Part three of the autism treatment series: why repetitive behaviors are coping skills rather than problems to punish — and how “joining” your child’s world builds the trust that change depends on.
The last article in the Series Treating Autism addressed the importance of a positive attitude and the critical role of motivation in working with your child. This week, we will discuss how to join your child’s world and manage the repetitive actions most children with autism engage in.
What Are Repetitive Actions?
Repetitive actions are rigid, obsessive, and hard to stop. These actions are often performed for minutes to hours at a time and are often abnormal. Examples are spinning plates, rocking, counting, and stacking blocks. These actions are solitary and do not include others. These actions can sometimes be socially unacceptable and are often the primary targets for elimination in most behavioral therapies.
A child who spends hours a day rocking back and forth performs a repetitive action. It is often difficult for outsiders to understand the appeal of this action. For someone who is not autistic, the idea of rocking back and forth is not understood because it is hard to imagine the benefit. Rocking is almost a universal symbol of autism, with many afraid to interact or even be near someone who is exhibiting this behavior.
Repetitive actions, in themselves, are not dangerous; however, they can hinder the development of social skills. These actions are a problem and need to be eliminated if the child is to enter into a neurotypical environment. Most behavioral therapies work to reduce the behaviors through consequences. A child who rocks may have something taken from them or be shamed into stopping. This approach does not work for most and often makes the problem worse.
Why Are Repetitive Actions Being Performed?
Repetitive actions are coping skills designed to help soothe in times of stress. As mentioned in past articles of this series, autistic children are often very smart and easily overstimulated. As their senses are heightened, most autistics experience sights, sounds, and even textures in greater detail. This can be painful to some and lead to distress. As most autistic children have problems communicating, they do not know how to tell someone they are in distress. They lack the social skills to communicate their pain. Instead, they devise coping skills that help distract them from the pain. A rocking child will do so to reduce their stress and anxiety, which may be continuous.
For example, take a high-pitched noise, say, nails on a chalkboard. Most find this noise annoying and may even have physical sensations. Imagine this noise being repeated over and over. It would be difficult to ignore. Now, imagine you can tell no one how this noise feels for you, and this is a noise you will experience often. What do you do? You find a way to distract yourself from the noise. Maybe it is closing your eyes and imagining yourself somewhere else. Maybe it is reading a book or looking at your phone for hours. No matter what you choose, you would be annoyed if asked to quit this action. This is how most autistic children feel. Imagine trying to teach a child under these conditions. It would not go well.
How do you stop these repetitive actions if they are coping skills for overstimulation? First, overstimulation often decreases with age. Over time, the physical discomfort will decrease, and some sensations will become neurotypical. The time this takes varies from person to person and is not exact. However, most individuals with autism report feeling less sensitive to sensory stimulation over time. However, the use of repetitive actions over time has become conditioned and will continue even if the purpose of the action is removed. The child will continue to repeat the action, because it is something they have done for years.
The Act of Joining
Your child needs to learn to use other coping skills besides repetitive actions. While this is common sense, at least for most behavioral therapies, the implementation is not. Most behavioral therapies have the child repeatedly practice a new coping skill to replace the repetitive behavior. The child learns the new coping skill but does not understand why. They learn not to get in trouble; they will do as they are told. This is not learning that will help them in the real world. They need to learn how to use the coping skill and when to use it.
To that end, they need to be taught new coping skills in a method they approve of and will understand. This is where joining comes in. Joining is when you enter your child’s world and meet them at their level. Joining involves spending hours of time engaging with your child by doing the same actions they are.
To make this clear, when joining with your child, you will spend hours with them, doing the same actions as the child. If your child likes to rock back and forth, you will sit with your child and rock back and forth. You will do this for hours a day, for as long as it takes, until your child begins to notice you and communicate.
Most behaviorists would scream at this. They would say that by repeating these actions, you are encouraging your child to continue them, which will make the problem worse. However, as your child is likely already spending hours a day, how much worse can it get? Your child needs to learn to trust you and to know you are someone who is there to help them. By repeating these actions, your child will begin to notice you and your actions. In time, they will take more notice and begin communicating with you.
Once your child has your attention, it is time to begin teaching other appropriate coping skills. At first, this attention may last only a few minutes. Over time, attention will increase, giving more time to teach. Eventually, you can begin teaching your child how to communicate as well. This process will provide an environment where your child feels safe engaging with you and learning more. Deep down, your child wants to learn and interact, but they need to know they are safe and that you, the parent, are there for them.
How to Join
When you begin to join with your child, first go to a room in the house with the fewest distractions. Clear out space so there is a good-sized area on the floor to sit on. Sit with your child in front of you, far enough so you and your child have your own space. Make sure your child can see you easily. Next, give them the toy or item they want to use for their repetitive action, and have a copy for you. Now, watch your child as they play with the toy or item. Notice their facial expressions, their body language, and their actions. You want to take note, as you will be doing similar actions. Now, begin to do as they do, and continue this for half an hour. Do not speak to your child unless your child looks at you or points at you. If this happens, compliment your child, then continue the action. You should be quiet and not speak to your child most of the time. At first, your child may not notice you at all. Over time, though, this will change, and your child will begin to notice you in the room. At this stage, you can begin to teach.
Some days may go well; others may not. Even if your child is more interactive, they may lapse back into previous behaviors on some days. Do not panic, as this is normal. Your child may not feel well or have had a bad day and may not know how to communicate this. Do not push your child or show disappointment.
Joining takes months, and in some cases even years. It is an activity critical to your child’s success. Building trust is the most important activity you can have with your child, as it will be the agent of change for them.
Teach Others to Join
You will also teach others involved with your child how to join. Everyone who interacts with your child needs to join with them. This will continue the cycle and teach your child to trust others besides yourself. This is the beginning of teaching your child social interactions. If everyone works to join with your child, then your child will not receive mixed messages, which could be confusing and damage the process.
In Conclusion
Joining is a powerful technique designed to help you build trust with your child. It is a critical component of your child’s treatment. Joining in is not difficult; however, it will take time for your child to fully engage with you. Once your child has built trust, you can begin to teach him or her social skills and how to interact better with others. Joining requires a calm, distraction-free environment. Creating this environment will be covered in next week’s article.
Article Series
Treating Autism: Part 1 – Mindset
Treating Autism: Part 2 – Attitude & Motivation
Treating Autism: Part 3 – Joining & Repetitive Actions
Treating Autism: Part 4 – Environmental Considerations
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