Avoidance

Avoidance

Not all behaviours occur because the child is trying to access something.

Sometimes problem behaviours occur because the child is trying to get away from something or avoid a situation altogether.

Avoidance behaviour can manifest itself in behaviours such as non-compliance, tantrums, self-injurious behaviour, aggression, running away, reciting something from television etc.,

Many children on the spectrum use inappropriate behaviours to avoid various situations. These behaviours are maintained and will continue to be maintained because they work!!

An example of this could be a parent asking their child to do his homework. The child may throw a tantrum to avoid doing the work. If the parent then sends the child to his room without having to do his homework the child is getting exactly what he wants ‘avoidance’. As a result the child is likely to repeat this behaviour whenever they want to avoid a task or event, because it works!!

There are many reasons why a child might engage in escape/avoidance behaviours.
We must firstly identify behaviours that function to avoid or escape.
We must then figure out a way to reduce or eliminate such behaviours and to teach the child tolerance.

Why Does Avoidance Behaviour Occur?

The reasons for avoidance or escape behaviour very often fall under the following categories:

Task/activity avoidance
Social avoidance
Sensory Experience/Environment avoidance

Task/Activity Avoidance

The child might try to avoid some work tasks, possibly because the tasks are too difficult or they have no interest in them. We all have tasks we need to do but do not necessarily enjoy, so it is important to teach tolerance. It is also important to recognise that the child may not have the pre-requisites to complete the task and may be genuinely struggling.

Intervention

Task/activity avoidance:

Shorten work session:  Reduce the time the child spends working on tasks by allowing access to regular breaks

Allow access to breaks: Provide regular access to breaks that are on a time schedule so they are not contingent upon anything but time. This will teach the child that they do not need to behave inappropriately in order to get a break. A visual timer can be used to allow the child to see when a break is coming. Make sure the breaks are regular and often at the start.

Teach access to breaks:  Some children need to be taught how to ask for a break. This can be done using verbal prompts such as ‘I want a break’ if the child is verbal. A social story can also be used to explain that by asking they will get access to a break. Non verbal children can be taught how to use a ‘break card’.

In order to build the skill it is important to give the child a break every time they request it at the start. When the skill is learned you can reduce how often they can access a break by making it contingent on something such as completing a task.

Make tasks easier: For some individuals on the autism spectrum, even simple tasks can present complex challenges. Having an understanding of all the steps involved for a particular task can assist in identifying any steps that may need extra instruction. This will help to teach the task in a logical progression.

Schedule tasks easy, easy, hard: Start with some easy tasks and then introduce a more difficult task. The child will carry out the easy tasks and will then be more likely to comply with the difficult one.

Allow choice for tasks or task order: Giving the child a choice in what tasks they want to do first or last allows the child some control. We all like to choose whether we want to get the difficult tasks out of the way first or leave them until last.

Use visual a schedule: A visual schedule will allow the child to see how much work they have to do before they receive a break. Not knowing how much work needs to be done can be upsetting for the child. Tasks can seem endless.

Prompting: This involves giving the child some physical or verbal prompting to help to complete the task. For example:

If a child has difficulty with completing a puzzle you could physically help, or if a child has difficulty answering a question you could prompt the child verbally.

Remember to praise and reward the child for their effort and to fade the prompting and the positive reinforcement as the child learns the skill.

Social Avoidance

Children with autism can often avoid social situations because they find them difficult to comprehend.

Unstructured settings such as school yards can be very scary places. These situations can cause anxiety before, during and after the interaction (see our section on Anxiety.)

Appropriate social behaviour requires social understanding. Children with autism very often have difficulty with this.

Intervention: Social Avoidance

Teach Social Skills

Younger children can be taught initially through turn taking. Then based on ability conversational skills can be developed.
Children should be paired with peers with good social skills.

Focus on areas of interest for the child. Choose a topic they are competent with and which they will be eager to talk about.

