Effective Therapy for Managing Tantrums in Children with Autism
Parenting a young child, especially a child with autism spectrum disorder (ASD), will likely involve coping with tantrums. Tantrums are often referred to as “temper tantrums” but tantrums can have different causes and behaviors. Not all children with autism have tantrums; some may have different problem behaviors that indicate distress or discomfort. Tantrums can impact a child’s quality of life and cause stress and anxiety for the whole family, especially if tantrums are frequent. They can also pose a safety risk.
Applied Behavioral Analysis (ABA) therapy is considered the “gold standard” of treatment for autism because it is proven to be effective in developing a wide range of skills and behaviors, including behaviors to replace tantrums. This blog explains why tantrum behavior is associated with an autism diagnosis and how ABA therapy replaces challenging behavior, such as tantrum outbursts, with appropriate behavior, such as verbally communicating a need, to improve quality of life.
What is a Tantrum?
Tantrums are an emotional outburst that might involve a combination of challenging behaviors, such as crying, screaming, yelling, or behaviors that are harmful to others or themselves . Tantrums are often a way for a child with ASD to communicate what they want, be that attention, something tangible, or the need to be removed from or end an activity. A tantrum is a deliberate way for the child to express needs, wants,emotions, or bodily conditions.
Why are Tantrums Common Among Children with Autism?
Tantrums are more common among children with autism because the core features of autism i.e., difficulty with communication, socialization, and sensory sensitivities, leave them more vulnerable to feeling overwhelmed, frustrated, experiencing sensory overload, and being unable to clearly express themselves. Children with autism often have difficulty with emotional regulation, i.e., the ability to manage emotions in a way that is appropriate for the situation, which contributes to more frequent and severe tantrum behaviors.
What is the Difference Between Tantrums and Meltdowns in Children with Autism and Why Does it Matter?
It’s important to distinguish between tantrums and meltdowns in children with autism because the two behaviors have different underlying causes and require different therapy approaches. Distinguishing features of tantrums and meltdowns are as follows:
- Tantrums are a deliberate way for a child to get what they want.
- Meltdowns are involuntary and are usually caused by sensory overstimulation or difficulty with emotional regulation. A meltdown is a way for the child with ASD to cope and express distress with sensory issues.
- Tantrums are typically short-lived and are usually caused by a specific incident or situation.
- Meltdowns by children with autism tend to last longer, several minutes or even hours, and be more intense than tantrums.
- Tantrums occur in the presence of a parent or person who can address the child’s need/wants.
- Meltdowns can occur in isolation or with other people present.
- Tantrums can be resolved by giving in to the child’s demands, redirecting their attention, being comforted by a parent, or withdrawing attention to extinguish the behavior.
- An autism meltdown, however, has no transactional purpose and therefore the meltdown will continue until the child is taken out of the stressful situation or until all energy is spent.
- There are typically no warning signs that a tantrum is going to occur.
- Meltdowns for children with ASD are commonly preceded by warning signs. This can be as obvious as the child’s request to leave or be removed from the distressing situation, stimming actions to relieve anxiety, e.g., rocking, flapping hands, or actions to block the disturbing sensory stimulation by covering ears or running away.
Understanding the differences between tantrums and meltdowns helps therapists and parents develop appropriate strategies to support the child’s needs and promote positive behavior. Briefly, strategies to manage meltdowns focus on ensuring the child’s safety, reducing sensory input, providing comfort, and creating a calm environment. The child should be allowed to work through the meltdown in their own time without any pressure to respond to demands or requests until they have calmed down. Interventions for tantrum behavior is the focus of this blog and is discussed in detail below.
How does ABA Prevent and Manage Tantrums?
Overview of ABA Therapy
Applied behavior analysis (ABA) is a treatment approach for individuals with autism that uses the scientific principles of learning to systematically modify behavior. Essentially, ABA treatment first determines what is motivating the tantrum behavior, i.e., what does the child gain from the behavior. The focus then is on replacing tantrums with more reasonable, socially acceptable behavior. ABA therapy develops the new behavior in small, manageable steps. Positive reinforcement such as praise, tokens or small rewards encourages use of new behaviors in structured, intensive one-one therapy. Ultimately, the child learns to use new skills and behaviors in the context of daily life.
