Self Aggression

[Miriamedavis]

I have a 9 year old nephew who is PDD-NOS.  He slapps his ears very hard against his head and clenches his teeth down on his shirt.  He is developing sores on the back of ears from slapping.  I've noticed that he tends to press against his right ear or hold his hand up to his right ear when he is not slapping both of them.    

I've been monitoring his behavior on a 5 minute increment behavior data sheet and it occurs all day and sporadically.  I have noticed that certain sounds will set off his ear slapping like buzzing from florescent lights, when the air vents kick on in school, the voices from Rugrats and when his gym teacher projects her voice.  If he hears a noise that bothers him, his head tends to turn to the right and the ear slapping begins.

He can speak up to 6 word sentences and recently has been saying he does not want to go to school.  He's been saying it so much, his mother is worried.  

The behaviors occur at home as well although not as frequently.

He is on a behavior intervention program, where his hands/arms are held down so he won't hurt himself and burst his ear drums.  He is praised when he is exhibiting good behavior.

There is a strong concern that something else may be going on with him.  Can you advise on what I've told you above?

Thank you for you help.
Miriam  
    

  

[Kevin Kennedy, Ph.D.]

I can't responsibly offer you an opinion about that.

[muffinne1]

Do you think maybe ear plugs would help as a temporary solution?  if right ear is overly sensitive to sound, maybe putting an ear plug in just the right ear would be enough to muffle some of the irritating noises.

[Kevin Kennedy, Ph.D.]

It goes without saying, I suppose, that he will benefit from a tranquil (re: noise) environment. However, it's the real world, so there's a limit to how much the stimulation can be reduced. To prevent his behavioral response almost requires a one-to-one aide, and this is not likely feasible.

[Miriamedavis]

Yes - a thorough diagnostic process was done to conclude his PDD diagnosis.  

The parents are making arrangement to see a Neurologist and will also make speedy arrangements to get an evaluation from an ENT specialist for this particular symptom.  

There are some stimuli that we can control, ie watching Rugrats with no sound.  However, for those stimuli that are out of our control, what can we do in the meantime while his appointments are being scheduled to prevent him from hurting himself when he is banging/slapping his ears?  

I've recommended that his hands be lightly pressed against his head/ears to prevent him from hurting himself.  Any suggestions?

Please advise.

[Kevin Kennedy, Ph.D.]

I'm assuming that a significant diagnostic process has been concluded in order to reach the PDD diagnosis. Since the behavior you describe indicates a significant auditory component, if it hasn't already been done, I would certainly suggest an evaluation by an ENT specialist re: this particular symptom. The behavioral intervention may be ineffective if the stimulus is as strong as it apears to be. I'd focus more attention right now on the stimulus/precipitant than on the response.