Post #33 Behaviour (1) The Tip of the Iceberg

What is behaviour and why do we sometimes label behaviour as ‘challenging’?  Well this is not as straight forward as it may seem – what is challenging to one person may not be to another, thus the ‘challenge’ is subjective. Personally I dislike the word ‘challenging’ as it is frequently used to label a person as challenging and this then leads to assumptions and misconceptions about an individual and how they behave. If we label behaviours as challenging, we need to recognise that part of the challenge is our own understanding and interpretation of what we see. This week’s posts focus on behaviour and the messages that may be intended through specific behaviours.  I reflect upon how we can understand behaviours and interpret what we see as communication and an expression of feelings. I also suggest different ways to think about behaviours that may be helpful at home. This first post focuses upon what we see – or the tip of the iceberg.

Behaviour - Introduction 
Everything we do is ‘behaviour’. Sometimes we behave ‘well’ and sometimes we may be described as behaving badly. These statements apply to all human beings. The ways we behave give messages to those around us – behaviour is communication. Our behaviours can be seen by those around us and judgements may be made about how we are behaving. There are many reasons for our behaviours, good and bad, and our behaviours are often linked to how we are feeling. The same is true of our autistic children and young people. Their behaviours are seen by those around them and others make judgements about their behaviours. There are many reasons for the ways in which they behave and their behaviours may reflect how they are feeling. Sadly there are some differences regarding the behaviours of our children and young people: those around them may focus primarily on what they see and ‘forget’ to look for the message; they may be too quick to make judgements based upon what they see and those judgements may be less than forgiving; the reasons for their behaviours, and the emotions they may be feeling, may be difficult for others to interpret. 

What do you see?
What you see is what you get…. well not really! It is easy to observe behaviours and then to identify those which we find challenging, but we should not stop there if we want to find ways to support our children and young people. Many years ago (over 30, which make me feel very old) I attended the first TEACCh seminars and workshop in the UK and amongst many ideas and strategies, Structured Teaching and visual strategies in particular, I was affected by the approach to autism and behaviour. The late Eric Schopler, (co-founder of Division TEACCH), introduced a metaphor for observable behaviours and autism as the tip of the iceberg. This simple concept is really helpful as we attempt to look beyond that which we can see in order to try to better understand and interpret. 

    

The behaviours we see are the tip of the iceberg and that is, understandably, where much of our focus is when faced with behaviours that we find difficult to deal with. However, the observable behaviours are underpinned by all sorts of factors which we can’t easily see (below the water line). Crucially, below the waterline is autism: social and communication differences & difficulties; restricted and repetitive patterns of behaviour and interests; for some, sensory processing differences. These are neurologically based and are not in the individual's control. Moreover, we know that autism will affect the way an individual behaves. Traditional behaviour management approaches chip away at the observable behaviours, however if the underlying reasons for the behaviours are not addressed then the behaviour may return or be replaced, sometimes with a behaviour that is more difficult – just as a tip of an iceberg may reform if the environmental conditions remain the same.

Other factors are also 'below the waterline' and need to be taken into account when thinking about behaviour:

So, think now about one behaviour which you see at home and then try and think about that behaviour through an autism lens – what might be going on that you can’t see which may be a reason for the behaviour? You may well come up with a list of many different reasons. From this list, work out which you think may be the most likely reason for the behaviour. Observe your son or daughter at different times of day and in different contexts, watch closely for any patterns - for example the behaviour always occurs in the morning, or the behaviour occurs when they need some help. From your observations decide which is the most likely reason for the behaviour, focus on that reason and decide on a strategy (more on strategies to follow). If you are right about the reason the behaviour will stop and/or change to a more acceptable behaviour. If not, you can go back to your list of potential reasons and try again. This offers a systematic approach, informed by knowledge and understanding of YOUR child’s autism. Note that one behaviour may occur for more than one reason and therefore may require more than one strategy. Likewise the same behaviour in 2 different children may occur for different reasons and therefore may require different strategies for each child.

An example: James has been biting his hand at home. An iceberg might look like this:

In this example, your observations may show that 'biting hand' occurs mainly when James needs some help (see next behaviour post for example of how to record observations). Your strategy will be to teach James how to ask for help. You might ask school if they already have a strategy for this in which case you can use the same strategy. If not, then you will need to think about what James currently uses to communicate successfully which you can adapt to teach him to communicate "I need help". This will of course depend upon individual needs and ability, but may be a 'help' card or may be the Makaton sign for 'help'. If James learns to ask for help, biting his hand may stop; if biting his hand reduces, but does not stop, you would go back to the list of reasons and think about the next most likely reason and develop a strategy for that.

Important:

Teach your son or daughter what to do, not what not to do! If you say "no biting" to James, he may comply but you have not addressed the reason for the biting, so he may replace it with another behaviour such as slapping his face.  
Think about how to replace the behaviour with a new skill/another behaviour that is more successful for your child. In the above case, James learns to replace biting his hand with asking for help (using a help card or Makaton sign). 

The iceberg metaphor helps us to think about what we see in a way which takes into account an individual's autism and their needs. For me, this is the beginning of an ethical and proactive process for understanding a behaviour and thinking about ways to address underlying needs for positive change,which improves the skills and wellbeing of the individual.

Next post: Behaviour (2) How might they be feeling?

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