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2

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  PASS’s  president  

2  

It’s  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  EEG’s  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   didn’t   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  parent’s  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   child’s   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   weren’t   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  Evan’s  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.   I’m   so   proud   of   how   far  
he  has   come   and   using   Social   Stories   is   a   big   part  
of  that  success.  

 

 
2  

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

1
2

Passages  
 

Issue  #  1,  March  2015  

It’s  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  let’s  look  at  his  
message:   all   behavior   serves   a   purpose,   and   until  
we  find  out  what  that  purpose  is  –  ie,  the  WHY-­‐   we  
won’t  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…  

3  

 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  

 
 

 
4  

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  I’m  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.  
BCBA’s  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  

 

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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  child’s  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  child’s  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  child’s  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,  don’t  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  doesn’t  mean  I  don’t  continue  to  work  really  hard  
on  the  behavior  or  cry  and  want  to  pull  my  hair  out.  
Let’s  face  it;  it’s  not  easy.  While  some  behaviors  will  
be   extinct   in   a   blink   of   an   eye,   others   seem   like  
they’re  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.   It’s   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  don’t  work  out  right  away.    How  often  have  I  
said,  “I’ve  tried  and  tried,  but  it  doesn’t  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   don’t   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.   It’s   my   way   of   keeping   track   of  
what  does  and  doesn’t  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   I’m   the   one   that  
Continued  on  pg.  8  
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 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  it’s  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  (I’ll  
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  
 
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The  information  and  opinions  in  this  
  newsletter  about  Challenging  Behaviors  and  
Autism  are  not  meant  as  advice.