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

2»

Comments

  • MS1964
    MS1964 Community member Posts: 7 Connected
    Welcome @sabernz!  Would love to hear your story?
  • Chloe_Alumni
    Chloe_Alumni Scope alumni Posts: 10,510 Championing
    Thank you for taking the time to update us, I hope the behaviourist can help! 
  • MS1964
    MS1964 Community member Posts: 7 Connected
    Update after team meeting.  Well, first update is about that winter coat.  I was able to take it home and repair it .  Before giving it back  I showed her the  "baby" sign language for "fix", telling her I had fixed her coat.  I had her repeat the sign to me.  Here is the link to the site I use https://www.babysignlanguage.com/dictionary/f/fix/?v=7516fd43adaa  when I need to sign.  She took the coat, hung it up and wore it four (4) more days before I read she had ripped it while out at her Day Program. Of note, was that staff reported she had noticed she had a urinary accident right before ripping her coat.  The behaviorist and team believes our client has a  life-long learned negative behavior of ripping as a means of communicating when something is not right. The behaviorist is working with her using picture communication cards.  At the team meeting, behaviorist reported the client is about 50% engaged with the use of communication cards - trying to verbally repeat back to the behaviorist the word. Behaviorist says it will take the client time to conceptualize the meaning of the word/ card/ langauge (think of Helen Keller movie).  The behaviorist has also   developed a Communication Book for the home that has behavior tracking sheets for staff to use. In addition, she will be implementing a “tool box” of calming items for the client's relaxation (proactive strategy). Hope some of these suggestions help someone.  I realize each situation is unique.  God's blessings to all caregivers who work with those less fortunate.  
  • newborn
    newborn Community member Posts: 828 Trailblazing
    MS1964 it is uplifting to see how much care and thought goes into your work. It was, though, distressing that the i.v. people were so uninformed and  bullying.  Excluding familiar people , forcible restraint, and even striking their patient.  It is they who should be struck.....struck off being permitted to practice.
  • MS1964
    MS1964 Community member Posts: 7 Connected
    Just to clarify.....staff did not strike the client.....they "stuck" her twice......trying to get the IV inserted.   I'm just delighted that in 2020, we finally are at a place where key members of the team are moving forward with changes based on the assumption the ripping behaviors occur due to an inability to communicate needs and feelings.  
  • Chloe_Alumni
    Chloe_Alumni Scope alumni Posts: 10,510 Championing
    Thank you so much for taking the time to update us @MS1964! I'm sure others will find this interesting and a valuable insight! 
  • sabernz
    sabernz Community member Posts: 2 Listener
    MS1964 said:
    Welcome @sabernz!  Would love to hear your story?
    Hi.  Tks for the warm welcome.  I enjoy working with the clients that we support as there is never a dull moment.  It always help me think, re-think for strategies that could help us do better.  It also makes a difference to find this support group to reach out and learn some more.

    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.
  • Habiba
    Habiba Community member Posts: 1 Listener
    Hello beautiful people,
    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. 

    Thank you and I feel very happy to see people so dedicated to their clients ! Since I have been diagnosed with autism everybody, even my own parents and sisters turned their back to me, telling that I just want to draw attention or just deny or tune out when I talk about it...
  • MS1964
    MS1964 Community member Posts: 7 Connected
    Welcome@Habiba and thanks for sharing your stories. Your brother is lucky to have you and your parents. Are you his guardian or your parents?  Someone else? The references to "you" below really means whoever  is the guardian. Does your brother have a Care Team (psychiatrist, psychologist, behavioral therapist, case manager, etc.)?  How often does the Team meet?  Below are my thoughts based on my experience in significantly reducing ripping behaviors with my client.  

    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.  



  • fairybellsxo
    fairybellsxo Community member Posts: 45 Contributor
    Hello :) 

    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 :) I think it's to do with the fact that they are ' new ' clothes I hate buying new clothes as I get used to how I look and feel in certain things, so I tend to avoid buying new things as I don't like ' change ' .

    Why not ask him what his favorite t-shirt and jeans are :) and then just buy him a few of each thing, who cares if they're not 'different designs/styles' they're clean and he will be much happier that way :) 

    Just something to consider!

    All the best.

Categories