needs of all living beings are classified as unlearned and natural; these include hunger, thirst, sexual drive, and the ability to maintain appropriate temperature. Once basic needs are met, individuals then look to satisfy what are known as secondary needs. Secondary needs include items and activities that are learned and are comprised of things that living beings desire but do not require for survival.
In relation to human action and primary vs. secondary needs, the term reinforcement is widely used in the behavior analytic community. Reinforcement refers to the presentation or removal of a stimulus immediately following a behavior which in turn, encourages the behavior to occur more frequently in the future. Reinforcement is individualized and personal and must possess desirable properties. Behavior is maintained through reinforcing consequences present in the environment; however, not all items and activities will maintain the same reinforcing value over time, across environments and across people as the significance of things change day to day and often moment to moment.
In relation to severe problem behavior that can put an individual at risk or risk the safety of others, experts strive to identify the function and the maintaining reinforcer as soon as possible in order to implement an intervention quickly. Initially, a clear description of the behavior is required in order to assess the function. Antecedents, setting events and environmental factors are all subject for review when determining the function of any behavior. Experts often look to do a functional assessment and sometimes a functional analysis to determine a cause or pattern in behavior.
Maintained across all functions, aggressive behaviors toward one’s self or others serve to meet the needs of the individual. Often times, individuals with autism are unable to make requests for the things they need and want. Once identified, the function of aggressive behaviors that are emitted can be replaced with a more appropriate and socially acceptable behavior. For example, if an individual is hungry and is not able to request food items effectively, upon seeing food he or she might hit a caregiver to alert attention in order to be given a meal or a snack. Similarly, if a teacher asks a child to put away a favorite toy and, in turn, the child begins to pull at his/her eyelashes it is likely that the child is not ready to put away the toy and would like more time to play.
At times, an individual might act aggressively or demonstrate self-injurious behaviors as a result of being presented with a change in the environment that is thought to be aversive. He or she may engage in particular behavior to escape a place, person, or task. If historically, the task is removed or the individual is taken away from the original environment upon demonstration of aggressive or self-injurious behavior, it is probable that he or she may have learned that in order to escape or avoid something that they “don’t like,” aggression or self-injury is what is necessary in order to have the aversive stimulus removed under a specific circumstance. By identifying causal factors (e.g. patterns in behavior and antecedents and/ or consequences to behavior), a clinician or teacher can create a plan to teach the individual to make requests more suitably.
Some studies suggest that aggressive or self-injurious behavior can be an extreme result of attention seeking motivating systems. These studies have found that children learn to emit problem behavior in response to low level adult attention (Carr &, Durand, 1985). Treatment packages must focus on teaching individuals to request attention aptly.
An individual may present with aggressive or self-injurious behaviors as a result of a medical issue. If the person has a limited ability to communicate, he or she may not be able to explain to a caregiver that they are not feeling well or that something is wrong. It can very difficult to identify as the reason for particular behaviors if there are no observable symptoms of illness. If aggressive behaviors are new and have not been a part of the individual’s history of behavior, best practice is to first rule out any medical issues or concerns by seeking medical attention to the problem immediately. If there are no medical reasons as to why the behaviors are occurring, professionals can then look to identify the maintaining variables and execute appropriate behavior strategies.
Self-injurious behaviors can be the result of a motivational system that does not require any other person to mediate (i.e. provide), which is known as automatic reinforcement. When the behavior itself is motivating and enjoyable to the individual person and he or she is not looking to acquire anything additional professionals are faced with a treatment and intervention challenge. Often, covert observations are conducted in order to ascertain that automatic reinforcement is the true function of self-injurious behavior (Toussant & Tiger, 2012). Professionals must discretely observe the individual engaging in this behavior in the absence of other people, without a response from anyone and across environments and various times of day. Once it is identified that the function of the behavior is automatic, therapeutic interventions can be designed and implemented. Although functional analyses are extremely useful for the basis of treatment development, assessments are often not possible due to the risks of harm to the individual or therapists (Borrero & Borrero, 2008).
Of all behavior that can occur, aggressive and self-injurious behaviors are by far the most dangerous and troublesome to treat. By identifying the reinforcing variables and the function of these behaviors, professionals can look to create treatment plans that will replace the harmful behavior and often functional communication training is pertinent to the treatment design. It is important to note, however, that behavior treatment plans must maintain a functional equivalence between the two behaviors. In other words, if for example, the function of the aggressive or self-injurious behavior is hypothesized to be attention seeking, the treatment plan must include a component to teach a more suitable way of requesting attention as opposed to providing an escape from a demand, additional access to preferred items, or using a time out procedure.
Due to the severity of aggressive and self-injurious behaviors, professionals strive to identify the cause of behaviors as soon as possible. By understanding the function of behavior as opposed to focusing on the form alone, lasting treatment interventions are possible.
QSAC (Quality Services for the Autism Community) is committed to providing the most appropriate interventions to our participants as possible. As a behavior analytic program, we continue to rely on evidence-based practices to improve the lives of our participants in a socially significant and safe way. For more information related to challenging behavior and/or treatment plans, please view our website at www.QSAC.com or contact Rachel directly at rlapiana@qsac.com or 718-728-8476.
References
Borrero, C., & Borrero, J. (2008). Descriptive and Experimental Analyses of Potential Precursors to Problem Behavior. Journal of Applied Behavior Analysis, 41.1(Spring), 83-96.
Carr, E., & Durand, V. (1985). Reducing Behavior Problems Through Functional Communication Training. Journal of Applied Behavior Analysis, 18 (2(Summer)), 111-126.
Sturmey, P. (n.d.). Treatment interventions for people with aggressive behaviour and intellectual disability. Retrieved from http://www.wpanet.org/uploads/Education/Educational_Resources/autism-part4.pdf
Toussaint, K., & Tiger, J. (2012). Reducing Covert Self-Injurious Behavior Maintained by Automatic Reinforcement Through A Variable Momentary DRO Procedure. Journal of Applied Behavior Analysis, 45.1(Spring), 179-184.
Vollmer, T., & Iwata, B. (1991). Establishing Operations and Reinforcement Effects. Journal of Applied Behavior Analysis, 24 (2(Summer)), 279-291.
Why is Autism Associated with Aggressive and Challenging Behaviors? (2012, January 1). Retrieved February 5, 2015, from https://www.autismspeaks.org/sites/default/files/section_1.pdf
