Attention

Attention
Attention is important for social development. It is normal for a person to look for attention from others. However, some children with autism engage in inappropriate behaviours because they very often do not know how to communicate their needs in a positive way.

Safety comes first

Some behaviours are impossible or too dangerous to ignore. Safety is paramount when dealing with any challenging behaviour. The danger needs to be removed or blocked. If the behaviour cannot be ignored you can provide attention that is of a lesser degree or not as frequent. Avoid labelling the behaviour and avoid any facial expressions such as shock or surprise. This is attention and will most likely cause the behaviour to escalate and to re-occur.

Negative Vs Positive Attention

Getting attention in the correct way can be difficult as many children with autism struggle with language and social skills. For instance a child might scream to get a person to look at them, laugh at them, hug them or even reprimand them.

It seems strange that a child would engage in a behaviour to deliberately have someone reprimand them, however, it can occur because for some it’s better to get negative attention than not to receive attention at all (Cooper, Heron & Heward, 2007).

Sometimes a child knows how to communicate appropriately but chooses to engage in undesirable behaviour because it gains attention quicker.

For example:  a child in a classroom who knows to raise their hand but decides to shout out the answer to the teachers’ question. The child is choosing the inappropriate behaviour because it gains the attention they desire quicker than waiting to be asked. It doesn’t always matter that they are reprimanded for this as they still gets the attention they require.

Attention Intervention
The first step when teaching a child to gain attention in an appropriate way is to

Ignore the inappropriate behaviour. This can be difficult as the child will often exaggerate the behaviour as they try harder to access the desired attention.

It is important to understand that by giving the behaviour attention you are maintaining it.

Giving attention to a behaviour does not just include reprimands, it involves looking at the child, any facial expressions or any physical contact.

Build Skills
If the child does not know an appropriate alternative behaviour that will get them the attention they require, teach them one! If they do, build skills! Make the appropriate behaviour considerably more effective than the inappropriate behaviour.

Positive Reinforcement
When building skills it is important to praise and reward the child for their effort. By doing this the child is much more likely to repeat the positive behaviour. Rewards and praise can be faded over time as the child becomes confident in communicating their needs appropriately.

How to build skills

In the case of a child who does not know how to attain attention in an appropriate way you need to teach them how.

Identify a communication form that will be quick for the child to use and easily understood. Initially picture or word communication systems or sign language are desirable as children with autism are often visual learners and these systems are easily understood. They can also help to promote speech and language skills.

One issue with sign language is that not everyone will understand it; however, it is quick and easy to use when communicating with those who are familiar with it.

Establish a teaching situation preferably a short one to one learning period where the child can access your attention a number of times without distraction.
For nonverbal children create a visual for attention. Visuals can also be used for children who are verbal as they can be more effective than using language alone.
Use reduced language focusing on the key words for example ‘help’, ‘hug’.
Use role play to practice asking for attention.
Social stories can also be used. You can create your own social story relevant to your particular situation using pictures or/and words.

Teaching the child to ‘Wait’
When the child learns to use the attention request consistently and independently, you can then start to teach them to wait before they receive attention.
This can be done by verbally asking the child to wait accompanied with a visual symbol or with sign language.
Begin by teaching the child to wait for just a few seconds before giving the attention.
Praise the child for both waiting and requesting attention appropriately.
Gradually increase the amount of time they have to wait as they become more successful.

Non-Contingent Attention

Another way to reduce attention seeking behaviour is to give the child attention on regular intervals without them asking for it. For instance a child who likes hugs could be given a hug without asking for it or you could ask the child if they need help when they are not seeking it. The child will be less likely to seek attention if they are already getting it.

Tom

Tom is a 6 year old boy with autism. He gets upset regularly and can assault, display self-injurious behaviour and he can be non-compliant. An ABC analysis was carried out by his father at home and by his Special Needs Assistant at school. The analysis was carried out over a number of days. The following is an example of the findings of the ABC analysis on one particular day.

ABC Chart (Read)

As you can see in the ABC analysis it seems as if Tom is looking for attention in each of these scenarios. He is seeking attention in the form of comfort, social attention and help.

Scenario 1: Comfort
Tom’s behaviour of screaming should be ignored.
When Tom hits his mom she needs to remove herself from his immediate proximity.
When Tom calms mom can then teach him the appropriate way to gain her attention. She can say ‘hug’ and use a visual cue for hug.

Preventative Strategies:
Tom should be taught to ask for attention at a time when mom is not busy.
Tom also needs to be taught to wait as there are times when it may not be convenient for mom to give him immediate attention.
Tom will only learn to communicate effectively if his parents and carers are consistent and constant in their approach.

Scenario 2: Social Attention
Initially the teacher needs to ignore Tom when he answers without being asked.

If Tom is quiet he can be praised for being quiet and then given a chance to answer a question.

Preventative Strategies:
Tom needs to learn to wait his turn. This can be done by teaching him waiting skills. Waiting skills can be taught initially with a peer and then in a small group. Visual cues, role play and social stories can be used to teach waiting and turn taking skills.
Another way to reduce or eliminate this attention seeking behaviour is to Praise Tom on a regular basis for any appropriate behaviour. He will be less likely to use attention seeking behaviours if he is already getting attention. This strategy involves giving Tom a regular schedule of attention no matter what he is doing. By simply talking to Tom or asking him every so often how he is doing or if he needs help with anything you are providing him with the social attention that he is seeking.
A token economy system or a reward chart can also be used to reduce attention seeking behaviour. Tokens or points are given to Tom for desired behaviours such as waiting and taking his turn. The tokens can be exchanged for a reward such as a tangible item or some 1:1 time with his teacher.

Scenario 3: Help

Self-injurious behaviour such as head banging should not be ignored unless you know for certainty that the child is not hurting themselves. If you are not certain, try to block the child from being hurt but give as little attention as possible to the behaviour.

Tom is looking for help to participate in a game with the other children.

Firstly, Tom must be blocked from hurting himself.
It might take some time for Tom to calm. As Tom’s self-injurious behaviour has possibly gained immediate attention in the past he may try harder to get attention before he realises his actions are not working. It is important to protect Tom but to give as little attention as possible to the behaviour.
When he calms use language and visuals to show Tom how to ask for help.

Preventative Strategy:

Pair Tom with children who have good social skills.
Provide peers with strategies for eliciting communication skills such as modelling social interaction, turn-taking and reciprocity.
This can be done initially on a 1:1 basis in a structured setting.
When Tom is ready he could practice his new skills in a small group where he can follow simple instructions and social rules.