Behavior & Autism

Join Lynette and Rich as they explore an intervention model for Autism called The S.U.C.C.E.S.S. Approach (SM). The model is designed to help you understand, respond, and help those in your world who live a life with Autism. Our goal is to help expand your thinking to better serve these amazing people, and to support you in your daily struggles and celebrations. In this episode we will define behavior and how it works into the pillars as it applies to The S.U.C.C.E.S.S. Approach (SM) as one of the 7 theories and/or models. It’s a fascinating episode that digs deeper into the profession of Occupational Therapy. Don’t miss it!

If you or someone you know could benefit from the full training for The S.U.C.C.E.S.S. Approach (SM), you can take the course online. Just go to https://www.thesuccessapproach.org/online-course for registration and other details.

The S.U.C.C.E.S.S. Approach is a registered Service Mark protected under intellectual property law unless otherwise specified, all music, audio visual, and proprietary content shared in this podcast is property of AWEtism Productions, LLC and it’s sister agency Integrations Treatment Center. The use of this content is unlawful without the expressed written consent of the proprietor.

CONNECT WITH S.U.C.C.E.S.S. Transcription

Season 2
Podcast Episode 201

Want to help your child and your whole family using The SUCCESS Approach? Check out our online course:https://www.thesuccessapproach.org/online-course

{INTRO MUSIC}

LYNETTE: Welcome to Connect with Success with Dr. Lynette Scotese-Wojtila, where we help connect you with knowledge. Our mission is to lead you to a new and exciting way of understanding, responding to, and helping all those with autism. We hope to expand your thinking about how to best serve these amazing people and to support you in your daily struggles and celebrations.

RICH: 0:00
Welcome everyone to the new season! Season two of Connect with Success, a podcast built around The S.U.C.C.E.S.S. Approach, and the person who coined it Dr. Lynette Scotese-Wojtila. It's so great to be back in the studio. I'm recording this podcast with Lynette as we both try to get back to --I put in air quotes “normalcy” of our regular episodes and routine with the podcast. Lynette, it's so great to be back with you. How are you doing?

LYNETTE: 0:23
I'm doing well. I've appreciated the break that we needed to be able to rejuvenate and come back stronger. So I’m ready for more success, right?

RICH 0:34
I agree. Once we get to October, once the school year begins, I feel I can breathe a little easier. We're in our routines and we can carry on with what we do. Well, I don't know if you know this or not, but we've hit over 1000 downloads with Season One. And to me that just makes me so thrilled to be able to bring this amazing approach to autism to those who need it.

LYNETTE: 0:55
Yeah, that's a lot of people. I'm so glad, and I hope to share more, and have our listeners spread it to their network as well. I think one of the things that we've learned about special needs is we learn to trust each other and our networks. And so if there's somebody out there who's struggling who you know, would benefit from some of this content, all of this content, go ahead and share the information on the podcast. We want to get it out there. It's a unique way of looking and understanding and relating to individuals with autism. And I think that the more people who know it as an option, the more hope there is in the world for serving individuals with these special needs.

RICH: 1:31
Absolutely. And you know, these podcasts kind of give you the glossed over version of what you would get in the online training that we have available.

LYNETTE: 1:38
Right. Yeah, that's a good point. So the podcast is designed to give you information and a global sort of way, almost surface if you will. And yet there's such depth of information in the content of the class called The S.U.C.C.E.S.S. Approach (sm) Training Program. And that's our online class that you helped to bring to life. Dr. Smith, thank you for that wonderful project.

RICH: 1:58
I’m glad to be a part of it.

LYNETTE: 2:01
Thank you. It's has reached so many people this way now that it's online and because it's self-paced, people have a good three months to really digest it. And of course, everything we do here is intentional. And, so all nine of the modules build on each other. So that kind of allows us to get a little seed, water a little bit, do a little bit more pruning, and pruning, growing and growing. And before you know it, we've got this mushroom of knowledge that really does have a wonderful way of working its way into our action and how we deal with kids. So it's an easy course to take from theory and methods to real-life application because we do a lot of video work so parents actually get to see kids, and some adults, and how we use the methods with them.

