This PowerPoint slide show was used in one of Dr.

Macs workshops
regarding youngsters with PDD (Pervasive Developmental DisorderAutism,
Aspergers Syndrome, etc). Certain notes slides (like this one) have been added
to help to explain the slides.
Understand, however, that there was three hours of narration accompanying
this slide show. The notes provided will certainly not provide the detail and
explanations provided during the workshop.
There is also a code to running the slide show. The slide show will run by
itself unless you see a red or green punctuation mark. A red question mark,
colon, or period indicates that the show has stopped and that you must click
your mouse to continue. A green punctuation mark means that you have
reached the end of the material on a particular slide. You must left-click on
your mouse to advance to the next slide. (click to advance to the next slide)

Defiance
(failure to comply)

from Kids with Pervasive

Developmental Disorders
(Autism, Aspergers Syndrome)

Understanding It, Assessing It, &

Doing Something About It
(in effective, respectful & professional ways)
Tom McIntyre, Ph.D., www.BehaviorAdvisor.com
.

Our Kids: A Review

is IT that brings out

autistic-like actions that
kids display

What

the
our

Demanding sameness
Displaying odd rituals
Stimming (self stimulation actions)
Uttering impolite remarks
Resisting assistance or direction
Refusing to comply
Aggression against otherspush, bite, hit, kick, grab hair, etc.
Self abuse
etc.

ITS ALL ABOUT

A N X I E T Y.

Anxiety? From What?

Life being experienced as

a series of random events.

The student remains in a heightened state

of tension and alertness, not knowing what
might happen next.

Unlike most youngsters, our PDD kids brains are

unable to:

organize the world effectively

learn quickly from experiences
recognize repeating patterns in life.

Life is uncertain & its happenings unpredictable .

Unstructured environments, and adults who are
emotionally unpredictable, add to our
students problems with organization.
Stress develops from being unsure of what will
happen next & defenses against the building
anxiety are employed.

Which Common Traits

(the appearance of which lead to the diagnosis of PDD)

Make Them Prone To Stress?

Difficulty interpreting events accurately

Difficulty adapting to change
Limited ability to self soothe
Limited expressive language to tell us what
they are thinking & feeling.
Limited receptive language skills to make
sense of the words spoken to them .

Life as a Series of Random Events

Imagine that youre the rat in a shock box, a walled-in floor with a

center line dividing the two halves.

You move across the center line of the box to other side when youre
electrically shocked on the side where you were placed. Youre certainly
on edge and wary after this event (and subsequent shocks to whatever
side you are currently on), but your coping strategies allow you to escape
punishment and continue functioning well .
Imagine then an electrical shock periodically and suddenly administered to
your side. Sometimes you can escape to the other side of the box. At
other times, the other side is also electrified. Might you develop odd rituals
(much like some sports professionals who engage in certain actions previous to
engaging in the event), withdraw (just like some rats that give up trying to

figure out the system, lie down, and endure the pain), and/or strike out
at the approach of others (because were tense, afraid, and unsure of their
intentionsespecially when they react differently at different times ).
Sorry for the comparison, but were mammals too, and react like others of
our ilk.

Rats & Other Mammals (Like Us)

Odd reactions are best understood as an

expression of the fight-or-flight dynamic in the
face of a threatening situation.
(real or imagined)

Inconsistent environments create confusion

and anxiety which lead to:

Agitation
Aggression
Ritualistic behavior & other ways to withdraw from
the real world.

Reactions to This
Granite Planets
Shock Box

For psychological defense in the face of profound

anxiety (caused by randomness), our PDD kids:

Retreat into isolated worlds of fantasy or

soothing self stimulation (rocking, chanting, head banging, fingerplay)

Aggress toward themselves or others

Perseverate in soothing rituals, adhere to

rigid rules of behaving, or turn conversation
to favorite topics.

Antecedents To Fight-or-Flight Responses

Unfamiliar settings/experiences

(even if nearly identical to one with which they are familiar)

Experiences in a familiar environment that are

inconsistent with the students expectations. Like?

Same-time exposure to multiple familiar stimuli

New bulletin board, student, or seating arrangement

Asst. teacher didnt park his/her car in the usual space .
Former teacher visits the present classroom
What else?

Intermixing of reality and fantasy worlds

From subtle magical beliefs

(Its only safe to drink from red smiley-faced
cups.) OTHERS?

To gross auditory and visual hallucinations.

Shutting Out This World

What benefits result from using social isolation ?

Cuts off overwhelming anxiety and confusion

Unfortunate consequences to withdrawal?

Undermines caretakers ability to gather information

from youngster that would help us to understand the
situation and respond effectively.
Allows the student to ruminate in his/her own confused
thoughts without input from others to help him/her
perceive reality more clearly.

