Tuesday, September 21, 2021

Deal With These Behaviors or Suffer the Consequences for a Lifetime

Self stimulatory behaviors, obsession and narrow interest are cornerstone behaviors of Nick's autism that began before his diagnosis. I hoped with intervention he would outgrow these,  still they are in full effect today. This behavior has been described in many words that mean the same thing for us, including; 

    • Repetitive
    • Repeating
    • Rumination 
    • Obsessing
    • Scripting
    • Perseveration 
    • Over stimulation 
    • Stemming
    • Echolalic 
    • Self Stimulatory Behavior 
    • Limited/Narrow Interest

Over the years Nicks need to put his favorite topic's on auto repeat by any means possible (internally or externally) has been given lot's of names but it has never changed!  Nick is addicted to repetition. Anything Nick likes, he likes a lot. Anything he likes he wants to have repeated in shotgun style; rapid, bold with no holds barred. Nick will find any way to get a thing to repeat, from lists, to baby video's, to end credits, toy sounds, to words, one phrase in a song, to questions anything he can repeat.  Nick wants to live in a loop where he can hear or see the same thing over and over. He is an addict for repetition, he loves it and Nick could replay a 3 second piece of a song, a dinosaur roar, video clip, or 6 second movie segment back-to-back over and over for hours either in the real world or just in his head.

He gets so happy; he jumps up and down laughing hysterically as he spins and drools with joy!  I know to some of you this may sound cute and harmless yet it is anything but.  Sadly, this thing that Nick loves so much that makes him so happy is like a drug, when you're up it's great, but the crash is ugly. 

Nick repeats and in doing so he grows more and more excited with each spin around the loop. But unlike the rest of us he cannot regulate his body's response to the things he loves. Repeating gets him overstimulated, when he is overstimulated, he can't think of anything else but the thing that stimulates him, and he loses all impulse control. When he is asked to stop, he gets upset. When he gets upset, he doesn't hear what you say to him, he begins to tantrum and he cannot be redirected to anything positive. He often becomes aggressive and then he falls into intense sadness and crying as he crashes that can last up to 24 hours.

It's so sad that things he loves are bad for him, and that is why I call it his heroine! 

Sadly, the problem is not just limited to how it makes him feel. Having things repeat over and over and taking part in Nick's tantrums makes others feel anxious, angry, tortured, nervous, frustrated and ready to crawl out of their skins as they beg him to stop and then are forced to deal with the fallout. 

What I know for sure is that this aspect of Nick's autism will be with him for a lifetime, but the fallout for us has been minimized using these five strategies. For Nick it's all about;

1. Constantly working to expand his areas of interest. The more things he has to do, the fewer opportunities he has to focus on his obsession's. 

2. Restricting his access to ANYTHING that he can use to access his obsessions. In Nicks case no one is allowed to let Nick get on a computer, a cell phone, TV, or tablet unless we have agreed exactly how it is being used, and Nick is not controlling it. 

3. Finding if there is any formula that works where he can have any amount of his obsessions. In Nick's case Nick can earn 15 minutes, 1 day per week of free time on the computer. During this time, he can look up and repeat any of his obsessions. I have learned that is how much he can tolerate and still retain impulse control. A change as simple as letting him go for 20 minutes results in a lack of impulse control and the subsequence crash.

4. Making sure EVERYONE who is around Nick knows the rules and follows them, even when they think I'm wrong or being too hard on him. 

5. Introducing incompatible behaviors. When Nick wants to be in his head playing one of his favorite video loops, I have him do an activity where he cannot be in his head at the same time. For him coloring a picture, doing a puzzle or a word search work. He can’t do any of these and play a video because the two activates are incompatible.

5. Not letting anyone talk me out of what I know is best for Nick. For years I let "experts" convince me and sometimes shame me into letting Nick indulge in his obsessions.  And, in the end, Nick did not build an improved tolerance, or gain from the experience. Instead, I was always left to deal with the fallout when they moved on to another case, or headed home. I finally learned that no matter how hard others tried to convince me that a little heroine can't be that bad! 


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