Biting; How to Help Your Child Communicate Without Aggression
Aggression can very easily creep in and build to overshadow other progress.
It’s been a painstakingly long process, but the data shows we are past the end of the extinction bursts of this behavior. The original blog entry addresses the first round.
The update addresses how the behavior came back with a vengeance and how we’ve worked through years of aggression to get to a more peaceful place.
It seems ridiculously simple; reward functional communication. If you don’t notice or pay attention to peaceful communication, aggression will follow. Your child is smart. If aggression gets a faster, more effective response from you or from anyone on their team, aggression will become the default method your child uses to communicate.
But even understanding this simple concept, it took us several years to get everyone on my son’s team on board with addressing functional communication over aggression.
For this section, my focus will be on biting, but you can substitute that word with any aggression you may be dealing with.
From February 2, 2017
The short version
- Protect yourself and others from your child’s violent behavior. Block them from hurting you. If their teeth are already clamped down, find an efficient way to get them off of you.
- Reduce any possible reaction to the violent behavior.
- Reinforce good behavior. After an outburst, as soon as your child is calm, offer an appropriate reward for them calming down and for their replacing the aggression with functional communication. The most effective reward includes some expression of love.
The long version
Good News: It is possible to help your autistic child to stop biting, especially while they’re young. Violence from children with autism, especially severe autism, is known all too well among members of the community. From yelling and scratching to throwing and biting, these violent acts are dangerous both to individuals with autism and anyone in the vicinity during a violent outburst. This is a challenge that can escalate quickly, so there is no time to wait to address this behavior.
First I’ll address WHY your child bites. They are smart! They recognize that biting a person creates a shock to their system which in turn results in an immediate reaction. The reaction can be entertaining or it can be a form of attention. Even if that attention is negative attention, it is still attention. Any reaction to the biting serves to reinforce the behavior. The reason that so many adults with severe autism continue violent behaviors is because those behaviors have been inadvertently reinforced so many times over many years, without parents or caregivers, or other developmental team members realizing it.
I discovered this by consulting with my son’s speech, occupational, food and ABA therapists. I had attempted various approaches that eventually failed to deal with the issue of my son’s violence. I tried consistent time outs. I tried saying, “No!” or “Stop it!” I tried special chewy necklaces designed for kids with autism. I tried holding his jaw in a specific way and pinching the nose, directed by his first ABA consultant. NONE of these methods worked for my son.
After reading about the case of Sky Walker, I was terrified, as my instinct confirmed what could happen years down the road if the aggression were to continue. I knew I had to help my son to curb his behavior or it would only worsen with time with irreversible consequences. He is growing bigger and stronger every year, and eventually he’ll experience puberty, which, for many autistic children, intensifies violent outbursts. http://blog.cleveland.com/metro/2009/12/kent_state_professor_trudy_ste.html
Learning about this event, I realized that the worst case scenario of my son’s potential futures was worse than the possibility of him ending up in a group home. The new worst case scenario was an option I could not allow. And now I have a solution.
As mentioned earlier, this is the problem to be conquered: Our natural human reactions to the child’s violence serve to reinforce the behavior. If you gasp or make a surprised facial expression, that is entertaining for the child. If you yell or say, “No!” to them, they take that as a form of attention. Negative attention is still attention. Holding the jaw yields the same result. The chewy necklaces are just a temporary fix that treats the symptom. Time outs serve as a break or an escape for your child.
There is only one safe and sure solution: Eliminate Natural Human Reactions, and substitute the behavior with a safe way for the child to communicate their need and have that communication immediately rewarded.
Eliminating your natural reactions means having NO REACTION. That’s right. Your instincts to gasp, cry, chide, scold, yell, or even to hit back are teaching your child to continue biting, hitting, scratching, etc. Stop all your instinctive reactions and STAY CALM.
The professionals are taught this skill, but for some reason it had not been passed on to me at first, despite my continuous search for answers. The statement that allowed me to figure out the solution was made by one of my son’s new ABA therapists who was working with children after working with autistic adults. She explained that adults have retained the violent behaviors because it has been reinforced so many times. That’s when I realized that everything I’d been doing to try to stop the behaviors was actually exacerbating the problem.
Physically and emotionally ignoring the violence is vital. Assuming you are already REDIRECTING, PROVIDING STRUCTURED SENSORY INPUT (described in the next section, “How to Help Your Child Concentrate), and
PAYING ATTENTION TO YOUR CHILD’S NEEDS; another necessary factor may be missing.
