Why Do Some Autistic Individuals Have Severe and Recurrent Problem Behaviors?

Parents and staff often ask these questions when they are witness to an autistic adult individual who is engaged in what psychologists call, problem behaviors. An autistic individual may be hitting or punching himself or others, throwing a tantrum, running away (elopement), screaming or yelling loud in an agitated manner or assaulting others in different ways.

There are two major frames of thought for analyzing these problem behaviors. We can think of them from a biological perspective, that is, view the behavior as a result of brain dysfunction and biochemical imbalances. We can also view these problem behaviors from a social environmental perspective (Bauman & Kemper, 2004; Hollander & Evdokia, 2007; Iwata, Vollmer, & Zarcone, 1990).

At this time, I would like to focus solely on the latter social environmental perspective and discuss the role the social environment plays in the occurrence and recurrence of severe problem behaviors. To begin answering this question, we must analyze not just the behavior itself, but also the sequence of environmental events surrounding that behavior. This type of analysis is what we call a functional behavior analysis, whereby we assess the role of the social and physical context and consequences (observable/measurable events) that surrounds the severe problem behaviors. The reason for analyzing the surrounding events is that this perspective assumes an existing relationship between the behavior and the environment. Another way of understanding this relationship is to view the severe problem behaviors as purposeful and working within a function of antecedent contexts and consequences (if “X”, then “Y”). For instance, when an autistic individual becomes agitated or self-abusive, most of the time a family member or staff will give him more attention, which may be what he wants. This relationship between the self-abusive behavior and “attention giving” may become strengthened, conditioning the maladaptive behavior by the positive consequences. Thus, a functional analysis accounts for the fact that social environmental events can either trigger or give purpose to the maladaptive behavior (Center for Autism and Related Disabilities, SUNY, 2008).

We can have two types of consequences to a maladaptive behavior: a positive reinforcement or a negative reinforcement. By using the words positive and negative, I do not make any value judgment about these reinforcers, meaning that I say nothing about whether they are “good” and “bad” things. Positive reinforcements are environmental stimuli that are introduced immediately after the behavior and subsequently increase the likelihood of occurrence of a particular behavior. For example, if an autistic individual gets agitated and a staff member takes him for a walk- an activity that he enjoys-, it is likely that through time the agitated behavior may increase in frequency and possibly intensity. The effect of the staff providing a walk to the autistic individual, contingent upon the agitation increases the frequency of the behavior over time. In this example there exists a temporal relationship between the behavior and the positive consequence of going for a walk. Therefore, we can say that the autistic individual learned how to get a walk with staff, by getting agitated (Austin and Carr, 2000; Cooper, Heron and Heward, 2007.)

Negative reinforcements are aversive environmental stimuli that are removed immediately after the behavior and subsequently increase the likelihood of occurrence of a particular behavior. Negative reinforcements are often seen in problem behaviors when we engage an autistic individual in task demands and compliance situations. The autistic individual tries to escape from a situation because it becomes an aversive event to him or her. It can consequently be negatively reinforced when that event or demand is removed, which may make the maladaptive behaviors more likely in the future. For example, an autistic individual may throw herself on the floor to avoid going back to engaging in a task. The negative reinforcer in this case would be the consequence of no longer engaging in that task as a response to this maladaptive behavior. Occasionally, self-injurious behaviors follow a negative reinforcement function and the misunderstanding of the behavior may lead to an unintentional escalation of the behavior. Therefore, it is imperative to perform an accurate functional analysis to understand the behavior because in the case of self-injurious behaviors the plan of ignoring the behavior may seem to be a good strategy for changing the behavior if the motivation (function) for the behavior is to seek attention, but it could be that the individual's contingency relationship (temporal cause-effect relationship) may be characterized differently. In another situation, an autistic individual may choose to engage in self-injurious behavior to avoid complying with staff instructions, for instance, to do laundry, take a shower or attend his day program. The autistic individual maintains his or her own non-compliance behaviors by negatively reinforcing that behavior through escape and avoidance of the aversive stimulus, such as doing laundry. In this scenario, we could try to modify the behavior not by ignoring it, but by increasing the motivational components of the low non-preferred activity to do laundry. Occasionally, a poor management of this situation may escalate to verbal and physical aggression and property destruction (Repp and Horner, 1999).

There are different contingencies that may strengthen severe problem behaviors such as attention-seeking, obtaining tangible items (e.g. food), escape-avoidance from a difficult task and self-stimulation (boredom or lack of structure) (Center for Autism Spectrum Disorder, 2005). If parents and staff members can understand the function of the severe problematic behaviors, they can change the stimulus that maintains the maladaptive behaviors and subsequently work to alter the frequency and motivational conditions of these problematic behaviors.