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Escalating Maladaptive Behaviours

jannyinTO

Good Day everyone.

I am a respite support worker currently helping a 22 year old male on the ASD spectrum. He is largely non-verbal. I work with him as support when he attends his regular day program, 5 days a week.

He has an acute interest in colouring and folding sales flyers with crayons for hours at a time, and has little interest in anything else. He requires constant supervision due to his relationship with this particular interest. I'm posting to get some advice, as his maladaptive behaviours seem to be linked to his "papers", and they are escalating as of late, to the point of being unmanageable.

My greatest issue with him is his "ripping" up and disposing of papers, which we only have a finite supply of.

To preface, I am aware that he at times will rip up his papers as a way to show anger, however lately, he seems to be in "destructive mode" as a way to attempt to control my getting him new papers to colour (as he often has a smirk or smile on his face during these instances). Typically, our relationship is mutual - if he wants new papers to colour, I will trade with him old papers for new. Every now and then if I don't have something he fancies, I will get him other papers to provide him some extra options.

Then I refuse to trade papers with him, or I notice he's doing it to get me out of the room and "waiting" on him multiple times in a short period, I ask him to wait a few minutes, and the next thing I know, he's up and ripping his papers, throwing them in the trash. Staff at his day program and myself keep telling him that if he rips up his papers, he does not get new ones for one hour. We attempt to be as constient with his rule as we can.

This, however, does not seem to be stopping the behaviour, and when he has to wait more than 15 minutes, he becomes very agitated and starts to attempt to escape the room to look around the building for more papers. At times he must be physically followed and pushed out of unwanted spaces. At times, paper-based catalogues, etc have been destroyed in the scuffle. These behaviours increase until he becomes so unmanagable that someone has to get him new papers, or I make an executive decision not to let him have any for the rest of the day - a which for the rest of the day, he is a constant flight risk.

The curious part is that this behaviour only seems to be happening when I am around for the day at his program. On off days when others are caring for him, he sits with only two papers for the entire day, and/or his behaviours deminish.

Obviously, this behaviour is linked to something I am doing incorrectly, or is in some way linked to my presence. I am at a loss as to what may remedy the situation. This is my first ASD client.

If any of you have any ideas, advice, or suggestions, I'd be all ears to hear them.

Thanks. J

Parents

  • I've cited under another posting a fairly old text book (2000) by John Clements & Ewa Zarkowska "Behavioural Concerns and autistic spectrum disorders: explanations and strategies for change" (Jessica Kingsley Publishers). The book explores strategies from lots of clinical contexts. I've picked it up again after finding it hard going before but am persevering this time because i'm finding useful tips for coping strategies.

    My basic grumble about the book is that they go through lots and lots of strategies, but I'm not sure I see outcomes. It is meticulous observation of interactions between support worker and patient without constructive resolve.

    However they seem to have a potential answer for your dilemma - p164 on obsessions, these are some that seemed most apt:

    "Check out your own feelings in relation to special interests to make sure that the reason for setting limits is that the behaviour is causing real problems rather than you thinking that it is a silly way to be spending time"

    "Hobby boxes are very helpful for interests that involve doing something specific (flicking, spinning, juggling, dismantling, tearing). They have to be kept supplied and always accessible at the agreed times".

    The most difficult problems in limiting hobbies is the problem that those setting the limits have in being consistent. Such inconsistency is confusing and handicapping for the person in need of support and can lead to angry confrontations. However once the person finds out you can be trusted and that she does get predictable access to her special interest the intensity subsides and the limits can be tolerated well".

    These writers always seem to write as if the subject is female, in case you are wondering.

    My query would be, why is the supply of papers finite? If this gives him calm and focus and security, why do you need to change this?

    My perception, and I think what Clements & Zarkowska are getting at, is that your meddling is unnerving him. You are, as they say inconsistent in your methods and hardly gaining his trust.

    Why dismantle his world? Do you believe he has to start doing more productive things? Is your job specification to brainwash him? Or to ensure his peace of mind?

Reply

  • I've cited under another posting a fairly old text book (2000) by John Clements & Ewa Zarkowska "Behavioural Concerns and autistic spectrum disorders: explanations and strategies for change" (Jessica Kingsley Publishers). The book explores strategies from lots of clinical contexts. I've picked it up again after finding it hard going before but am persevering this time because i'm finding useful tips for coping strategies.

    My basic grumble about the book is that they go through lots and lots of strategies, but I'm not sure I see outcomes. It is meticulous observation of interactions between support worker and patient without constructive resolve.

    However they seem to have a potential answer for your dilemma - p164 on obsessions, these are some that seemed most apt:

    "Check out your own feelings in relation to special interests to make sure that the reason for setting limits is that the behaviour is causing real problems rather than you thinking that it is a silly way to be spending time"

    "Hobby boxes are very helpful for interests that involve doing something specific (flicking, spinning, juggling, dismantling, tearing). They have to be kept supplied and always accessible at the agreed times".

    The most difficult problems in limiting hobbies is the problem that those setting the limits have in being consistent. Such inconsistency is confusing and handicapping for the person in need of support and can lead to angry confrontations. However once the person finds out you can be trusted and that she does get predictable access to her special interest the intensity subsides and the limits can be tolerated well".

    These writers always seem to write as if the subject is female, in case you are wondering.

    My query would be, why is the supply of papers finite? If this gives him calm and focus and security, why do you need to change this?

    My perception, and I think what Clements & Zarkowska are getting at, is that your meddling is unnerving him. You are, as they say inconsistent in your methods and hardly gaining his trust.

    Why dismantle his world? Do you believe he has to start doing more productive things? Is your job specification to brainwash him? Or to ensure his peace of mind?

Children
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