1

Passages

Issue # 1, March 2015

Challenging Behavior when everyone has a

meltdown

Social Stories for Scary Situations by Jeannemarie Passaro

Issue #1, March 2015

Challenging Behavior
How using social stories can help improve
challenging behaviors caused by anxiety.
Information from PASSs president

Its all about the why. All behavior serves

a purpose. A brief overview with
additional resources.

3-4
Aggressive Behavior and Self-harm. One
parent discusses how she helps her
daughter through these challenges

5
Tell me if this sounds familiar
whether your child is 18 months
or twelve years old, does it take at
least five adults to hold him/her
down to have ears checked,
throat culture? What about blood
drawn? Or EEGs or CT Scans? Are
you breaking into a sweat just
thinking about it? Does your child
become part Tasmanian devil,
part mongoose during exams or
medical procedures? That was
Evan. It was always a nightmare
for me on so many levels. Why

was my son so fearful, terrified?

He was non-verbal and I was his
interpreter so why didnt the
Doctor and staff listen to me?
Why did they insist on trying to
reward him with stickers he had
absolutely NO interest in? We all
wound up stressed with red faces,
sweaty and at least two of us in
tears and usually unsuccessful
with whatever we were trying to
accomplish.
Continued on pg. 2

What is TSS s upport and how can a TSS

worker help children at home, in the
community and in school? Insight from a
professional in the field.

6
Taking things one day and one year at a
time as a strategy for lasting change and
skill building, one parents perspective.

7-8

Pike Autism Support Services

The mission of Pike Autism Support Services is to
empower, support and educate families and friends of
individuals with Autism Spectrum Disorders (ASD) by
assisting and encouraging parents to be informed
participants in their childs education and effective
advocates on their behalf. We are dedicated to providing
support in addressing the social and emotional needs of
family members who have been affected by ASD and we

are committed to educating the community regarding this

disorder by raising public, professional and governmental
awareness of the challenges families face, in hopes that
persons with ASD may lead a more fulfilling and
independent life. We recognize that ASD is a lifelong
condition that may require Lifespan supports for many
persons on the spectrum.

 Passages

Issue # 1, March 2015

Challenging Behavior when everyone has a meltdown continued from pg. 1

Many years ago we were introduced to Social Stories. Just a few

sentences with photos attached in a positive narrative.. what to do
NOT...what not to do. Although Evan could read, we werent sure of
his ability to comprehend the material, so we kept it short and sweet,
infusing the script with accurate photos. For example, My husband
would go on line and find photos of the lab at Geisinger Medical
Center, or Staff photo the ENT Specialist we were about to visit so
that the photos were of the actual facility, doctor, equipment, etc we
would do our best to be honest.
If it was going to pinch or be loud, we would say so. If we could go
with him, we would say we would.. if not, we would tell him where we
would be waiting. Ready with his favorite reinforcer. Like a magic
wand it worked every time. Unless we messed up and left
something out. I think it was always about the fear of the unknown for
him. The anxiety was off the charts. If you are dealing with anxiety on
top of auditory processing issues, nothing you say is being understood.
Evan always relates better to the written word and visual cues vs.
auditory instructions. So this was a perfect fit. We would read it with
him the first time, then have him read it over several times over the
course of the day prior to the visit/test.

For more information on Social

Stories visit :
http://www.pbisworld.com/tier-
2/social-stories/ If you would like
to see one of Evans stories,
please email me at
jmpassaro@passnepa.org.

I know that age and maturity has played a factor

in all of it, but our success with social stories for
the dentist, blood work, scans, hospitalizations,
you name it began many, many years ago. It is
certainly worth a try no matter what functioning
level or age your child is. As long as Evan knows
what to expect, he is cooperative and most
importantly not afraid. Im so proud of how far
he has come and using Social Stories is a big part
of that success.

The information and opinions in this

newsletter about Challenging Behaviors and
Autism are not meant as advice.