The last time that my child bit me (at the time of this writing) was very scary. He pulled out some of my hair. Initially I kept my cool, as I’d been practicing. I calmly removed him to his room. He was so heated that he kept attacking me, teeth bared, “claws” out, growling. He scratched my arms and bit me so hard that the mark swelled up for days afterward. I held back tears. I thwarted the instinct to knock him down and hit him (When anyone is attacking you—even your own child, your survival instinct surfaces. The feeling is involuntary; It’s how you handle it that matters).
He would temporarily calm down, but then his outburst kept returning. Not reacting was insufficient in this situation.
Finally I had the idea to give my son POSITIVE REINFORCEMENT. As I held him, I stroked his arm and told him every good thing I could think of, “I love you. I’m so glad you’re here. I’m happy you are my son. You are so smart. You are so cute. You are amazing and wonderful. I love you …” I repeated the list of good things. He finally relaxed and this time remained calm.
Next: DO NOT REWARD THE BEHAVIOR. After the child becomes calm, help them use a functional communication for what they are trying to escape or access; This can be a word, picture, or hand gesture to represent something. For example; if they need a break from the current activity or area, they can say “break”, or tap or hand you a picture of taking a break, or use the ASL sign for break.
If they’re trying to access a treat, or activity, or toy, or video, etc, make sure they have a functional, calm way to ask for that, and help them use that symbol or gesture before giving them that reward.
As I continue applying the skills I’ve learned to calm him, he may have sporadic outbursts known as extinction bursts, where the biting behavior returns for brief intervals. But now I know how to address an outburst without unknowingly and unintentionally rewarding it.
*Note: Over 4 months later, my son had almost entirely outgrown the biting behavior. I used to bare marks on my arms in a different place each week from his attacks. At the time of this post, I could not remember the last time he’d bitten or scratched me. His ABA data showed it had been over a month since the last bite.
Update Spring 2021:
I followed the top recommendation from my son’s diagnostic kindergarten class, sending him to a school entirely dedicated for special needs in first grade.
After his experience there I can say this; it seems like a positive experience for students who don’t have as much room to grow. My son was sent there for his behavior issues, which had continued to decrease over the summer before attending. His new teacher at the special needs school called him her angel child because he followed directions so well at that time.
He had been progressing with ABA therapy at home; thirty hours per week for 7 months. I was not aware at that time that there were better options for him, since they were not recommended by his previous school; options like regular schools, with special needs classrooms, including mainstream time during the day—integration as opposed to segregation.
For a child with untapped potential, being cut off completely from neurotypical or “normally” developing peers, put a figurative wrench in the gears of his development. My son was surrounded by students who all also had behavior delays, and none who were at a typical level that he could have been learning to imitate.
Everyone misses out when students are separated to this degree. We adapt, we invent, we solve bigger problems with better solutions together. We hurt ourselves and each other when we exclude certain groups. How can we prepare our children to interact in the world with neuro-differences if we separate them completely in their schools?
Instead of being given the opportunity to imitate neurotypical children his age, my son was given a limited selection of people a lot like him to imitate; a dozen other kids in the behavior class along with all his other peers at the special needs school. Like a sponge, thirsting for information, he adapted to all the new maladaptive behaviors.
This was evidence of his intelligence and potential; he implemented the new behaviors that achieved the needed results in the fastest, easiest way possible. He found creative ways to meet his own needs, when he was not given more functional ways to meet those needs.
After a few months he would not comply with directions like he did in the beginning, when the teacher had been calling him her angel child. Though the staff at the time must have had good intentions, they unwittingly rewarded the maladaptive behaviors and discouraged appropriate behaviors. Here’s what that looked like;
*First; it’s hard to write about it and put it out there because these people are practically saints. They dedicate their lives to serve a cause that is underappreciated and misunderstood. I remember how bright and happy the environment of the school was, and that they even had all the students participate in an annual play. If you remember only one thing I write about what happened, I hope it’s that positive light.
Furthermore, I am by no means a perfect person. We are all on this journey together; and I’ve made my fair share of mistakes, some of which I am still striving to forgive myself for. With that qualifier, I venture to paint a picture for you of my son’s journey at the time he attended his special needs school.
He continued to communicate well at home with his communication device, but he was denied a device at the school so he did not communicate appropriately at the school. In fact, over three months into his first grade year, when he was finally given his PECs binder from kindergarten, so that he at least could communicate with handheld pictures, most of the pictures were from items he missed from his previous classroom and were no longer available to him. So, when he repeatedly requested these items and was repeatedly told ‘no’, he learned that communicating was emotionally painful, so he stopped trying. When I read this information in a subsequent investigation by a disability lawyer, I almost couldn’t believe it. I couldn’t bear it; I couldn’t go back and change what he’d been through; And it gets worse.
