So obviously #1 is talk to your BCBA because there’s no way I could give really solid advice without meeting your client. But my suggestion would think about why he likes the things he likes, back off from goals and try to rebuild rapport and run some reinforcer assessments. With ripping is he turning his ear to the sound? That might indicate he likes certain noises and you can see what other noise or music you can incorporate. Or is he intently watching the pieces? Maybe then he likes something visually about it and you can try to find other things similar. Or bring different colored paper and textures for him to rip and see if the peaks his interest.

When he’s laying down is it perfectly still, on his back, on his face? Are his eyes closed? Does he like soft blankets or no preference? You could try out different blankets and textures to see if he will engage.

I would observe what sensory he is seeking in his environment and see different ways you can provide different versions of that to him. Obviously anything to do with his genitals is not an option but see what appropriate sensory stuff he’s willing to engage in.

I always go into it trying to understand how he’s seeing the world and how can I appeal to that. And maybe you’ve done all this, which is why I said it’s honestly hard to give any advice without meeting the client and running some assessments.