Inappropriate stimming in public :-(

[Piggywiggyiggypiggy40]

Please help,

I have a 6 year old DD who has some fairly strong high functioning ASD traits. She is currently having appointments with OT, physio for toe walking and shortened ham strings and every 6 months for the paed. - who thinks it isn't worth having her formally assessed for ASD as she shows appropriate social interactions and has friendships. She has quite a few sensory problems, this is much more the focus of her 'issues' than social problems themselves. She is very bright, speaks well and is very popular with other children. She is also rigid, controlling and inappropriately outspoken - but we can handle that...

The main thing is she has since she was 18 months had a certain sort of stim that she does that gets worse if she doesnt like the environment she is in, if she is uncomfortable or if she is trying to manage her stress levels. The problem is that it involves genital stimming, rubbing herself against the chair that she is sitting it. It is set off by almost every chair she ever sits in OT have not seen her yet but have offered her help via a wobble cushion, stress ball and diversionary activities like sucking lemons that also give a massive sensory input. Nothing works completely

It was really bad today. I left her for a few moments in the canteen of the swimming pool while I collected my older child from the poolside and I could see her through the glass, going at it like a train everyone else had moved away from her and she was bright bright red in the face. It looked awful, the worst I had ever seen it.

I'm at a complete loss as to what to do. She says she can't stop it. I have told her a hundred times that its a private activity and shouldn't happen in public places in front of other people. I have set goal based rewards and sanctions. I have had her looked at for yeast infections and uti's over a period of YEARS. Nothing seems to stop it. It reduces for a while and then it is back with gusto. She doesn't seem to understand that it just isn't something that we should do in front of other people. I'm worried for the future.

Please please help

Have you looked at constipation. We found that with ds1 the rubbing was worse when he was suffering from constipation. Rubbing is almost non existent when the constipation is under control. Lots of people mistake it for yeast etc because it looks like it is genital area but in our case it was most definitely tummy aches etc.

Is she able to express why she does it? Because if not I will try and look at constipation if the yeast has already been looked at.

Have you ever thought about using ABA (applied behaviour analysis) rather than OT approaches?

We have had success eliminating a number of socially inappropriate behaviours using ABA. An ABA therapist would teach alternative (socially acceptable) strategies e.g. deep breathing etc to manage stress instead and use rewards for not engaging in the unwanted behaviour / choosing the more appropriate strategy

They would also use rewards to build tolerance to situations she finds stressful through desensitisation - again we have had a lot of success with this

Not really sure how a wobble cushion would help really , would need to teach alternative coping strategies I think

I'm fairly sure she isn't constipated as she has frequent loose stools - but thank you for highlighting it. She isn't able to say why she starts, except that she can't make it stop - her self awareness about her actions is pretty limited :-( she was once able to say that it happens when something is going wrong, but it can be as simple as the room being too dark or crowded. Unfortunately she can't pinpoint it at the time and its only after the fact she might allude to something she didnt like in the room. Interesting about the behaviour approaches - we tried a hypnotherapist for relaxation last year which really improved things but she cost a FORTUNE :-( we did that alongside a rewards based approach and she stopped for about 2 months, but then it reared its ugly head again. You've given me some things to think about though! Thanks so much for replying :-)

I still recoil with horror at 2012 when we had to deal with that.What you described about the incident at the swimming pool was pretty much exactly how it was for almost on a daily basis.

We also do ABA and consultants always suggested it was behavioural. Whilst I agree that it can become behavioural, unless you find out what exactly caused the problem in the first place, you will never be able to get rid of it. Even now, if ds's tummy is upset he starts up again. he is non verbal so this is his only way to express himself.

I would tackle it as a medical issue first and then deal with the behaviour.
OP btw, we were also told that it was yeast… it wasn't. Ds also has loose stools occasionally as well. In OUR case, only thing that helped was making sure his bowels were clear, once that bit got sorted, only then behavioural approaches worked. Good luck and hope you can resolve this. We don't have the rubbing now, so it does get better.

I too use ABA and here I think what might help is to "disrupt" the habit. Simply put, you have to physically stop her doing it with a firm no and hand stop prompt every single time for as long as it takes to disrupt the habit, ie displace it.

Then, if it comes back, you disrupt it again. And repeat.

It is exhausting, but it is the absolute only thing i have found that works with stims. Eventually the irritation of being stopped all the time outweighs the pleasure they get from doing it.

I guess it is more obvious when a boy does the equivalent, but we taught my boy "private time" is fine in his room only, when alone.