Home > Got Questions?, Science > My child is sometimes aggressive – what can help?

My child is sometimes aggressive – what can help?

This week’s “Got Questions?” response comes from Simon Wallace, PhD, Autism Speaks director of scientific development for Europe.

A few months ago, I was visiting an autism clinic in Albania, one of the underserved countries where Autism Speaks is making a difference through our Global Autism Public Health Initiative. There I met a three-year-old girl receiving a diagnostic assessment for autism. Clearly, she wanted her parents to stop talking to us and take her outside. She kicked her father and bit his hand and then began slapping her own head. This young girl was trying to make her preferences known but lacked speech. Aggression was her way of communicating her needs.

Whatever their age, some individuals on the autism spectrum act out aggressively, and clearly, this can be distressing for everyone involved. In fact, aggression is among the most common challenges reported by parents of children and adolescents with autism.

What can help? I suggest working with your child’s physician and therapists on a four-stage approach to tackling this and other problem behaviors. The four steps are identification, understanding, management, and prevention.

By identification, we mean characterizing the problem behavior. As parents, you can write down the type of aggression your child demonstrates along with the time and setting of when the behavior occurs.

Next comes understanding. Specialists often use tools such as the Functional Behavioral Assessment decipher why a person with autism is behaving a certain way. In other words, what is the function of a given behavior for the person with autism? Is she telling you she doesn’t like what you’re doing?  Is he telling his teacher that the school work is too complex? Does she want something she cannot have? Identifying the “communication” behind the behavior is the first step to teaching appropriate behaviors that can convey the person’s needs and desires.

In addition, underlying problems can trigger aggression. Among those with autism, common triggers include disturbing breaks in routine, lack of sleep, jarring “sensory stimuli” (noises, lights, or smells) or even undiagnosed mental health problems. Clearly, it’s important to look beyond the behavior itself to identify the underlying cause.

When it comes to managing aggression, there are many options. The information you gathered in identifying and understanding your child’s behavior may guide you and your child’s healthcare providers in developing a plan.

An abundance of research supports the effectiveness of Applied Behavior Analysis (ABA) in helping children with autism learn new and effective behaviors—so that aggression is no longer needed to communicate wants and needs. Research as shown that, in many cases, ABA alone is effective in reducing aggressive behaviors.

When ABA is not effective, it is important to consider the possibility of an underlying medical condition. For example, we know that autism is frequently associated with sleep disturbances and gastrointestinal distress. Disrupted sleep is likewise associated with uncontrolled seizures. Addressing these medical conditions can make a difference in reducing aggressive outbursts. Also remember that the sudden onset of aggression may signal that your child is in pain, ill, or simply exhausted.

Medication has been used successfully to reduce aggression and self-injury in both children and adults with autism. Risperidone, in particular, has gone through extensive testing in this regard.  Both risperidone (Risperdal) and aripiprazole (Abilify) are approved by the U.S. Food and Drug Administration (FDA) for treating autism-related irritability, which includes aggression, tantrums, and self-injury. A recent study demonstrated that a combination of parent training (in behavior intervention) and risperidone reduced tantrums and other problematic behaviors in children with autism to a greater degree than did medication alone.

However, the decision whether or not to use behavior modifying medication is can be difficult. Autism Speaks has developed a medication decision aid to help you work with your child’s physician to determine whether this option fits your family’s goals and values. (Available for free download on our Tools You can Use Page.)

Finally we have prevention. Strategies to prevent aggression include working with your child’s therapists and teachers to create calming, predictable, and rewarding environments. Other helpful approaches include visual timetables and structured schedules—both of which can help smooth transitions between activities. Rewarding positive behavior and providing communication tools are additional strategies that many families find helpful.

I hope some of these suggestions help your child and family. And readers, I’d love you to use the comment section to share resources and ideas you’ve found useful.