Purposes of Aggression?
Protection

against a (perceived) threat

Make the source of anxiety withdraw.

Obsessions, Rituals & Stimming

Can be personal quirks or major interferences in ones life

What are some common rituals seen among your
kids with autism, Aspergers, and other PDDs: ????

Head banging (to sooth oneself after being touched softly by you)
Rocking
Finger play
Repeating verbal utterances
Turning all conversations to topics in which one is learned/interested
Rigid adherence to idiosyncratic rules
Required procedures for setting the stage.

Linked to a neuro-cognitive tendency for perseveration

(locking into a repetitive thought or behavior, like a skipping record) .

Purposes of Repetitive Behavior?

Familiarity is soothing and self-reinforcing

(Although the actions may also have been unintentionally reinforced by others)

Rituals give a sense of:

Accomplishment
Mastery
Safety from anxiety
Security
Control over a situation.
Extreme things that many normal people do might include:
Vacuuming several times a day (keeps the environment looking
unchanged)
Excessive care of pets (one feels worthwhile & nurturing when
treating the animal like a child in ones care)
What things do you return to that give your solace, comfort, or sense of
accomplishment?
Re-read a book, watch a movie again, visit familiar places
Me: At night; visit with daughter and wife, watch West Wing on TV
with glass of wine while holding hands.

Surrounding the sleep experience, this infant

experiences the same routine (just like there are
routines for dressing in the morning, preparing to enter
the car, preparing for a meal): Soft piano music, reading
of a book (or two), singing Good night ladies, and a
kiss goodnight. Accompanied by the same loving
statement. Awakens to the Good morning song and
tour of house (in the same order of rooms as the
previous day).

Routines & consistency give kids comfort in a

world that can seem random. It gives them
respite from trying to comprehend the what they
experience.

General
Reasons for
Defiance in Kids
with PDD?

Misunderstandings due to a
weak ability to organize lifes

Misperceives the situation:

Misinterprets approach as having hostile intent

Displays inappropriate behavior because of difficulty
generalizing what has been learned about the world and
appropriate behavior to similar settings/events

OR has formed rigid models for understanding how

the world works

Exceptions to their expectations, even minor discrepancies

Produce anxiety
Bring about the fight-or-flight reaction

Because They Are Confused

& Uncomfortable

They remain in a constant state of hyperarousal to possible threats

OR
Retreat (when overwhelmed) into social
isolation, rituals, or a fantasy worlds in
order to minimize confusion, obtain
comfort, and limit his/her psychological
vulnerability.

Show Time!
In this video clip, imagine that the student has a form of PDD

Phil is a kids with Aspergers Syndrome.

In this situation, what is the stressor?
How does he react to the anxiety?
How might teachers other than this one react?
Unproductively
Productively

How Anxiety Due to Randomness Affect

STAFF Who Work With Kids With PDD
Because our students react in unpredictable

ways, we have a career equivalent of a

shock box.
We experience random reactions to our
interventions, often developing strategies
similar to those of our students.

The Staffs Shock Box

Student actions seem inexplicable, unpredictable,

personally charged, or random. Student behavior
may be viewed as a threat (to our authority,
professional self image, physical safety). We often
respond in shock box ways to the random or
threatening environment (just like our kids react to
these stressful circumstances).
Hostility (verbally or physically)
Rejection (refusal to work with the student)
Flight (pull back or leave when feel ineffective/threatened)
Withdrawl (avoid approaching students who cause us pain)
Odd rituals to prevent behavior or make it go away
(because it worked once or twice before).

? What are some examples of:

Staff hostility when agitated?

Withdrawal when unable to influence the situation?

Angry words
Physical attack (pinching, pushing, restraining)
Threatening postures/gestures/facial features
Punishment without instruction in how to behave in new ways

Ignoring/walking away from head banging

Failing to intervene in a developing situation because of uncertainty
as to what to do (or fear of experiencing professional pain)

Ineffective reactions/rituals to unpredictable situations?

Telling a student to Be good. or Be careful.

Rituals (holding up finger to warn to stop, saying Dont be getting all huffy
now.)

So What Do Responsible Staff Members Do?

True professionals are in control of their emotions.

In stressful situations with students, they stand
back and say to themselves:

Here is a kid in crisis who needs help. What would a

caring and competent professional do in this situation?

We need to be consistently calm, gentle, and

supportive in our interactions with kids with PDD .
Staff members who become irritated or skittish
create a non-consistent stimuli (a shock box) for the
student with PDD.
Consistently calm, gentle, and supportive staff have
their effective interactions sabotaged by colleagues
who are unable to manage their emotions well .

