OCD and autism - how to deal with ripping of clothing?

Amber_76

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. 

Jean_OT

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

Yiman60

Amber_76 said:

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. 

I presume he has access to the likes of Autism Iniative, try their Forum see if anyone has any suggestions.
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.

Amber_76

Thank you for your reply

Yiman60

No problem. 
 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.

Amber_76

I guess not all my reply was captured lol. The gentleman is nonverbal and has OCD. I am not totally sure if it's sensitivity to the feel but will change design and fabric to see if this is the cause as well as dwtergen. It does seem ritualistic as he will only rip his clothes in his room nowhere else and rips as soon as he gets dressed in the morning. 

Yiman60

https://www.speechandlanguagekids.com/stop-flapping-and-self-stimulatory-behaviors/

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.

Amber_76

Thank you so much for your advice!!

Yiman60

Amber_76 said:

Thank you so much for your advice!!

It's is a very complicated subject. If you have some way to communicate , e.g. Writing, sign language work with the positives .
You sound like a wonderful kind caring person wanting to help your clients. That's lovely to hear and Thank You xx

Amber_76

He has a PEC book (picture exchange communication system) but is very limited with it. He only communicates some activities and food to us. He is not willing to go beyond that. He's quite complex and I feel so bad for him as he has very little funding and it's running out because we've purchased so many new clothing for him. 

Yiman60

Amber_76 said:

He has a PEC book (picture exchange communication system) but is very limited with it. He only communicates some activities and food to us. He is not willing to go beyond that. He's quite complex and I feel so bad for him as he has very little funding and it's running out because we've purchased so many new clothing for him. 

Oh bless I see what you mean. Part of the issues of Autism is Prediction, what happens next. 
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. 

Amber_76

He is 28 years. We have lots of activities for him but he's uninterested he will do a lot of humming and fist or head banging and will try to make you put them away. He seems to only enjoy food and  tv as he asks for them constantly but we can't have him in front of the tv sleeping his life away and eating till he explodes lol. He does like to walk/hike but half the time he wants to cut it short lol  I live in Northern Ontario, I will take a look at the site you gave me!  Again thank you so much for your help

Yiman60

http://www.linkage.org.uk/wp-content/files/Out_of_the_Shadows.pdf

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 .

Yiman60

http://www.autism-help.org/communication-autism-introduction.htm

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 . 

MS1964

Hi.  I’ve just become the legal guardian for a SMH (severely mentally handicapped) female who also is non-verbal much like Amber’s situation.  Also OCD behaviors.

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?

laura_otr

I am consulting on a very similar situation as MS1964.  I would love continued advice.  I haven't looked at the links yet but hope to pick up more ideas.  My individual is middle 20's as well, nonverbal.  This individual collects all the small pieces after the ripping/shredding events and then hides or throws them away as well.  It's almost like they had to finish the activity but maybe (shamefully) know they need to dispose of it.

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.

MS1964

Hi Laura. This can be frustrating but hang in there.  You are absolutely correct that this behavior serves a purpose.  Getting the team on board to acknowledge this will be key to success. 

Things have improved greatly for my client with the following new insights and changes.  

1. Having staff just give the client more direct 1:1 interaction, smiles, talking to her, complimenting her helping her chose clothes ( she picks out her outfits every night for the next day).  Unfortunately, I think staff have a tendency to really ignore clients that don’t talk. It takes staff re-education about the importance of non-verbal communication (smiling, hand touching, etc).  Also, trying to find other ways to communicate- teaching the sign language for “don’t like” or “ need help”.  Just giving a  little bit of attention was a game changer for my client.  
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. 

3.  Have her participate in washing, drying, putting away her clothes. 

4.  Make sure all clothing in her closet fits her properly and removing all items that don’t. 

5.  Early removal of anything in the environment that becomes a fixation.
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. 

7.  Redirection-  create a bag and have it easily assessable for staff at all times with redirection items in it.  Maybe a favorite stuffed animal, toy, papers to shred, food, play, etc.  bring an item out and attempt to give it to the client with the words, “ Joe, I’ll fix the shirt if you give it to me.   Here, you take “this” and I’ll fix the shirt.”  Teach sign language for “ fix it” and practice this with the client. 

8.  Playing music maybe a great redirection. Especially, if you can get staff to encourage the client to get up and dance with them.  

9.  My client had bilateral tendinitis and needed anti inflammatory meds for 30 days and a proper fitting for correct shoes. After this, she went 60 days before she ripped her new shoes and I’m convinced that behavior was due to something between a staff person and the client that day. This behavior has greatly improved overall since addressing the foot pain issue. 

Hope this helps. Finally,   I’m not a behaviorist but the guardian. It is key to get a behaviorist on the team who specializes with challenging behaviors like this. 

Chloe_Alumni

Welcome to the community @MS1964 and thank you very much for taking the time to share this with us! How are you doing?

sabernz

Hi,  I enjoyed reading the insights that everyone shared about ripping behaviour in the spectrum.  We have the same client that we support who exactly manifest the same ripping behaviours.  We can't leave any clothings in his bedroom as he will demolish it,  no beddings as well as mattress.  We imported a set of unrippable mattress, pillows and blanket which lasted for 6 years until he found weaker points and had ripped them.  We found a replacement material though in which he seems to like the texture and haven't touch it since.

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.

Chloe_Alumni

Welcome to the community @sabernz! 

MS1964

Update:  Things were going well but had a ripping episode recently. Client received a winter coat and proceeded to rip the zippered hood off the coat the first time seeing it. (it was reported to me, I didn't actually see this). Client always wears a winter hat, so perhaps saw no need for the hood or had never had a coat with a hood and thought therefore something was "wrong" with the coat.  My client destroyed items that are damaged in anyway (e.g. chair with a wobble). The coat was still wearable. Later that same day, after a test at the hospital, client returned to the waiting room and immediately went to the chair where the coat was and ripped it again to the point it was no longer wearable.  Client smiled as though this behavior gave some type of stress relief. Behavior only took 3 seconds!  Client did stop when told to do so and gave up the coat to staff when asked.  Staff hid the coat behind them. Client was redirected to sit down and did. Comforting words were provided, client's shoulder was rubbed and was told to take some deep breaths- which client did. During the test, the client's arm had to be restrained in order to attempt to put in an IV. Client was stuck twice and yelled out loudly both times. No IV was started because of failed attempts. Usually I am with the client for any IV starts and/or procedures but was not allowed in the room due to the nature of the test.  I believe the client's stress level was "high" because of being with strangers. Any "restraining" could also have risen a stress level since there was a history of family abuse where the client's hands were often times tied as of means of control. For my client, ripping could be a learned behavior from years ago that provides stress relief because client can't communicate needs/ feelings.   Our first team meeting with the new behaviorist is in February, so I'll update after hearing her thoughts.