  1. October 7, 2011 at 10:36 am

    My son is 12 years old. In my case the school and their rigid rule is the problem. At home my son no longer has temper tantrums or any aggressive behaviors. School is a very different problem. I quit my job in February 2008 because the school was calling me to pick my son up at least once a week. Last year a teacher actually told me if Joseph acted out aggressively again she would be forced to call the police. I finally had to pull him out of the school because the adults he was with every day at school couldn’t control themselves when an incident occurred. At every IEP meeting I explained to them the best way to deal with my son was to allow him a choice. Don’t misunderstand I’m not saying he shouldn’t have to do a task if he doesn’t want to. They have what they call a quiet spot. It’s a place in the classroom where the children can rest, reflect, calm themselves for a few minutes until they feel able to rejoin the class. I advocated on every IEP that when my son balks at a task, give him the choice of performing the task or going to the quiet spot to reflect and calm down. The school simply won’t do this. I don’t even know why they have a designated spot if they refuse to utilize it. This week on Tuesday my son didn’t want to go to PE. According to the teacher he was fretting about PE for the last two weeks, but on Tuesday he displayed signs of upset at the prospect. When he questioned the teacher just before the class lined up for PE she told him everyone in the class was going to PE and he needed to go as well. A few moments later after lining up my son started to cry. The teacher and a teaching assistant proceeded to lead the class outside and ignored the clear warning signs my son was exhibiting. Once outside my son refused to move so the teachers aid towered over him and told him to join the others on the field. My son promptly began hitting him. The teachers aid grabbed at him and my son ran out into a driveway that bordered the field screaming No No No. The teacher and the teachers aid ran after him and finally grabbed him and forced him back to the field. By this time he was in full blown meltdown, hitting and kicking both of them. Finally another teachers aid went to a phone and called me. Now heres what I think should have happened. Whe my son began to balk in line he should have been given the choice of going to PE or going to the quiet spot to reflect. There are three adults in his class every day. Certainly one of them could have remained behind with my son. If given this choice my son would have decided he wanted to join his classmates within 5 minutes. When I said this to the teacher the next day I was told my son couldn’t be allowed to decide when he would perform a task. If they allowed him this option it would be complete chaos in the classroom. My son has not been back to school since. He is in a homebound program in combination with being at school half days. He gets a teacher here at home for three hours a week and I supplement his lessons. Last year after I pulled him out of school and put him in the homebound program his academic progress was remarkable. When we started he could barely read and he couldn’t do any math at all, but over the year I and the visiting teacher managed to get him reading at a fourth grade level, He has mastered adding and subtracting, even like fractions, and we are teaching multiplication now. Until I pulled him from school I really believed what the school told me. They said he might be able to read enough to get by in life but he would probably not be able to master math concepts. My advice to parents of autistic children is not to accept a less productive life for your child. I thought the people at the school were experts, but at least in my case they are not. I would like to know if I have any recourse with the school system. I would like them to increase the number of hours for the visiting teacher to maybe six hours a week and I would like to enroll him in the online school program they offer, but I want to keep the visiting teacher as well. If they can’t deal with him at school doesn’t he still have the right to an adequate education. I live in Oklahoma if anyone can help I would really appreciate it. My email is bboren@cox.net. Sorry for the length but I have a lot to say on this subject.

    • Jen
      October 7, 2011 at 1:59 pm

      WOW!! Does this bring back memories. My son was in just about the same situation. It sounds like your son was also placed in a school that had an obvious lack of expertise with children on the spectrum. They had no idea what to do for my son. I was also getting calls from the office on a weekly to daily basis. He was so distressed there that he would run out of the class yelling and screaming and actually left the building on one occasion prompting them to call me and threaten to call the police if he did it again. They regularly sent him to the principal’s office for his tantrums because they couldn’t understand his needs. He kicked, he hit, he threw things, etc. Then they would call me at home(imagine if I had to work) and tell me that they needed me to talk to him to calm him down. ARE YOU KIDDING ME? Now we’re getting him into the routine of talking to Mommy on a daily basis after he throws a tantrum and is sent out of class. They then started sending paperwork home for me to fill out regarding his behaviors and after I reluctantly filled out he paperwork, which was soooo vague in detail, they said that he was “mentally disturbed.” NOW mind you, I gave them his file from his previous school(we moved), which included paperwork from his psychologist, his neurologist, etc. I also talked extensively about my son being on the autism spectrum. Would you believe…after nearly five months of misery for my son and despite everything that I had said and offered…After they threw the term “mentally disturbed” at me and I begged them to look again at his file which had all his previous info…they finally said that they didn’t see that part of his file(AND IT WAS RIGHT THERE-PAGES OF IT). Suddenly they were saying that his diagnosis changes everything and that they would have to completely rethink how they were going to help him and teach him! This school was still painfully ill-prepared to serve a child like my son, so he was placed, about a week later, in an appropriate environment with teachers capable of getting the best from him.
      I don’t have anything to offer you as far as what possibilities would be open for you in your area, but DO keep him out of that school. I too had to live through a heartbreaking process with my son which I felt no one was listening. And if there’s one thing I’ve learned it’s to always be my son’s most vocal advocate…no matter how hard this gets…AND always listen to my instincts. If something doesn’t feel right, question it and be bold about it. As far as recourse…for me, as much as I wanted to sue the pants off these people for blantantly ignoring me and my son’s file, I couldn’t do it. Just knowing that the district, which is already struggling to meet student needs, would have to take more money away from students to fight in court…it didn’t feel right for me. I’m not sure what can be done…I wonder, at times, if this is happening to another student at this same school…and maybe I’m an idiot, but I’m hoping they’ve learned a lesson. I wish you all the best and I’m sure that, with tenacity, you’ll get what is needed for your son.

