What to do about an autistic student who is spitting?

Question

Positively we have tried social stories but he still does it occasionally. It seems to be linked to doing something he doesn't want to do- leave the playground or start a worksheet.

I have been advised to try using lots more positive rewards for when he doesn't spit and does comply with requests. I am able to do this but other staff members don't agree and have more punative ideas for the behavior (a mask). I would appreciate any ideas people have.

Answer 1

I think you are right in identifying the reason or "function" to the spitting behavior. If you correctly identified the function as escaping a task or situation, you can apply a treatment that addresses that function. In behavioral literature, the idea is to tailor treatment to the function or the "why" it is occurring.

Therefore, in using the hypothesis of negative reinforcement (using spitting to get out of aversive situation), you could:
1. Identify situations that are aversive to him.
2. Give choices prior to engaging in activities, even if it is "do you want to do this worksheet or that worksheet". Choices, sometimes, give him the feeling that he IS doing something that he wanted.
3. Set up a system (visual schedule) where he still has to do some of these things, but will earn breaks. And, let him see when the breaks are coming and let him know exactly what he needs to do before he earns a break. This is called Differential Reinforcement of Alternate Behaviors (DRA).
4. You could also give him like 3 break cards each day, and he can use them whenever he wants to get out of task or continue doing something preferred for a certain amount of time(e.g., 5 minutes).
5. At the same time, you want to extinguish the unwanted behavior. In other words, withhold reinforcement. In this case, you would continue to prompt through the task and he would NOT get a break when he spits or does not complete work.
6. Increase breaks for absence of spitting. This is called Differential Reinforcement of Other Behviors (DRO).
***If his behavior is motivated by access to positive reinforcement (access to playground), then you could set up your system according to this. Like give him access to the playground for not spitting for 2 periods. And, if he spits, deny access for a certain amount of time...
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Just to dispel some bad information on several responses, ignoring behaviors isn't always an appropriate response for a couple reasons. Ignoring is most effective if the student is spitting to gain access to attention. And, as the teacher described above, it does not sound like the case. So if someone is spitting to get out of doing something, and you ignore it, but they are still getting out of doing somehting, then they will continue to do it... even if you ignore it!

Also, spitting is a health hazard. And if you allow it to occur in class, this effects all the other students, both from a health standpoint and from a disruption standpoint. So, again, ignoring spittiing is AWFUL advice in this case.

Additionally, a mask is not a horrible idea if all else fails. It's considered a mechanical restraint, and you would need approvals. But, you would have to show that you tried other measures first. Spitting is quite serious because of the potential to pass on sickness and disease. Therefore, a mask is not an unreasonable intervention if all else has failed...

Answer 2

A mask?! What are you going to do, wrestle it on to him? That's just setting yourself up for a power struggle you cannot win (or will win at very great costs) Plus, he's getting exactly what he wants...while you are distracted from the masking, he's NOT doing a worksheet, he's NOT going into the building from recess. HE is winning the power struggle. Take that struggle away!

My daughter didn't like transitions. She hated coming in from recess because it was loud and messy and people were everywhere. So she had a visual schedule for while she was on the playground, an assistant would take her in a few minutes early, offering her a chance to be first at the water fountain and to get back to the room to settle in while still quiet.

She often disliked worksheets because the rules were stupid and because she never got to draw or write what SHE wanted. I mean, imagine if you were typing in an email and someone was over your shoulder saying "Now, you need to write about your great aunt Ruth, and don't forget to capitalize your proper nouns." After a while it would really hack you off, yes?

There have been other great suggestions, so I'll sum up. Call an IEP meeting to request a functional behavior assessment. This should be done by someone who is experienced with autism and trained, not by a few teachers who are offended and have no special ed training. Even sped teachers aren't always trained in autistic behaviors and how to manage them. All IEP team members need to follow this, and anyone not on the team should NOT be dealing with the child, not allowed to reward or punish.

Keep up the good work. Positive reactions while ignoring negative behaviors (or not allowing them to work) Realize that there are DIFFERENT reasons for the spitting, and you'll have to address each circumstance and fix it, rather than just eliminating the behavior. Good luck!

Answer 3

A MASK! My blood pressure just went through the roof! I am assuming the child has an IEP and behavior plan? Call a team meeting.Everyone who works with the child has to be on the same page.You said you have had success with positive reinforcements, then the other staff should HAVE to do it too! Blaster gave you some excellent advice.Giving him the "break time" cards should be very helpful if you feel the behavior is being done to get out of a task.You have to figure out what purpose the behavior has for him and offer alternatives. Giving him choices of tasks should also help,and rewarding rewarding rewarding proper behavior.
Try not to react at all,as difficult as it may be,when he does spit.Get the Behavior Specialist to help you all set up his behavior plan,and everyone should follow it until it is no longer a problem.

