Autistic Child Has An Outburst – This Is Autism
What Is Autism? What is Autism Spectrum Disorder?
Keeping my child clean and neat is a real challenge.How do other parents deal with this?
A common complaint among parents of autistic children is the difficulty in getting their child to bathe, brush his teeth, and perform even basic grooming. Although not unheard of among typical children, this behavior is intensified in the autistic population. An autistic child’s tendencies to avoid noisy environments, close contact with other people, and tactile stimulation make personal hygiene difficult. Autistic children find the bright lights and loud noises in tiled bathrooms, difficult to tolerate. Similarly, the close physical contact, noise, and strangeness of a barber shop are equally difficult. Despite this, most parents are able to achieve acceptable levels of hygiene and grooming in their children. Like other behavioral challenges in autistic children, it requires equal measures of resourcefulness, discipline, and compromise from the parents.
Some suggestions include:
Extremely high levels of cleanliness may be inappropriate or simply too difficult to achieve. There is no medical reason to bathe your child daily. If your child resists bathing, aim for one or two baths per week.
Explore alternatives to daily bathing or showering. Consider sponge baths or washing him or her with a damp cloth while he or she watches television or plays a video game.
Discrete trials that are aimed at desensitizing the child to the water in a bath or shower can be effective. Using the novelty of jumping into swimming pools, playing in outdoor showers, or jumping over lawn sprinklers may help the child overcome their fear of water.
For some children cutting the finger and toenails is frightening or unpleasant because of its strangeness. Parents can try to cut their child’s nails when they are distracted with a TV program or video game or even when they’re asleep. Alternatively, a parent could try teaching them to do it themselves.
If your child is sensitive to getting his or her haircut at the hairdressers, try hugging him or her in your lap. Regularly brushing your child’s hair may “desensitize” him or her to getting his or her hair cut. If the child is frightened by the noise of an electric clipper or hair dryer, ask the barber or stylist to only use scissors and a comb and to let the hair dry naturally.
Getting (and keeping) my child dressed is very difficult.What can I do to make it easier?
For many autistic children, wearing clothes is an uncomfortable proposition, and it is common for them to tend to take their clothes off whenever they can.
Some clothes present an overwhelming tactile stimulation to the autistic child and while their desire to remove their clothes is understandable, it can be socially inappropriate for them and embarrassing for their parents.
Some suggestions for avoiding these situations are:
Make sure they have comfortable clothes on.
Ask your child why they want to take their clothes off. They may be able to tell you what’s irritating them.
Choose soft fabrics, preferably cotton.
Check clothes for thick or rough seams that may irritate skin before you purchase them.
Avoid clothing with tight waistbands, collars, or cuffs.
Remove clothing tags that may rub against their skin.
When the children are older, allow them to pick out the clothes they want to wear for the next day. Try to determine why some clothes are chosen and not others.
Remember, your child also may be sensitive to the color or pattern of the clothes.
If keeping a diaper on is difficult, make sure it is not on too tight. Change brands to find one whose texture is the least irritating. This may take some time.
If communication is difficult or the child is too young to work with, try dressing them in clothes that are difficult to remove.
Select overalls or jumpsuits.
Choose shirts, dresses, and pants that button at the back.
Replace zippers, Velcro, buttons, and other easily opened fasteners with more complicated options.
Your child may be overly sensitive to the feeling of clothes against their skin. Consult with your occupational therapist for help to develop a “desensitization” program.
Be aware of other issues that may cause the child to want to remove their clothes.
Are the clothes too warm for the temperature or activity level?
Are they too restrictive for the type of play?
Does your child have an allergy to the cloth or detergents used to clean it?
Does your child have a skin rash, such as eczema or sunburn that is irritating?
Does your child have an infection from parasites such as pinworms, ticks, body lice, or scabies?
This is not an unusual finding, especially in children that attend special education classes with other developmentally disabled students. Consult your pediatrician if suspicious.
Provide reinforcement to the child for proper behavior.
Praise the child effusively for wearing appropriate clothes.
When dressed in a new outfit, have your child look in the mirror; they may like what they see.
Point out that siblings and parents wear clothes; autism does not eliminate a child’s desire to dress like an adult.
What are some causes of behavioral change in autistic children?
