When should we NOT intervene?
“What do you mean, we should NOT intervene?!”
I met with a service provider last week, for a really interesting discussion about a young person they were working with.
The young person in question collected some rather unusual items... I won't specify what he collects, as it's specific enough that it might make the child identifiable!
The service provider expressed some concern, and asked whether my input would be helpful in reducing the item collecting. My question was:
Quality of life is all about improving a child’s physical and emotional wellbeing. Behaviours of concern may reduce quality of life in situations where they occur to a frequency, severity or duration that means they impact the child’s access to ordinary provisions, such as being able to do activities that they enjoy, go to everyday places that we might take for granted, and engage with the world around them. Changing behaviour should always be in the child’s best interest, and improving their quality of life should always be at the centre of our decision-making. Essentially, if the child is communicating that the want or need something through their behaviour, it’s helpful for us to try to create an environment where their needs are met, and where they have other - more effective - ways of communicating than engaging in behaviours of concern.
So collecting strange objects - although SOCIALLY unacceptable - does not impact the child’s quality of life. And it was something that the young person in this example specifically did NOT want to change.
So my response was that there's not scope for behavioural intervention in this case. Although we might continue to work on some of the verbal and physical aggression, collecting unusual items will not be part of the scope of behaviour change programmes that we create.
“So what sort of behaviours would we NOT intervene on?”
At Draig Behaviour Consultancy, neuroaffirming practice is very important to us. This means that we don’t intervene on DIFFERENCE - we intervene on quality of life.
Sometimes, children and young people with sensory differences, including those who are Autistic, may engage in behaviours called stimming. These are repetitive movements such as hand flapping or rocking, which help the person feel safe. They are rhythmic behaviours that the child or young person may do at baseline, when they’re happy, or when they’re upset. Crucially, these behaviours are usually not harmful. Although they may make the child or young person stand out from their peers, “fitting in” is not our goal. Our goal is to improve children’s quality of life - and removing or replacing behaviours that help the child or young person to cope with every day life, especially in a world that would otherwise be scary or overwhelming, is not our goal. Of course, there may be times where the stimming behaviour causes actual harm to the child, such as eye poking, head banging or body hitting (at high intensity) - in that case, the child’s quality of life may improve without that behaviour. But these caveats are few and far between.
“But removing stimming would make the child ‘fit in’ better”
A child who is ‘fitting in’ is not the equivalent of a child with a good quality of life. When we suppress stimming, this can result in children and young people having no other way of coping with difficult or stressful situations. Sometimes, Autistic children and young people may ‘mask’ in order to fit in with their peers. However, this can result in them coming home from a stressful day at school, where they’ve felt unable to express themselves, and feeling like they’re at breaking point. Our goal is not to make Autistic children and young people ‘fit in’ - our goal is to improve their quality of life. The child’s quality of life is just as well improved by being around people that allow them to express themselves and with whom they feel comfortable - so instead of changing the child, we should create a more inclusive and nurturing environment where they can stim without fear of judgement or differential treatment.
And the same is the case for other behaviours - collecting strange items as a perfect example. Collecting strange items does not decrease the child’s quality of life. If anything, it gives the child a healthy outlet for their special interests, and creates opportunities for them to integrate other enjoyable activities (such as connecting with nature to go out and find strange and interesting items). When framed in the right way, we might actually recognise that collecting strange items is something that enhances the child’s quality of life - not something that makes it poorer. And if other people can’t see the amazing child behind their collection of strange items, that’s their loss, not your child’s!
“So where does that leave us?”
Well, sometimes behaviours of concern genuinely do impact a child’s quality of life. And in these situations, reducing the frequency of the behaviour by changing the environment or teaching alternative strategies for communicating and coping can be helpful. Behaviours such as aggression impact the child’s ability to engage with the community - to go to new places, and try new activities. It might result in the child getting asked to leave places that they enjoy, or not being welcome. And in these situations, it’s clear that the behaviour closes the child’s world down - it makes their world smaller, and reduces their access to things that are important and meaningful to them. So in these situations, we would typically agree that intervening would be in the child’s best interest.
If you are looking for support for your child’s behaviour - if they are engaging in a behaviour which reduces their quality of life - get in touch with us via the contact form for an initial consultation.