As you know routine is everything so throwing of a schedule will cause issues. I know this is difficult with showering but there is some part of it that is bothering her, and finding out what that is may help.

Maybe it is her being wet she doesn't like, or maybe it is being cold after being wet. You can test out the being wet by washing hands or just her hair and see if the same thing happens. If she is ok with those then maybe it is being cold, then you would try to get her warmed up as quickly as possible. This is a tough situation because breaking a shower down to small steps is difficult.

If she is nonverbal or limited in communication and she is trying to tell you what is nothing her then that is an issue as well, so working on methods of communication would help. I am sorry there is no easy answer for this tgat is going to work right away, it is going to be trial an error.

With her age yiu probably have some hormones getting in you way on top of the demands she doesn't like. Has this been a problem all along or is it something new? The reason I ask is that this is what ABA is for and if she has been getting that then maybe there is some other trigger setting this off. What you are describing is what ABA does, it challenges the child to try to motivate a behavior.

Trying to redirect is the best way to go, but also taking the task in steps is also good. You would reward her after she completes a step with whatever motivates her the most. This is not a quick easy fix it is going to take a while. Also training her to use something soft like a pillow when she tries to hurt herself works to. Again you would reward for using the soft object as appeased to anything else.

The best thing is to get children the therapy and help as early as possible because as they get older it is harder to deal with.

After I get these tests done that you speak of that i looked into.. what do you do with the information/results? Do I take them to her developmental dr? Where do you get the treatment plan from? There are no medmap or dan drs in rochester ny.. we wld have to drive several hrs to see one which is not an option.. and i want the OAT test done if the only one but dont want to spend the money to just have a lab report and not know or have some where to get a treatment plan?

Autism speaks has what they call tool kits and they have a lot of different ones that pertain to what Im starting to face. I have printed them to start my research.. we have never really had negative behaviors in the home like this with her with regular routine things (taking a shower, etc) but now we are starting to experience this and dont know how to handle it. It is kind of a totally new area for us so we dont know much about it when it comes to this stuff.. which may sound crazy but i guess we were just blessed before.. i am working on things as we speak.. i do use an ipad to help with communication for her.. and she does get it.. but we use it mainly for her needs and wants with food right now.

I have noticed that the self injury has kicked up since she turned 13.. bday was in march and have seen an increase on self injury and self injury placed demands around late April/ Beg May.. She had aba therapy for awhile after she was first diagnosed (age 3) and has had treatment consistently since that time (just not aba specifically anymore). I think a lot of it is more environmental behaviors now that she didnt have before. For instance taking a shower.. We have had a set schedule for showers in our house for years at this point.. every sunday, tues, thurs and when needed otherwise. She will be reluctant to shower but will.. there are times that she will start getting upset in the shower but most times it is after we get her out of the shower she starts to scream, cry, stomp her feet, self injure.. How or what do I do to stop the meltdown from coming after she gets out of the shower? Same thing with sleep. I do know about positive reinforcement and it was something they used to use for her when she was having aba therapy but during that time their biggest problem was finding a positive reinforcer for her. There was not much that she liked that much to be a good enough reward for doing good.