RICH: 2:45
Yeah, it's really beautiful. If you've ever had a chance to see any of the work that's being done through The S.U.C.C.E.S.S. Approach (sm) and really just watching. Those who are on the spectrum achieve their given potential. Now, today's episode is actually a very special one because we're going to be presenting the last pillar of what The S.U.C.C.E.S.S. Approach (sm) is built upon which involves behavior and autism. So, do you want to share our term for this episode?

LYNETTE: 3:12
Yes, today's term is behavior and we can define behavior a number of ways. I think a very common way is something that's observable. Another way, maybe a more scientific route, would be defining behavior as a response to a stimulus, I’ve heard about that in behavior terms. But I think today we're going to talk an awful lot about how we hear at Integrations Treatment Center, under the auspices of The S.U.C.C.E.S.S. Approach (sm) , understand and define behavior.

RICH:
Alright, so we're going to jump right into our message today, which really speaks to behavior in a different way than we might be used to hearing about behavior. And it's a beautiful process through The S.U.C.C.E.S.S. Approach (sm) . And as we kind of wrap up our conversation of what The S.U.C.C.E.S.S. Approach (sm) is with this episode, bear in mind that we'll probably be working on a synthesis episode next -- just to kind of bring everything in and tie it up with a nice little bow to present to you guys. And then we're really excited about some of the content that's going to come up this season as we take The S.U.C.C.E.S.S. Approach (sm) in a fundamental view of how it might be utilized in a given situation. So we're really coming up with some cool stuff for Episode Two, but before we get there, let's talk about behavior.

LYNETTE
So, a lot of people think behavior is a bad thing. It’s gotten a bad rap when we say the word behavior, but if we think of behavior as a response or something we see a response to a stimulus again, if we think scientifically, it kind of puts things in perspective. And so at least at ITC and at least to an occupational therapist, behavior has a lot to do with how we meet the demands of the environment or respond to the demands of the environment. And it has everything to do with function. So how we behave and respond really is related to function. How we do or don't function. So I'd like us to kind of be challenged to think about behavior, but we really can't think about behavior without the concepts and the terms of function and performance. So we're going to be hearing a lot about function and performance in today's episode. And I think we're going to be surprised that behavior is more than just a response. And here's why. So, first of all, in my class, and The S.U.C.C.E.S.S. Approach (sm) training program, we visit the history of behavior back from Skinner in the 1950s to Pavlov many theorists between their initial coming into the field of psychology, those two, and now so there's a lot of years covered. If you think about the ‘50s, and here we are in 2021.

RICH:
It's crazy. I mean, you talk to some people and think, the 1950s was yesterday, and it really it's been a long period of time.

LYNETTE:
And in that time, the amazing thing about behaviorism, is that it's kind of grown, the technology is vast, completely vast. Whereas some people think it's just punishment. It's so much more than punishment and behavior is very complex, I would say in terms of methodologies, and the technologies, some of which we might learn about today. So when we talk about behavior in terms of Integrations Treatment Center and The S.U.C.C.E.S.S. Approach (sm) , we need to talk about and define function.

So, function can be defined as the why, or maybe the “what” behind what one does, meaning the purpose or the intention behind the behavior. So if you think about that, the reason or the purpose behind behavior, it gives us something to assess, something to wonder about. Whereas if you just look at the behavior, we tend to fall as a society, at least in America, into the trap of assessing it in the sense of good or bad, so we cast judgment on it. We place judgment on it.

RICH:
Almost like triaging a situation, as opposed to stepping back and reflecting on the cause.

LYNETTE:
And the function. Exactly. So when we start to shift that focus from “He did this and it was wrong” or “She did this and it was bad” or that word maladaptive. We have to stop thinking in that moment and go back and say, “But why did they do it? What function was served by it?” So we have to think of function. So whenever we start talking about purpose or intention, or function, we have to be thinking about the brain, and how this is a cognitive thing. We have to think about the function; we have to know and understand the function, we have to be intentional. So when we think about that, and the cognition or the thought behind the function, it allows us to see deficit, so remember, like I said, many episodes in a row, autism is a brain-based problem. It's a neurodevelopmental brain-based problem. It impacts behavior, but in itself, it is not a behavioral condition. And so if we take that cognition out of it, so if function has to do with purpose and cognition, and we are engaging in the behavior as humans do, of raising our hand to answer a question, then the purpose or the intention is this gesture, means I have something to say. That's the meaning behind it. If we take that out, we take cognition out, or intention out, we’re basically left with a motor performance, just an act of our body, a movement of our limb. And the point in expressing it that way and giving that example of raising your hand, is because there are a lot of kids out there who, and in an analogy kind of way, are raising their hands and don't know why. So they have learned a motor act. They've learned something that is a performance skill. In the model of human occupation, if you remember that we talked about that triangle of performance, the very base of it is motor skills. So the child has the motor skill to raise their hand. They do raise their hand, but do they know why they're raising their hands? Right? So it's one thing to put a child in an environment and have them understand the value of raising their hand as a gestural cue: I have something to say. And it's another thing to put them in an environment have them raised their hand just so they fit in like everybody else.

