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Fixation on doors and switches

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JLS

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I am working with a young man who fixates on open/closing, locking/unlocking doors and switching lights etc on and off (less than the door fixation). It seems that once he sees the door he is compelled to repeatedly open & close or lock & unlock unless we can distract him which can be very difficult. Sometimes saying "one more and then let's do ..." works as long as we invite him to do something else of interest but often it doesn't work. Asking him to stop or trying to prevent him just increases the compulsion. This can be very problematic when attempting to carry out personal care as he won't move away from the door to get in the bath or go to the toilet.

He has a similar reaction when he sees there are crisps in the cupboard. He will have a packet but will keep going back to the cupboard for another. On one occasion an agency staff member gave him crisps each time and he had 4 packets and still went back for a 5th when a member of the permanent team intervened.

We have tried distraction, prevention and letting him do it once and then try to stop. Niothing works consistently. Does anyone have any other suggestions?

Edited on February 23, 2017 - 9:07am

April 13, 2016 - 11:38am

Hello,

From what you’ve said, it may be worth reading our information on ‘Obsessional, Repetitive Behaviour and Routines’ here:  http://www.autism.org.uk/about/behaviour/obsessions-repetitive-routines.aspx

Many people with autism can have an obsessional or repetitive behaviour.  These behaviours perform an important function for the person in what can otherwise be quite an ‘unpredictable world’.  The intensity of these behaviours may increase at times of anxiety, so it would be a good idea to consider the young man’s current life and whether things are as settled and predictable for them as they can be?  Have there been any recent changes or challenges that they have faced before the behaviour started?

As these kind of behaviours perform such an important function for a person with autism, we do not generally suggest trying to stop them from happening.  On the occasions when this is done, often a hug amount of anxiety and distress is often caused and the person can quickly move onto a different obsession/repetitive behaviour.  With this in mind, we suggest trying to set limits around the obsession, providing only certain times of day when they can engage in the behaviour.    

 

Other elements to consider are what is appropriate for him to do, as well as safe for him and others.  For example, it may not be safe for him to open and close doors/turn lights on and off but there may be other similar things that still give him the same experience?    It may also be worth looking into structuring his time more, and using visuals to show him what he is doing etc.  For more strategies, have a read of our link above or you may want to contact our Behaviour Specialist on behaviour@nas.org.uk

It’s very important with any approach used that there is consistency across all people that are involved with the young man.  This is really important as an inconsistent response can mean that the young man may become confused, stressed and frustrated. 

Hope that helps,

Helpline Team.

April 14, 2016 - 1:15pm

Hi, I worked with a young man with a similar obsession in a special school a number of years ago.  It caused particular difficulty at the end of the day as he would pass multiple door handles and light switches that he felt compelled to operate: unfortunately he shared a taxi home with another child who would be very distressed if delayed.  We found that we were having to start his transition earlier and earlier to accommodate his need.  The breakthrough for him came when we switched the focus from distraction/ prevention to the complete opposite tactic: instead, we would direct him to each handle and switch and tell him to touch the handle/ switch the light.  We even would tell him to do it again when he had finished (he didn't speak but did understand some language with genstures).  It worked for him because it almost immediately put him back in control and alleviated the anxiety he had that he would be prevented from carrying out his behaviours.

Good luck!

April 15, 2016 - 8:40am

I too have had a similar case with a student and we gave him his own padlock and key to carry around with him.