Effective Staff Demeanor

Emotionally, verbally, and physically calm &

consistent (inter)action, even when under stress.
This consistent, restrained approach reduces
anxiety in the student, and thus the likelihood of
inappropriate behaviors.
However, the chances of us engaging in (continued)
inappropriate, unprofessional, & ineffective
behaviors are increased, unless we search out:
New models for understanding our students
Better intervention strategies for reducing
and handling stress.

We are calm and tolerant of young children because we realize that

they are doing their best to function and communicate given their
developmental level.
As professionals, we are paid to be tolerant, supportive, and
nurturing to youngsters who are doing their best, under difficult
circumstances, to function and communicate. Consummate
professionals do it because they believe that all individuals are
deserving of dignified & respectful treatment.

Is it defiance? What common traits

might account for these behaviors?

In a staff members absence, the student refuses to respond

verbally or give eye contact to the replacement person (substitute

teacher, supply teacher, person from other part of facility).

(Withdrawal from overstimulation; Not yet done with a ritual when the new
staff member intervenes)

Laughing at others misfortune.

Your direction brings a destruction of materials or self abuse .

(Receptive language problem; Literal interpretation of your language

Whats shaking?)

Refusal to sit down immediately upon entry to room .

(Misinterpretation of an event; paranoid thinking that others are

conspiring to harm him; Your voice and image were distorted by an
hallucination and was threatening to the youngster)

Looks at you blankly after your direction or question .

(Unusual affect found in kids with PDD)

(The direction is contrary to the youngsters ritual of touching all handles

on drawers before sitting in an environment)

Barks rude order at you.

Interventions

Any attempts to replace anxiety-reducing behaviors

must involve:

Assessing the circumstances surrounding the behavior in

order to determine the?

stimuli, reinforcers & other variables that contribute

(see www.BehaviorAdvisor.com page titled Figuring out why kids misbehave & FBA)

Reducing ___________in the environment?

Building a ______________ relationship with student?

unpredictability (via consistency which reduces stress/anxiety).

a supportive & trusting (see www.BehaviorAdvisor.com page titled nice ways).

Teaching alternative behaviors that do what?

serve the same function in a more socially acceptable manner

(see www.BehaviorAdvisor.com page titled Differential Reinforcement.)
.

Questions to Ask Before Intervening

Is the anxiety-relieving behavior

Quirky and socially odd, but non-harmful? Examples?

Rocking
Turning conversation to a favorite topic
Repeatedly asking questions without having listened to the
responses of the previous ones
Uttering repetitive phrases

Debilitating enough to justify denying it to a student with

limited adaptive capacity to develop alternative useful
strategies. Examples?

Self-abuse
Physical aggression directed toward others

SHOWTIME : A VIDEO
Your students have been given the task of . . .

and you notice that one young lady is off task.

What might be the reason for her behavior?
What setting events and stimuli might have
sparked the behavior? What consequences
maintain this behavior?
Behaviorist view: All behaviors have a benefit

so what is it in this case.

Our Continuing Role(s)

Identify the often counterintuitive, highly idiosyncratic

dynamics driving many of the problematic behaviors. Create
environments that are?:

Scan new environments for?:

possible sources of change and stress.

Be attuned to early indicators of students quality of thought

and affective state, because?:

highly predictable, so they dont require kids to use own internal

resources to create structure.

if they get anxious, their ability to think and learn is impaired.

Chances for defiance increase.

Apply support early. Once agitated or confused, it is often

difficult to calm the student.

Discovering Counter-Intuitive Dynamics

Conduct an Environmental Assessment

A-B-C and FBA for sources of stress (e.g., transition, new staff member)
for lower functioning (its one part of analysis for higher functioning)
(see www.BehaviorAdvisor.com pages by these titles)

Is the soothing rituals quality more kinesthetic (movement oriented) as is

likely with low-functioning kids, or more symbolic (need to touch drawer
handle in room before sitting) as is more typical of high-functioning
youngsters?
For higher functioning kids, follow the E-A with psychological testing and
analysis of the childs inner experience to determine the quality and
character of the:
thought processes
affective profile
Determine if the child in need of medication for?:
anxiety disorder
distractibility (see www.BehaviorAdvisor.com page titled ADhD)
hyperactivity (see www.BehaviorAdvisor.com page titled ADhD)
depression (see www.BehaviorAdvisor.com page by this title)
psychotic thought processes

Scanning New Environments

for Possible Stressors

How would you prepare students for a trip to the

firehouse so that it is a familiar experience when
the day arrives to visit?
Consider the students knowledge base,
transportation, familiarization with the site and
equipment, preparation for frequent events at the
firehouse, & preparing the student to handle
anxiety if it develops.

