One in 68 Children has Autism

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Emotional Regulation, Social Anxiety and Challenging Behaviors: An Agenda for Intervention.

September 16, 2010 2:52 am Published by

A relatively new focus of Autism Spectrum Disorder research is emotion regulation. Emotion regulation could be defined as the ability to enhance or reduce emotions in the presence of anxiety-related events. For instance, if an individual with autism gets upset because he / she does not receive immediate gratification, instead of hitting self or others, the autistic individual or staff working this individual might try to distract him / herself from whatever stressor event by engaging the autistic person or yourself in an alternative replacement behavior.

Evidence-based research suggests that individual with autism spectrum disorder (ASD) experience high levels of social anxiety, hyperactivity, challenging behaviors and emotional difficulties in response to sensory input in educational settings (Ashburner, et al. 2010). Brian Boyd and colleagues (2009) found that repetitive behavior (e.g. stereotypes and compulsions) were related to sensory features in autism. Susan Smalley and colleagues suggested that autistic anxiety is higher in autistic individuals when they compared with controls. Individuals with an autistic spectrum disorder are impaired not only in understanding others’ mental states, but also in self-regulation of social-emotional behaviors. It seems that individuals with ASD are likely to be distressed by frequent changes and / or interruptions to narrow interests, compulsions or obsessions. Some individuals with autism may also become overwhelmed and underperformed relative to their level of ability and are struggling to regulate their emotions and behaviors by sensory stimuli such as intense noise, touch or visual stimuli (Ashburner, et al. 2010; Myles & Simpson, 1998). High proportion of individuals with ASD exhibited clinically significant problems in the area of emotional lability than on any other scale including social problems which are part of the diagnostic criteria (Ashburner, et al. 2010).

Deficits in socio-emotional cognition and behavioral self-regulation seem to be related with dysfunction of the orbitofrontolamygdala circuit of the brain (Bachevaliera, et al. 2005). This hypothesis supports the notion that the self-regulation of social behavior, then, depends first on the ability to perceive or infer relevant information about what others may think, feel or intend, because this information indicates what others are likely to do. Failure to perceive or infer accurately what others know, feel or intend could lead to the expression of challenging behaviors such as aggressive behaviors or self-injurious behaviors and also could lead to a failure to modify one’s own behavior appropriately in light of accurate information. Some studies have suggested that individuals with autism may not modify their own behavior appropriately in response to the perceived distress of others, event when they seem to be aware of it (Loveland and Tunali, 1991; Sigman et al., 1992). Although there is evidence showing that some autistic individuals have the ability to “mind-read”, or predict others’ mental states, they do not necessarily to so in their daily lives (Rieffe et al., 2000).

Data for studies on emotional regulation skills are suggesting that a decrease in anxiety may improve emotional regulation skills by reducing the instability and impulsive behaviors in autistic individuals and then result in changes in the social symptoms characteristic of ASD( e.g. self-injurious behaviors, property destruction or aggressive behaviors towards others)(Dawson, et al., 2009; Kasari, 2002 and Lovaas, 1987).

As clinicians, we should focus on the development of emotion and behavior regulation strategies in autistic individuals. We should examine the effectiveness of autistic-specific trainings and setting environments and explore how we can make educational and habilitation programs more autistic-friendly. For example, Kari Dunn Buron, from the Autism Awareness Centre, suggests a 5-point scale visual system to enhance emotional regulation skills in high functioning autistic individuals. The first step in using the scale to support emotional regulation is to identify problem areas for this autistic individual (for example, problems involving changes in routine, playing with peers, following rules, program demands or delaying gratification). The second step is to break the problem area into 5 parts clearly illustrating the degrees of the situation and putting this information onto a visual scale. The staff working with the autistic individual should create a visual scale that breaks down stress into the following 5 parts: 5 = this could make me lose control; 4 = this can really upset me; 3 = this can make me nervous; 2 = this sometimes bothers me; 1 = this never bothers me.

Then, staff generates a list of environments and social situations that the autistic individual is exposed to everyday and that might cause stress. Next the staff makes cards that can fit into the pockets with the situation and environments written on each card. This scale will provide the foundation of an emotional regulation plan.

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