Post #34 Behaviour (2) Looking Below the Waterline - Feelings

With prolonged school closures and uncertainty about almost everything, it is not surprising if you are seeing more behaviours at the tip of the iceberg than is usual for your son or daughter. This post is about looking below the waterline to think about feelings and how these relate to how an individual behaves.

How are you feeling about the current situation, the many uncertainties and the sometimes unfathomable decisions regarding the way forward? How have your feelings affected the ways in which you behave? Perhaps you have been more irritable, or maybe you have withdrawn from usual activities? The same may well be true for many autistic children and young people. They may be experiencing feelings which are more intense than usual and/or feelings they have not experienced before. They may well be behaving in ways which are different from their usual behaviours and you may feel overwhelmed by behaviours at home which are more intense and/or which you are finding difficult to manage. As I posted yesterday, the behaviours that you can see are only the tip of the iceberg, albeit a larger ‘tip’ than usual! For some behaviours we may have to focus on the tip of the iceberg to keep everyone safe, but longer term it is important to explore the underlying reasons for the behaviour.

Underpinning surface behaviours are a multitude of factors 'below the waterline' which, when we understand, explain and give reasons for the behaviours we are seeing. These factors, left unaddressed, may threaten wellbeing which in turn then intensify behaviours further. In particular, intertwined with behaviours are feelings which need to be taken into consideration if we are to support individual wellbeing. 

Just as the way we feel is reflected in our behaviour, so the feelings of your son or daughter will also be reflected in the ways in which they behave. The focus of any strategy will have a longer term benefit when feelings are considered. 

How might your son or daughter be feeling? This is a tricky question. We may not know how an individual is feeling, we may misinterpret how they are feeling, or we may focus on a specific behaviour more than any possible feelings, in part because it is easier to see behaviour than it is the feelings which give rise to that behaviour. Clearly these factors will depend upon the individual and their strengths and needs and in particular their communication abilities (more on communication in next post). Nevertheless, whatever their communication ability, their feelings will impact their behaviour. Moreover, when feelings are confusing and/or more intense, communication skills drop. Think about a time when your feelings have felt inexplicable, intense and overwhelming. During these times we are not usually at our best at communicating and that’s when we are most likely to communicate via our behaviours! 

So what might your son or daughter be feeling and what factors affect how they feel? To some extent these questions might only be explored through trial and error, based on knowledge of the autism spectrum and knowledge of your own unique child and how autism affects them.  It is also important to think about external and internal factors that are likely to impact how they feel at this time and their behaviours.

External factors
External factors which may be impacting feelings and behaviours may be linked to the current stressful situation. This includes huge changes to routines, such as, staying at home, closure of school/college, learning at home, changes in the environment (e.g., 2 metre distance rule) and so on. These factors are affecting everyone, but your son or daughter may feel the impact more intensely. As a result they may be feeling anxious, afraid, confused, worried, upset, frustrated and angry. These feelings are likely to fluctuate, day to day and even moment to moment and contribute significantly to changes in behaviours. 

Internal factors

Internal factors are also likely to impact feelings and behaviours. Firstly it is always important to identify basic needs which may not be being met and which may give rise to behaviours that we may find difficult. For example, feeling hungry, thirsty, too hot/cold, pain or tired. Changes to routines, such as in the current situation, can affect all of these basic needs and have direct impact upon behaviours. For example, your son’s or daughter’s sleeping patterns may have changed; they may be eating too much/too little. 

Key characteristics of autism, below the waterline, will impact how an individual processes a situation and how they subsequently feel. For example, anxiety due to close proximity to other people may cause an individual to lash out. Difficulties communicating fear of failure  when completing school work may cause refusal. Other internal factors which may be affecting a young person’s feelings and behaviour include cognitive factors. They may have a shorter attention span than is usual for them and find it difficult to concentrate, it may be harder for them to shift the focus from one thing to another, they may find school/college work that is usually within their capability more difficult to complete. Cognitive factors may contribute to feelings of helplessness, frustration, low mood and so on.

Sensory processing differences are important internal factors which relate to how an individual feels and behaves. During stressful times, such as the current situation, an individual may become more hypersensitive and/or hyposensitive than usual (see post on sensory needs). As a result, for example, they may feel more pain, sounds may feel too loud or they may feel lethargic. (Note that changes to external factors, such as the environment, can help to address internal hyper/hyposensitivity).

Emotional regulation may be affected by the current period of stress and confusion and as a result you son or daughter may experience the feelings and emotions rollercoaster more intensely than usual. For example, they may experience intense feelings of sorrow at not being able to see their friends, or they may feel angry more frequently and/or more often.

External and internal factors will impact how you son or daughter feels and subsequently this affects how they behave. If we mix combinations of the above, we should not be surprised to see more frequent and/or intense behaviour outbursts or withdrawal. Your son or daughter may, for example, lash out at others, scream, shout or swear, hurt themselves, throw objects or withdraw and not engage with you or other family members. These behaviours may be upsetting to see, and you may have to intervene at the behaviour level for safety concerns, but it is essential to think about what they might be feeling internally and which may have a direct link to their observable behaviours. This takes us back to the iceberg model. The outward behaviours are easily seen and may be due to external and internal factors and an expression of how an individual is feeling. Again, list all potential reasons for a behaviour, taking into account both external and internal factors and identifying how the individual might be feeling.

For example, look at this 'iceberg' for Joe:

If we focus on intervening ‘below the waterline’, then we would need to develop strategies which focus upon external and/or internal factors and the individual’s feelings. In the example above, based on our observations, we might decide: 
1) the house is too noisy at times (external factor), 
2) causing discomfort and making it difficult to concentrate (internal factors) 
3) Joe is afraid to 'get things wrong' and can't communicate easily about his fears, hence he feels overwhelmed and frustrated.... 

… and so he refuses to attempt any school work. 

At this point you might be thinking it is easier to intervene at the behaviour level, using rewards and sanctions. Of course, this is a useful strategy but may well result in only short term success. If the external/internal factors are not considered and we do not think about feelings, refusal to work in Joe's case may return and/or he may behave in additional ways to show increasing frustration and feelings of being overwhelmed. 

You next question may well be, ok so what do we DO?
At this stage I am suggesting that you focus on using the iceberg model to explore one behaviour, the internal/external factors which may be contributing to the behaviour and what your son or daughter might be feeling. This is a crucial 'data gathering' phase (but no graphs!) which will be used to inform your strategy. Tomorrow's post will add communication to the mix before subsequent posts on strategies!