ADD ON:
I just wanted to add that I agree with Happy,distraction can be very useful.Two things we found helpful with my son when we saw the signs of a negative behavior coming on (hopefully you'll find the signs with this child) is to take his picture,especially if you catch him while he is still acting appropriately,you can use a positive reinforcement while taking the picture ie: "what a good job you are doing on the worksheet".My son would pose for the picture,and totally forget about what was bothering him!Another way to distract him,depending on his verbal skills,is to ask him a question about a subject you know he loves and will start thinking,and maybe talking about.Good luck!

Answer 4

,All behaviour is a form of communication.....yes even spitting! He will know that this is gaining your attention more than anything else. Even if you are the best actor he will still sense the stress that this is causing. They do have a sixth sense for this! Visuals, reinforcements all the usual strategies will help in some way. The only way of stopping it is FINDING the cause. There is something that is triggering this, it is usually fear and great anxiety....your job, and it can be a challenge, is to find out WHAT! Keeping detailed observations A.B.C s time of day, who was there, what they were wearing, clothes and perfume, what they were saying, noises in the room scraping of chairs, someones voice, what happened before school, what is happening after school........it can take a while but usually a pattern usually emerges pretty quickly. Good luck, it will all make sense soon ...because you want it to!

Answer 5

I need a solution to extinguish the child s spitting on other students who also have special needs. I am frustrated that no ever mentions the victims. You can have meetings you can find out the function of the behavior you can put a plan into action but how do you remove the fear the other students now have and the anger that their parents feel. One parent asked "who is protecting my non-verbal, non-ambulatory child from being assaulted (legally speaking that is what spitting on someone means). I have had the spit land in my mouth. I know that the behavior with a strong plan of action and consistency be eliminated. My concern is not soon enough for the other students to feel safe and the parents to feel that someone is protecting their child. Please offer me advice for the victims

Answer 6

Distraction and positive reinforcement are the keys to spitting in autistic children. If something or a situation triggers the spitting you must change how you approach the trigger that he does not like. I have a child who bites (very hard) and have found if I see she is leading up to biting me I distract her with something I know she will like and is interested in. It doesn't work 100% of the time but it does stop a lot of pain and it has cut down on her temper tantrums. Remember this is probably his only way of expressing his dislike of something and he will also get very frightened being forced to do something he is not happy with. You need to handle him calmly and with good humour and distraction is usually the best way. Good luck.

Answer 7

No Spitting Social Story

Answer 8

I agree. Almost every college has rules about bullying, and in some states, there are laws saying institutions have to put a stop to any bullying they know about. I'd make that appointment, tell the authority what is happening, and say exactly what you want done about it. If they don't, write a letter (or have someone else write it) stating that Such-and-such law requires that they do so-and-so, you met with Professor such-and-such, said X and Y, and nothing was done. This lets anyone with half a brain know that you might be thinking of filing a lawsuit. That will get there attention.

Answer 9

Tell your staff that aversive punishment is not allowed, period. Here is the problem. In order to put a mask on him, you will have to hold him down because I can bet he won't like it at all. If none of you are trained to do restraints, you may NOT do this. Every time you lay your hands on a child, you may hurt him or he may hurt you. This is unacceptable and can and should invite a lawsuit. Make this clear to them.

It is always better to use positive reinforcement to get people to do what you want them to do. This is no longer the Dark Ages and we know what works through research. Here are some suggestions:

Autistic children take in most of their information through their visual channel. To that end, picture prompts work better than almost anything else.

Go on the 'Net and find pictures of kids spitting and then find pictures of kids doing the right thing, like leaving a play area. Also find pictures of his favorite things, like treats or activities.

Now you are ready to do an If/Then Chart. Create a page that has If on one side and Then on the other. To make it clear, delineate it with lines. On the IF side, show the child spitting and on the then side, show a picture of the playground with an X through it or an empty playground, depending on his level.

Then put a child doing his work on the IF side and a reward (perhaps he has to earn recess) on the other side. Also do a picture of a child leaving recess and a reward on the other side.

Sit down and work with the child using the visual prompts. Explain it both verbally and visually by pointing. When he has to begin work, walk him through the correct prompt. "In order to go to recess, you must finish your work."

Now, if he starts spitting, I want you to ignore him entirely. He has the information that he needs and he can now make choices. If he is spitting on other people, move them away to another area. Then leave him in for recess.

If he is really low, you might have to do an If with the student doing work and the Then with a treat. Then gradually increase the number of assignments he has to finish to get the treat. Then you can move it to exclusion from recess.

To get some pictures, try the Do2Learn website. For more information on positively managing behavior, go to Dr. Mac's Amazing Behavior Management page. You'll be glad you did.

Answer 10

As well as what others have said, if he is deliberately spitting at you, one way of dealing with it is to get a book or something, and when you know he is going to start spitting pretend to read it. This has two effects- it ensures that spit doesn't go on your face (health hazard) and it stops him from getting a reaction off you- even a negative reaction can be very rewarding to an ASD student.