本帖最后由 自闭症新闻 于 2016-3-24 20:01 编辑
Physical Discipline &Autism: A Parent Asks for Guidance 体罚与自闭症：家长提问
Friday, August 15, 2014 2014年八月十五日星期五
“When I physicallydiscipline my 6-year-old son [who has autism], he starts to hit himself. ShouldI use physical discipline? Do I just let him hit himself?” “当我体罚我患有自闭症的六岁儿子时，他开始打他自己。我应该体罚他么？我该让他打自己么？”
Today’s “GotQuestions?” answer is by psychologist, of the Kelly O’Leary Center for AutismSpectrum Disorders at Cincinnati Children’s Hospital Medical Center. The centeris part of the Autism Speaks Autism Treatment Network. 今天“提问时间？”由来自辛辛那提儿童医院医疗中心的Kelly O’Leary自闭症中心的心理学家Stephanie Weber提供回答。这个中心是“自闭症之声”联盟成员之一。
Thank you for your question. You raise an important topicthat many families deal with on a regular basis. 谢谢你的提问。你提到了一个很多家庭在日常生活中都会面临的问题。
The short answer to your first question is “no,” physicaldiscipline is not a good approach – particularly for a child on the autismspectrum. I’m glad to provide a longer answer to the question of why we don’trecommend physical discipline to address problem behaviors. 简单的回答是：不，体罚并不是一个好方法——特别是对有自闭症的孩子。我接下来会更仔细地阐述为什么我们不推荐用体罚来纠正有问题的行为。
First, I understand why some families use physicaldiscipline. After all, it often makes the behavior stop – and quickly. Sophysical discipline can feel like a quick fix. However, it isn’t a long-termsolution to your concerns about your child’s behavior. Why? 首先，我理解为什么有些家长会采取体罚，这个方法常常能快速地制止错误行为，所以体罚会让人觉得是一个快速的改善方法。但是，它并不是一个能够长期解决你对孩子行为的担忧的方法，为什么呢？
To start, it doesn’t teach your child how you want him tobehave. For example, if you want your child to stop running down the hallway athome, you could say, “Don’t run.” Unfortunately, your child still may notunderstand what you want. However, if you tell him, “walk in the house,” youare communicating what you expect. Along these lines, physical disciplinequickly conveys the message “don’t,” but fails to help direct your child towardthe right behavior. 首先，它没有告诉你的孩子，你希望他怎么做。比如，如果你不希望孩子在家里的走廊里跑，你可以说：“不要跑。”但是，很可能你的孩子仍然不能明白你想要什么。然而，如果你说：“在家里只能走。”你就表达了你想要的行为。同样的，体罚能很快地传递信息：不能，却没有直接地帮助你的孩子向正确的行为发展。
The importance of modeling behavior 模仿行为的重要性
Another important way children learn behavior is throughimitation. To put it another way, “modeling” is a powerful way to teachchildren how to behave. The danger, when you use physical discipline, is thatyou may be modeling that it’s okay for your child to physically disciplineothers – or himself. 另外一个孩子们学习的重要方式是模仿。所以，作榜样是一个非常有效的教孩子正确行为的方式。所以，当你体罚的时候，你也可能正在教孩子可以用这样的方法去对别人。
Addressing self-injury 处理自我伤害
You also ask how to handle your son’s reaction to physicaldiscipline – hitting himself. Certainly, we don’t want him to hurt himself. 你也问到了应该怎么去控制你孩子对体罚的反应——打他自己。当然，我们都不希望他伤害自己。
Whenever I talk about self-harm behaviors with families, myfirst priority is safety. If your child is leaving bruises or making himselfbleed, it’s very important to discuss your concerns with physician orpsychologist. If you feel that your child may seriously harm himself or someoneelse, don’t delay! Call 9-1-1 or take him for an evaluation at the nearestemergency department. 不论什么时候，在我跟各个家庭讨论自我伤害的问题时，前提是安全。如果你的孩子让自己受伤或者出血的话，你一定要去和医生或者心里咨询师讨论这个问题。如果你觉得你孩子有可能严重伤到自己或伤到他人的时候，马上打报警电话或者带他去最近的急救室。
If there’s no danger of serious self-harm, I suggest workingwith a behavioral specialist to determine why your son is hitting himself. 如果他并没有特别严重地伤害到自己，我建议你可以和行为专家一起来找出孩子伤害自己的原因。
All behaviors have underlying reasons. Just as we makedinner because we’re hungry, a child misbehaves for a reason. One common reasonis to communicate. This motivation is particularly common among those who havetrouble communicating with words – which is true of many individuals who haveautism. 所有行为都有它潜在的原因。就像我们做饭是因为我们饿了，孩子做出不正当的行为也是有原因的。一个最常见的原因就是为了交流沟通。这个动机对于有交流障碍的孩子们来说是非常常见的，这也正是大多数自闭症患者会有的问题。
Five common issues with self-injury 关于自我伤害的五个常见问题
Generally, we see five main motivations behind problembehaviors such as self-injury: 大体上来说， 我们看到类似自我伤害的行为问背后主要有五个主要动机。
First, some children have painful medical issues such as atoothache or headache that cause them to hit themselves to mask or soothe thepain. I suggest you talk with your child’s doctor if you suspect this may becontributing to your child’s behavior. 首先，一些孩子正在经历一些剧烈地疼痛，比如说牙疼或者头疼，这些问题常常会使他们去打自己来掩饰或者减轻这些疼痛。我建议如果你怀疑是这方面的原因导你孩子产生自我伤害行为，你就应该和你的孩子的医生好好聊聊。
