Teaching a Child with Autism to Inhibit Socially Inappropriate Verbalizations Using a Collaborative, Trauma-Informed Approach

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Some children with autism spectrum disorder (ASD) demonstrate full sentence speech but have developed patterns of socially inappropriate speech that is a barrier to developing positive social relationships. There is currently very little research addressing this behavioral challenge in highly verbal children with ASD. We report on the case of an 11-year-old boy with ASD who exhibited socially inappropriate behaviors that interfered with his relationships with peers and teachers. Additionally, the child had been exposed to potentially traumatic experiences in a previous school. A critical aspect of the case was the use of a collaborative approach incorporating the commitments and strategies of trauma-informed care. The intervention was implemented by his teachers and was associated with a significant reduction in inappropriate social behaviors. During the baseline phase he averaged 0.37 inappropriate verbalizations per hour; During the intervention phase, he displayed a decreasing trend and averaged 0.09 per hour. After 56 days of intervention, the behavior remained stable, well below baseline, for 8 consecutive weeks with no occurrences on most days. He completed a social validity questionnaire and rated the experience as mostly positive and indicated he achieved goals that were important to him at the outset. We describe how the collaborative procedures and tactics we used align with the commitments of trauma-informed care. An implication for practitioners is that key components of trauma-informed care can be incorporated into behavioral intervention through an individualized, collaborative process.