Social Thinking and Applied Behavior Analysis - “black and white”

Michelle Garcia Winner and Chris Abildgaard

There is a tendency when exploring treatment options to build walls and think in the black and white. As we have moved from developing treatment with people with classical autism to exploring and developing treatments for the entire autism spectrum and related disabilities, we have to shift from thinking there is one way to treat by embracing a range of approaches to better meet the range of challenges our students and adults experience across the “spectrum.”

One’s language and cognitive abilities matter greatly when exploring methods of intervention or “treatment”. The huge shift in discussing treatment for those with “Autism” to those on the “Autism Spectrum” is really about understanding how to design programs for students with different abilities in language, cognition, sensory and perspective taking abilities.

As we now have caseloads filled with ASD students with reasonable to advanced verbal intelligence scores and spontaneous expressive and receptive language abilities we have had to move into a more sophisticated treatment approach. The treatments chosen are not only rooted in language based explanations (e.g. Social Stories®) but also need to teach more nuance and sophistication as this new generation of those we now call high functioning “ASD” are expected to merge and adapt into the neurotypical world of functioning in adulthood. Furthermore, our teaching methods need to also address a multitude of issues ranging from sensory needs to compelling mental health issues that coexist and impact the majority of our “brighter” students.

As we strive, collectively, to develop models of intervention that serve our diverse population of folks with ASD, I hope we are slowly taking down the walls and arguments about whether to use Applied Behavior Analysis (ABA), Social Thinking, Floortime®, SCERTS®, mental health supports, etc.. and instead take the best all of these programs have to offer to decide which to use and how to use them together to form a meaningful “intervention plan” that is individualized to the needs of each of our students/clients.

The SCERTS® model is a holistic treatment program that considers all aspects of the child and how best to serve the child given many different factors. As its name suggests, it explores treatment for social communication and emotional regulation by providing transactional supports. In keeping an eye on all factors that impact a student, methods of intervention and teaching approaches need to be multifaceted. Social Thinking, sensory integration, relationship development, structured teaching, use of some principals of ABA, etc to better help support and teach a student can all be considered for an individual within the bandwidth of this SCERTS model.

As we use those visible and invisible “transactional supports” within one’s environment we can explore how our programs overlap as most of the strong treatment programs now being developed for our brighter and language rich students share common tentacles. Let’s take, for example, ABA and Social Thinking. While philosophically these treatments have different core tenants upon which these treatment models differ, the actual application of these teachings for this higher functioning group are blending.

What is the first thing that comes to mind when thinking ABA? Lovaas, tokens, discrete trials? Well, you would be right…but there is more. Applied Behavioral Analysis (ABA) is the science in which procedures derived from the principles of behavior are systematically applied to improve socially significant behavior to a meaningful degree. Through systems of reinforcement, punishment and contingencies, a target behavior can be shaped, strengthened or decreased to improve one’s level of functioning. As one’s behavioral goal is met it is hoped that the external means of producing the behavior can be faded out.

A core tenant of Social Thinking is learning to acquire a new social behavior is part of a larger process. The process begins with recognizing what people think and feel about each other in different situations, and then determining the expected desired behaviors to keep others around you accepting you in their presence. The motivation for this learning comes from the desire to be socially validated (socially included) by others.


Treatments of ABA and Social Thinking Merge
As the treatment for students with social learning challenges broadened from those with classical autism to those with more nuanced social learning challenges, so have our treatment approaches.

For those who are higher functioning the everyday aspects associated with the hidden curriculum, social language peers use and most recently with the advent of various social networking sites, social roadblocks appear out of no where. With the intention of helping our students to recognize when those roadblocks are coming and how to navigate in day to day interactions without apparent road blocks, we continue to develop and implement ideas to help those who appear more neurotypical to blend into society. To do this, our guys/gals have to utilize their social thinking skills to uncover the “what, how and why” of the social behaviors that exist in certain situations. Understandably then, our treatments have had to shift to focus on more subtle and sophisticated lessons. Most notably, our treatments need to teach a process through which we engage in social decision making to choose our social behaviors; thereby teaching the students how to use various tools across their day.

8 TIPS To Improving Behaviors in Children with ASD

By Laurie Stephens, Ph.D.

Children with Autism Spectrum Disorders (ASD) experience the world in a very different way than other children. For these children, behaviors considered to be inappropriate, such as outbursts, tantrums or "meltdowns" may be their only way to communicate their needs, wants and frustrations. Sadly, many parents and family members often do not understand why a child is misbehaving and their actions may make a behavior worse. In addition to causing family problems at home, these behaviors may also result in children with ASD doing poorly in school and at community events, and lead to a difficulty maintaining friendships.

Understanding potential causes of behavioral difficulties for children with ASD and developing tools and techniques to improve your child's behaviors can lead to a happier and more fulfilling life for the whole family.

Leading Causes of Inappropriate Behaviors

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Communication delays: Children with ASD may not always understand what is being said to them or asked of them, due to their communication delays. They also may lack the language to adequately express their wants and needs. Acting out, or throwing a tantrum, is a good way to get attention and often is the only way the children can express themselves.