The interactions can be modelled and practiced in a small group for children who have the ability to learn in this setting or in a 1:1 setting for children who have more difficulty.
See our Social Skills section.

Sensory Avoidance

Hypersensitivity is when a person struggles to cope with everyday sensory information. This means they may see, hear, feel, smell or taste the world in a more acute way than others. They can become uncomfortable when experiencing minor environmental encounters. This can lead to sensory overload.  As a result of this the person can very often become stressed, suffer from anxiety, or even physical pain. A person who is hypersensitive may try to escape from a situation or avoid particular places or people altogether.

In some children, for example, the sound of a lawn mower may cause them to run and hide. They may scream and lash out when touched. They may try to escape a room if they are hypersensitive to smell or refuse to go to the playground because they have a fear of different movements.

Intervention: Sensory Avoidance

There are many ways that you can make the environment more sensory friendly for a child who sensory processing difficulties. The best way to prepare a child for any uncomfortable situations is to give them the tools to cope themselves. Teach the child to ask for a break or for help using words, visuals or sign. Once the child can communicate their needs and you can help them they are less likely to become upset and anxious.

See the Sensory and Communication Section.

Smell:

Make the environment as fragrance free as possible.
If this is not possible give the child something that he likes to smell so that he can block out the unpleasant fragrance.

Sound:

Cut out conflicting sounds by closing windows and doors.
Reduce volume when necessary.
Provide head phones or noise reduction ear muffs.

Sight:

Provide a quiet space without bright lighting.
Use black out blinds
Block out any visual distractions
Avoid fluorescent lighting where possible
Use sunglasses or a sunscreen for sunlight

Touch:

Forewarn a child if you are going to make physical contact.
Remove tags from clothing.
Buy clothes made of materials you know your child can tolerate.
Teaching a child tolerance of different textures can be done in a gradual way with guidance from a trained professional

Taste:

Use plain tasting food
With some children it might be possible to introduce flavoured food gradually but only one food at a time
Plain food is fine to eat once the child is getting the dietary nutrition that is needed

Proprioception:

Both fine motor and gross motor activities can help to develop proprioception
Fine motor activities: peg boards, lacing boards, wooden puzzles, stringing beads, Lego
Gross motor activities: Jumping on a trampoline, climbing, swinging or any playground activity

Vestibular:

Gross motor activities that can help with balance and spatial awareness.
Activities can include bouncing on a trampoline, using a swing, bike riding, ball activities, a DIY obstacle course or most playground activities

Emma

Emma is a 10 year old girl with autism. She is very often non-compliant in the classroom. She also appears anxious and stressed at school, home and when in public places.  An ABC analysis was carried out by her mother and by her Special Needs Assistant at school. The analysis was carried out over 10 days. The following is an example of the findings of the ABC analysis on one particular day.

ABC Analysis (Read)

Scenario 1: Task Avoidance

Look for a pattern for task avoidance.
Emma seems to have difficulty with maths so it is important to break the maths question down into smaller steps so she can understand it better.
Schedule maths questions easy, easy, hard so she is more likely to comply with the difficult question.
Shorten the sessions.
Allow access to breaks initially at regular intervals, but when Emma starts to show tolerance schedule breaks for tasks completed.

Scenario 2: Social Avoidance

Teach social skills to Emma in a structured setting initially with one other child who has good social skills.
Begin with turn taking games.
Although Emma is verbal, visuals may help her to understand social rules more clearly.
Conversational skills can be taught by focusing on areas of interest for Emma.
Interactions can be modelled and practiced.
As Emma becomes more confident she can practice her skills in a small group setting.

Scenario 3: Sensory Avoidance

As Emma is in a public place it is difficult to control sudden sounds that may be extremely challenging for her to tolerate so be prepared!!
Bring head phones or sound reduction ear muffs that will reduce the impact sudden sounds have on her.
Make Emma aware that the headphones/ear muffs are available if needed.
Teach Emma to ask to for the headphones/ear muffs at a time when she is at home and relaxed.