1
2

Passages

Issue # 1, March 2015

Its All About the WHY

Christine Kerrigan, Itinerant Autistic Support, DDPS

In my seven years of teaching special education
classes, I have been told It happens out of the
blue! more times than I can ever remember, and
each time, I feel like batman in the picture above!
Ok, batman is clearly displaying behavior in this
picture than I cannot condone, but lets look at his
message: all behavior serves a purpose, and until
we find out what that purpose is ie, the WHY- we
wont be able to modify or change it.
When a student is brought to me displaying
aggressive behaviors towards him or herself or
others, one of the first things you will hear me ask is
What was happening right before this started?
followed by And what happened right after the
behavior? Experience has backed up the research:
the antecedents (what happens right before) and
consequences (what happens right after) maintain

that behavior. Recently I have been making my own

graphs (for this technologically challenged girl, this
is a big deal!) and this fact is extremely clear.
Below, I will give a brief behavioral description of
why antecedents and consequences are so
important when looking at behavior data and,
ultimately, designing interventions to modify or
change behavior.

"The function of a behavior

refers to the source of
environmental reinforcement
for it."
Tarbox et al 2009
Continued

 Passages

Issue # 1, March 2015

Challenging Behavior when

everyone has a m eltdown, cont.

Research has shown that function-based interventions are

more efficient and effective than interventions that are not
matched to the function of behavior.

Additional
Resources

Regardless of what behavior intervention system a person may

believe in, when analyzing behavior, four main functions are
always clear. These four main functions are:

Escape/Avoidance: The individual behaves in order to

get out of doing something he/she does not want to do.
Attention Seeking: The individual behaves to get focused
attention from parents, teachers, siblings, peers, or other
people that are around them.
Seeking Access to Materials: The individual behaves in
order to get a preferred item or participate in an
enjoyable activity.
Sensory Stimulation: The individual behaves in a specific
way because it feels good to them.

When teachers or parents ask for my assistance with

problematic behavior, I am a firm believer in the Functional
Behavior Assessment process: conduct observations in multiple
settings, analyze data, and develop behavior plans specifically
based on that data.
In order to develop effective behavior plans, we must match the
functions to the reinforcement. For example, all too often, a
disruptive child in a classroom seeking attention is given
immediate attention for an outburst, and therefore will continue
to be disruptive the next time he or she wants attention. A plan
for that child would be to ignore the problem behavior
(as difficult as it is), teach replacement behavior (AKA
ways to obtain attention appropriately) and
IMMEDIATELY reinforce the replacement behavior
when it happens. As you might guess, this is not going
to be a quick fix, but when implemented consistently,
it will be a lasting one.

http://www.pattan.net
http://www.education.com/re
ference/article/positivebehavior-support-functionalbehavioral-assessmenteducators/
http://www.educateautism.c
om/behaviouralprinciples/functions-ofbehaviour.html

The information and opinions in this

newsletter about Challenging Behaviors and
Autism are not meant as advice.

1
2

Passages

Issue # 1, March 2015

Self-Harm and Aggressive Behavior

By Melissa Fabian

The top two behavior categories that I have encountered with my daughter Jayde who is a child
with autism are self-harm and aggressive behaviors. Operationally defined self-harm behaviors
are as follows; head-butting floor or other objects, banging her arms on the underside of tables,
trying to choke herself and pulling her hair out among others. Operationally defined aggressive
behaviors are as follows; head butting others, pressing chin into others, hitting open and closed
hand, kicking, and hair pulling among others. After going through many, many, medical tests it
was found that she has, GI issues, migraines and less white brain matter than what is
considered to be typical. Which Im sure are contributing factors it was also found through an
extensive functional behavioral assessment other antecedents or triggers are demand based,
excepting no, denial to preferred item, and sensitivity to sound. The professionals that work
with her and myself conducted the functional behavior assessment. In the 2013 and some of
2014 these behaviors were so severe that at school the professionals spent most of their time
keep her safe and her
learning was being greatly
negatively being affected.
So it was at this time I came up
with a helmet, alternative
behaviors and social narrative
protocol
for
the
professionals and myself to use
to keep her safe and
minimize the above mentioned
behaviors. When Jayde
displays these behaviors with
intensity whoever is
working with her at the time they
are to put the martial arts
helmet I have provided on her
and then tell her, When
you can calm down the helmet
will come off. The next
step is to model and encourage
her to engage in deep
breathing, which she now does
quiet a lot on her own. If it can be detected that she is getting upset before engaging in these
behaviors with and without help, start using the deep breathing. Other alternative behaviors that
have been successful is that she has been taught to indicate on her I-pad that she needs a break,
needs to go for a walk, and wants the swing in the sensory room or to listen to music. It took
some time but these techniques have been successful for her and continue to be used when
these behaviors occur. Although the behaviors still do occur the rate and intensity of them have
been greatly decreased and are now manageable. I happy to report that in the last couple of
months Jayde has been able to perform these alternative behaviors and or coping skills more and
more independently. I think it is important to note the strategy that did not work for Jayde was
using a social narrative alone especially if she was already upset as just escalated even more
when I tried to talk to her. I hope that this article has been helpful to fellow parents with children
with an autism spectrum disorder.
BCBAs December Newsletter discussed changes to their practice guidelines and
supervision requirements. For more information, check their newsletter:
http://www.bacb.com/Downloadfiles/ABA_Guidelines_for_ASD.pdf