    • Greg
      October 17, 2011 at 11:49 am

      You’re problem is similar to the problem we had with our youngest son. The teacher’s sugesstion was that maybe the best place for him would be a special home. He was only 7 years old at the time. The constant lack of listening and not telling us when major decisions were made led us to pull both of our boys out of the autism program in our school district. You’re child is entitled to a public education under the IDEA act. I suggest you visit wrightslaw.com. The specialize in the IDEA act and what’s requied of the school district under federal law.

  2. shannon
    October 7, 2011 at 11:00 am

    my son takes respirdone but it only partially helps but he is 16 too so i assume hormones and social problems are part of this anger and frustration.. the calmer i stay the better he responds!

  3. denise
    October 7, 2011 at 11:10 am

    do not attend to negative behavior~! Reward positive behavior! never use food as a reward!!!! use pictures to demonstrate the outside activity will begin at this time! Draw a clock on paper for visual and have the child be ready for (2 o’clock) time learning and rewarding! Even if the child was acting out at 1:55, you still keep your word for the 2 o’clock outside time!

    • Sheila
      October 7, 2011 at 11:22 pm

      It’s called having problems with transitions. They do need some choice of how they need to transition. As they become adults they should be allowed to have choices. There is a reason that he did not want to go to P.E. problem resolution and understanding may also be the answer.

  4. Jamie Richardson
    October 7, 2011 at 11:18 am

    My son is 12 years old now. He is Autistic and is -15 in chromosone.. He has some aggerssion at times like kicking trying to bite or better yet pinching,,,What ushually works for me is redirecting him by asking if he wants go outside.. Or just hand him a book to look at with me. Most the time this has worked well for him .. Or also just take him out to see his pets chickens and pigeons..The animals always have calmed him..Just a constant redirection ushually helps for me..

  5. Takeyia
    October 7, 2011 at 11:18 am

    Yes I’m glad there is someone out there that knows what i’m going through. My son is four years old and he goes to special school for children like him. Normally he cooperates with the staff (well atleast last year) but this year his behavior is very aggressive. He’ll tell the teachers “NO WAY!” Like screaming at them, not follow directions such as circle time, playtime to not line up from recess to not willing to color, cut, paint and etc. Even at home its the same thing and I’m like what to I do? I want him to express his feeling but really I need to know whatelse is their should I do to better help him? Any Suggestions? All for it….

  6. naomi
    October 7, 2011 at 11:52 am

    My daughter did have times when she became either agressive or totally withdrawn. It was important to maintain a strict schedule with her including bedtime and mealtime. She needed to know what to expect and in turn what would be expected of her, as she grew older “major meltdowns” only occured if she was ill, overtired or exposed to a situation she wasun- prepared for. The only medication we have ever found effective for her has been the antidepressant Wellbutrin, and only the name brand. She is now 21, living on her own, has graduated college and has finally found a job. My heart goes out to other parents, because raising children with diagnoses is the autism spectrum becomes a full time job. Time is taken from your careers and time you should be spending with their siblings. The time and effort are worth it. These kids can go on to lead productive fulfilling lives.

