Crisis Management Strategies for Individuals with Autism Spectrum Disorder

The NZASD Guideline defines challenging behaviour as: behaviour of such frequency, intensity or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviour which is likely to seriously limit or deny access to the use of ordinary community facilities.(Ministries of Health and Education, 2008, p.244) These behaviours may include: Non-compliance Physical aggression Verbal aggression Self-injury Destruction of property Sexual assault These behaviours exist along a continuum from meltdowns that teachers or parents can respond to without additional support, to more serious or frequent incidents requiring support from crisis services. The first part of this artefact examines ways of dealing with crisis behaviour, or meltdown, in the classroom. It then goes on to look at crisis services and training within the New Zealand context.

Managing Meltdowns
Many crisis management interventions are underpinned by Applied Behaviour Analysis (ABA) and Functional Behaviour Assessment (FBA), using models based around phases or cycles. These models help those working with the child to identify and recognise the triggers to the behaviours, allowing them to apply a reasoned response avoiding punishments and negative emotions. This approach facilitates positive, consistent responses that can be applied at every stage of the cycle, as well as across situations and individuals working with the child. The model shown below from the Synapse website shows 5 clear stages: Trigger Phase Knowing what can act as a trigger for a child means triggers can be avoided or reduced in intensity. Responses to a specific trigger need to be consistent and applied calmly. Escalation Phase At this stage it is still possible to stop the behaviour getting out of hand and reaching the crisis point. This is achieved through: clear instructions in a form accessible to the child, calmness and consistency. Crisis Phase Continue to remain calm whilst minimising any danger to the child or those around them.

Recovery Phase Talking about the situation at this point may result in the behaviour escalating again. Continue to remain calm and positive. Afterwards Discuss the event away from other children, listen and offer support. Attempt to identify the cause of the behaviour and ways in which this cycle can be prevented in future.

Retrieved from: http://www.autism-help.org/behavior-intro-autism.htm

Consistency in response is crucial for the child to learn how to change their behaviour. The following video clip demonstrates the phases and consistency of using a behaviour response cycle.

Retrieved from: http://www.autismspot.com/videos/Managing-Classroom-Meltdowns

Crisis Services: NZ Ministry of Education

In a few individuals with ASD, the frequency and intensity of their challenging behaviours may increase to such an extent that they can no longer be dealt with by the class teacher, school or parent alone. In these situations crisis services are available. In New Zealand the Ministry of Educations 2009 Positive Behaviour for Learning initiative (PB4L) aims to help all children to feel safe and secure and to train teachers and parents to be able to defuse challenging situations. PB4L includes the following crisis management services available to all schools: Behaviour Crisis Response Service This service aims to: Stabilise the school Ensure the safety of all involved Prevent the situation from deteriorating further Implement an immediate plan which will lead to a workable behaviour plan Connect the school to other resources or support providers

Interim Response Fund This fund can supply resources, strategies and expertise and can be used to stabilise a crisis situation until appropriate intervention packages can be put in place and implemented. At the start of this year I received Interim Response Funding for a child transitioning from kindergarten. His needs were described as global and he had no diagnosis or funding before coming into my class. An IEP transition meeting listed the following areas of concern Non-compliance Soiling and refusal to let adults change him Aggression towards adults and children Running away or attempting to climb over fences Refusal to eat at kindergarten Inappropriate touching of peers in a sexual way Very limited spoken language

Interim funding was obtained allowing the school to employ a teacher aide daily for 1 hours in the classroom and for cover in the playground at lunchtime. This gave us the assurance of a

safe environment for the child and the class whilst we got to know him and developed an intervention program

Intensive Behaviour Service This supports the most complex and challenging cases amongst children from 8-12 years of age and can be attached to a child for 9-15 months. The options for the family in these cases are either a residential school or attendance at the local school with support from a wrap around service. The process involves: Assessment of the childs needs Plan to meet these needs Support from a Ministry of Education psychologist Service to support childs return to the local school

Severe Behaviour Service This involves a team of specialists including a psychologist and special education advisor who look at what the antecedents to the behaviours are and what changes can be made to manage the behaviour. The parents, family/whnau and school work collaboratively with the specialist team to design, implement and monitor interventions. This service is available for children in Year 1-10 whose behaviour is severely effecting their learning or social relationships. Incredible Years Program This program is aimed at parents and teachers of children aged 3-8 years and provides training on managing childrens behaviours through positive approaches. This program will be made available to over 10,000 parents and care givers and 8,260 teachers by the end of 2014.