Second, a child may be acting out to “escape” a distressingsituation or avoid a task or chore. 第二，一个孩子可能会用这样的行为来逃避一个有压力的场景或者逃避一个任务。
Third, individuals with autism sometimes strike themselvesas a way to get another person’s attention. 第三，有自闭症的孩子有时候会用这样的攻击行为来得到另外一个人的注意力。
Fourth, an individual may use a distressing behavior to getsomething he or she wants – be it a food, toy or other item. 第四，可能有些人表现出压抑的行为以此来获得他（她）想要的东西——可能是食物， 玩具或者其他的事物。
The behavior may be a broader attempt to self-stimulate orself-soothe. Rocking is a classic example of a self-soothing, repetitivebehavior common among children and adults who have autism. Your son’s hittinghimself may fall in this category of behaviors. 自我伤害行为可能也是广义上的自我刺激和自我安慰的尝试。摇摆就是一个很典型的自闭症的孩子和成人重复的行为自我安慰行为的例子。
Finally, as mentioned above, your son may be imitating yourphysical discipline when he hits himself. 最后，就如上面提到的一样， 你的孩子出现自我伤害的行为可能也是在模仿你体罚他时的行为。
Once you and your child’s therapist understand why yourchild is hitting himself, you can work together to find solutions and moreappropriate “replacement” behaviors. 一旦你和孩子的理疗师明白了为什么孩子一直在打他自己，你们可以一起努力想出解决的办法，并且以更适合的行为取代这种行为。
For instance, if the underlying reason is "escape,"then I recommend teaching him a better way to ask or signal his need for abreak. If your son’s behavior is a way to get something tangible, I suggestteaching him waiting skills. We often do this with visual supports, like a"First/Then” picture board. The first picture shows the task he mustcomplete before receiving what he wants – as shown in the second picture. (Moreon working with visual supports below.) 例如，如果孩子出现这样的行为是为了逃避，那么我就推荐教他们一个更好的方式来表达自己的要求。如果你的孩子的行为是为了得到什么具体的事物，我建议你可以教他们等待的技巧。我们一直都以视觉支持来做这件事，比如说“首先/然后”的图画板。第一张的图片展示出了在他接收到他想要的东西前他必须完成的任务——正如第二张图片表明的一样。
Building on positive behaviors 建立积极的行为
A more-positive approach can help you address both the challengingbehaviors that led you to use physical discipline and your son’s subsequenthabit of hitting himself. I suggest starting by building on the constructivebehaviors your child shows. For example, praise him, give him a high-five orsome other positive reinforcement when he “keeps nice hands” and doesn’t hithimself when frustrated. 一个更积极的方式既可以帮你解决孩子让你想使用体罚的不良行为，也能改变孩子因此养成的自我伤害的习惯。我建议可以从孩子已经展示出的良好行为开始。例如，当他没有做出不良行为或者在沮丧时没有打自己，你就奖励他，跟他击掌或者使用一些积极的强化方法。
Also look for more-positive ways to show your son what youwant him to do. Visual supports can help you convey what you expect of him. Theuse of a visual schedule, for example, can be helpful to let your child knowwhen things will happen in his day. The Autism Speaks ATN/AIR-P tool kit VisualSupports and ASD can help. Download it free of charge here. 另外使用一些更积极的方法来展示你想要孩子做什么。视觉支持可以帮助你表达你期望他做什么。例如可视日程表可以帮助孩子知道今天一天的安排。
Token boards are another example of a visual tool forcommunicating what your son needs to do to earn something he wants. A tokenboard (photo below) includes a picture of the “reward” with tokens that can beearned for each task completed toward the goal. Once all tasks are completed,the child receives the item in the picture. I suggest customizing the rewardsto your child’s interests. You can have fun with the tokens as well. I know onefamily that used pictures of their child’s favorite action hero as the tokens. 积分板是另外一个很有效的视觉工具，你可以用它来告诉孩子他到底需要做什么才能得到他想要的东西。一个积分板（请看下面的照片）包括一张这个奖励的图片和孩子通过完成每项任务得到的“奖励”。当孩子完成了每一项任务，他就能得到积分板上面的奖励。我建议根据孩子的具体兴趣来调整这些奖励。你也可以让这个过程很有趣。我知道一个家庭，他们用孩子最喜欢的动作明星作为象征。
I also recommend the Autism Speaks ChallengingBehaviors Tool Kit, available for free download here. This tool kit is full ofpractical strategies for encouraging positive behavior and teaching replacementbehaviors.
By making the change from physical discipline to positivereinforcement, I think you will see many improvements in your child’s behavior.Please let us know how you’re doing with a note belowor by emailing GotQuestions@autismspeaks.org. 通过从体罚过渡到到积极的强化，我觉得你可以看到孩子在行为上有很大提高。
对本文的特别申明: 文中红色部分没有翻译。由于我们的医学专业知识和翻译水平有限，译文可能会有瑕疵，欢迎大家提出宝贵的意见和建议，以便帮助豆苗计划翻译小组更好地开展工作。
翻译：梦缘 Smiley 复核：Rexx 牛
| 
窥视卡
雷达卡
发表于 2016-3-23 16:35:19
提升卡
置顶卡
沉默卡
喧嚣卡
变色卡
抢沙发
千斤顶
显身卡