RICH: 10:04
So, their reaction to that is, is natural because their body is responding to the way they're feeling, but our reaction to the behavior needs to be strategic in a way that we're assessing what's causing

LYNETTE: 10:17
it. Yeah. And that in that sense, we're talking a little bit about behavior that might be maladaptive that we have to understand, but an important thing to know about behavior, and it's good that you put it out that way. It can also be adaptive raising your hand is adaptive. Kicking up here is not, right? And so we want to ask the question, because it's important to answer it. Why does the child raise their hand to answer a question, and why does the child kick? There's reasons to both. One is very positive and functional, and the other might be perceived as maladaptive. And but they both had a reason behind it. And they both involve performance. One was the upper limb and one with the lower limb. And so if we look at the function of the first, raising the hand to answer a question, it is a motor act, but it's a motor act - only engage - the brain only engages in that task when it ties it to function and cognition. And knows this is what I do when I want to express an answer to the teacher. For the child who's kicking, they may be not be so thoughtful, they may not be so intentional, they're probably more reactive. And remember, a behavior is nothing more really nothing less than a response to a stimulus, right. So if somebody agitated that child, that's the stimulus, right? And the reaction is the kick. Well, the child who raised their hand had a stimulus to it was a little synaptic light bulb that went off that said, I know this answer, right. So they both have reasons and triggers as to why they do it. And we tend to as a society, especially in America, worry about or attend to, or notice more, the maladaptive behaviors, but both have reasons and I think we need to start pointing out to our kids and to ourselves, and to our, our fellow team members on the child's team, the teacher, the principal, the gym teacher, the bus driver, whoever it is, that's part of this team, that this child is doing a lot of things that are good all day long. They are raising their hand when they know something they're opening the door for a teacher, or they are getting their lunch when they're asked to. But when something pushes them beyond their capacity, they might also kick. So the kicking is probably out of all those behaviors, the thing that's going to get a teacher's note sent home, or a parent's going to get a call or a parent's going to be embarrassed in a store. It's not just teachers that store these things. It's our parents too. But our kids are doing a lot right all day long as well.

RICH:
It could be a response to maybe a feeling of fight or flight too.

LYNETTE:
Absolutely. So we're going to hear a lot more in our successful synthesis session of the seven pillars of The S.U.C.C.E.S.S. Approach (sm) and how they work together. And some of those are sensory and some of those are behavioral as well.

RICH:
So tell us a little bit more about this process of behavior and how it's connected with treating autism with The S.U.C.C.E.S.S. Approach (sm).

LYNETTE:
Okay, so one of the most common things families ask us is to undo, undo a behavior that's developed. And I noticed when families ask that of us, they're wanting to undo behaviors that the child has learned or performed, even been encouraged to perform, that don't have function. And so this might be what people consider a rote behavior. So they're doing something without true knowledge of what it means or they're doing something without function or purpose. So we tend to call that rote, which kind of means automatic or almost without thought. And so an automatic performance or an act, well, that sounds like great, good. You want to do things automatically, if it's not tied to meaning then it's, it's a void. It's just a performance of a, of a movement or an action that isn't tied to life is just tied to performance. And that gets us in trouble. And we sometimes as a society, don't know the difference when we're watching a child with autism, or watching a child with autism or an adult with autism. We sometimes think that because the child does, he therefore knows, and it's a very, very big trap and a big mistake. But when parents come to us and want us to undo these automatic responses or these rote behaviors, we have to do what we call disassemble. And the challenge and all this as we're trying to disassemble these behaviors is that the brain of a child with autism is like a steel trap memory, as we all know, those of us who live with and care for kids with autism. And so once an experience or an activity or a task is done or performed or the child engages in that, they can't help but make an association. The parts of their brain that make association work really, really, really well. And unless and until the value or the meaning or the purpose of that action is really made salient for them, they won't tie it in that association.

