Axel's Autism: Challenges & Solutions for the Saunders Family - Essay Sample

Introduction

Axel's parents, Jeanette and John Saunders, sought help because Axel has recently been diagnosed with an Autism Spectrum Disorder and expresses behavioral challenges that they feel are related to the autism. The parents report that Axel exhibits rigidity, non-compliance, tantrums, and physical aggression on a daily basis. These behavioral challenges can occur up to five times daily and negatively impact the rest of the family. Axel's behavioral problems have resulted in lateness, missed appointments and canceled activities because he typically expresses the challenging behavior when the family is preparing to leave the house. The behavior usually follows a pattern. The pattern typically begins with a rigidity which results in non-compliance. When the non-compliance is challenged, a tantrum follows during which he may display acts of physical aggression.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Indirect Assessment

Indirect assessment involves collecting information on the client through other parties or means other than direct observation (Miltenberger, 2016). The subjective nature of indirect assessment makes it less trustworthy than direct observation but it remains a crucial source of information (Miltenberger, 2016). For Axel's case, the Parent Interview Form for Functional Behavioral Assessment and the Autism Treatment Evaluation Checklist (ATEC) were used to collect data on indirect assessment. Standardized measures were also used to assess Axel's cognitive and language behavior patterns.

The assessment corresponded with the parent's concerns concerning Axel. Rigidity, non-compliance, and tantrums were the behavioral takeaway from the FBA forms. The assessment also showed the typical pattern of behavior and how the response Axel got reinforced his behavior. The behavior followed a pattern that started with rigidity, which was followed by non-compliance and the tantrums. Axel had a variance score of 67% for the ATEC assessment. He had good language skills, socialized well with peers and was only slightly behind his peers developmentally.

Direct Assessment

The direct assessment involved direct observation of Axel's behavior as he went through his daily activities using the Antecedent-Behavior-Consequence (ABC) Data Collection Form (Steege, 2009). The assessment was done over three days from 8 A.M to 5 P.M with the assessor and mother present throughout the assessment (the other family members went on with their routines as usual and were not present throughout the period). The A-B-C data collection form allowed each instance of problematic behaviors, the events preceding it and events succeeding it to be recorded (Miltenberger, 2016).

The A-B-C form showed that the primary antecedent involved Axel being asked to do something like getting ready for school. This was typically followed by rigidity and non-compliance (ignoring the request at first then yelling No!). When the request was reaffirmed and assistance offered to meet the request, a tantrum typically followed. The consequences observed generally involved the mother allowing or offering Axel an escape from the request made. His initial non-compliance was often ignored for some time until it became apparent that further delays would result in lateness. The mother's offer of assistance to get ready also constituted providing an escape for Axel. The assessment showed that Axel typically has 4 tantrums a day each lasting about 10 minutes. The behavior was typically worse when the request made involved leaving the house.

Line Graph of Baseline Data of Target Behavior

Probable Function of Behaviour

The assessments identified the probable function of challenging behavior as Axel's means of escaping unwanted activities. The behavior occurred most consistently when a request to leave the house was made suggesting that it is typically designed to avoid going out of the house.

Target Behavior of Concern

The behavior of concern was identified as instances of refusal to comply, screaming, crying and aggression that occurs for more than 20 seconds whenever Axel was asked to leave the house.

Function-Based Behavior Intervention Plan

The indirect and direct assessments of Axel's behavior identified a request to leave home as the primary trigger for his behavior. The request to leave home forms the primary antecedent in this case and needs to be managed better to effect behavioral change. The best way to achieve this is by ensuring Axel receives ample psychological preparation for leaving the house through both visual and verbal warnings.

A timetable with ample visual guides that clearly shows when Axel will be expected to leave the house for school or appointments will help prepare Axel psychologically. The timetable should be put in a place that is easily accessible to him. In addition to this, Axel's mother should prepare Axel by giving him frequent warnings and ample time to prepare when he has to leave the house in non-emergency situations. The first warning can be given three hours beforehand, the send two hours beforehand, the third an hour beforehand then thirty minutes before and the final warning 15 minutes before leaving.