Sensory dysfunctions: Sensory dysfunctions can also be a primary cause of behavioral issues. A common feature of ASD is oversensitivity to sounds, texture, smell and lights. For a child with ASD, it can be as bad as experiencing his or her environment as a jarring alarm going off constantly, a strobe light flashing, a putrid smell everywhere, a feeling of clothing being overly tight and itchy, being asked questions in a foreign language and getting in trouble when the answer is wrong. Very few people would be able to keep their behavior in check under such circumstances, but this is often an everyday reality for children with ASD.

Need for routine: A core feature of ASD is the need for sameness or routine. When children impose a high level of rigidity and structure on their environment, they are setting up unrealistic expectations. When these expectations are not met, it leads to an increase in anxiety and frustration, which, in turn, leads to an increase in behavioral problems. 

Tips to Avoid Behavioral Difficulties in Children with ASD

1. Focus on the positive: The best way to eliminate negative behaviors is to reinforce the positive behaviors children engage in throughout the day. This will increase the likelihood they will repeat those behaviors. For example, praising children for homework they've already completed is more effective than yelling at them to finish it. Use motivating statements like, "Wow, I see you've been working hard on your homework. I'll bet you'll be finished in no time at all." When children with ASD finish a task, it is important to give some kind of reinforcement, such as a treat, a token or praise.

2. Tell the child what to do instead of what not to do: In general, it is more effective to give children direct commands. This is particularly true for children with ASD as they often take language literally. When we tell kids what not to do, we assume they will know what the appropriate alternative behavior is. For instance, if you tell a child with ASD "do not jump in the puddle," he may not understand that means "go around" the puddle; instead, he may think it is ok to splash in the puddle, walk through the puddle, etc. Saying, "Walk around the puddle" makes expectations clear and reduces behavioral outbursts or unexplained reactions to what they perceive to be correct.

3. Avoid using too much language: Children with ASD often have communication deficits. When frustrated or anxious, they may be even less able to understand spoken language than usual. Rather than trying to reason with a child in the middle of a tantrum, try to use few words and concrete language. Statements such as, "It is time to get in the car" are more easily understood and followed than if you explain why the child needs to get in the car, how you are going to be late and what will happen if he or she doesn't get in the car.

4. Warn your child of upcoming changes or transitions: While it may not always be possible, it is best to tell a child with ASD about any change that may be occurring and give them plenty of time to adjust. If you are buying new furniture, share pictures or bring your child to the showroom to see and touch it. Ask for help to decide where to place the furniture. This prepares the child for change and reduces anxiety.

5. Use visual schedules or reminders: Structure and consistency are two keys to improving behaviors. A fun way to do this is to develop simple visual reminders or schedules. This can be as simple as putting a picture of your child's teacher on the calendar for every day that he or she needs to go to school, or as complex as having a full schedule written out for every step for getting ready to go to school, along with the expected times of completion.

6. Teach calming techniques: Often, we tell a child to "calm down" when they are feeling anxious or upset. The problem is that we only use the word "calm" when a child is upset. It is important to identify for children what it means to be relaxed or "calm" so that they know the feeling we want them to experience. Try different relaxation techniques - counting to 10, taking deep breaths, yoga, music - to see which ones works best for your child. What calms any child may be highly individualized.

7. Beware of sensory overload: It is always important to look at the environment that your child is in, and determine if it is over-stimulating. A child may throw a tantrum in the grocery store because it is too bright or the "beep beep" of the price scanners is bothersome. The tantrum may be the only way the child knows to quickly get parents out of the store. If you think your child has sensory issues, develop coping strategies, such as letting him or her wear sunglasses in the shop, or listen to music to drown out upsetting sounds.

8. Use "time-out" effectively: The use of techniques, such as "time-out," - a common punishment that removes a child from an enjoyable activity -- needs to be used with careful consideration in a child with ASD. Time-out may not be effective because what other children consider an enjoyable activity may not be fun for your child with ASD. For example, a child may be held back from recess because she hasn't finished her work. However, if the child finds recess too loud, too unstructured and too crowded, she will actually prefer staying in over going to recess, and may even stop doing school work in an effort to avoid recess. The teacher in this case has mistakenly reinforced the negative behavior by assuming that the child wanted to go to recess. At home a child may be sent to his room after having a temper tantrum during the family dinner. The child may have thrown the tantrum because there was too much language being used at the table, or he did not like the smell of the food. Therefore, sending him away from the table and allowing him to be alone in his room may actually be what he prefers.

These simple strategies are applicable in any environment and can be used by parents and family members as well as health care professionals and educators. Consistent and regular use of these tips can prevent or reduce inappropriate behaviors. It's important to always keep in mind that children with ASD are not necessarily being manipulative or stubborn when they are having behavioral difficulties. They may not have any other way to express what they are experiencing. If we learn to listen to behaviors, we'll be able help them handle them in a more effective and productive manner.

Laurie Stephens, Ph.D., is the Director of Autism Spectrum Disorders Programs, The Help Group, www.thehelpgroup.org

The 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.

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