Remember how the aggression had decreased and almost extinguished before the school year started? I also saw the school’s data on the aggression from the investigation by the disability advocate.
The data showed one bite in August; another bite in September; then a gradual increase of bites in October and November. By December the biting behavior was daily. Eventually, by March, it was 5 times a day at school.
What we discovered is that my child was using the act of biting to access breaks. He’d clearly figured out that the consequence for biting was a time out, which to him is a break. At home with ABA therapists he’d already learned to use a break card to peacefully request a break for free time. The break card is the most important tool to introduce with your child if they are using aggression or other maladaptive behavior to escape an activity.
At my son’s initial intake meeting, months before he’d attended the school, I’d requested one-on-one ABA support in the classroom. His team through the behavior company had even offered to act as an outside provider, which insurance laws in our state support via their policies; this was made possible due to a five-year process vested groups in our state took to discuss and figure the whole thing out about whose responsibility it is to pay for these services when needed. It was decided that ABA (Applied behavior analysis—or data driven intensive behavior therapy) is a medical need.
But for some reason schools, and the Utah State Board of Education, at that time hadn’t gotten the memo, or acted like they hadn’t. I’ve written more in my book, Heard Without Words about the process I went through, along with more parents, to push the ‘memo’ forward, so to speak. The following year the USBE (The Utah State Board of Education) held a summit with various school administrators, teachers, etc. to present and discuss when it’s appropriate to include ABA in a student’s IEP. This was a huge accomplishment after the year we had at the special needs school, when my son was repeatedly denied services necessary to his developmental education.
After the disability lawyer filed due process with the special needs school, my son was transferred to the top elementary school in the state with an established special needs class, integrated daily with a mainstream class. Additionally he was finally allowed the type of one-on-one aide I’d been requesting for a year. He was the only student in Utah at the time who was assigned an RBT (registered behavior technician) in a public school setting.
We finally broke through that barrier. I’ve heard since then that many other students here have also been able to access that service necessary to them.
It took a year to finally obtain that service, and we are extremely grateful to all who made that possible, and to my son’s original team for trying with the best tools the state and district would allow. It takes massive force to move a massive system, like state education; and I for one am glad we are seeing that force in action.
During the year it took to obtain that service, my son’s behavior worsened so significantly that we had many dangerous, life-risking moments. And it is now three and a half years since we’ve changed his situation and we are just barely getting almost back to the progress he’d made with near-extinguishing aggression before attending the special needs school.
In those three+ years we’ve made gradual steps forward; and perhaps I’ll save more stories from that phase for another time.
Update Fall 2021:
He bit again for the first time in 74 days. That is huge progress! At the special needs school, his biting had increased from once a month to 5 times a day.
5 times a day in 74 days is 370 bites. So he’s made a 99.5% improvement since then.
It still was upsetting. I mean, he bit my face, and he’s ten. So now I have a “fun” bruise that’s healing. As a family we discussed the antecedents to the event. He was escalated. My parental instinct was to comfort him. I didn’t follow the BSP (Behavior Support Plan), which is to give him space when he is escalated; safety first! Instead I picked him up and held him, and asked him a question, which was too stimulating, especially since he was already overstimulated with sensory input.
This event was a strong reminder, with a physical wound, to stick to the safety plan. Our initial reactions were not good. There was yelling and extreme blocking in an effort to protect more people from being hurt. We are all learning. We all apologized to each other afterward, and built each other up with kindnesses, and commitment to choose better responses in the future. I’m the only one with a bruise, and that will go away. We are all working through the emotional trauma together. We’ve had years now of working past these kinds of experiences. And it’s super exciting that they are fewer and farther between.
One bite in 74 days is a hell of a lot fewer than 370 bites in the same period. We most likely, if not certainly, would not be experiencing this, if the system had been set up to include my son, and provide the services needed at the time his progress had reduced biting to once a month 4 years ago. The fact that the school system increased his aggression by 150% in half a school year shows that something is wrong and needs to change.
I already helped change the system by setting a precedent for one-on-one RBTs to be present in the classroom, and that’s a great move forward. But it doesn’t need to come to legal battles. We should be able to have logical conversations with our IEP teams without the school board setting standards in special needs cases that inevitably hurt the students, families, and communities for years after.
Let’s work together and learn what it takes to create and celebrate real progress towards sustainable scholastic and home living, sans unnecessary trauma.
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