RICH
And that’s the forming of the schemas that we've talked about, right?

LYNETTE:

That's exactly right. So it kind of goes back to information processing and Gestalt learning style that we spoke about earlier, in our earlier episodes on info processing, and it comes up in behavior. So this is why The S.U.C.C.E.S.S. Approach (sm) is what we call “synclectic”. And again, we'll talk about that in a synthesis session. But there's so much overlapping of these pillars, but it's difficult to tell a family, “We can't treat it without disassembling it.” Because that sounds like we're going backwards to that. And I get that and in a sense it is. But depending on the age of the child, Rich, I told you it's many times like peeling back the layers of an onion. And the older the child, the more layers.

So I remember very distinctly the twins, the parents of the twins who I made a movie about called My Hiccups Are Gone. That's a wonderful family from Texas, the Brooks family. The Brooks family came to us and said. “They [the twins] are just wanting to push their buttons on their iPads to watch this particular show. Over and over again. Or they just want to play this educational song over and over again. And so the exposure that these twins had in their previous programming used iPad as a reinforcement, as a reward when they would behave certain ways or perform certain ways. And so they got very good at using the iPad and pushing little buttons to play their little videos and things. But it became, it just overruled the child's consciousness, and they just wanted nothing but it. They became basically addicted. And so the mom said, “Please undo what we have started because it's ruling everything. We can't get them to bed at night. They won't stop to eat, they won't they cry and have a fit every time we try to take the iPad away.” And so unfortunately there's nothing wrong with the task of using an iPad or using your finger just to hit a button on an iPad or a screen. There's nothing wrong with that, per se, but because the value to the child wasn't the instructional lesson or the educational song it was the sensory component. They were missing the content of the little educational lesson that they were supposed to be getting. And they were not getting the educational pieces of the song. They were just experiencing the sensory and we know that because when we watch them, they would become very dysregulated and flap their hands and bring the iPad very close to their eyes will be called sighting behavior. And so they weren't like singing along and building the content or talking about the content with their parents or replicating the content when the iPad wasn't on and if the iPad had blocks in the lesson. They weren't finding blocks and replicating it. They were only interested in the screen and the audio that comes with these audio visual tools.

And so to disassemble all of that, we had to first ask the question that almost nobody asks. It’s the question why? So I will tell you that the brightest families and the most insightful interventionists are professionals will always, always, ask, “Why does the child behave this way?” But sadly, the number one question I get from families and some professionals as an autism specialist is “Dr. Lynette, what do I do when my child does this or that?” So they want understandably, the fix. But I just warned us that we're not ready for a fix if we don't first understand why. So if you try to fix something without knowing why you do things like Leslie Brooks did, in my movie, she took the iPads away, and the kids would have a meltdown. And so you can't try to fix something without understanding it. I understood that it was a sensory need. That they were meeting. And it was quite addictive. And so they had this experience of doing it over and over again. And it also as a developmental specialist hit me that if they're spending all this time on videos, and iPads, what aren't they doing? They're not doing play. They're not rolling down a hill. They're not digging in dirt. They're not jumping in puzzles. They're not building towers, they're not doing puzzles. They're not mixing paint with glue and making some fun project. That's what they're not doing. So they're not developing, in essence. And so by giving them opportunities without the iPad present to build those skills, they had other schemas, other ways of behaving, other ways of performing, other ways of interacting with the world, and that became valuable to them, as it does any child. So this is what we have to try to understand. Where the behavior is coming from, or why it exists, and how to disassemble it and then reassemble - build back in all the skills and things they need - to be able to flourish as a fully developmentally appropriate child or fully developing child in the right kind of age matched category for how old they are.

RICH:
As human beings that stands to reason we don't think of ourselves as something as functional as a robot. You know, if I'm working with a robotics team and something's not working, we have to sometimes tear it all apart and figure out what parts aren't functioning together in order to rebuild it back better. And it's no different than a neurological function for a human being.