Professional Development Opportunities in New Zealand The Safe Crisis Management (SCM) training program was developed in 1982 in America and is now used in the UK, New Zealand and Guam. Christchurch is the base for this program in New Zealand. The focus of this program is preventing and managing crisis behaviours in schools and in doing so improving safety. SCM uses a trauma sensitive approach, based on staff building positive relationships with the individuals involved, by responding to their needs appropriately. It supports safety, positive growth and improved performance recognising that responding to challenging behaviours needs knowledge, skills and commitment to the individual.

SCM integrates Functional Behaviour Support Planning (F-BSP) with behaviour management theory looking at: Reasons for the behaviour, viewing aggressive behaviour as representing misplaced coping The design of a wraparound service Individualised behaviour management approaches

The interventions used are not as intrusive as restrictive procedures which are only used as a last resort. The positive nature of this intervention allows individuals to exercise responsibility and control over their own behaviour. SCM works on the process of: Resolving the situation Recording the situation Restoring the individual to the environment

In response to the unique situation of individuals with ASD, a SCM training unit specifically for ASD has been developed. This unit recognises that traditional interventions and deescalating strategies may not work with individuals with ASD because owing to core impairments in expressive and receptive language and in reading non-verbal cues.

Conclusion
A consistent, non-violent approach to crisis management is promoted by most agencies offering training in this area. However, the focus of the approach is not always on support for the individuals growth and development, sometimes it is on making working with the challenging child easier. Teachers and other professionals need to be aware of these differences in approaches and when possible use interventions based on valid, empirical data. Unfortunately, scientifically based research in crisis management for individuals with ASD is limited and further research is needed. Schools need to develop a crisis management toolkit, informing senior management of external services available to the school and including an appropriate behavioural response model to inform staff of best practice in the face of challenging behaviour. NZASD Guideline 4.7.2: Proactive crisis support management should be routinely undertaken and reviewed on a regular basis. (Ministries of Health and Education, 2008, p.158)

The core characteristics of children with ASD and the way in which these may affect regular responses to challenging behaviour need to be taken into account. Crisis management interventions need to be delivered by trained professionals with experience and understanding of the unique situation of children with ASD.

References
Introduction to Challenging Behaviours. (n.d.). Retrieved October 2013, from Synapse: http://www.autism-help.org/behavior-intro-autism.htm Managing Classroom Meltdowns. (2007). Retrieved October 2013, from Autismspot: http://www.autismspot.com/videos/Managing-Classroom-Meltdowns Ministries of Health and Education. (2008). New Zealand Autism Spectrum Disorder Guideline. Wellington: Ministry of Health. Retrieved from Ministry of Health: http://www.health.govt.nz/ Ministry of Education. (2013). Behaviour. Retrieved from NZ Education: http://www.minedu.govt.nz/NZEducation/EducationPolicies/SpecialEducation/Services AndSupport/Behaviour.aspx Ministry of Education. (2007). Interim Response Fund Behavioural Crisis Support: Manual for Principals. National Operations, Early Childhood and Regional Education Group. Retrieved from http://www.minedu.govt.nz/~/media/MinEdu/Files/EducationSectors/PrimarySecondar y/SchoolOpsResourcing/OtherFundingProgrammes/PrincipalsManual.pdf Welcome to JKM training inc. (n.d.). Retrieved October 2013, from Safe Crisis Management: http://www.safecrisismanagement.com/main.aspx