    • Betsy M
      October 7, 2011 at 12:09 pm

      Yay! So good to hear from someone whose child is older than ours. I just posted a long comment (awaiting moderation); our daughter is 18, away at college. Good to hear good news!!!

  7. Kristy
    October 7, 2011 at 12:07 pm

    This article lines up exactly with what works for my son. My son is now 7 and still has severe speech delays. Every inappropriate behavior is a result of his lack of communication. He tries to get the message across by by doing things he knows works. By identifying WHY he’s doing the behavior and WHAT he’s trying to communicate or accomplish with the behavior, we have been able to replace the bad behavior with an appropriate one for the situation. Once this is established, we ignore the bad behavior and positively reinforce/encourage the new one. I have also noticed that my stress level has a lot to do with how well my son behaves. The more upset or frustrated I get, the worse my son acts out. As long as I stay calm and in control of the situation, he falls back in line rather easily. My son has been hitting, head butting, pushing and punching at school. Some days his hits/aggressive outbursts numbered beyond 90 a day. We have recently pulled him aside for one on one teaching until his aggression can be better managed and prevented. He is working with one teacher aid in a very controlled environment in his own portable at the moment. They integrate certain parts of his day back into the classroom, but for now that integration is very limited in order to keep his classmates safe. The school has been doing ABA and compliance training and his hits are down under 20/day consistently within a two week period. By the time he returns back from winter break, we hope to integrate him back into his classroom so that he may gain the socialization that he needs.

    • Kristy
      October 7, 2011 at 12:13 pm

      Might I also add, that we have been very fortunate to have found a school that is willing to work with us to address the needs of our child. This seems to be a very rare thing. But, we have monthly meetings where the specialists, teacher and principal meet with us to touch base on what is working and how my son is progressing. They even hired an additional staff member to help work with my son. As a parent, it is essential for the staff at the school to listen to what you have to say about your child. You know your child and they know teaching. Putting those two knowledge sets together in order to meet your child’s needs is very difficult to accomplish, but is vital to successful teaching of your child. I am so grateful to have a school and principal who really take time to understand my son and how best to meet his needs. I am truly blessed!

      • Michelle
        October 10, 2011 at 5:38 pm

        Kristy – It was so great to read your comment! Our son is 12 and has been having a difficult time transistioning to middle school. He is also non-verbal and a ton of sensory issues. The school has him mainstreaming some and even if it’s for a small amount of time, it just doesn’t work (right now). At this point, I think all of the teachers and aides are afraid of him so they are just letting him do what he wants. What you said above is really helpful for me and I am going to use some of these words during our meeting this week. One big thing is that he gets more stressed when those around him as more stressed and needs a calm environment. A typical classroom with buzzing, bright lights and lots of activity just doesn’t work. BTW it sounds like your school is amazing!

  8. Lisa
    October 7, 2011 at 12:07 pm

    My son (11) struggled with aggression when he was told no or when it was time to stop a preferred activity – he would attempt to squeeze or choke the nearest smaller child (typically a sibling but sometimes classmates). We put him on respirdone over a year ago and have seen significant reduction in behavior and an improvement to his sleep patterns. Recently we are starting to see more aggression towards siblings when they cry. Rather than increase his medication (we’re concerned about further weight gain), we are trying more of a management approach. It is challenging because he does not understand how badly he can hurt someone so our focus has to be on providing an alternate reaction.

  9. Betsy M
    October 7, 2011 at 12:08 pm

    Our family doesn’t have all the answers, & we’re still working through life & it’s still difficult many times, but as the mother of an 18-year-old daughter w/PDD, I can say (at least for us), it DOES get better as the child matures. :)