LYNETTE:
You know, one of the things that is so important to also ask when we think about how we're impacting those human beings is: What part of the puzzle am I? Do I have anything to do with a child raising their hand? Do I have anything to do with the child kicking in front? The answer might be yes. Now in the first example, raising the hand, some parents, some teachers, somebody along the way, helped them know that that was an acceptable behavior when you have an answer to give. And while it wasn't necessarily taught to kick a child, the parent didn't go and say, well just kick somebody when you're mad. How the parent handles that can be the very fine line determinant of if the child's going to do it again, or if they're going to not do it again. So I think what's an appropriate thing to turn to now is our role on impacting behavior.

So I have an interesting story to share with you. But in order to explain it, I have to give you three terms of behavior. Or three terms common in the field of psychology and behavior. And those terms are 1) antecedents, 2) behavior, and 3) consequences. So these components are interrelated. So an antecedent is a fancy name for “trigger” and the trigger is what happens before the “behavior” and then the behavior, the response to the stimulus or the response to the trigger. And that's the B -- ABC -- and the C is “consequence”, what comes after the behavior. So that's the relationship it's very linear ABC. Trigger, Behavior, Consequence. And as I think about good ways to explain the dynamics of this dynamic trio, if you will, and the inner relationship it calls me back to a time when I was asked to consult in a school and to do a school consultation observation. So there I was in the school and I was called in because the child had behaviors that they call a flight risk. So that means that they tend to run or elope, is another term in the field. So, he at the time was five this child that I observed and he would elope around the same time every day. And obviously, there was a trigger to that behavior. And I was observing the child before he ran, and then I observe the child running. And then I observed how the child was handled and how the episode was handled. And the trigger is not the most important part of the story, believe it or not, it was an expected trigger. It was circle time, he was asked to come and sit. He couldn't sit because of sensory issues that I saw right away as the OT, but the aid and the teacher didn't recognize understandably, and so had this child that have a sensory issue, they probably could have sat next to Long Locks Lucy and in between, you know, Happy Hands Henry and have that sensory load on him, but he couldn't; and so at some point, long before I went there to observe, this child got used to running out of the room, and he ran out of the room. And down the hall and out the parking lot. This was the concern. And so the aide, who was responsible for him, would take off after him. He's charging down the hall and the whole time, he's looking over his shoulder a big grin on his face. She's running as fast as she can, this huge dynamic, and I'm thinking witnessing all this. Oh, my goodness, this child's going to get hit in the parking lot. I can see the outcome. It's happened lots of other places, lots of other times, as one called and so often to do consulting and help kids “behave” quote unquote, whatever that means in the classroom. And I thought this could be a real disaster. So the aide finally caught up with him at the vestibule literally about to go into the parking lot.

And so in that little analogy we have trigger is anticipation of being in circle time. Behavior is running true flight out the door with a little bit of behavioral, cattiness if you will cat and mouse-iness, and then here comes the consequence. Okay. So she gets the child. She picks the child up. Kind of puts the child a little bit at her shoulder level laying down and goes like an airplane [airplane noise] all the way back to the room. So with that kind of a response from this aide, who was desperate, didn't want the child to get hurt. Didn't know what else to do. Probably tried reprimanding 1000 times and it just didn't work because no one fixed the trigger. There’s a clue. This child literally was practiced. And he was accidentally -- because airplane rides down a long hallway back to the classroom are so much fun -- one would say when analyzing this, that it's quite possible that he was actually reinforced, or rewarded to run, and that that becomes the antecedent next wanting that joy, right? Even if they don't go to circle anymore, even if that original trigger isn't there. You've reinforced, you've taught the child by what you did -- and what you didn't do -- that coming back to the classroom after running in that way is fun and desirable.

So of course, she didn't mean to teach this, but the first thing I suggested is that we analyze the relationship between the trigger the behavior itself and how it was handled, or what we call the consequence. And so that's just a little example of how those three terms in the field of psychology and behaviorism are applicable.

RICH:
You know, I mean, sometimes that's hard as a parent or as an educator, and me having experience in both, I've seen both sides of this, realizing that we could be part of that situation in terms of being triggers for that behavior. And it's hard. As an educator to say I may be part of that problem.

