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OCD and autism - how to deal with ripping of clothing?
Amber_76
Member Posts: 6
Hello! My name is Amber, I work work with individuals with Autism in their homes (group homes) I have been having difficulty with one individual who is an Adult male that has OCD tendencies and is also on the spectrum. My question is what are some ways to deal with ripping of clothing.
Replies
Hi Amber
There is some info about challenging behaviour on the Scope website: http://www.scope.org.uk/Support/Parents/Behaviour/What-is-challenging-behaviour
Also, I wonder if the Challenging Behaviour Foundation might be able to advise you : http://www.challengingbehaviour.org.uk/
Best Wishes
Jean
Jean Merrilees BSc MRCOT
You can read more of my posts at: https://community.scope.org.uk/categories/ask-an-occupational-therapist
One thought might be the clothes are uncomfortable on his skin. Things like rough material, labels , seams in clothing can all be a painful experience to someone on the Spectrum. Ask him, does your clothes make you feel uncomfortable, are you in pain. Work from there.
It's the over and under sensitive to taste, touch , hearing, smell, any of the senses.
It could be a case of using non allergic washing liquids and conditioners. Also the smell of some of these detergents are overpowering to us. Can you imagine what's it like to an Autistic Person.
Its the same as a wet coat, or sweaty trainers, these can be overpowering to a person on the Spectrum.
The clothes could feel too heavy . Just ask , it's amazing what you find out.
Have you read The Reason I Jump, it's facinating and an easy to understand insight into the Autism Spectrum world.
It could be quite complicated . Someone could use this as Stimming , it's just like hand flapping, twiddling a pen, jumping , may be that's why he does this.
If this has become an obsession then it's gently trying to stop the obsession.
If it is Stimming then that's what often happens , they do this in private.
Its going to be a case of trying different solutions till you find the answers.
You sound like a wonderful kind caring person wanting to help your clients. That's lovely to hear and Thank You xx
Could he be bored ? How old is he ? Have you anything like this ?
http://www.lead.org.uk/
I found masses of information from this Charity. I live in Scotland.
Try asking about the clothing first. Work from there.
This may explain a number of the issues.
http://aspiewriter.com/2015/07/temperature-regulation-why-does-my-autistic-child-refuse-to-wear-a-coat.html
http://www.autism.org.uk/about/behaviour/challenging-behaviour/self-injury.aspx
This explains some of the self harming issues and causes.
I know it's difficult but one tip I was given, think of the positive achievements , even if it's only one , not the negative . Choose your battles carefully.
Thats fantastic you get him out for short walks ,. Glad we can help from so far away .
Have you tried making your own book with photos of him doing things himself himself and adding to it. May be photos of people and things he likes .
http://www.nas.org.uk/about/health/dietary-management/over-eating.aspx
http://network.autism.org.uk/sites/default/files/ckfinder/files/Eating issues Dr gould.pdf
http://pdaposterchild.blogspot.co.uk/2016/06/pda-and-food-issues.html
Eating can cause serious issues to folk on the Spectrum varying from very picky to not being able to stop, they always feel hungry.
http://www.pdasociety.org.uk/what-is-PDA/about-pda
I am trying to get a diagnosis of PDA for my boys. Basically it's extreme Demand Avoidance . Thinking about what you have said so far , you will have to investigate the medical history further is there a possibility he has PDA. It's the extreme lengths they go to to avoid situations. Often children will remove their underwear , or deliberately e.g. Hide car keys to avoid Social Situations.
There is a questionnaire on the website and lots of information . Some can be subtle others blatant extreme refusal.
You can have PDA on its own or with Asbergers , ADHD etc. You could also have dyslexia but that will be difficult to test for.
Its another possibility. I wish you luck in your investigations .
Any further updates from Amber or others on this topic? She also is ripping her gym shoes. I am in the process of getting as much detail from caregivers when these events happen.
As far as shoe ripping, I am going to first take her to podiatrist. If nothing medical, plan on buying her a pair of shoes without laces since I learned she first removed her laces before rippping her shoes so am thinking her OCD may have kicked in when she saw her laces “weren’t perfect”.
Her other OCD behavior is then hiding, covering up, or throwing away the destroyed clothes/shoes.
Any updated thoughts from others?
For my client, it seems to be light touch or string related. I also suspect by engaging in this preoccupation somehow serves a purpose. (Stopping the activity? Or an intense desire to fix something that doesn't look right/feel right, etc).
This individual shreds shoes, clothes, jackets, mittens, hats, shower curtains, couches, car seats, etc. If the activity is interrupted in a 1:1 situation - then this person becomes extremely agitated and violent. At times 3 adults introducing themselves to the environment when a new shredding routine starts has helped to stop a sock ripping routine.
