PT Needing Advice on Autistic Child with Particular Behavioral issue

GUEST BLOGGER: Kathryn Biel.

Jacqueline submitted this clinical question:

I am a physical therapist working with an autistic child who continues to throw toys and other items constantly. He will throw items over, under and thru railings, in his sister’s crib and pack and play. This behavior happens all day in his home and other relatives’ homes. Parents and team members have tried several strategies to prevent this but nothing seems to help. We have tried ignoring the behavior, getting him to pick up the item each time he throws and try to distract him when we know he is about to throw an item. He has been doing this for over a year and now parents are concerned because he is beginning to throw larger toys and he now has a little sister and parents are concerned about her safety. Any suggestions to stop this behavior would greatly be appreciated.

This is a tough one. The behavior is meeting a need for this child. What is it? Is it simply fun and now it became a habit or a routine or is it somehow meeting an underlying issue? If such, then it would need to be replaced with another habit/routine (and finding one that is less harmful may be difficult). How you go about doing this will be challenging.

The other thing that I can think of is to help sculpt the behavior of throwing into a more limited activity. For example, he can throw, but it has to be into a large bucket (like one of those rope-handled beverage buckets). Putting several of this same container throughout the house so he has a place in each room to throw into may eventually channel this behavior. If part of the enjoyment is throwing through things, then how about putting a grate (or slots, like in the crib rails) over the opening to the bucket/container could help carry this behavior over to the buckets, rather than his sister’s crib.

I’m going to turn this question over to the experts out there. What else would you do to help with this behavior? Looking forward to hearing what you have to say!

~Kathryn Biel, PT, DPT