LYNETTE:
It is hard. I’ve got to hand it to you for saying that, such an honest statement. It's hard. No one wants to be the cause of anybody's hardship. But here's why you should give yourself grace. If you're thinking this out there and listening to this, give yourself grace that it's, yeah, it's hard but don't beat yourself up because of this. These children have a gestalt learning style. And so they struggle very much to generalize concepts, and so you don't sometimes assume that they're going to be able to generalize and understand and that they have true, deep understanding and semantic knowledge of what you're saying and what you need from them and their expectations. But they don't. So you only kind of learn that the hard way. Now most children do have the capacity to generalize and build their skills based on experience. They take an experience, they learn from it, and they carry it to the next opportunity to do that same thing again, and our kids really don't once they have experience because their cash outlay is down. It's like a steel-trap memory and it is locked in there. So really, the emphasis needs to be on making sure that what gets in, gets in well, and gets in right. So all of the efforts of The SUCCES Approach are to manipulate what we call the antecedents.

RICH:
And don't be afraid to use that why, I mean, I tell educators all the time that why is part of reflection, and we always say reflection is a big part of education, as a parent too, you know, stepping back and saying, “Well, what could I have done better?” Like that's the best part of what we do is to say I have another chance to try this again.

LYNETTE:
That’s right! What a great perspective, I have another chance to try this tomorrow, or in five minutes from now, as the case may be. Knowing what you have to get in in that five minutes or what you have to get in before tomorrow, is the insight and the knowledge and that's where the class comes in. Giving us the theory and the insight about how these children's brains are wired. This is not a choice. These kids are not waking up at 7am and saying, “At two o'clock, I'm going to run down the hallway!” They're not. They're not that intentional. If they were, they would not have autism. They're not that deliberate. So these associations they are building, and how we are or are not responding to them, is what drives them to do it again or not.

RICH:
Wow, this is a lot to take in from just that little tiny piece of The S.U.C.C.E.S.S. Approach (sm). But I agree with you. I mean, I think that's the beauty of The S.U.C.C.E.S.S. Approach (sm) in general, is just being very strategic in the way that we work with those individuals, and really kind of assess how we can be a part of that success story for them.

LYNETTE:
Literally and figuratively. Absolutely.

RICH:
All right. Well, we'll come right back with Dr. Lynette's challenge for this episode.

LYNETTE:
So today's challenge is to look at your loved one, your child with autism, or your student, as you're serving them. And as you see a behavior ask yourself, what might be the trigger? Why is this behavior happening? What caused it? And take it one step further, and jot down your answer and then watch for that behavior again. And repeat the same exercise. You'll start to see what we call a profile, a profile of what is triggering the child. And once you have that information, you can bring it to the resources you have, hopefully, the least of which is an occupational therapist, who can help you know what to do about the profile you've revealed.

RICH:
Okay, as we wrap up this episode on behavior, I mean it is it has been a powerful episode and I'm just going to give you my summation of what I think I've heard today and that is the power of reflection, taking some time to really think about what our role is in the things that are going around around us, and what might be eliciting that response in the behavior that we're seeing. How would you recap this episode today, Dr. Lynette?

LYNETTE:
Well, I would remind ourselves that behavior is sometimes nothing more nothing less to a stimulus and there's lots of stimuli out there for us all to have responses to so we're always behaving; and that not all behavior is bad. There is adaptive behavior and we need to credit our kids for having it, because they have it a lot, and that sometimes goes unnoticed. And if there is a maladaptive behavior, something that isn't ideal, there's a reason why it was triggered. And so we need to be honoring the triggers and try to manipulate those triggers, so that the behavior never happened. That is in my professional opinion, the best way to apply behavior principles.

We hope that you learned something today to help you on your journey with autism. We'll share more on our next connect with success podcast. Until then, expect success.

RICH:
The S.U.C.C.E.S.S. Approach is a registered service mark protected under intellectual property law. Unless otherwise specified, all music, audiovisual and proprietary content shared in this podcast is property of AWEtism Productions LLC and its sister agency Integrations Treatment Center. Use of this content is unlawful without the expressed written consent of aforementioned agency. For more information about THE S.U.C.C.E.S.S. Approach, Please go to our website atwww.thesuccessapproach.org.

For more information about The S.U.C.C.E.S.S. Approach (SM), please go to our website atwww.thesuccessapproach.org.

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Behavior & Autism

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