In this video series, I give my thoughts and suggestions about the treatment of children with autism. I believe physical therapists have a lot to offer to this …
Hello! My name is Amy Sturkey. I'm a
pediatric physical therapist,
and I'm doing a series on just my
thoughts on
how to work with children with on the
autistic spectrum.
And one of the things that people say
they have a really tricky time with is
how to deal with
a child's behavior. So I wanted to talk
my thoughts and philosophies on behavior.
I'm going to do a couple of videos.
In this video, I'm going to talk about
the functions of behaviors.
And according to who's
presenting the information there could
be two functions of behaviors. There
could be
four functions of behaviors. It could be
five. There could be six.
For my…I think seven on somebody
else's group.
On mine I think about six really
important functions of behaviors when
you're looking at
behaviors you might be dealing with
with your child. So the first one I
always like to try to rule out
is medical issues. So when I was growing
I often had my mouth open.
I had my mouth open when I was
talking or when I was just hanging
often I just had my mouth open.
And my family used to try to get me to
close my mouth,
not from just talking just having my
mouth open.
And so they would come around and pop me
up on my chin to remind me, or "Amy, close
your mouth."
And I never could change that behavior. I
also was a big snorer.
So my family, my sister particularly,
because I shared a room with her, would
get me up in the middle of night and
walk me around and get me get back into
bed and try to go to sleep before I started
snoring. And no matter what they do they
could never change
me from snoring. Well it turns out I have
a deviated septum.
So no matter what they did, it wasn't
going to change
my behavior because I had a medical
problem behind
my behavior that explained it. And there
was no way to change it.
So one of the things you always want to
look at is there a reason that's
medically related. For example, my father
whenever he'd get really hungry, he'd get
grumpy. The only way to fix that was to
feed him.
And the same thing with our kids sometimes.
Sometimes, our parents will
tell me,
"Well, he didn't sleep well last night."
So he could be more
hyperactive or more tired the next day,
because he did not sleep well. I
have another child who had ear
infections. And when she had bad ear
she was really really clingy. And she was
I thought that her balance was off, and I
was working on fixing her balance.
But the core of what needed to be
changed was that she had an ear
So the first thing I look at is to rule out
is there a medical issue that's causing
the behavior that's really bothering me
or the family.
So the second function of behavior is
A child is doing something to get out of
doing something.
If this is what you perceive your child
is trying to do, to get
out of work, get out of what you need
them to do,
then no matter what they do you need to
make sure
that they do what they have to do. So
if you allow them to escape and allow
them to get out of your expectation,
then they remember that that screaming,
fit that they had…worked. Thumbs up. I'll
remember to do that again.
And so they can learn to control you
with their behavior.
So it's really important that
if a child I'm trying to get them to
walk down the hall, and they don't want
to walk down the hall
that I physically assist them walk down
the hall
and do what they're supposed to do. In no
way shape or form if a child
is not wanting to jump, then I go, "We're
going to do it three more times." And I
will physically help them
finish it, get it done. And then I will be
the one that decides when it's done, and
something I think is really important.
Sometimes I think families
let the child choose when they're done.
At a certain level
it's really important that I'm the boss.
If they're done, then I'll go, "Okay we'll
do two more or we'll do one more. But it
ends up being
me, saying we're done, not them. Because I
don't want to set a precedent that they
they're in control. It's really important
that the parent
or the clinician is in control. So escape
is a really tricky one. It can be
really hard to deal with. But I'll tell
you what, if you handle it and a child
that what you say and what you mean is
business, then they're going to give you
less bunk in the future.
But if you sometimes cave and they think,
"Oh, that worked" then they're going to
push that button
over and over trying to get out of
whatever it is you want them to do.
So escape is a really important one.
Okay the next function of behavior–the
last one was to escape something. This is
actually to get something. They're going
towards something.
And whether that's appropriate or not, or
it's something you want them to have or
not, that they'll give you a behavior to
try to get access to something that they
So this one is really a positive. They're
motivated towards something. So one of
the first things I do as a physical
therapist is I find out what a kid likes
and then we work toward getting what
they like.
Sometimes what they like or want is not
something you can provide.
Now the research says with mice, for
example, that if
a mouse wants some food and they
set up something so they push a button
and they get some food, and the
mice figure out push the button get the
food, push the button, get the food. They
push the button a whole lot.
If they do a study to try to
extinguish that behavior–get them to
stop pushing the button,
then what they did two groups they had
one group that cold turkey
they no longer once they pushed
the button/rang the bell,
they no longer got the food. Those mice
figured out
really quickly, I don't push the… if I
push the button, nothing happens.
Heck, I'm not going to push that button
anymore. On another group,
they sometimes reinforce the mouse–
sometimes when they pushed the button ring/
the bell
they got the food. Those mice
did it so much more because
sometimes it was rewarded. So it was like
ding, ding, ding, ding, ding, ding. How many
times do I have to do this to make this
Don't do this to your child. If there's
something you're trying to break your
child of trying to do
that they're trying to get, don't
sometimes reinforce that behavior–
sometimes give in. You need to be really
otherwise you're going to be dealing
with this behavior for a lot
longer. And then the other thing you want
to do is
learn to use things that your child
wants. Now this can be really tricky.
Because I do lots of things in my room
so that
if you do this, then you get that thing
you want,
if it's appropriate. Now that's tricky
because sometimes our children
don't have a– can't hold two things in
their head.
They can't think of if, one, I do
then I get that. It's only right now or
never. If I don't get it now,
I'll never have it. That's really, really
But I'm telling you that if you practice
this skill
of having them do something and then
they get it,
that's how they're going to tie those
two things together and help them learn
those two concepts.
And I'm telling you that that concept
of "if I do this, then I get something"
that is massive. That is life
changing. It is so important, because then
you can learn to negotiate with
your child. And they can feel like
they can do something positive to get
what they want.
So this is the third, the third function
of behavior,
to act a certain way to get
something that you want.
Very important. So that is
one through three of the functions of
that I really consider strongly when I'm
working with children who are on the
autistic spectrum. I hope that's really
I'm going to do on the next week's
four, five, and six. But this is a good
I'll see you next time. Thanks a lot!

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