Field Trip Prep

Mark on calendar 7 days in advance

Review on calendar each day
Show photos of firehouse & ask to draw what he thinks it will look like
when visits.
Meet bus driver. Visit bus on day before to?
Select a seat
See where teacher and others will sit
Look at map of route & identify things will see on way to firehouse.
Have students draw them.
Describe what will probably be seen at firehouse.
Discuss rules for behavior in this unfamiliar setting
Discuss events that might happen while there (emergency call, jovial humor
uttered).

Discuss what will do if feel anxious or confused.

Who to tell about the emerging and escalating feelings

How to express them.

Review the plan several times prior, and again before leaving. Give
students a copy of plan (pictures/words)

Building Student Capacity to Accept

& Seek Out Our Support

Trust and reliance upon relationships during times of stress

depends on matching the student with skilled, caring, and
persistent professionals who create a predictable environment.

How can we reach the goal of becoming an empathetic & trusted

guide?

Build a history of positive interactions/events

Even though making mistakes, believes were trying hard
Be predictable by being:
unswervingly calm, positive, supportive, understanding & nurturing
Create a symphonyget everyone on the same note on the same line of
music
Realize that disallowing an established strategy is generally
a slow, difficult, and to some degree, traumatic process.
Be highly attuned to the students emotional state so that we
are there when needed
Speak in an effective and positive manner.

Building & Maintaining Relationships:

The way we talk to kids is important

Right now, pull the

Nice Ways
packet out of your folder
(for those of you viewing the slide show on your
computer, this material can be found at
www.BehaviorAdvisor.com inside the page titled Nice
Interventions that build self discipline in kids )

Trading In Old Behaviors for New

Use our understanding of the student and the

stressors, and the inappropriate rituals soothing
quality to identify possible alternative responses.

Teach new soothing behaviors while reducing

the inappropriate ritual through
strategies such as negative consequences
or removal of reinforcement.

Teaching

Visit www.BehaviorAdvisor.com and check out the links titled:

The practices of ABA (8 links under this section)
What is ABA? (Applied behavior analysis)
Contracts
Differential Reinforcement Procedures (reducing misbehavior in positive ways)
Overcorrection
Response Cost
Schedules of Reinforcement (Deciding how often to give rewards)
Self monitoring (Students keep track of their behavior, thus building self-control)
Shaping (Building a desired behavior that the student doesn't show at present)
Task Analysis
Time Out
Token Economies and Point Systems
Managing behavior with your teaching style
Autism
Aspergers Syndrome

Take a look at the handout youre about to receive that will offer lots of
tips for various scenarios.

General Principles for Intervention

Go

positive!
Punishment does not teach new behavior!

Use the least intrusive intervention possible.

Be predictable. Always follow through.
Hate the behavior, but stay attached to the
child.
NEVER give up on a kid.

The Future (at present)

Our kids will live their entire lives within the

supportive structure provided by others.
They measure the quality of their lives by their
capacity to obtain security and remove fear.
That optimal state is largely influenced by the
ability to accept and trust in the support and
structure created by others.

THE END
Feel free to contact me at
Thomas.McIntyre@Hunter.cuny.edu
And check out www.BehaviorAdvisor.com
where you can post your concerns on our bulletin
board and receive help from teachers around
the world.

Stop Here . . . . Unless time

remains in the session. In that
case move on to Social Skills

Assessment of Social Skills

Assess adaptive functioning

Capacity for appropriate social behavior

Ability to manage social anxiety
Understanding of social conventions
Ability to read social cues

Capacity to use relationships as a source of

emotional support

Social Skills

Facilitate their ability to establish an accurate

perception of social behavior. How so ?

Provide consistent and simple patterns of social

experiences from which to learn.
Create school environments in which social
interaction is predictable, consistent, and
governed by explicit rules.

Once established, promote the students

effective use of this understanding to make
decisions with the social arena.

Examples of Social Rules

(consistently applied and reviewed often with the student)

Hands, feet & objects to self

(unless part of activity or have permission)

Use only the real names of others

Ask permission to touch the food & belongings of
others
Raise hand and ask permission to leave seat
If another kid is having a difficult time, inform the
teachers and let them handle things
If you are feeling upset or angry, ask the teacher for a
time out or a chance to discuss the problem

So Why the Refusals or Retreats?

Manage anxiety from

Task complexity or volume

Situational inconsistencies
Staff (re)actions
Misinterpretation of student behavior

Take it personally
Unable to handle

Student perception of staff intent or threat potential

Misinterpretations of intent
Accurate perception of rejecting or hostile action

More Questions

Have we conducted an analysis of the childs

environment to correlate inappropriate ritualized
behavior with specific events or environmental
dynamics? (Well need more than conventional perception or
empathic insight to determine the sources of stress when someone
views the world much differently than us).

Do we have a procedure/plan?(DR, Shaping, Chaining)

Do we have the necessary

permission
materials
staff