The rhetoric abounds concerning early identification and intervention of children with Autism Spectrum and other neuro-developmental disorders. Sadly, even early identification may fail to properly address the serious issues faced by children with challenging disorders. Focused and long range goals must be addressed in early intervention planning to prepare these children for a lifetime of success. A short term focus on goals and intervention strategies often leaves children falling short on critical life skills and self-management that can lead to lack of productivity and life determination … and in some cases even incarceration, homelessness, and institutionalization. Being Autistic is not an excuse for engaging in ongoing dangerous or inappropriate behavior; intervention strategies can help correct problems.
ABA [Applied Behavior Analysis] therapy, widely recognized as an effective behavioral intervention strategy to help children who are neuro-atypical, is only as good as the goals and desired outcomes that are written into the intervention plan. Children with social, emotional, behavioral, and mental health challenges need swift and dramatic intervention support to help them get on track for a successful transition from the school environment to the real world.
Just this week, I watched two precious children with serious behavioral challenges go untreated. The schools focused on whether these children were potty trained. I say diapers and pull-ups are cheap. What is most valuable – and the hardest to acquire – is the safe, lawful, and socially appropriate behavior of neuro-atypical children who also have challenges with violent outbursts, running away, and exposing themselves in public.
While the picture to the left is an eye-catcher that represents someone caught with their “pants down” … it is the opposite of what happens with some children who are neuro-atypical. Some of these children lack any awareness of social rules and boundaries. A child who was focused on changing their clothes for a field trip may undress and change in the middle of a classroom or parking lot. Some children drop their drawers as they are walking toward the bathroom for a potty break. Other children openly masturbate in public, unaware of the deep taboos that society places on such behavior.
Parents often stare at me with wide eyes, sometimes tearing up, as I point out that their child will never be put in jail for wetting their pants in public. When that child becomes a legal adult at age eighteen, however, the behaviors that were overlooked during early childhood can lend them in jail, in an institution, or living on the street.
Children with neurodevelopmental disorders that involve violent behavior, such as hitting, kicking, head-butting, biting, body-slamming, spitting, and scratching, must receive immediate, focused, and precise intervention. The fervor behind the intervention targeting safe, peaceful, and socially appropriate behavior of the child must be at least 10% more intense than the child’s underlying violent behavior. The idea is that the intervention should dissuade the child from choosing to engage in the dangerous behaviors, favoring more effective and socially appropriate alternatives to violence.
The same is true for children who undress in public, masturbate, or sexually self-stimulate. Children who failed to develop healthy social capacities may be unaware of the social pressures to remain clothed when in public or to refrain from touching one’s own [or another person’s] private parts. Parents and teachers who try to ignore auto-stimulation and disrobing in public are failing to recognize the severity of that same behavior ten or twenty years into the future.
Behavior management and impulse control is best taught when children are very young. The younger the child, the more neuroplastic the brain. That means a child’s brain has a greater capacity to learn to do new things. Older children have a dramatically diminished capacity to shift to accommodate new demands for social awareness and appropriate behavior. This is because of a phenomenon called synaptic pruning, when the young brain begins to break down the abundant excess of brain cells that are present in the infant brain.
The implications for parents, teachers, mental health professionals, and behavioral interventionists is clear: Intervention plans must address the long term goals and interventions that are likely to produce the most favorable outcomes for the child. Children must never be allowed to engage in rough or forceful behaviors; while a child who is three or four might be easy to handle, the same thrashing about may be dangerous when the child is thirteen or fourteen.
In our programs, we carefully analyze the way children with all types of disability behave, and analyze the long term implications of that behavior. If they are very loud, we recognize that failure to modulate their vocal volume could result in losing classroom privileges. Children may forcefully grab a caretaker’s finger or hand to drag them across the room or to point to a desired toy or food. While this behavior may seem harmless in a toddler or preschooler, the same behavior may result in serious harm when the child grows in size and strength. Some children who forcefully grab onto others to get their attention may break a finger or rupture a tendon or ligament in the hand of the caretaker.
Join Orchard Human Services in demanding better long range planning and services for those children with neuro-developmental or other disorders that also experience challenges of socialization, behavior, and maintaining appropriate boundaries around private parts. Better interventions lead to better behaviors and more capable social, emotional, and self-regulatory capacities of children who are neuro-atypical.
Dr. Darleen Claire Wodzenski is available for consultation private or group intervention services, and public speaking engagements to help parents, educators, and other professionals understand the critical goals for early intervention for children with severe behavioral challenges.