Assessing the efficacy of the psychological preparation intervention will be difficult because of potential ethical concerns (Gabor et al., 2016). A research design will be useful but only a correlational research design in an A-B form can be used because of ethical concerns about terminating the plan to see if the poor behavior would return. The plan can be introduced in bits (one-hour warnings, two-hour warnings then three-hour warnings) to allow effectiveness to be gauged.

The problematic behavior of tantrums should be managed by identifying and providing an adaptive behavior that replaces the tantrums and serves the same function. In this case, an intervention plan would serve to teach Axel the replacement behavior (Gabor et al., 2016). Axel throws tantrums to avoid leaving the house when he is required to so his replacement behavior can involve expressing himself in a better way rather than through tantrums. Axel should be taught to verbally express himself to other family members and tell them why he doesn't want to go out. He should also be taught to identify his feelings and express them in words. The intervention plan for his tantrums will be best achieved through using differential reinforcement of alternative behavior (DRA) which encourages desirable behavior and discourages undesirable behavior. For DRA to work effectively, the desirable traits(in this case effective communication) and undesirable traits (tantrums) must be well defined.

Axel's mother noted that he liked candy, singing and watching cartoons. These can be used to reinforce good behavior (Gabor et al., 2016). Every time Axel expresses himself well using words rather than tantrums, he will be given a piece of candy and verbal validation. If he manages to express himself well without tantrums five terms he will get to watch cartoons for 30 minutes and if he manages it 10 times his mother will sing him his favorite songs.

The DRA framework should proceed until Axel begins utilizing the desirable behavior consistently. After that, the positive reinforcement should be withdrawn gradually so that Axel can learn to behave appropriately without expecting rewards. For instance, he can be given candy every other time he behaves well rather than every time (Gabor et al., 2016) while verbal validation is maintained throughout and should be the last item to be withdrawn. The number of times he needs to behave appropriately to watch cartoons and to have his mother sing can be doubled and the rewards are gradually withdrawn.

For effectiveness, it is also important that the undesirable behavior is tackled. Axel's Parents need to learn not to reinforce his bad behavior by providing escapes and validation. His mother will be encouraged to be firm when a request is not met and to avoid giving Axel assistance or attention when he is throwing a tantrum. Withholding validation and rewards will also serve to discourage undesired behavior (Gabor et al., 2016). For the DRA intervention to work effectively, other members of the family will have to be taught how to manage Axel and to give him time to form appropriate responses.

Assessment of Mastery and Discharge Readiness

Constant improvement with a few setbacks is expected for the duration of the intervention (Gabor et al., 2016). However, for Alex to be considered to have mastered the desired behavior when he can communicate effectively without tantrums and without expecting rewards across all settings. However, he can be discharged pending the completion of the program once his behavior is deemed to have sufficiently improved (Gabor et al., 2016). Axel can be considered ready for discharge when verbal validation (applause) is the only positive reinforcement for desirable behavior that is still being applied without significant lapses.

Conclusion

Axel Saunders expresses undesirable behavior that includes non-compliance, rigidity, and tantrums. The intervention should effectively address the behavioral challenges identified. In this case, psychological preparation and Differential Reinforcement of Alternative behavior (DRA) which utilizes positive reinforcement will be used. The short term goal is to ensure Axel can leave home without causing tantrums. The long term goal ensures he can communicate effectively without in all situations without resorting to tantrums.

References

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis, 2nd Edition. Upper Saddle River, NJ: Pearson Education, Inc.

Gabor, A. M., Fritz, J. N., Roath, C. T., Rothe, B. R., & Gourley, D. A. (2016). Caregiver preference for reinforcementbased interventions for problem behavior maintained by positive reinforcement. Journal of applied behavior analysis, 49(2), 215-227.

Miltenberger, R. G. (2016). Behavior Modification: Principles and Procedures, 6th Edition. [Purdue University Global Bookshelf]. Retrieved from https://purdueuniversityglobal.vitalsource.com/#/books/undefined/

Steege, M. W. (2009). Conducting School-Based Functional Behavioral Assessments, Second Edition, 2nd Edition. [Purdue University Global Bookshelf]. Retrieved fromhttps://purdueuniversityglobal.vitalsource.com/#/books/9781606237267