Is it Non-Compliance or inability to Self-Regulate?

Is it Non-Compliance or inability to Self-Regulate? 

 

In the last two months, I may have had more than two or three dozen conversations where parents share that they are getting notes home from the teacher that their child is non-compliant. In most cases, the child or teen is avoiding the task they are being asked to complete. It has always been my belief that no child wants to fail. There is always a reason for the behavior so finding the reason is important.

With an autistic child, the question should always be what is the skill needed to complete the task and do they have this skill. The mindset should be a skill gap leads to task avoidance. Task initiation, avoidance, completion, and endurance all fall under the skill set of self-regulation. Autism impacts self-regulation and the gravity varies depending on the child’s autism profile. This impact results in skill gaps in the executive function which is the mental processes that are involved in managing oneself. In autism self-regulation and self-management will require support to organize their mind and bodies to complete tasks. The question to ask when there is task avoidance: what tool, strategy, resource or support does the child need to be more constructive? Not how do we manage the behavior?

Self -regulation is a process internal to one’s self that involves “controlling one’s behavior, emotions and the thoughts in pursuit of long term goals. Self-regulation is the core aspect of adaptive behavior-meaning adjusting to the situation. Executive Function is a set of mental processes that have to do with managing oneself and one's resources in order to achieve a goal and involves mental control and self-regulation

In the last few years, we have really placed an enormous emphasis on behaviors in autism. To the detriment of identifying the skill deficit that results in this behavior. The most common behaviors that are identified by a teacher for an autistic child are:

• BIG SKILL: underlying all these other skills is language acquisition (what words mean and how to put them together), for example asking for help, or a break when needed

• BEHAVIOR: does not transition from one task/activity to another

• SKILL: focus/attention, impulse control, cognitive flexibility

• BEHAVIOR: does not follow directions

• SKILL: attention, focus, listening, language processing and comprehension, working memory, impulse control

• BEHAVIOR: unable to get started independently or does not want to do work

• SKILL: initiate task -getting started independently requires sustained attention, impulse control (block distracting thoughts), and cognitive flexibility

• BEHAVIOR: not staying on task, scattered attention, getting up or distracted from the task with other thoughts

• SKILL: staying on task requires sustained attention, impulse control, and cognitive flexibility (shift attention back)

• BEHAVIOR: not completing work or tasks

• SKILL: task completion/finishing requires staying on task, sustained attention, impulse control, and cognitive flexibility (shift attention back) skills

Story:

Both of my kids have an incredibly unique and diverse learning style. When it comes to their ability to self-manage/self-regulate they are polar opposites. We all have unique ways to get goals accomplished. Self-regulation is goal-driven behavior. There are many skills involved in accomplishing goals.

My son was under-responsive to his environment. What that means is he had difficulty getting his mind and body organized to tackle the day.

Each child on the autism spectrum uniquely navigates their daily differently depending on their needs. They all need support with self-regulation/self-management because autism impacts self-regulation. So the inability to initiate or get started is not always behavior.

The level of difficulty in self-regulating is impacted in autism by the level of deficit in:

• social communication,

• the inflexibility of behavior,

• difficulty coping with change,

• or other restricted/repetitive behaviors .

In my son’s case, his social communication was greatly impacted at a young age, however, there was not a high level of inflexibility, coping with change, and/or restricted or repetitive behaviors. There may be several explanations for this but due to him being non-verbal we provided tools and supports that possibly allowed more flexibility in dealing with change very early in the diagnosis. We implemented the visual schedule and communication system PECS at 2 years old. This made his daily life predictable and consistent.

Since Nick was really not one to engage his environment we set up a routine that would promote engagement. He was a good baby and toddler he stayed where you left him. So much of our intervention was increased exposure and experience exploring the world. I viewed them as guided interactions and I was the tour guide. We engaged him frequently and consistently we did not allow him to be zoned out in his own world for too long.

There are children that are over-responsive to their environment and we can characterize them as extremely active and engaging their environment not always appropriately.

With this profile, the focus would be on activities and strategies to increase focus, calming, coping, and exercise. The over-responsive child can struggle in an academic environment where you are expected to stay seated for long periods of time. Sensory integration difficulties can make a child over-responsive since they are seeking to feed their sensory needs. Meeting these needs with a daily sensory diet is important to help bring balance to the child's mind and body. Ignoring sensory needs will lead to behaviors that can be managed.

In both scenarios over-responsive or under-responsive, what is important to know and understand is that the regulation/organization will need to come from the outside in for our autistic children.

The level of support will vary depending on their level of dysregulation. Why is this so important? Dysregulation is the first thing that is seen, typically called behaviors. Why do I not call it behaviors because everything in autism is not a behavior although it may appear that way to so many?

What presents as behaviors is an autistic person attempting to navigate their surroundings with no tools.

My son’s toolbox was extensive. Since he was not able to communicate substantially till age 4 we started with PECS at age 2 and continued with a communication device. We also invested much time in teaching him to meet his own needs. His intervention plan prioritized language development, communication, and independent function over all other interventions. The communication tools made his world more organized, and predictable as well as outline social expectations. They also repeated the language for him that applied to that situation. It gave him the order he needed to proceed and explore the world more safely.

Skill: Self-Regulation

Self -regulation is a process internal to one’s self that involves “controlling one’s behavior, emotions and the thoughts in pursuit of long term goals.

Promoting self-managing in autism requires focusing on building independent functioning skills. This requires intervention planning that prioritizes these skills over academic instruction. It is critical in autism that the child can navigate their classroom or any environment as independently as possible.

Initiating a task and completing a task independently is more important than advanced academics. Having an advanced reading level is great however, if the child cannot read independently. With autism know how to do a task is just as important as doing task independently.

Strategy:

Providing a support system to help the child organize, manage sensory needs and engage. This is a toolbox that will evolve with your child’s development. Having an autistic mind means that you learn differently so you must have the tools to support this learning style. The expectation cannot be that the child will develop a skill independently without instruction or support.

The expectation that a child with autism will self-manage independently continuously and consistently without organizational tools and strategies is the same as you expecting to navigate your day without your smartphone, laptop, or planner.

• Thinking tools!

  • schedule: provide a structured learning environment that is predictable with advance notice

  • visual schedule, checklists, and reminders in lieu of verbal prompting

  • additional time makes the world of difference for a child that is trying to organize their mind and body continuously

    • providing additional time for transitions

    • providing additional time for initiation of task

  • written instructions or steps for tasks that are difficult such as writing or reading comprehension that require the child to generate and organize language

    • story maps - outlines the story

    • writing prompts to get started on an essay

    • reading and writing tasks are split into sections/steps

  • work folder - organize tasks

  • breaks - a child with autism uses their brain for social, emotional, and academic so frequently there is mental exhaustion incorporating movement, sensory or quiet space breaks can restore focus and endurance

• Build

  To build self-management skills it’s critical to use the same systems, strategies, and tools consistently. Secondly, use the same systems, strategies, and tools across environments. The goal is to build independence and help your child to manage their own needs. The biggest challenge in setting up these systems is that you need to self-organize to sustain a home environment that can follow the system that you set up. Consistency is the hardest for families for obvious reasons.

Better to teach one skill consistently than teach 10 skills inconsistently. The autism learning style requires varied repetition. Not just repeating the task in the same way but varied ways to also increase the mental flexibility.

 

Works Cited:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).