Expert: Dr. Sharon A. Mitchell - 11/10/2007

Question
I have several students with autism.  One of my biggest problems is a 157 lb. 5th grader.  He drops at a whim and chooses to get up when he wants.  I have resorted to pressure points on the arm to get him going but I am afraid this hurts him.  Am I wrong?? Do you have a better answer??

Answer
I understand your frustration. You have a large boy who lies on the floor during class time, disrupting your lesson, interfering with the learning of the other kids and obviously not learning himself during those times.

But, I have grave concerns about what you're doing to get him back into his seat.

You're quite right to wonder if pressing pressure points hurts him. It definitely does hurt him, but likely what you're really wondering is if you're going beyond momentarily hurting him and actually causing him harm. Unless you have formal training in this tactic, I definitely would worry about the possible harm you might do to the nerves in his arm.

You'd be devastated if you harmed this child. His parents and your employers would also be alarmed and you could possibly face legal and/or employment repercussions for your actions.

There are other safety issues as well. Your student is a big boy. What if you hurt him when you press on his arm and he comes up swinging at you? Or at anyone else who may be in his way? A child under stress may not think, just react and someone could get hurt.

Apart from the physical harm aspects, there are psychological aspects. If we consider just the other kids in your class for a moment, what are they witnessing? Yes, it's distressing for them to see a classmate drop to the floor and disturb their lesson. But it must be even more distressing for 10 year olds to witness their teacher hurting a fellow student. In their minds, could they wonder if they would suffer the same treatment if they make a mistake? How are they feeling toward you when they see, or interpret what they see, as their teacher hurting another child? Kids learn much better in an atmosphere or trust, rather than fear.

And even if using the pressure points brought this boy to his feet, what is it you've taught him? That someone bigger and stronger has the right to apply force? Or to hurt him to make him do what they want? That may not be the life lesson you want to teach.

Let's think about just what it is you do want. Likely, you'd prefer that this never happened in the first place. That may not be under your control but perhaps there are things you could do to help lesson the possibility.

- now that you know this child, can you predict when he might drop?
- is he tired and needs a break but does not know how to ask for one?
- if he feeling overwhelmed for sensory reasons?
- has an Occupational Therapist given any suggestions for body breaks or a sensory diet throughout the school day?
- is there a safe place he can go to when he's overwhelmed or needs a break?
- if he's unable to ask for a break, could he hold up a card to let you know he needs to move or leave?
- does it often happen at certain times of the day?
- does it happen during certain lessons or when he's asked to do particular tasks?

If so, don't ask him to do those tasks. While in the short-term, that might compromise his academics, he's not doing the assignment anyway if he's on the floor, so you don't have a lot to lose.

Does he enjoy the attention he receives when he's on the floor? Does he drop to avoid doing something? What do you think he's getting out of the behavior?

Have you tried doing a Functional Behavior Assessment to figure out why he's using this dropping tactic? The special ed teacher in your school may be able to help you with this. There's good information on FBA here: http://www.behavioradvisor.com/FBA.html

One of the best sites I've found for behavior is Dr. Mac's Amazing Behavior Management Advice Site. There is a wealth of information and sections pertaining specifically to kids with autism. http://www.behavioradvisor.com/ While we all have our own styles regarding what works in our classrooms, at Dr. Mac's site you'll find great suggestions for classroom management and even on using peer pressure to help with behavior management.

Likely you don't to wait weeks more while you read, consult and come up with a plan to help this boy. In the meantime, can you ignore his behavior? When he drops to the floor can you carry right on teaching? You'll find that the other kids quickly follow your lead and can continue with their work quite well, despite a prone or even a howling classmate.

If you fear that he may be an immediate physical danger to the other children in your care, you might be wise to remove all the other kids from the room rather than try to physically tussle with a 157 pound child.

If he needs to be physically moved, don't do it alone. Have another adult help you. There's less chance of hurting the boy if there are two adults who can remain calm and support each other. And less chance of a potential law suit. Before attempting anything physical with this or any other student, I'd feel safer having first received formal training in proper lifting or holding methods. You might want to consider training such as that provided by the Crisis Prevention Institute http://www.crisisprevention.com/ While their course does get into safe holds, etc. a large part of their training is aimed at preventing things from ever getting that far.

Can his parents come for him if he won't get up from the floor and continues to disrupt the learning of the other kids? Does he show this behavior at home? How do his parents cope?

Is this a new behavior? How did his previous teachers handle it?

When he drops, he obviously does not want to be part of the class. What if on these occasions, you immediately stopped the lesson, ignored this child, but switched gears with your other students to something they really enjoy. And that this boy would enjoy. To be part of the fun, he'd need to be sitting in his seat. The instant his bottom comes near the seat of his chair, include him in the fun, just as if nothing else had happened. Continue the fun for a few more minutes then settle the class back to their assigned tasks. Be sure to let your particular student know how much you appreciated his participation and praise him for the part he played. Ignore the fact that he initially was on the floor.

Try ignoring the undesired behavior and rewarding anything approximating what you would like to see. Take a look at Dr. Mac's Amazing site (http://www.behavioradvisor.com/). Talk to your principal - this is something you should not have to deal with on your own. A team approach would be better.

But please, don't get into a tussling match with a 157 pound child or risk harming him or your career.  

Sharon A. Mitchell, B.A., B.Ed., M.A.
www.autismsite.ca