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Written by: Sindy Victor, MS, BCBA, LBA
Autism is a developmental disability that can't be cured and is often linked to higher incidences of childhood trauma (Lobregt-van Buuren et al., 2021). Trauma is an emotional response to aversive events. A well-informed treatment practice will address an autistic's health & wellbeing using systematic prevention and intervention methods.
In applied behavior analysis, events that are aversive have punishing behavioral effects. The function of behaviors associated with trauma are escape and avoidance. Escape motivated behaviors are associated with the removal or termination of an aversive (unpleasant) stimulus. Avoidance behaviors are associated with the withdrawal or prevention of an unpleasant stimulus.
Examples of escape associated behaviors:
running away
hiding
throwing food on the floor
physical aggression
Examples of avoidance associated behaviors:
rapid changes in conversation topics
showing up late
leaving early
lack of eye contact
Principles Of Trauma Informed Care
The main principle of trauma informed care is to acknowledge trauma and its potential impact. Best practices involve allowing trauma victims to cultivate their own reality. The impact of trauma on a child with autism is typically characterized by repetitive patterns of behavior and impairments in social communication. Individuals with autism often display qualities of selective mutism. Selective mutism is described as the consistent failure to speak when speaking is expected. Acknowledging the impact of trauma also includes making ethical considerations for the impact of guilt and shame on communication.
2. The second principle of trauma informed care is to ensure client safety and trust. Best practices involve pairing with the client and identifying preferences. Assent occurs when the client verbally or non-verbally agrees to participate in treatment. Practitioners should prioritize the client's assent during treatment. Individuals with autism who have experienced trauma may often show signs of no body autonomy (having little control over their bodies). This is why implementing cohesive treatment sessions with the use of behavior analytic and sensory integration strategies are ideal for autism health.
3. The third principle of trauma informed care is to promote choice and shared governance. Best practices include increased opportunities for choice making. When working with autistics, practitioners should avoid planning interventions that are likely to evoke trauma responses. This requires a clear understanding of the client's needs & history.
4. The fourth principle of trauma informed care is to emphasize skill building. Best practices involve monitoring negative emotional responses to interventions and adjusting the plan of care as needed.
Benefits Of Using a Trauma-Informed Approach
For physical wellbeing and adaptive behavior modifications practitioners who utilize a trauma informed approach do not engage in ableism. Ableism is discrimination in favor of able-bodied people.
For emotional wellbeing and monitoring improvements in self-regulation practitioners who utilize a trauma informed approach maintain client dignity by centering practices in compassion-based care.
The impact of using a trauma-informed approach on social and spiritual wellbeing is psychological and can be observed during parent-child interactions, peer play, and in other group settings.
Collaborating With Multidisciplinary Providers
The benefits of coordinating autism care services across the multidisciplinary providers include:
Allows clinicians to create treatment plans that address both disciplines in a shorter amount of time.
Aids in generalization of skills to different people, settings, and situations.
Creates opportunities for problem-solving to occur in the natural environment setting.
If your child or loved one between the ages of 24 months - 25 years old has been diagnosed with autism spectrum disorders and is seeking 1:1 therapy/social skills training, please call: 470) 829-1333 to verify your family's eligibility for ABA treatment services today!
