[ShortyLPN]

Hello-
I didn't know whether to post this here or the HH Nursing..so I'll just see how it goes. I just started Home Health Nursing and I love it. My main case is a 9 year old boy with Down Syndrome and Autism. I love him to death but there is a little bit of a problem...behavior. He'svery mentally handicapped but still able to use sign language so I know he somewhat knows what's going on. He's constantly biting, scratching and pinching. He is INCREDIBLY strong for his size. I've left there with bruises that cover the width of my arm and scratches everywhere. We've tried putting him in "time out" but that's becoming ineffective. It all seems to be a big game to him. Another thing...he's his mother's baby...she babies him all the time. Time out is basically the only punishment he has...and then she tells him "good boy" whenever he gets out, which totally defeats the purpose. I will be honest..one time when he pinched me I smacked his hand..not hard or anything, I wasn't abusing him but more like self-defense. His eyes got big and he stopped for a while. So I questioned the mom asking if that was a technique that we could try and she said "Oh no, I don't like that...some people might not know what a light smack is." So basically all the nurses are between a rock and a hard place. He KNOWS what's going on...he laughs everytime he does it and laughs even more when I sign "that hurts!" I know I sound mean, but he honestly knows enough to know the difference between right and wrong. Discipline is the major part..so anyone have any similar experiences or have any suggestions? Any will do...I'm so frustrated...I look like I've been beaten. Some of the nurses have demanded raises for taking care of him, myself included. Any help...please?

[madwife2002]

I dont know about US but it is illegal here to smack or use any kind of physical punishment on a patient. As he has downs, he has learning disability and he will not understand the same diciplines you would utilise on a nine year old who had no learning difficulties. I would recommend positive reinforcement you praise the good behaviour and ignore the bad behaviour, it is difficult to ignore bad behaviou but you must give him no eye contact walk away then return and ask him if you may continue, if the bad behaviour continues you must keep walking away until he stops it. But to make this work when he behaves then you must give him lots of praise and encouragement. Belive me it works but you have to be patient. Please dont hit a child again, that is not your responsibility nor your right.

[DDRN4me]

welcome to the world of downs with autism! i work in a school with the exact type of kids. first of all, corporal punishment of any kind is against the law!!!The best thing for mom and nurses would be a behavior specialist consult, so a behaviour plan can be developed. Positive reinforcement is good, but it needs to be consistent, and he needs both good and negative consequences for his actions. Also, maybe a course in non violent crisis intervention would be helpfull to learn how to deal with the abusive behaviors. Hope this helps!

[DelightRN]

Perhaps someone could merge all of these multiple threads.

[madwife2002]

Originally Posted by DelightRN

Perhaps someone could merge all of these multiple threads.

I agree there are few around saying the same thing, we should maybe let new members know that we all get to read threads from all forums, that may help.
So new members you only need to only post one thread on one subject in any one forum.