“He only wants to do what he wants to do when he wants to do it. Then he tantrums or resists following my directions when it’s time to stop doing what he wants to do. He knows what he’s doing so it couldn’t be autism.”
This is a theme I frequently hear when teachers or colleagues are in the process of evaluating a child for a possible autism spectrum difference.
So how do you make sense of the distress and agitation triggered by students during the transition from a preferred activity to one that is directed by the teacher?
This is a common pattern seen in children with autism spectrum differences. Oftentimes we assume the child is engaging in resistant behaviors because he or she is willfully choosing not to comply with the adult’s request. However, with children who have autism spectrum differences in the area of sensory use and interests this resistance during transition times involving the transition from a preferred activity to a less preferred activity may be better understood as a function of the child’s sensory attachment to the preferred activity and the subsequent difficulty in shifting his or her attention from the highly preferred activity to following the agenda of the adult. Compounding this shifting difficulty is the fact that most of the time transitions are signaled when the adult talks to the child as directions are given and requests are made. Incoming language demands are frequently sources of stress and agitation for children with spectrum differences—even when the child is highly verbal.
This understanding of the underlying triggers for the behaviors of noncompliance and resistance to directions—and the accompanying emotional dysregulation in the form of anger outbursts and agitation—as being related to the child’s restricted range of interests, engagement in repetitive activities and resistance to changes in routine is important.
Why is this distinction so important? Because when we interpret the child’s resistant behavior as willful or noncompliant, the strategies that come to mind involve the use of consequences and verbal explanations to the child regarding the consequences for noncompliance. We assume the child is capable of making the choice of moving with ease from the preferred to the non-preferred activity as long as the consequences we provide are powerful enough.
What we miss with that interpretation is the information the child is giving us regarding the function of the preferred activity. If we entertain the idea that the child is seeking out the preferred activity as a way to regulate input then we can begin to get curious about the form and function of the preferred activity. Usually the activity is solitary, involves visual, familiar, and repetitive input, may have a predictable auditory component, and is under the control of the child. In other words, the sensory dimensions of the preferred activity (computer, books, specific toys or materials) serve the function of providing the child with a sensory regrouping time within the social and language-based environment of the classroom. The repetitive and solitary nature of the preferred activity serves as a way to block out incoming language and social demands, and provides the child with a way to self-regulate. In other words, it serves an organizing function for the child.
Once we understand the behavior through the sensory regulation and organizing framework we are led to different interventions. Specifically, we know that child will need a visual cue to signal the upcoming transition from the child’s agenda to the agenda of the teacher. The use of a visual cue serves two purposes: the adult direction goes in through the child’s strongest channel (visual versus auditory) and the adult is less likely to bombard the child with verbal directions (a trigger for disorganized and dysregulated behavior).
We can also look at ways to build sensory regrouping breaks using the preferred activities into the child’s daily routine. For higher functioning children we can use a visual cue such as a battery that gets recharged as the child engages in brief sensory breaks. As the child engages in the preferred activity his or her battery fills up and the child is ready to work. This type of visual tool helps the child visualize the internal process of regrouping when engaged in the preferred activity. The challenge that we face at the outset is that the child has set up a routine of selecting the preferred activity and then resisting the transition. In the routine established by the child we lose the opportunity to use the organizing function of the preferred activity as a springboard to effective participation in other activities.
The sequence of work-break-work-break has to be taught by creating repeated successful cycles of transitioning from the preferred activity to the less preferred activity and then back to the preferred activity. Many children resist leaving their preferred activity because they have difficulty anchoring the idea that they will have additional opportunities to engage in their preferred activity throughout the school day. Children with autism spectrum differences respond well to the use of visual transition cues, visual ways to understand the function of the sensory regrouping breaks, and the establishment of work-break-work-break routines. The addition of social scripts that lay out the narrative for the child to understand the function of their preferred activity (recharge the battery/regrouping break) is useful in that the child gains an understanding of how the preferred activity fits into his or her school day.
The challenge is for us to consider the possible underlying function of the resistant behavior as being sensory-based rather than based in willful noncompliance.
So the next time someone describes a child’s behavior by telling you “he only does what he wants to do when he wants to do it,” or something along those lines, get curious about the preferred activity.
Here are some statements and questions that get the sensory conversation started:
Tell me more about the child’s preferred activities.
Does he/she select activities that are solitary/self-directed/three-dimensional/low verbal and social demand?
Is it possible that the activity helps the child block out language and social demands?
What do you say to the child when it is time to change activities?
Do you “show” as well as “tell” the child what you want him/her to do?
Tell me about times when the child successfully transitions from a preferred activity to a non-preferred activity.