This can be a tough one to treat because children and adults often engage in these behaviors to get internal feedback (like biting your fingernails when you’re nervous). When you can’t control the feedback that someone is receiving, it can be challenging to make the behavior go away.
I’ve had several clients in the past eight years that engage in some type of stereotypy. I just read a great article that had some awesome, evidence-based tips. It’s a literature review titled Evidenced-Based Behavioral Interventions for Repetitive Behaviors in ASD (Boyd, A., McDonough, S., & Bodfish, J., 2012). Click here to read the full article. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3709868/
One of my favorite strategies mentioned was having a client go through a short exercise before doing an activity that is associated with stereotypy. For example, jogging, yoga, or jumping on a trampoline before having to take turns during a game or doing a difficult worksheet.
A few other successful strategies they discussed include:
- Diversion – blocking the client from doing the behavior and trying to divert their attention to something else.
- Differential reinforcement – giving the client lots of praise, positive attention, and things they like when they are doing just about anything besides stereotypy.
- Visual schedules – letting the child know what is coming up next and what can be expected, which helps reduce the anxiety and stress that can lead to stereotypy.
- Response cost procedure – something is taken away from the child (preferably something the child is highly interested in) when the problematic behavior occurs. It is recommended that this mild form of punishment should be left as a last resort when all other positive forms of interventions have not worked.
What have you found works best for your clients?