    Our daughter wasn’t diagnosed as being on the autism spectrum w/PDD till end of the 9th grade b/c she was so high functioning. She has seen a child psychiatrist since the 3rd grade, & was diagnosed w/childhood depression & then ADHD. When she was younger, many of her symptoms were attributed to depression, ADHD, age &/or immaturity. By the time she was in the 7th grade, her psychiatrists recommended that we take her to autism experts, b/c maybe that was the “missing link” or thing he “couldn’t put his finger on” regarding her behavior. Unfortunately, she was so high functioning, the experts misdiagnosed her as not having PDD, not being on the autism spectrum. Around the same time, our insurance dropped her Dr, so we saw 2 different general psychiatrists (we TOTALLY recommend CHILD psychiatrists for CHILDREN!!!) over the next 2 yrs. (The 1st one was good, but b/c he was w/the county mental health system, which was the closest in-network psychiatrist available to us. However, the CMHS didn’t have frequent enough appointments for our daughter’s complex issues, so after seeing our daughter for a few months, he recommended we see a private psychiatrist. By this time, an in-network psychiatrist had opened a practice in our town.) After being dissatisfied at seeing minimal improvement w/the in-network, private-practice general psychiatrist, we returned to her out-of-network child psychiatrist (whom we pay out of pocket). By this time (end of the 9th grade), I had read a lot about autism spectrum disorders & was fairly certain she WAS on the spectrum, tho didn’t exhibit enough symptoms to qualify as having Asperger Syndrome. At our 1st visit back to her former Dr, he agreed w/my thought that she WAS on the spectrum, w/PDD. His official diagnosis qualified us for services from the state-funded autism experts who had misdiagnosed her 2 years earlier. The waiting list to see them was >1 yr! When we got in to see them, it was the beginning of our daughter’s 11th grade year of HS. Their services have been helpful – & they said they now have NO DOUBT our daughter IS on the spectrum!

    Unfortunately, the saying, “If you’ve seen one person on the autism spectrum, you’ve seen ONE person on the autism spectrum!” is accurate – what works for one person doesn’t always work for another. But, here are the things that have helped us:

    1) God/Jesus :)
    2) Board Certified Child Psychiatrist
    3) Rxs (our daughter has tried probably >30 different Rxs over the past 9 years. No one, not even the Drs or pharmaceutical companies, can predict/know what Rxs will work for any particular child. Some children, like ours, require a “cocktail” of Rxs. Some Rxs will help SOME symptoms, but not all. So then you have to find ANOTHER Rx – or more – to help w/the other symptoms. Some Rxs will help some symptoms while making other symptoms WORSE, so obviously, those Rxs will need to be rejected. Keep a log of Rxs – which your Dr will do – but it helps if you do it, too, & write down the whether the Rx helped, didn’t help, had side effects, etc. Know that it takes TIME for some of the Rxs to take effect, which can make this process frustrating for the child, the Dr & the parents. :( I’m not a pharmaceutical rep, nor am I getting paid for any endorsements, but ABILIFY was probably the most helpful of all her Rxs, the “magic bullet.” Risperdal had helped somewhat, but not as well as Abilify, & Risperdal had made her more tired/lethargic than Abilify, which also has those side effects for her. Risperdal also made her gain a lot of weight quickly b/c of increased appetite, but b/c she had been thin, that was an acceptable side effect for a while. However, now she has the tendency to gain weight easily. :( The final piece of the puzzle, tho, for her, was adding Yaz, a birth control Rx. Not for birth control purposes, but hormonal influence. Her other Rxs include Prozac – for depression, Wellbutrin XL – for OCD tendencies, Ritalin LA – for ADHD, Abilify & Yaz – for mood/aggression. Prior to the Abilify, tho, she could not tolerate stimulant Rxs, which help her focus. They made her MORE aggressive, so she instead took Clonidine for ADHD. It’s an anti-hypertensive, but it calmed/slowed her down.)
    4) a book called “Straight Talk about Psychiatric Medications for Kids” by Timothy Wilens, MD. It’s my 2nd Bible. AWESOME book w/great advice/info.
    5) other books about mental disorders & autism spectrum disorders
    6) understanding relatives (we’ve been blessed!) & teachers (sometimes we’ve been blessed, other times, NOT!) &, of course, trying to be understanding & patient ourselves! Our daughter’s 4 sisters (ages 9-20) have sometimes been understanding, sometimes not. Just like other kids, including ones on the spectrum, maturity helps!
    7) TIME/maturity, & knowing that it DOES usually get better. I can’t speak for the parents of those who are more affected, but at least for higher-functioning spectrum kids, time/maturity DOES help. There IS hope! :)

