Saturday, June 23, 2012

Repetitive Behavior

With the summer comes relaxed structure. This is great in some ways, as we don't have to worry about getting out of the house at the same time every day for school, we can decide more of how we want the day to go, etc. But if you know little kids and how much they like (and NEED) structure, you know that this is a challenge, too.

I thought this challenge would be greatest with Cole, as he has always been happier when school is in session and his day is more scheduled. Actually, it's seemingly been hardest for Dean.

In the absence of structure, Dean engages in a lot of repetitious behavior. From what I understand, this is pretty common for PWS. For Dean, it's mostly books. He'll sit and flip through book after book. It's not just mindless, because he's flipping through and acting out certain scenes on different pages, or laughing at a funny scene or saying a few words that apply.

I know, it's books. Books aren't a problem, right? They're good for you. But Dean gets stuck on the books. Uninterrupted, he could go almost the whole day just flipping through books, not interacting with anyone else. We have to remind Dean constantly throughout the day to try other activities and to interact with his brothers. The interesting thing is that when we help him get "unstuck," it's almost like a breath of fresh air for him. His whole demeanor changes, as if he knew that he was stuck, too, and just needed some extra help.

With increased repetitious behavior comes increased general misbehavior for Dean. It's like his whole brain is so fixated on the repetitious activity that he loses the ability to function in other areas. He has more tantrums, is grumpier, more antisocial, and is more uncooperative than if his day is mixed up a little more.

In PWS, this repetitious behavior also is tied to OCD and anxiety (as mentioned in the previous post). Here is a summary of some research regarding this: http://www.pwsausa.org/research/summary/repetitive_and_ritualistic_behav.htm

So, we'll enjoy the summer, but I will also be happy for Dean when the structure of the school year returns. I think the regularity of the school routine will be good for him, and I'm interested in seeing how it reinforces particular *helpful* behaviors. Reflecting on this helps me appreciate both the summer and the school year for what they offer our boys.

3 comments:

Giulia said...

Hello,
Did you try to plan and implement some structure at home ?
I know it won't be "school", and that you may have heard it.

I also know that for children with ASD, unstructured time -> anxiety -> OCD-like behaviors and misbehaviors.
Even if Dean does not have ASD, you can inspire yourself from the available tools for people with ASD.

I also could know that uncertainity -> anxiety -> misbehaviors.

So, what you can do is creating a visual schedule, exactly the same as for people with ASD.
Do the same for menus (the more Dean will worry about food, the worst) : visual menus.

And stick to it.

If a change has to happen, then, you talk to him about it and you change the schedule.

Also, and even if you already know it, a person with PWS is more visual than auditory.
So, instead of telling him, you can show him with pictures, signs etc etc...

Hope it helps.

Ali Foley Shenk said...

Giulia,
We are trying to implement some kind of structure. Realistically, with 3 little children, there has to be a lot of flexibility. We have a visual schedule for some things (like getting ready in the morning) and I've thought about using it for our day in general.

Also, we've noticed that the repetitive behavior is at its peak after he's had something structured, like therapy, etc. Tricky to know how to manage it.

Giulia said...

Ali,
TEACCH philosophy is " rigidity for flexibility".
So the visual timetable seems very rigid, but instead, it allows more flexibility, as Dean understands better our world.

I think that a visual schedule for your day in general can only help Dean : like that, he knows what happens at what moment. So you reduce anxiety.
And it will help also your two other children :)

From what you say, Dean's repetitive behavior is a way to discharge himself from tiredness after therapy or a very structured moment.
I think that in some way, you have to allow him to have his repetitive behavior : the risk is that when suppressing his repetitive moment, he comes with a more inappropriate behavior to substitute his repetitive behavior.
I think that you can plan moment(s) in his day when he can have his repetitive behavior. Not all day long, but some moments.

The key is changing the way you provide info to Dean. The info itself are by no mean different : rules are rules, day plan is day plan etc etc...
But you provide info to Dean that he can better understand, so less anxiety, so less repetitive behavior.
Think also that he does not process spoken info as well as you or Emmett. So if you give an info, but he forgets/does not understand let say half of it, it's like if you didn't provide any info at all as he cannot use the info you provided to him.
It does not mean you have to change your rules. You just change the way you explain them to Dean.
Which is slightly different.
And it can only lessen his anxiety, as he will have the whole info instead of 1/3 of it.

I can only advice you to get an eye to the available tools for children with ASD.
I didn't imply that Dean has ASD (I am by no mean qualified for it).
I only say that the available tools for people with ASD can benefit to Dean, even if the root causes of his behaviors are different.


Take care