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Five Views of Autism

Person-centered

Understanding symptoms, strategies, and services can improve individual lives.

Describing Symptoms: BEHAVIORAL

Severe behavioral challenges in autistic individuals are not random acts of defiance or "bad behavior"—they are symptoms of underlying neurological, sensory, and communication differences inherent to autism. Here’s how they connect to core autism traits:

1. Rooted in Neurological Differences

Autism is a neurodevelopmental condition that affects:

  • Sensory processing (over- or under-sensitivity to stimuli).

  • Executive functioning (planning, flexibility, impulse control).

  • Social communication (understanding norms, expressing needs).

  • Repetitive behaviors (self-regulation through routines/stimming).

Example:

  • Elopement (running away) may stem from poor danger awareness (neurological) + escape from overwhelming sensory input (e.g., noisy cafeteria).

Doctor Analyzing X-Rays
Young Woman Contemplating

2. Communication Barriers

Many autistic individuals struggle with expressive/receptive language, leading to frustration-based behaviors:

  • On the more "severe" side of things, self-injury or aggression may be the only way to say, "I’m in pain" or "Stop this now."

  • Pica (eating non-food items) could signal unrecognized hunger or oral sensory needs.

Example:

  • A nonverbal student bangs their head because they can’t say, "The lights hurt my eyes."

3. Sensory Processing Dysfunction

Autistic brains often misinterpret or amplify sensory input, causing:

  • Meltdowns → Overload from sounds, lights, or textures.

  • Food aversions → Gagging at certain textures (e.g., mushy foods).

  • Stimming → Regulating sensory input (e.g., rocking to calm dizziness).

Example:

  • A child destroys a classroom poster because the buzzing fluorescent light above it is unbearable.

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Futuristic Robot

4. Anxiety and Rigid Thinking

Autistic individuals rely on predictability to feel safe. When routines break:

  • Tantrums or property destruction may follow unexpected changes.

  • Sleep disturbances arise from the inability to "switch off" anxiety.

Example:

  • A teen has a meltdown after a substitute teacher rearranges desks because "It’s not how it’s supposed to be."

5. Biological Factors

Co-occurring medical issues intensify behaviors:

  • GI pain → Fecal smearing (attempt to relieve discomfort).

  • Sleep disorders → Irritability and aggression.

  • Nutritional deficits → Pica (craving non-foods like ice or dirt).

Example:

  • A student’s aggression spikes due to chronic constipation (common in ASD).

Human Anatomy Model
Water

6. Adaptive Functioning Gaps

Some autistic individuals may lack "automatic" social or safety skills, leading to:

  • Touching → Not understanding personal space or appropriateness.

  • Elopement → Wandering toward water without recognizing danger.

Example:

  • A child hugs strangers because they don’t grasp "private vs. public" boundaries.

Key Takeaway: It’s All Connected

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These behaviors are symptomatic of:

  1. Distress (pain, fear, sensory overload).

  2. Unmet needs (communication barriers, biological issues).

  3. Neurodivergent coping mechanisms (stimming, routines).

Interventions must address the root cause, not just suppress the behavior. For example:

  • Sensory accommodations (noise-canceling headphones) reduce meltdowns.

  • Picture exchange systems (PECS) replace self-injury with communication.

Image by Gabriel Vasiliu
Image by Declan Sun

3 Key Intervention Principles

  1. ​Assume Behavior is Communication

    • Example: A child who bites others may be saying, "I need space" → Teach them to hand a "break card" instead.

  2. Fix the Environment, Not the Person

    • Example: For a student who elopes due to noisy hallways → Provide noise-canceling headphones + alternate transition routes.

  3. Prevent > React

    • Example: A child melts down at 11 AM daily → Track patterns (hunger? math class?) → Offer snack/sensory break before 11 AM.

Sample Intervention Plan for
"Aggression During Transitions"

Trigger: Unpredictable schedule changes
Root Cause: Anxiety over loss of control
Strategies:

  1. Visual Schedule (Photos of daily activities + "FINISHED" pouch to move completed tasks).

  2. Transition Warnings (5-minute + 1-minute sand timer cues).

  3. Choice Offering ("Do you want to walk to math or take the scooter?").

Replacement Skill: Teach child to point to a "break" icon instead of hitting.

Students on Stairs
Hardware Tools

Tools to Explore

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  • Assessments: Functional Behavior Assessment (FBA) to identify triggers.

  • Therapies: Occupational Therapy (OT) for sensory needs, ABA (controversial; use cautiously with neurodiversity-affirming approaches).

  • Tech: Goally (visual schedule app), AngelSense (GPS for elopement).

Is it a "symptom" or a profound trait - or both?

Below is an expanded breakdown of SEVERE behavioral challenges commonly seen in autistic individuals within educational settings, along with potential triggers, impacts, and intervention strategies for each.

 

1. Self-Injurious Behaviors (SIBs)

Examples: Head banging, biting, scratching, hitting oneself.
Possible Causes:

  • Overwhelm from sensory overload (e.g., loud noises, bright lights).