These individual are not trying to be naughty. I think about this a sensory event, a communication event, an obsessive event. At this time we're working on engaging the person in activities that are highly rewarding (visually) by introducing various building toys/science activities to keep the eyes and hands engaged in something productive and potentially habit breaking.
2. Getting rid of all her stained clothing and have staff have her wear a “bib” when eating. Having staff explain to her that they want her to have nice, clean clothes.
6. More careful 1:1 monitoring of the client by staff. This is a must! We noticed behaviors were occurring when she was left on her own in her bedroom or in the bathroom.
Even the lounge suites he would demolish. We bought new lounge suites and re-upholstered it to the same material he liked and so far so good it lasted us a couple of years now and going.
With regard to clothings and even the carpet he would still rip them up. What we tried to minimize the behaviour is engage him to a more physical activity that he prefers that might help with the boredom. For us, as what we observed, the behaviour seems to have an underlying cause. We try to understand the cause at the moment and we are still learning.
With our client, we have enrolled him in a regular gym session after some free trials. We focused on what he likes and at this stage the treadmill. So far, he could walk for a couple of hours with no issues. With the regular exercise seems to minimize his destructive behavior. We still encounter minor ones but it comes down to whoever is looking after him. He gets frustrated when his needs aren't met and would try to rip his clothing's for attention.
Both my brother and me are on the spectrum.
He has a “strong disable autistim” (Léo Kanner type diagnosed when he was 1,5 years old), is totally non-verbal but knows how to use PECs and seems to always be understood even without that, well, to people who want to actually understand him. He is 27.
Me, I was very lately diagnosed, last year, after struggling with psychiatric issues, multiple diagnosis and chemical treatments that had very bad effects on me. I am 30, and have been diagnosed with Asperger HIQ.
We live in France, my brother lives in a specialised institution for adults on the spectrum, he goes one week-end out of two to my parents.
I live with my husband.
Concerning the problem of ripping clothes, we really need help because my brother destroys a lot his clothes. It has been now for years, I can’t remember when was the first time, but he already was in institution, not living home, and as a young adult. The past years, each time he is back home, my parents give to the institution brand new clothes, he rippes apparently all of them, especially the underwear’s and in the end all of them, only wearing them (but I think at home and in the institution he can’t have access to his clothes, maybe because he used to torn them too... don’t know).
I want to find and help giving solutions because my parents are spending a lot of money each week to renew his clothes, and to me it is for my brother a sign of suffering, I hate leaving him like this.
it is possible and a good hypothesis to link the periods of ripping clothes with his masturbating rituals, as I am his sister, my parents don’t tell me much about that... and the institution doesn’t give us any details about that, or not to me... the told me that there are some periods where he doesn’t touch any clothes and don’t torn them... they don’t make any proposition or hypothesis about the difference between a period with tiring and a period without...
to me it is linked to a special context, sensorial first (I am in this case and will explain my solutions for me), and linked with the people he is with...
I just can’t forget his strange behaviour once we’ve took him with my husband back to the institution after a ride to the beach, he was very strange and making weird thing with his jeans fly when next to the man who went to open us the gate... I precise that he is non verbal and I just can’t tell everyone that I have a bad feeling about a man working with this folks, just because I saw my brother acting weirdly...
As I am autistic too, I use my own experience with clothes.
for years I was feeling very bad sensations in my body, especially on my skin. I’ve tried many things, and when I decided to live my own way and wear only clothes I like (I used to force myself wearing clothes my mother and sister bought me because I hate buying clothes, and since I am a teenager prefer only wearing clothes I made myself, but always was told they are not what I have to wear to be accepted by the society...
so when I decided not to care anymore, I bought 3 models (with multiple exemplifies) of tops, of trousers in the perfect fabric I can only wear and, my life changed when I decided to stop wearing underwears...
I have been experiencing No Bra for now 8 years and it was very helpful, even if people told me it was dangerous for my breast.
so some months ago I tried and definitely apply wearing no underwear’s (panties, I don’t know if this is the good word in English, for the record, English isn’t my mother language). I felt more freedom and want annoyed by something I couldn’t guess was so invasive to me and my anxiety...
so this is my contribution, I need help to understand how to help my brother. I am sure that if he could make sport such like me (I do 3 hours a day as a minimum, I have also ADHD, which my brother doesn’t seem to have, but I think we don’t know many things about him... he takes so much medicines...)
I read your posts and loved the solutions you proposed but need a light up for my brother situation if possible.
