Dear BBC News,
We are writing in response to your article, “Autistic teens face ‘barbaric’ treatment, parents tell MPs.” We appreciate your effort to raise awareness of the difficulties that families in the UK face when attempting to access safe and effective behavior support for their family members on the autism spectrum. We were distressed to read that children and young people with autism were routinely being placed in hospital settings and restrained and sedated in response to challenging behavior, as a result of a lack of specialist services to provide evidence-based behavior support in local communities. We commend the families who spoke up and raised this issue with government officials on the Health and Social Care Committee.
Your article presents a discussion of an ongoing issue; that is, the overuse and misuse of restrictive practices, such as restraint, seclusion, and medication, in response to challenging behavior. These practices, when used as the sole approach to behavior management, can be harmful to the physical and mental health of individuals on the autism spectrum. It addition, these practices have not been proven to reduce challenging behavior and promote the development of new skills in the long term. It is especially concerning that these restrictive practices continue to be widely used, given that more safe, humane, and effective support strategies exist.
Your article presents an opportunity for us to highlight a viable alternative to restraint, function-based behavior support. Function-based behavior support is a person-centered way of helping an individual who displays challenging behavior, by first identifying the underlying cause (or purpose) of the challenging behavior, and then teaching the person safer and more understandable ways to communicate their wants and needs. A functional behavior assessment (FBA) focuses on identifying the cause of the behavior; it asks questions like: What is happening in the person’s life that may be difficult for them? What happens before and after the behavior? What is the person trying to communicate by engaging in the behaviour? The results from a FBA are used to design an individualized set of behavior support strategies that involve changing the environment around the person to make challenging behaviour less likely, teaching the person new ways to communicate their wants and needs, and helping the person spend more time doing things they prefer and enjoy. The behavior support plan allows people who work with individuals with autism to help nurture necessary skills in order to minimize challenging behavior.
Function-based behaviour support benefits from decades of peer reviewed published research supporting its effectiveness for reducing challenging behavior, strengthening new skills, and improving quality of life for individuals with disabilities. Function-based behaviour support presents a viable alternative to the use of restrictive practices. However, too few professionals working in hospital settings have formal training in a function-based approach. We hope you will direct your readers to our website, in particular our page dedicated to medical professionals, for more information about how to best support individuals with autism and related conditions, using safe and effective approaches that are backed by research.
Sincerely,
Hein Ngo
Dr Erin Leif, PhD, BCBA-D
Association for Science in Autism Treatment