The ABA Therapy Team
A licensed, Board-Certified Behavior Analyst (BCBA) leads the therapy team. A BCBA is a professional who completed either a master’s or Doctoral level (BCBA-D) degree in applied behavior analysis and who is certified by the Behavior Analyst Certification Board (BACB). A behavior therapist works 1:1 with the child, under close supervision by the BCBA. BCBA’s often work with other professionals to support the child across various settings such as schools and clinics. Parents are crucial members of the team to the extent possible and are trained to help their child carry over new skills into everyday life.
ABA Therapy Process
ABA treatment plans are individualized for each child. However, every ABA treatment plan includes core elements described here.
The BCBA observes the child in their home environment and gathers data to determine what triggers the tantrum, the features of the tantrum and what happens after the tantrum – do they get what they want? Are they allowed to continue until they tire out? How a parent responds could unintentionally be rewarding the tantrum behavior. The therapist also collects information from parents and other significant people who can identify factors that influence the behavior.
Based on the assessment, the BCBA sets specific, measurable goals to address the whole context in which tantrums occur.
Example: Prevent crying at bedtime by implementing a consistent, predictable, 15 minute routine that helps the child transition from playtime to bedtime.
A strategy in ABA therapy is a specific approach to help a child with autism learn new skills and behaviors or reduce problem behaviors. Strategies are selected based on the individual child’s needs, capabilities and goals. Here are strategies that address the bedtime goal stated above.
Create a visual schedule: A visual schedule can help the child understand what is expected of them during the bedtime routine. Pictures or symbols represent each step in the routine, such as brushing teeth, changing into pajamas, reading a story and going to bed. A picture of playtime can be used to help the child understand when playtime is over.
Teach replacement behavior: ABA therapy techniques teach the child how to communicate without throwing a tantrum. To continue with our bedtime example, the child can use the visual schedule to request more playtime, either by pointing to the picture of “playtime”, saying, “I want to keep playing” or communicating through other modes available to them.
Shape new behavior by reinforcing successive approximations:
New behavior is gradually developed by reinforcing successive approximations of the desired behavior. When the child communicates their wish to play by pointing to the playtime picture, positive feedback and reinforcement is provided. For example, “Great job telling me what you want! Let’s finish our bedtime routine quickly and then you can have extra playtime tomorrow.” Ultimately, the child is rewarded for following the bedtime routine independently and using non-tantrum communication to express their wishes.
ABA therapy uses positive reinforcement to encourage and reward new behavior. Positive reinforcements include tangible rewards (toys, treats), verbal praise, or social recognition. A reward needs to be highly valued by the child to serve as a reinforcer.
Data collection and evaluation
ABA therapists collect data on each individualized goal throughout the treatment process to evaluate progress. The BCBA analyzes this data in order to evaluate progress made. Adjustments to the treatment plan are made as needed to ensure goals are being met.
ABA therapy teaches the behavior in increasingly “normal” settings . Practice of the bedtime routine may include different parents/caregivers, different settings such as naptime or in school setting, different materials or pictures to visualize the routine. Ultimately, the child uses the behavior spontaneously in new situations and without prompts or cues.
Parents play a crucial role in therapy depending upon the needs of the child and family availability. Parents have input to the goals of therapy, on strategies and on valued reinforcers. Parents are pivotal to developing routines and using strategies consistently at home and promoting generalization of the new behavior in everyday life.
ABA is proven to be effective in preventing and reducing the frequency and severity of tantrum behavior for children with autism, but it is not a one-size-fits-all approach. A qualified, experienced ABA therapist can ensure that treatment is individualized to meet the specific needs and strengths of each child. To learn more about ABA and the services of Propel Autism visit out website at www.propelautism.com. We invite you to schedule a consultation with one of our highly-skilled, Board-Certified Behavior Analysts.
Contact us at email@example.com or call 1 (404) 593 0078.
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Propel Autism, How to Find a Good ABA Therapist for a Child with Autism, fall, 2022, https://propelautism.com/find-aba-therapist, accessed winter, 2023
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