A summary of the Greg Hanley presentation on intervention on stereotypy
Stereotypy is the repetitive behaviour a person engages it. We all do it- hair twirling, leg/ feet shaking, finger tapping...etc. When it comes to a person with ASD, this may come in the form of hand flapping, head shaking, hand gazing, repetitively talking about a topic or repeating phrases heard in a movie/ video.
Shouldn't we accept people with ASD to display stereotypy instead of treating it?
Yes, you may ask, “Why does stereotypy needs treatment?” or you may feel that “treating” stereotypy is preventing a person with ASD from being who they truly are. If you strongly believe a person with ASD should be able to express themselves through stereotypy, and they should not be taught to mask their differences, carry on reading, because you will be surprised by the principles of this “treatment” and how it is done!
When does stereotype need treatment?
Ultimately, it is about interfering with daily life. If these behaviours prevents a person from learning, or it is socially stigmatising and affects the person building meaningful relationships, then treatment is needed. When we say treatment however, it doesn't mean the person has to stop engaging in stereotypy completely. It is rather about them learning to do it at the right place in the right time, so that these behaviours are not inhibiting the person from day to day functional activities. In other words, if a child engages in hand flapping every now and then when they are on their own, not doing much, it is absolutely okay. If they flapped their hands during learning, and you can easily re-direct them to engage in the task, there is no need of intervention either.
How do you treat stereotype then?
In the last article we talked about delivering function based reinforcers, so that we are acknowledging what the person really wants matters. In this case, the same principle is at work- when the person stops engaging in stereotype under instruction, the reinforcer is time to engage in stereotype. Of course we don't just ask the person to stop spinning an object and sit there to do nothing. While they are not engaging in stereotype, they are being taught other skills such as functional communication (asking “can I play please?” to access time for stereotype) or academic tasks.
What if the stereotype is inappropriate or dangerous to the person?
Behaviours that may look socially inappropriate can be engaged in a private area, and dangerous behaviours such as will need to be replaced by a safer, functional equivalent alternative. For example, if the person likes to put non-food items into their mouth, it will be replaced by eating/ chewing safe items as a reinforcement of the absence of ingesting non-food items.
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Written by Danthy Lo Leça, a Behaviour Analyst who is passionate about training, working with schools and being creativity in her practice