To add to what folks have said, I have seen several reasons for this
behavior from some of my older kid clients especially with their family.
Wetting yourself on purpose is definitely a problem. Several things,
medical check up and psychiatric work up with review for meds with peer
counseling. I would also, (being an OT) see about ensuring proper
communciation, development of goals (with the person) to gain more
independence, etc. Do they have a job, vocation, self-care, vocation, etc.
By early to mid 20's I would expect less tantruming if the person has been
out on their own. Yelling at the staff to be left alone could be a sign of
depression or a sign of just that wanting to be left alone. Soiling
yourself is just being a pain in the butt, doing dangerous things to prove
your independence is just stupid. Personally, I would see what type of
reaction the staff is giving this person and if it continues could be a sign
of being a danger to themselves and others, I would let person A know that
and come up with a solution such as you do stupid things, we will be forced
to Baker act you to the psych ward just like we would any other stupid
person playing in the street with cars.
Not knowing the history of person A before the staffing issues, it sounds
like this may have been a long running problem and the person has never been
expected to act like an adult. While many people with cerebral palsy may
have depression and occasionaly bouts of inappropriate behavior and many
children with any speech delay or moderate to severe motor delays have
difficulties with the typical types of rebellion.
Hope I'm making sense today...
Beth t.
> -----Original Message-----
> From: Cerebral Palsy List [mailto:[log in to unmask]]
> On Behalf Of Gary Peterson
> Sent: Friday, September 14, 2007 9:52 PM
> To: [log in to unmask]
> Subject: CP and behavior
>
> Hi all,
>
> So I have some medical questions here, and I'm trying to
> find out if there's any connection between Cerebral Palsy and
> these other medical issues if that's indeed what they are.
> I'm very weak in the area of medical terminology so I ask
> your indulgence while I stumble my way through. I'll set
> this up as best I can via fictitious example.
>
> So we have two people. Person A and person B. Both can be
> male or female. Person A has Cerebral Palsy from birth,
> and uses an electric wheelchair. They are in there mid to
> late 20's and have severe speech limitations. They have
> lived independently in their community for a little over two
> years and have 24-7 staffing.
>
> Person B is the primary staff person for person A. Among other
> duties, they assist person A in finding and hiring other staff.
> All staff for person A are in there early to mid 20's.
>
> Since moving out on their own, person A has always bin
> plagued by an unusually high amount of staff turnover.
> Usually on an average of every two weeks to a month. Person
> B is told person A is very hard to work with. Person B is
> told, person A isn't very patient when it comes to working
> with staff to help better
> understand them, and They loose their temper to the extreme.
> At times when they don't feel they're being understood, they
> will often at the top of their lungs order staff to just go
> away and leave them alone. Then person A just stays in their
> room refusing to say or do anything. They will often behave
> in this manner for up to three hours at a time.
>
> Also When person A is in this state, they will take their
> anger out on staff with frequent bouts of wetting them sells.
> There are staff past and present who feel person A is
> deliberately wetting them sells as a way of getting back at
> one particular staff or another. There have also been
> incidents when person A
> often puts them sells and staff at great risk. On more then
> one occasion, person A has gone into the street after being
> advised by their staff that it's not safe to do so. Staff
> describes the look on person A's face as one of: "Don't tell
> me what to do, I'll go in the street if I want to!!"
>
> Person A has also been approached by total strangers in the
> presents of staff, and told how it's not a good idea to just
> dart out into the street like that in their wheelchair.
>
> When person B sits down with person A and shares the
> information given to them by the rest of the staff, after
> some hesitation, person A tells person B they are aware of
> how angry they get, but they cannot give any reason for why
> they get so angry. They tell person B when they start to get
> angry, they try and stop them sells but they just cant.
> Person B has advised person A that if their anger continues
> unchecked, at some point, it may become really hard to find
> adequate staff. Person B also tells person A he has heard
> through the grapevine that person A is getting a reputation
> in the community as someone to stay away from. Person B has
> tried to assist person A in coming up with ways of trying to
> deal with their anger. They've talked about everything from
> person A just going outside for a while, to slow breathing
> exercises. While these kinds of things seem to work now and
> then, often they end up being no more then a temporary band
> aid with the underlying issues just waiting to surface all
> over again.
>
> Now if the above scenario were a real life situation, and if
> one of my co workers asked me what my thoughts were about
> person A, I would say they were someone who was still
> adjusting to living on their own. Someone without a lot of
> maturity or life experience. Someone who is still learning
> just who they are and what they want their life to look like.
> So there for, they have a right as all of us do to make
> misstates along the way. Even at those times when they end
> up putting their independence at great risk. Someone who is
> justifiably frustrated do to the constant challenge of having
> to make them sells understood to all those around them. Or
> they might just be a real punk who just doesn't care about
> how their behavior affects those around them.
>
> However at the same time I wonder. I wonder if there are
> issues being overlooked regarding person A. So my questions
> to all of you are these:
> With all the information I've given you in the above
> fictitious example, aside from Cerebral Palsy, are there
> other medical issues going on here? Is there some kind of
> cross over or hard wire disconnect in person A's brain to
> where something gets switched on or off, and the only way
> person A can express them sells is by wetting them sells? If
> so, is this directly related to Cerebral Palsy or could
> there be totally separate issues going on here? If this is a
> medical condition, is there a specific name for it? If this
> is directly related to Cerebral Palsy what is the connection?
> Could Someone direct me to a site where I might learn more
> about these issues?
>
> Thanks in advance for any and all help, and everyone have a
> greaaaat weekend!!
>
> See ya-Gary
>
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