Behavioral problems in autistic children can range from difficulty with transitioning from task to task, associated with uncooperativeness or defiance to aggression, uncontrollable tantrums, and self-abusive behavior, such as biting of the hands and arms. These behaviors are recognized as part of autism and can be expected to wax and wane over time. Exacerbations of behavior are sometimes easily attributed to changes in the environment, encountering strangers, or having new demands placed on the child at school or at home. Sometimes the behaviors have no identifiable cause and must be tolerated as part of the disease. Before a worsening of behavior or new behaviors can be attributed to “being autistic,” parents, teachers, and physicians must be aware of other causes that may be serious. Because communication is a problem with autistic children and adults, they may find it difficult to tell their caregivers that they are feeling sick or are in pain, irritated, or frightened. This frustration, caused by an inability to communicate, may manifest itself as aggression or self-injury. Alternatively, severe pain, nausea, or weakness may make the child withdraw and not participate in play or school. Behavioral problems can escalate in these situations, especially if the child is pressured to continue with daily routine or work activities.
Some things parents should look out for are:
Infection. Parents and caregivers should be vigilant for illnesses that can be the cause of behavioral changes, even changes that occur slowly and are sometimes dismissed as typical autistic behavior. When a child has a deterioration of behavior, parents or caregivers should consider influenza, sore throats, ear infections, tooth abscesses, migraine headaches, abdominal pain, or even appendicitis. If the child has a fever, diarrhea, vomiting, lethargy, loss of appetite, or takes to their bed, an infection should be considered and a physician consulted.
Neurological disorder. Seizures and motor and vocal tics, as well as Tourette’s syndrome, occur more commonly in autistic children than nonautistic children.
Convulsions and staring episodes may be the result of a seizure disorder. Unusual facial movements, hand mannerisms, or feet shuffling may be the manifestation of an uncontrollable tic. These are usually worsened in stressful situations. Finally, unusual vocalizations, barking, or repeated words may be a sign of an undiagnosed Tourette’s syndrome.
Medication side effects. The side effects of many medications can cause behavioral changes in both typical and autistic children.
Cold medicines containing pseudoephedrine can cause hyperactivity and anxiety.
Antibiotics such as tetracycline can cause abdominal pain and diarrhea.
Antidepressants can cause increased anxiety, increased appetite, and disinhibition. (Disinhibition is an unusual loss of self-restraint, fear, or inhibition.) Pain. An autistic child’s behavior can be affected by pain. Therefore, common painful situations should be considered when there is a change in behavior. Common painful situations that should be considered include bumps and bruises, bone fractures, impacted wisdom teeth, sinus infections, perianal abscess, ingrown toenails, hemorrhoids, and menstrual pain.
Fear. Autistic children may have an inappropriate fear of people, objects, or events. They may fear water because of the tactile stimulus; they may fear the school bus because of the noise or the smell of the exhaust; they may fear a teacher because of her height or tone of voice. Although these are inappropriate fears, they, nonetheless, need to be identified and corrected, if possible.
Autistic children may have appropriate fears that are unappreciated by parents and teachers. They may fear aggressive children in their class, physically or verbally abusive bus drivers, and teacher’s aides or cleaning people. Episodes of physical and sexual abuse of disabled children, while unusual, are not unheard of. Unexplained bruises and cuts should be investigated.
Physical signs of sexual assault should be investigated thoroughly, even if an alternate excuse is given. Law enforcement agencies should be involved if the parent is suspicious of this type of activity.
Discomfort. Many unusual behaviors of autistic children can have a simple explanation and be resolved easily. Tight or itchy clothing can cause a child to writhe in discomfort or take off their clothes. A song, musical note, or discordant noise can cause the child to hold their ears or have a tantrum whenever entering a room with those sounds. Certain smells, especially strong smells like detergents, alcohol, or gasoline, can cause the child to run away, refuse to eat food, or even vomit.
Every effort should be made in these cases to identify and treat the underlying condition medically before treating the behaviors unnecessarily with sedatives or tranquilizers.
Terms:
Discrete trial – A short, instructional exercise that has three distinct parts: e.g., a direction, a behavior, and a consequence.
Tactile – Related to the sense of touch.
Despite this, most parents are able to achieve acceptable levels of hygiene and grooming in their children.
Tight or itchy clothing can cause a child to writhe in discomfort or take off their clothes.
