Chewing, sucking, hands in pants...

I am a special education teacher who is currently working with a bright nine year old boy. His current diagnosis is multiple handicap, he does have some autistic tendencies. Two behaviors which are quite concerning are placing his hands inside his pants and sucking/chewing on his hands when he is excited. His team is trying to develop a behavior plan, but we're not in agreement. Any suggestions?

Children with disorders other than autism may share some of the sensory sensitivities commonly found in people with autism spectrum disorders. That may be what your student is experiencing.

Do his parents notice the same behaviors at home?  What strategies have they found that work? Are they some that you could emulate at school?

He sucks or chews his hands when he’s excited. Perhaps he has a need for extra sensory feedback in his hands and/or his mouth.  When he’s excited he has less ability to inhibit the need to suck or chew. You may not be able to get him to stop chewing his hands but you might be able to substitute this behavior for one other people will find more acceptable.

Is he a child who always has something in his mouth? Does he chew on pencils, erasers, etc.? If he’s craving oral-motor stimulation, possibly if he has a regular dose of oral-motor input throughout the day, he’ll not feel quite the need to chew on his hands when he’s excited.

You could try offering him other things to chew or suck. For some children, crunchy foods like pretzel, crisp cereals, carrots, and celery help fill the need for something in their mouth. Others do well with gum but you might have to experiment with flavors until you find the one that has the most settling effect.  Sour candies work well for some children. (If they’re stale or frozen, they stand a lot of sucking and each candy then lasts for a long time. 

Drinking through a straw gives good oral-motor sensory feedback. He could have water in a sipping bottle on his desk and sip through his straw whenever he wanted throughout the day.  Thera-tubing is another chewing alternative.  I know a couple older students who chew on plastic coffee stir sticks or toothpicks throughout the day.

If it’s feedback through his hands he’s craving, some type of fidget toy might work. You could try koosh balls, stress balls, fabric swatches (try bits of silk, satin, corduroy, fake fur, etc. to see which he likes), a pencil grip, small plastic toys, or a smooth stone. Ask him what things he likes to handle – he may come up with suggestions that would not occur to you. One child I know likes to rub a piece of plastic pot scrubber between his palms.  Another presses his palms hard against his desk or on his thighs.

If he does the chewing/sucking when he’s excited you might be able to decrease the behavior by preparing him ahead of time. While most of your students would have already internalized that the favorite subject comes after Science.  The child with autism may have a poor sense of time and find it a surprise when he hears that the anticipated event is happening now. 

He may be over stimulated by the sights and sounds other children find enjoyable.  A visual schedule on his desk may help prepare him for what is coming next and make it easier to sit through Math, knowing that the treat is coming once Math is finished.

When you introduce substitute suggestions to your student, you’ll have to give him an explanation as to why you want him to try these things.  Although it’s perfectly obvious to you, he may be unaware that other people find it unpleasant when he sucks on his hands. He may not have noticed or interpreted that look of horror on the face of the girl sitting next to him.  And, it he might be doing this because it makes him feel good or calms him. 

He’ll need to understand why you want him to stop doing it and that he can get similar feelings through different means.  A social story is a good way of explaining what you do and don’t want him to do.

The hands-in-the pants could also be a sensory issue.  Again, it could be something for his hands to do and any of the fidget toys mentioned above could work as a substitute.  A piece of fabric or small fidget toy could be kept discretely in his pants pocket or in his desk.

Is he bored or overwhelmed when he does this?  Is it a cue to you that he needs a short break to get a drink of water or sharpen his pencil? Is he on overload and using this as a method of tuning out what’s going on around him?

This could be the start of early adolescence and he may like the sensations produced when he handles his genitals.  If so, that may be acceptable in certain circumstances but not in a classroom.  He can be given clear directions that he may do such things only at home in his bedroom or bathroom but no where else (or whatever parameters you and his family work out). 

This is another instance where using a social story is very helpful. Carol Gray gives examples on this and similar topics on her web site @ http://www.thegraycenter.org/writing_social_stories.htm.  Another resource you might find helpful is the book Sexuality: Your Sons and Daughters With Intellectual Disabilities by Karin Melberg Schwier.

As with any new skill, it will take guided demonstrations and practice before he learns to substitute any of these other devices for his hands.  Rather than constant verbal reminders, a visual picture of what he should be doing would be helpful as a cue card. One cue card could be taped to his desk and the teacher could have another one she could hold up when a reminder is needed.

When a child shows an obsessive behavior, it is very difficult to eradicate that behavior.  Rather than fight that battle, you may be better off replacing that behavior with a similar but more socially acceptable one or limiting that behavior to certain times and places.

Sharon A. Mitchell

 

Sharon A. Mitchell Autism Help for Home and School