1
2

Passages

Issue # 1, March 2015

Wraparound Services: Therapeutic Support Staff

By Michael Paleno

I have had the privilege of working closely with families, and

school districts, for the past five years, and the common factor,
to the big picture, is behaviors. In my opinion, behaviors are not
classified as good or bad, but rather appropriate or
inappropriate, depending on the situation and individual. When I
work with families or teachers the first question I have for them
is What are the expectations for your child or student? The
second question I ask is, What are your expectations of me as a
TSS worker? Expectations tell me a lot about how I will
approach a new child and family, as well as a school, to increase
a childs education and lifestyle.
I have the unique perspective as a TSS worker to observe and
interact with a child both in the school and home setting. Both
environments show and teach me how I can help the child. The
pressures of everyday life and needs, as well as the personality of the child, can change depending on the
environment. The behaviors a child displays at home are not always the same behaviors that a child will have
at school, and visa versa. I have found that the common factor that will help families and schools, when
working with a child with difficult behaviors, is to approach the childs behaviors the same way, both at school
and home. Such approaches I am speaking of are holding the child responsible for independent tasks that
need to be done at home, as well as in school as a student. Responsibility teaches the children to act as their
own advocate or therapist.
Consequence is another approach to difficult behaviors that hold the child responsible for their actions.
Consequence allows the child to learn the difference between right and wrong. Communication and
interaction with all members of the therapeutic team, such as parents, teachers, siblings, and most
importantly the client, is extremely vital to the decrease of difficult behaviors. Seeing and asking questions to
all members about how they approach the childs therapy are important for all members to be aware of. A
wrap around approach will benefit all members to increase communication and the delivery of appropriate
and interactive therapy, or education.
Lastly, I have and always will approach each day as a new one; meaning, dont carry difficult behaviors into
the next day. Allow what will happen today, to happen, and approach tomorrow as a new day, in the journey
of a more productive and independent lifestyle for our children.

For more information about Wraparound Services in Pennsylvania:

http://www.phlp.org/wp-content/uploads/2011/11/Guide-to-Understanding-
Wraparound-Services-Oct-20111.pdf
6

The information and opinions in this newsletter about Challenging Behaviors and
Autism are not meant as advice.

1
2

Passages

Issue # 1, March 2015

This Time Next Year

By Mignon Reisky
getting on the bus, whatever the behavior might be, I
give us (my son and myself) a year. Yup, a whole
year!
It doesnt mean I dont continue to work really hard
on the behavior or cry and want to pull my hair out.
Lets face it; its not easy. While some behaviors will
be extinct in a blink of an eye, others seem like
theyre here forever.

