Ask any parent how they feel when their child throws a tantrum or has a public meltdown and most will tell you it’s frustrating and often embarrassing. But for mother of two, Nabila Usman, frustration had turned to distress as she struggled to manage her son Anas’s increasingly challenging behaviour.
Five year-old Anas has a diagnosis of Autism Spectrum Disorder and began receiving services from Therapy Focus in early 2018. When his behaviours began to escalate, Advanced Speech Pathologist Christine Bosch saw that Nabila was struggling to cope and enlisted the support of Therapy Focus’ Behaviour Support Team.
“Anas had become very aggressive and would hurt his younger sister. He would throw and break things and have terrible meltdowns out in public and at home, which made going out or having people over very difficult for the family. To make matters worse, his sister had started copying these behaviours,” Christine said.
“Nabila would cry most days. She felt sad for her son because his behaviour was causing others to dislike him and was so concerned that she couldn’t sleep at night and had started taking medication.”
Therapy Focus Behaviour Support Clinician, Rachael Tan, began working with Christine and the family to address Anas’s escalating behaviours. She said that the first thing she did was to identify why the behaviours were occurring.
“In our first session together Anas screamed, threw things, slammed doors and hit his Mum and sister for the full hour. Based on my observations, and from what Nabila had told me, most of these behaviours were for attention or to get something he wanted.”
Rachael encouraged Nabila to use a strategy known as Planned Ignoring, which Nabila found difficult at first, having always responded to her son’s outbursts.
“When behaviours are inappropriate but safe, I encourage parents to make a mindful decision to ignore the child,” Rachael said.
“When we react or respond to inappropriate behaviours we’re actually reinforcing or rewarding those behaviours. Nabila was giving Anas a lot of attention for inappropriate behaviours by telling him off, giving him cuddles or trying to give him time out.”
“I asked Nabila not to look at him, and not to say anything, to just ignore him. She found this really hard because, like a lot of parents, she felt she needed to be doing something to discipline or calm him. Planned Ignoring feels passive, but it’s actually active because you’re purposefully avoiding reinforcing the behaviour.”
“I also talked to Nabila about ensuring she gives Anas lots of praise and attention whenever he is behaving appropriately. This helps him learn that he will get attention for doing nice things, rather than things like screaming and hitting.”
In addition to Planned Ignoring, Rachael and Christine helped the family implement use a simple ‘First-Then’ reward system to support Anas’ behaviour during routines such as mealtimes.
“Anas was very resistant at mealtimes and would scream until he got the food he wanted. So we used a ‘First-Then’ system to explain that, first you eat your breakfast, then you get the chips you want – for example,” Rachael said.
Since accessing specialist behaviour support services for the family, Christine said that there have been dramatic changes in both Anas and Nabila.
“Nabila has learnt to be patient and wait Anas out – not give in to his bad behaviours. She now feels in control and knows how to handle difficult situations,” Christine said.
“Anas has started paying attention to his mum, listening to her instructions and understands the consequences of bad behaviour.
“At our last session he was so engaged and showed an openness to learn. He has started to play, communicate and interact with others in a more positive way.”
“Rachael and I can’t believe the difference. Our first session with the family was screaming and mayhem, but we left the fourth session listening to happy laughter. And for the first time in 18 months the family was able to go to dinner at a restaurant for three hours!”
For more information about Therapy Focus’ specialist Behaviour Support services, visit https://therapyfocus.org.au/behaviour-support/
Note: As Nabila’s second language is English, Christine helped her share her experiences in this article.