When I first met Mark he seemed like a normal child with an intellectual disability. He was playing video games in the living room. His Mother had just got done telling me their story. She had expressed how they were basically held hostage by their son. Every day was a constant battle. They had to fight with him to take a bath, to go to sleep, to get up in the morning, to go out to eat. She stated they had not been able to go on a family vacation in years. She appeared to be, simply exhausted. I was working for an agency that was there to help with just such situations. So I went into the living room and sat down with Mark while he played. He was playing Predator vs. Alien. I knew the basic concept so I engaged in conversation. We talked about the game for the entire first session. I thought I was in the clear, great rapport built, we would be off and running with no problems. Boy was I wrong.
The next visit we came back with the standard charts and picture schedules to help Mom out. She said she would try them, but she didn't think they would work. She stated that Mark usually just got violent when demands were placed upon him that he did not like. Mark was very into video games so we tried to use that as a reward. If he didn't get them he would just go ballistic, until he got what he wanted. I could now see the hell the family had been going through. The typical charts and pictures did nothing for Mark. He simply manipulated his way around the system put in place. He found every loophole. Typical Asperger's.
We decided a more advanced strategy was needed. We began a week long intensive intervention. I was there when Mark woke up and when he went to sleep. We would sit by his bed in the morning making sure he woke up on time. This required taking his pillow away after two warnings, then his blanket. We then went to the task of getting him to brush his teeth. I think I stood in the bathroom with him for an hour the first two days just verbally and nonverbally redirecting him to brush his teeth. All the while he screamed and yelled. We had removed every distraction from the bathroom, but his tooth brush. When he would protest I would simply point to the tooth brush or simply say "the next thing you are going to do is brush your teeth". We used this strategy for every step of the getting ready process. Then we repeated this with the nightly routine. After about three day the time for him to complete the tasks began to shrink,and the violent outbursts were less and less.
By the end of the week I was the one who was exhausted. I could not imagine how the family had done this for so long with no training. They were finally free though. Mark was now listening, showering, and following his schedule. They even went on a family vacation shortly there after. Due to our efforts my team and I won team of the year from the Autism Society of Cincinnati. I learned a lot from Mark and carry a lot of that knowledge with me today. From what I hear he is still doing well today.