Should support workers use discipline/punishments for autistic adults?

Hi. I'm a support worker for a 40 year old man with quite severe autism. He does not have the capacity to make decisions based on known outcomes (eg he would eat and drink constantly if he could as he does not understand the consequences). He has some behaviour issues and lots of obsessions, most of which are harmless (for example wanting to leave the car radio on a certain channel when getting out of the car, tucking all the chairs in, in his way) Sometimes he does things which Do cause problems such as running to the house next door (which is also a supported living house with the same company) and going into one of the residents bedrooms and taking a specific toy. 

My my question is about what we support workers should do. A lot of my colleagues don't let him do the things he is obsessed with/his 'habits' including the car radio thing. I don't understand this as he is autistic therefore of course has obsessions like this and as it is not causing any harm why shouldn't he do it? Telling him not to usually agitates him even more and causes disruptive behaviour like running to the other house as I mentioned above, swearing and kicking out. I don't know if I'm right but I don't see why it is necessary to stop an autistic persons obsessions as long as they are harmless and not putting anyone at risk?

my second question is about discipline, other support staff often tell this resident when he is 'acting up' that he won't be allowed his usual evening snack (which he has every night) or his bottle of coke which he has twice a week.. This seems harsh to me as he is not a child, abd although it does sometimes stop him from doing whatever he's doing that's causing a problem, I don't think he remembers when it comes to the time he'd usually have his snack/coke and therefore he just gets confused. It also seems like a threat which doesn't seem right as we are there to support them. An autistic person is always going to do things like that, their little quirks and habits, because they're autistic right? If we could stop them doing all those things then we could cure autism which we know we can't, so do we really need to be raising our voices and threatening to take certain things away from him to stop him from doing things which cause problems (but not actually serious, risky problems)

i just want some advice really as I'm not hugely knowledgable on autism and this is my first time working with people with autism, and there's just some things that other staff do that I don't quite feel comfortable doing myself or seeing them do.

any advice would be great?

  • Before you punish an Autistic Adult do you need legally to get the consent of the Adult concerned?  In 1984 I refused to sign a contract with a Therapeutic Community in Israel  One of the conditions was to accept punishments and consequences.  I did not sign and went back to London on the next available plane.

  • Hi,

    I totally agree, if rituals and obsessions are not causing any harm, then there is no reason to stop them. To do so causes anxiety and can cause behavior considered challenging. 

    Likewise, withdrawal of a treat will cause anxiety and due to such a delay between the unwanted behaviour and the "punishment," it won't help change beviour. Natural consequences are better and teaching communication strategies. What is the highly desired toy? Could the service user save up for one of his own?

    How to respond to these harmless rituals should be part of his care plan, staff clearly need more training. You are right. I hope you feel able to raise this with your manager.

    melly

  • JHay, I am not an expert on working with severely autistic adults, but I do feel strongly that the way you describe your colleagues treating this man is wrong.

    We all have different ways we like to do things, wether we're neuro typical or have an autistic spectrum condition, wether its how to arrange the furniture or what radio station we listen to. Yes, we have to learn to compromise, not do things that are unsafe or endager others as well as follow laws and rules, but in our own homes we should be able to do things how we like, as long as it doesn't endager others. The people employed to support him should be doing just that, supporting him, not punishing him. Yes there are things he doesn't understand the consequences of (such as not constantly eating or running into next door), but stopping someones personal preferences just because it annoys or inconveniences you the employee is just plain wrong.

    Is there someone at work that you feel comfortable talking to about this, maybe your manager?

    I wonder if there is any information on the Quality Care Commission site that would be helpful to you www.cqc.org.uk/.../community

    Well done for treating your client with the dignity he deserves