I was asked if I would like to participate in

the making of the PASS newsletter. I figured,
sure how difficult could that be?! Well, it was
to write an article on behaviors, and that
topic is as deep as a well! I could go on and
on about my son with multiple diagnosis,
Down Syndrome, Autism and ADHD and the
behaviors we deal with. But again, that deep
well comes to mind. So, after much
thinking, rethinking and talking it over with a
few good friends, I decided that I would
write briefly how I approach a talk analysis.
The one thing we as parents are always told
is to be consistent. Consistent, ok?!? And
persistent! How do we go about being
persistently consistent when we are so
frustrated and tired of being tired? I am not
a specialist but through the years I have dealt
with many behaviors and tried many
different methods, the one thing that has
worked for me, is to give my son and myself
the gift of time!
This time next year, is what I say to myself
when I am about to deal with and strategize
a behavior. Whether its food, toileting,

I try to think about how difficult it is to diet, or quit a

habit. Its consistency, commitment and time that
ultimately bring success. If we give ourselves a year,
we can eliminate some of the stress and anxiety if
things dont work out right away. How often have I
said, Ive tried and tried, but it doesnt work! Did I
really give it enough time? Did I try 2 times, maybe 3,
even 4 times and nothing! Remember dieting, how
hard is to give up a craving? How can I just give up
chocolate cake? Overnight? Over the course of a
week? A month?
A year allows me to make mistakes, do overs, talk it
over with a support person, group and or a
professional. I dont give up on the behavior, but I
get to strategize and tweak it. If it happens in less
time, then it becomes one of those aha moments; I
can celebrate a job well done.
I use a basic yearly wall calendar to write down the
goal, then use those little tic marks every time my
son does it correctly or comes close to it, also to jot
down a quick note. Its my way of keeping track of
what does and doesnt work; I start to see progress
over time, even if they are only baby steps. By
keeping track of things and talking it over with
friends I realize that many times Im the one that
Continued on pg. 8
7

3
1
2

Passages

Issue # 1, March 2015

Support Meetings
Join us at 7pm on the 3rd Wednesday of each
month at:

Milford Health and Wellness Center
111 E. Catherine Street
Milford PA 18337

We can provide babysitting with reasonable
advance notice.

This Time Next Year, cont.

complicates things. I make it too difficult and want immediate results. I also get to slow down!
Currently we are working on face washing, completely independent. I have had to rethink this basic task.
We take for granted these simple things and forget just how many steps there really are. Get washcloth
(providing it is within easy reach) put in sink (without tripping over the garbage pail) turn on water
(hopefully its the right temp) and wring it out (the hardest of them all) wash face (not just plopping it
back in sink or just laying it on the top of his head) then, put washcloth back in sink (not walking around
with it or shaking it and getting everything wet) dry! I am using picture cards of the basic steps listed
above, and a first this, then that app on his iPad (which hangs way off to the side as to not get splashed
hopefully). I have also spoken with a BCBA who has helped to break down these basic steps and make
the task doable. Since the end of November I have rearranged my bathroom to make things more
accessible for him, I also run into the bathroom ahead of time and run the water till it runs warm (Ill
address the task or waiting for the hot water to actually run hot, after running cold for a full minute
another time). I use hand over hand assistance with the wring out washcloth, I talk and gesture more
and assist less, hoping to fade my verbal cues over time as he becomes more proficient. He is involved
through the whole process, he points to each picture as it comes next. If he gets distracted or the
morning seems more challenging I redirect him to the app which states clearly first turn on water, then a
reinforcer. I have been doing this since the end of November of 2014. Things are going rather well,
although not without a challenge, some days are better than others. I put a little / mark on my calendar
and tell myself this time next year!
Find out more about the status of Autism in Pennsylvania with the most recent census
information: http://www.paautism.org/en-us/inpa/pennsylvaniaautismcensus.aspx

Pike Autism Support Services (PASS) is a Federally recognized 501(c)3 Non-Profit

If you have questions or would like more
information about PASS or Autism
Spectrum Disorders please contact us at:

Pike Autism Support Services

209 E. Hartford Street
Milford, Pa 18337

8

Find us on Facebook:
https://www.facebook.com/groups/pikeautism
Visit us on the web:
http://passnepa.org/
Email us at:
info@passnepa.org
The information and opinions in this
newsletter about Challenging Behaviors and
Autism are not meant as advice.