Thursday, February 18, 2010

Those Repetitive (OCD?) Things That Drive Us Crazy

Kids with autism and other sensory impairments often develop repetitive behaviors. Some of these activities can become problematic in the home, school, or community setting. Some can even be dangerous to the child or those around him.

I could draw up a rather extensive list of the types of activities I have encountered over the years: lining up toys, sifting small objects through the fingers, looking at things at odd angles out of the corner of their eyes, spitting (and/or flicking spit - ugh!), screaming, eating non-edible items, and on and on.

Or I could ask those of you who live with a person who has autism to add to the list. I think we'd find a very, very long list with many commonalities and also many chosen behaviors or activities that are highly unique in nature. How many of you know a child who LOVES water play? What about a fascination with trains, doors, light switches, mirrors, Disney movies or Sesame Street?

I work with a young man now who has an intense fascination with bar code stickers and can't resist soda vending machines. I have heard recently about another young man who is repeatedly tearing his clothes. I am sure you get the idea.

What tends to happen is someone (other than the person with autism) decides the activity or behavior is interfering with "normal" functioning. But let's be careful. It might be that the behavior is different or not exactly socially appropriate, but unless it is truly dangerous in some way - such as jumping from a moving vehicle when it passes a vending machine or convenience store that is likely to have such a machine - I no longer am in such a hurry to remove these activities from the person's repertoire.

An example from my personal past: "J" was a cute, pleasant boy who was highly verbal and full of energy, almost always smiling and completely charming. He had gone through quite a few "obsessions" in his young life - including Matchbox cars, lightswitch boxes, laundry baskets, and clocks, among others. His family had been very tolerant and accepting, tending to add to his vast collection of all these items on a regular basis. As we gradually increased his level of inclusion in regular classes during his early elementary years, we (the IEP team of teachers, therapists, administrators and parents) decided that his newest fascination with jumpropes had to be eliminated. It is embarrassing to me now, but we were all in agreement that his habit of carrying a jumprope with him from room to room was somehow interfering with his learning, or maybe his social acceptance, or what????

Believe me, in looking back after all these years, this boy was learning ALL the time and everyone loved him. If those jumpropes were a problem, I am afraid it was the IEP team that owned the problem! But we didn't look at things that way back then, and the jumpropes became a major issue.

We came up with an ingenious plan to ever so slowly make that jumprope grow smaller, cutting a few inches from one end each day till there was nothing left. "J" played along with us, and seemed quite content, happily carrying the shrinking rope through the halls at school until it became so small that waving it in front of him no longer gave him the same pleasure or sense of security that it had in the beginning. And at just about that same time, his success in the school mainstream took a serious turn for the worse.

You see, "J" - whose autism is relatively mild - was living with a tremendouse amount of anxiety, and that jumprope was working better than any medication the pharmaceutical or psychiatric community might have come up with. We took it away, and he fell apart. Waving a jumprope might not be what other kids in the school were doing, but with the right intervention on our part as professionals, we surely could have helped his classmates accept that "J" needed that extra comfort item in order to be happy in school. After all, the kids loved "J" and wanted him to be happy; the rope was bothering US, not them!

Ripping up clothing or throwing a TV to the ground would fall in another category and would need attention before the added costs get out of control. Same for those behaviors that might hurt someone. We can't just ignore, or accommodate ALL preferred activities. I will attempt to address these more serious behaviors in a future posting.

Adding a meaningful communication system to the picture can make a huge difference. If we can find a way for the person with autism to give us some input and insight, maybe we can find a way to work together to choose which behaviors can be tolerated and which need to be replaced. If the child starts to sense that we are sincere in our desire to help and not just imposing the desires of the adults in his life, we can move forward in a spirit of cooperation and respect.

A reliable way of asking and answering yes/no questions is a good place to start: "Do you REALLY need that rope with you right now?" "Do you understand why we don't want you ripping your clothes?" Or maybe pointing to answers from a choice of two, three or four possible options might be possible. The idea is to involve the child in making the plan before changes. "J" was very young, but very wise, and should have been consulted before we took away his jumprope.

I visited "J" in his home several years later. He was thrilled to see me, and happily showed me his vast collection of clocks and other things. He never stopped smiling as he waved his newest jumprope and said to me, "Remember when we tried to get rid of my jumpropes? That sure was silly!" I had to agree.

Thanks for being one of my best teachers ever, "J!"


  1. Do you actually have any answers for the clothes ripping? We have a student who rips up her and her families clothes due to anxiety. She has autism and we suspect OCD, but are awaiting further diagnosis. Please share any thing you know of that can help her alieviate the need to rip up clothing. Thanks!

  2. Age? Level of communication ability? Is she receiving OT services? I am thinking good OT may have some ideas for sensory-based activities that might help. I hesitate to suggest medication for anxiety, mainly because I prefer to exhaust all other avenues first. But I know that's not how it usually goes. You mentioned anxiety so I assume you have seen other indications that may be the cause. But there are so many other factors that may play a part - starting with food sensitivities, sensory needs or overload, frustration, boredom, etc. If she has no reliable means of communication, of course, that makes it so much harder. I do work with a couple young people who actually wear a chewy toy on a lanyard-type thing around their neck. Their parents have had some luck getting them to use that for chewing when needed. It DOES save on the clothes if you can get their cooperation. If it's the ripping/tearing that she seeks, I guess we'd try to find something ELSE that's OK to rip - newspaper, etc.

  3. And for some unknown reason, my comment was cut off at that point. :-( Not a lot more to suggest at the moment - except that I KNOW there are some very tough situations out there, and I sure don't have answers for many/most of them. Above all, I hope we can respect the individual and engage them in the problem-solving as much as possible, so that we are always working together to find identify problems and come up with solutions. Good luck!