  • Communication frustration (unable to express needs).

  • Pain or discomfort (e.g., undiagnosed medical issues like migraines or GI problems).
    Interventions:

  • Functional Behavior Assessment (FBA) to identify triggers.

  • Replacement behaviors (e.g., squeezing a stress ball instead of hitting).

  • Sensory accommodations (weighted blankets, quiet spaces).

 

2. Aggression Toward Others

Examples: Hitting, kicking, biting, hair-pulling.
Possible Causes:

  • Defensive reaction to perceived threats (e.g., someone standing too close).

  • Frustration over disrupted routines or denied requests.

  • Overstimulation leading to fight-or-flight responses.
    Interventions:

  • Clear visual schedules to reduce unpredictability.

  • Social stories to teach appropriate responses.

  • De-escalation techniques (e.g., giving space, using calm tones).

 

3. Property Destruction

Examples: Ripping books, throwing objects, breaking furniture.
Possible Causes:

  • Anger or anxiety due to unexpected changes.

  • Sensory-seeking (e.g., enjoying the sound of crashing items).

  • Attempt to escape a non-preferred task.
    Interventions:

  • Structured reinforcement (reward systems for safe behaviors).

  • Access to sensory alternatives (e.g., crash pads, tear-resistant toys).

 

4. Elopement (Wandering/Running Away)

Examples: Bolting from classrooms, hiding, escaping school grounds.
Possible Causes:

  • Overstimulation (seeking a quiet space).

  • Pursuit of a special interest (e.g., running toward water or traffic).

  • Disorientation or lack of safety awareness.
    Interventions:

  • GPS trackers or ID bracelets for safety.

  • Designated "safe zones" within the school.

  • Alarmed doors and staff training on emergency protocols.

 

5. Rigid Routines & Resistance to Change

Examples: Meltdowns if a teacher is absent or a schedule shifts.
Possible Causes:

  • Anxiety over unpredictability.

  • Cognitive inflexibility (difficulty adapting to new rules).
    Interventions:

  • Advance warnings for transitions (e.g., timers, countdowns).

  • Social scripts (e.g., "Sometimes plans change, and that’s okay").

 

6. Repetitive Movements (Stimming)

Examples: Hand-flapping, rocking, echolalia (repeating phrases).
Possible Causes:

  • Self-regulation (calming or focusing mechanism).

  • Sensory processing differences (seeking or avoiding input).
    Interventions:

  • Only redirect if harmful (e.g., replace head-banging with pillow-hitting).

  • Provide sensory tools (fidgets, chewable jewelry).

 

7. Inappropriate Touching/Personal Space Issues

Examples: Hugging strangers, standing too close.
Possible Causes:

  • Lack of social awareness.

  • Sensory-seeking (e.g., liking textures of others’ hair/clothes).
    Interventions:

  • Explicit teaching of boundaries (e.g., "arm’s length" rule).

  • Alternative sensory input (e.g., textured blankets).

 

8. Fecal Smearing

Possible Causes:

  • Sensory exploration.

  • Communication of distress or physical discomfort (e.g., constipation).
    Interventions:

  • Medical check for GI issues.

  • Toilet-training programs with visual supports.

 

9. Pica (Eating Non-Food Items)

Examples: Consuming chalk, paper, dirt.
Possible Causes:

  • Sensory curiosity.

  • Nutritional deficiencies (e.g., iron deficiency).
    Interventions:

  • Close supervision and safe alternatives (chew toys).

  • Medical testing for deficiencies.

 

10. Sleep Disturbances

Examples: Insomnia, irregular sleep cycles.
Possible Causes:

  • Melatonin dysregulation.

  • Anxiety or sensory discomfort (e.g., scratchy pajamas).
    Interventions:

  • Structured bedtime routines.

  • Weighted blankets or blackout curtains.

 

11. Food Selectivity/Aversion

Examples: Only eating 3–5 specific foods.
Possible Causes:

  • Sensory sensitivities (texture, smell, color).

  • GI pain (e.g., acid reflux).
    Interventions:

  • Food chaining (gradually introducing similar foods).

  • Occupational therapy for oral-motor skills.

 

12. Meltdowns vs. Tantrums

Meltdowns:

  • Involuntary responses to overwhelm (sensory, emotional, or cognitive overload).

  • Interventions: Remove triggers, ensure safety, wait it out.

Tantrums:

  • Goal-directed (e.g., seeking attention or a desired item).

  • Interventions: Ignore if attention-seeking, offer choices.

 

13. Difficulty with Transitions

Interventions:

  • Visual schedules (photos of "next steps").

  • Transition objects (e.g., carrying a favorite toy between activities).

 

Key Takeaway

These behaviors are communication attempts—not defiance. Solutions require:

  1. Identifying triggers (FBA).

  2. Teaching replacement skills (communication tools).

  3. Adjusting the environment (sensory supports, structure, educate others to modify their own approaches towards someone with autism).

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