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Autism & Asperger's Syndrome (Expert Forum)
obssive chewing
Answered by
Jason C Bourret, Ph.D., BCBA - autism
The New England Center for Children
Questions in the Autism & Asperger's Syndrome forum are answered by researchers at the New England Center for Children. Topics covered include Attention Deficit Hyperactivity Disorder (ADHD), Antisocial Personality Disorder, Asperger Syndrome, Autism, blindness, bullying, clinical depression, deafness, dyslexia, mental retardation, and social alienation.
obssive chewing
by EdieMarie, Dec 20, 2007 01:00PM
My son just turned 12 he has been diagnosed with Asperger's and ADHD. years ago. My son is always putting things in his mouth..chewing on everything! He doesn't even realize he is doing it and he can't seem to stop him self. This is a problem since he got braces last year. He is also a Black belt in Taekwondo and even with a mouth guard he still gets hit in the mouth and a brachet comes loose. Every time one of his brackets needs to be replaced the Orthodontist charges $30.00 which adds up quickly.
My question? Is there anything I can I do to help distract my son from putting things in his mouth? and any advise I can pass on to this "PEDIATRIC ORTHODONTIST" who say's" I've see your son putting things in his mouth!" Tell him not to chew on things or his brackets will come off and you are going to have to pay for it! Any suggestions?
My question? Is there anything I can I do to help distract my son from putting things in his mouth? and any advise I can pass on to this "PEDIATRIC ORTHODONTIST" who say's" I've see your son putting things in his mouth!" Tell him not to chew on things or his brackets will come off and you are going to have to pay for it! Any suggestions?
Doctor's Answer
by Jason C Bourret, Ph.D., BCBA, Dec 21, 2007 12:09PM
, Dec 21, 2007 12:09PM
To: EdieMarie
The problem you’re describing can be considered to be a type of habit disorder. These types of disorders are not uncommon among both individuals diagnosed with an autism-spectrum disorder and individuals without these diagnoses. Other habit disorders that you may have heard of or encountered include thumb sucking, fingernail biting, and hair pulling. These are topographies of behavior that may occur quite frequently without the individual engaging in them being aware that they are happening. One of the most successful forms of treatment for these types of behavior is habit reversal (Azrin & Nunn, 1973). Habit reversal is typically composed of four phases: (1) awareness training, (2) competing response training, (3) motivation procedures, and (4) generalization procedures.
The training might initially be done by taking an hour of your day each evening, sitting down with the child, and practicing. Awareness training is designed to teach the individual to identify each time that the behavior occurs. This might be done by having the individual practice emitting the response and having the individual watch you and identify when you are emitting the response. Five-minute sessions of practicing emitting the response and identifying your emitting the response might be followed by an extended period of more naturalistic training (for example, spending 20 minutes with your child watching TV or a favorite movie with items that he might typically chew on around, pointing out each time he engages in the behavior, and having him point out each time he engages the behavior or begins to engage in the behavior). It can be a good idea to incorporate self monitoring and have him keep track of how many times in a day he catches himself chewing on objects. This can be a project that you and he work on and touch base on daily. You might consider having him keep track of these data and graph the number of times that he emits the behavior each day. This can help him become more aware of his behavior and may also result in decreases in the chewing.
Competing response training involves teaching him to do something else when he notices that he’s chewing or about to place an object in his mouth. This might be something like chewing on a piece of gum instead, manipulating a stress ball with his hand, or just putting his hands in his pockets. Once the awareness training is done, it is also possible to have him start to keep track of how often he emits the competing response rather than the chewing. By having him keep track of these data and possibly graphing them, your child will be able to see the progress he’s making daily.
Motivation procedures are those that help motivate the individual to participate in the treatment. For your son, this might involve setting some goals (for example, chewing on objects less than ten times per day) and then arranging particular rewards for meeting the goals. For a successful day or week, this could involve going out to a movie, dinner, or any other activity that he enjoys.
Generalization procedures are designed to help the intervention spread into novel contexts. It might be the case that you are able to get him to not chew items when you are around, but it might be that he does chew items when you are not. One way of accomplishing this is to recruit other members of your family and perhaps your son’s teachers to help with the treatment. If he is receiving praise and support for emitting competing responses rather than chewing by a variety of people in a variety of settings, it is more likely that the treatment will generalize.
It is crucial that you stick with it and that you and your son are practicing the components of the treatment frequently and regularly (ideally daily). If you are having continued difficulty, I would recommend seeking out a behavior analyst in your area who has experience treating habit disorders to help with implementation and monitoring of the treatment.
Azrin, N. H., & Nunn, R. G. (1973). Habit reversal: A method of eliminating nervous habits and tics. Behaviour Research and Therapy, 11, 619-628.
The training might initially be done by taking an hour of your day each evening, sitting down with the child, and practicing. Awareness training is designed to teach the individual to identify each time that the behavior occurs. This might be done by having the individual practice emitting the response and having the individual watch you and identify when you are emitting the response. Five-minute sessions of practicing emitting the response and identifying your emitting the response might be followed by an extended period of more naturalistic training (for example, spending 20 minutes with your child watching TV or a favorite movie with items that he might typically chew on around, pointing out each time he engages in the behavior, and having him point out each time he engages the behavior or begins to engage in the behavior). It can be a good idea to incorporate self monitoring and have him keep track of how many times in a day he catches himself chewing on objects. This can be a project that you and he work on and touch base on daily. You might consider having him keep track of these data and graph the number of times that he emits the behavior each day. This can help him become more aware of his behavior and may also result in decreases in the chewing.
Competing response training involves teaching him to do something else when he notices that he’s chewing or about to place an object in his mouth. This might be something like chewing on a piece of gum instead, manipulating a stress ball with his hand, or just putting his hands in his pockets. Once the awareness training is done, it is also possible to have him start to keep track of how often he emits the competing response rather than the chewing. By having him keep track of these data and possibly graphing them, your child will be able to see the progress he’s making daily.
Motivation procedures are those that help motivate the individual to participate in the treatment. For your son, this might involve setting some goals (for example, chewing on objects less than ten times per day) and then arranging particular rewards for meeting the goals. For a successful day or week, this could involve going out to a movie, dinner, or any other activity that he enjoys.
Generalization procedures are designed to help the intervention spread into novel contexts. It might be the case that you are able to get him to not chew items when you are around, but it might be that he does chew items when you are not. One way of accomplishing this is to recruit other members of your family and perhaps your son’s teachers to help with the treatment. If he is receiving praise and support for emitting competing responses rather than chewing by a variety of people in a variety of settings, it is more likely that the treatment will generalize.
It is crucial that you stick with it and that you and your son are practicing the components of the treatment frequently and regularly (ideally daily). If you are having continued difficulty, I would recommend seeking out a behavior analyst in your area who has experience treating habit disorders to help with implementation and monitoring of the treatment.
Azrin, N. H., & Nunn, R. G. (1973). Habit reversal: A method of eliminating nervous habits and tics. Behaviour Research and Therapy, 11, 619-628.
Did he do the chewing before he got the braces?