Guest Author - Bonnie Sayers
Self-stimulatory behavior is not confined to the autism community. Take a look around at the office, library, waiting room and lines for service. You will see ordinary people twirling their hair, tapping a pen or pencil, biting a pencil or fumbling in their pockets, playing with a button on their clothing, snapping their fingers, cracking knuckles, whistling, blowing bubbles with gum, rocking in a chair, playing with toothpicks or playing with a beard or moustache.
Mostly adults take part in these soothing behaviors to counteract boredom or stress. This is not the same as some steps people who might suffer from Obsessive Compulsive Disorder do before leaving the house or getting into a vehicle.
My son Matthew touches the carton of eggs and squeezes the gallon carton of milk each time he goes into the refrigerator. Some people only eat one food item at a time, while others like to mix theirs up. There is no right or wrong way since each individual has their unique style.
The same is true for those on the Autism Spectrum Disorder who engage in repetitive behaviors also known as Self Stimulatory Behaviors. Matthew has had a variety in his nine years, starting with head banging, hand flapping, flicking light switches, flushing toilet, playing in water, picking at the wall (peeling the paint), biting his fingernails, constant rewinding of videos, shaking magazines, playing with string on clothing, twirling buckle on backpack and shaking papertowels.
Matthew also has a habit of making noises as part of a stim, as well as facial movements that bring some sort of comfort to him. As mentioned in the Floor Time Assessment, the Therapist followed his lead and interest in shaking magazines and books as a way to interact with Matthew. She grabbed a book as well and walked around mimicking, but in a positive way. He really seemed to enjoy this interaction.
The Report stated self-stimulatory/perseverative behaviors - Matthew has stereotypic motor movement in the form of shaking and flapping books, magazines and videos. Also, vocalizations with throat and mouth.
The first time I heard the term "perseverated" was on a report from the Speech Therapist for Nicholas back when he was about five years of age. It was noted that he perseverates on animals, something anyone familiar with him would know almost immediately. I would not incorporate both words to have the same outcome, since I have seen such different responses to each of them in my children on the Autism Spectrum.
Matthew also flaps magazines in front of Nicholas when he is watching television. I feel this is a way for him to get his attention and start some form of communication between them. He wants to play and this is his way of starting the back and forth process.
Part of Matthew's Behavior Support Plan mentions his walking around a taped section that the Occupational Therapist made into a lap with his backpack filled with some books. This is to help him in stressful situations, which are times that self-stimulatory behaviors can strike.
Several years ago his aide at school told me that Matthew's class played on the small playground around the time other classes were waiting in that area to enter the lunchroom. She said that kids were staring because Matthew was playing with himself. I was stunned that this women would say such a thing, but should not have been surprised that she was so clueless to autism in general. It turns out his aide was not very keen on detail since Matthew was actually feeling the string inside his pants. Since that episode I have kept the string on the outside for Matthew to shake.
She did not believe me when I said that Matthew had developed PICA and was eating dirt and rocks and to use caution on the playground. She soon learned this was true when I picked him up one day and showed her what he had in his mouth. She also was unaware of the side effects he suffered with Risperdal and insisted his behaviors were stereotypical behaviors. A note from his Physician set the record straight on what to observe and take into consideration regarding his behaviors.
Everyday there is a new adventure in the autism class Matthew attends. He likes to wear Prospirit and Adidas sport type pants that have the string inside. Several times his pants have had the string tied in a knot so he does not have access to them. I do not appreciate their doing this without seeking my approval beforehand.
Today the two aides along with the Teacher told me something that has been happening this week at school. Matthew has a habit of shaking his head sometimes and his hair goes all over. He screams and does a head shake, easiest way to describe it. They indicated this got more severe and they wanted to know if he was doing this at home. The answer is no I have not seen an expanded version of the head shaking.
The teacher informed me that she rubbed his stomach and thought maybe he was in pain. His aide then said she thought he had a stomachache. I repeated back to her the following - you think my son is shaking his head because he has a stomach ache? I mean this is absurd and another example of how clueless these people who work with my son are.
Matthew also likes to flap around the buckle to his backpack, yet that has been tied in a knot many times also. There is one jacket that he wears that has string on the side. The other day after I left him in his line I heard another aide tell him to keep his hands behind his back. I am waiting to hear this again so I can quote her exactly and inform the school that this is unacceptable.
Another interest of Matthew's is the mouse pad. I learned from someone who was observing Matthew to determine if another school option was appropriate for him, that he would grab the mouse pad upon entering the computer room at school. I hope they have not curbed that stim as well.
The teacher and aide complained in the Behavioral Log last year that Matthew would not sit still at circle time and always scratched the aide. In my opinion it serves them right for stifling his soothing behaviors that he needs to calm down. I also suggested to the teacher that they do the laps around the playground before the circle time. I will ask at the parent-teacher conference whether she ever initiated this change.
The Behavior Log is part of the IEP, yet since Christmas break we have not received this. I also have yet to get accountability for the therapy appointments he gets each week. I stated I wanted to know if he in fact does see the Adaptive PE teacher, OT and Speech the alloted times he is suppossed to and I want a listing of the compensatory time.
It seems a letter is in order to get this requested material. I wrote a letter to the school in March of 2005 asking for the removal of this aide. This is year four and looks like she will be following him to another school for his fourth and fifth grades.
I am contemplating whether it is best to have no aide for a severely autistic child who is nonverbal, or to continue with an inept aide who has no formal training in autism and has likely never read a book on the topic.
I found a great resource for self-stimulatory behavior that breaks down these for the senses by Deaf/Blind Outreach. A great site even if it does not touch on Autism Spectrum Disorders. I did find a few of the listed behaviors I mentioned earlier from this article, although the bulk was from my own memory and experience.
Educational Autism Tips for Families 71 page resourceful ebook for families entering the school system with a recent autism diagnosis. Find out what issues take place over the course of a school day and meet these challenges head on.
Repetitive or Unusual Behaviors from the Watson Institute
Motivation Assessment Scale a free service to psychologists, teachers, parents and others devoted to positive, nonaversive responses to problem behavior