When I began working with my autistic, non-verbal client in 2019 ( I am the court-appointed agent for guardian), her residential staff, day program staff, and the behaviorist told me "She's always ripped. She just needs more medication." Nobody wanted to "work the puzzle" to figure out the root cause of the problem. Her entire life, she was just "medicated" to deal with her ripping, property destruction, and aggression (at times). Today, there has been a drastic reduction in all three areas. Below is the approach I used. I can't say it will work for your brother (or anyone), but I believe the principle of gathering and analyzing data to analyze is important to help understand and possibly reduce this behavior.
First - Report Suspected Abuse. If you suspect any adult abuse (even if it is just a feeling), I would encourage you to report it.
Second - Befriend the care-taking staff at the Home. Bring cookies, write a note, send flowers every now/ then. Get to know the staff as individuals by asking them about their lives. Build trusting relationships so staff feels comfortable sharing their insights with you "off the record" at times. I gained lots of information about what was really happening just by spending time talking with the staff.
Third -Work the your Care Team. Tell the team you would like to see if we can work together to find the root cause of the ripping and that first includes collecting key pieces of data to analyze:
- Date/ Time/ Location/ name of staff person who witnessed ripping
- What was your brother doing right before ripping?
- Describe the ripping: what was ripped, how long did he rip the item? Was he smiling?
- What interventions did staff try to do? (redirect him? distract him? How? speak to him, etc.)
- How did he respond to the intervention? Did he stop ripping? Grunt, grimace. smile, show aggression, etc.?
- Staff to save the ripped item for you to see/or take a picture of the item and send it to you & the Care Team. This is important so you can look at the item to see if it you see a pattern in the clothing. Do all items have tags inside of them? The same color? Same fabric? All have buttons? All requiring pulling over the head? Was the item dirty? Have an odor?
I strongly suggest you ask for access to where staff is required to document everything that is happening each shift. For me, this was getting security access to their online reporting system. Each day, I review the previous day's documentation including staff notes, if her medications that were given as ordered, vital signs, etc. If you can't get online access, ask the home to email it to you.Third - Create a "Behavior Log" Staff Report Template. The next question will be how to gather the data listed above. Again, start working with your Care Team to find out where information about each ripping episode is now recorded. Look at their report and if it does not contain the details above, ask if their report can be changed to include items. Ask if this report is available online for you to see as well. The staff will need to be told by their managers they now "must" complete this in this form each time there is a ripping behavior and you need to be notified via email.
Fourth - Work the Puzzle. Now comes the Sherlock Holmes part. Work with the Care Team to start analyzing each piece of data listed above for patterns. How many times is the ripping happening in the morning, afternoon, evening shifts? How many times does he rip int he bedroom vs. the bathroom, etc.? How many times does he rip when he is alone vs. with someone? How many ripped items were dirty? Had buttons? etc.
Fifth-Experiment with Solutions. Work with your Care Team and ask them to come up with creative ways to address what the team thinks may be a "triggers" for the behavior. Be specific and be sure to identify who/ what/ where/ when about the solution. For example,
for my client, the patterns showed: most ripping was happening at the Day Program or around 4pm after she got home from the Day Program. There was a behavior pattern when a new staff person started giving her care. By looking at the staff narratives, we also determined, the 3pm-11pm shift was documenting she "smelled" sometimes after returning from the Day Program and had feces in her pants. We addressed that issue by working with the Day Program Director who increased her daily trips to the bathroom. We also thought she may be hungry because she was eating her lunch at 11 am but not getting her dinner until 5pm (6 hrs later). We started giving her a small snack when she got home after the Day Program. We removed all tags in the clothing and made it a point to tell staff she was NOT to wear any dirty clothing. You get the idea, I hope.
Note on working with your Care Team. The guardian has power and should not hesitate to seek new Care Team member if it is determined someone is not working as a team member to address this problem. I had to get a new Behaviorist because the old one was not engaged at our meetings, did not update her reports with new information, did not work with my client 1:1 and consistently said just to medicate her more. She was a lovely woman, but in my opinion did not have the experience or desire to help my client. She ended up changing career-path directions from working with mentally disabled adults and is now working with children in the public school system.
It's a complex problem but breaking the "puzzle" down into objective, data pieces, and working with a team makes the problem solving much easier. I hope this helps and please keep us posted.
I have autism and have severe issues around OCD in terms of my clothing and I am very much a perfectionist when it comes to my hair/makeup and it can really upset me at times.
I think I know what could solve this issue
Why not ask him what his favorite t-shirt and jeans are
Just something to consider!
All the best.