    Our 18-year-old is now a freshman in college – earned a couple of nice-sized scholarships. The saga continues, however, as this is a new phase of life. Autism experts recommend a single room for those on the spectrum as an accommodation. However, at the private university she attends, this accommodation comes at an extra expense. So we tried having her room w/someone. Didn’t work out. (I don’t know WHO put them together, but her roommate is anal-retentive, not a good combo for someone on the spectrum! Her roommate wanted “lights out” @ 11 PM!!! I didn’t know ANY college students went to bed @ 11 PM!!! Kids on the spectrum would need someone who is more laid-back & mature, which is difficult to find among any college students. :) Perhaps someone who also has a disability, or a sibling w/a disability. Or maybe an older psychology major who wants a live-in experience. :) ) So, we are still experiencing bumps in the road . . . but we dropped her off at school Aug 20, & tonight is the 1st night she’s coming home (10/7)! I saw her 8/24, when I brought some forgotten items to her, but other than that, we hadn’t seen her in person again till dinner last weekend, for her school’s parents’ weekend.

  10. Melanie
    October 7, 2011 at 12:15 pm

    My son takes risperidone (Risperdal) under the supervision of his psychiatrist and receives behavior support services from a behavior analyst who works with him, me, and the staff who work with him in his adult day program. The combination of medication and ABA has not completely eliminated my son’s aggressive and self-injurious behaviors but has reduced their frequency somewhat and given us options for working with him.

  11. Rachelle
    October 7, 2011 at 12:33 pm

    My 10 yr old son has asperger’s syndrome and has become increasingly aggressive, physically or verbally. I have noticed that this is usually when he the most frustrated, as in he wants to go out but it’s dinner time,etc.
    Also, his younger 8 yr old brother has Reactive Attachment Disorder (RAD)which only adds to the problem. The combination of diagnosis’ is an issue in and of itself. The 8 yr old will taunt, tease and lie, steal and manipulate my 10 yr old w/ Asperger’s to the point that they become physical.Where the 10 yr old needs less stumulation, the 8 yr old thrives on stimulation causing a nonstop excess stimulation for my 10 yr old.
    I live in Rhode Island and have found it difficult to find a therapist for my 8 yr old w/RAD that doesn’t have an extensisve waiting list. I already have my 10 yr old on Zoloft for his severe anxiety, but it does not help w/ the issue caused byhis brother or other social situations.Any ideas would be greatly helpful. I am biologically their grandmother, but have adopted them d/t circumstances. They both call me
    Mom.I have recentltly been on a medical leave primarily d/t exhaustion, as I am the only adult caregiver they have. When the cause/enemy is in the home and is a child, what does one do???

  12. Nesrhten
    October 7, 2011 at 1:32 pm

    Great post, but one should always check out medical factors, befor applying behavior analytical interventions..

  13. Myrna Gomez
    October 7, 2011 at 3:26 pm

    my son is 14 years old now. last year, coming back from vacation to our home country, he developed aggressive behaviors. he would pack all his clothes, didn’t want to see his clothes inside his closet. he was so obssessed with this behavior that sometimes in the middle of the night, he would wake up and start putting away his belongings. being that he is non verbal, i interpreted this as his way of telling me that he wanted to go back to the philippines. his behavior got worst to the point that he became aggressive, physically violent, destructive and started engaging in obssessive compulsive behaviors. i was at a loss, frustrated, depressed and didn’t know what to do. i had a lot of help from YAI PREMIER HEALTH CARE. i went through a series of behavioral modification sessions to help me handle my son’s behaviors. we also went to a psychiatrist and after a lot of thinking and weighing of pros and cons, i finally decided to start my son on Zoloft. it’s as if nothing happened to him. needless to say, my son is a different child now. gone were the obssessive compulsive behaviors, aggressions and violence.

  14. Angi
    October 7, 2011 at 4:19 pm

    Honsetly somedays nothing I have tried helps his therapists have tried tons of “coping” skills that just don’t click with him, and some days just talking calmly shuts it down. The biggest issue I run into is that the same thing rarely works with him twice in a row. (14 year old male with Asperger’s)

  15. JudgeRoy
    October 7, 2011 at 5:49 pm

    I’m 25 and have autism and do have angry outbursts. Not always violent unless furniture is near. I take Ritalin to help with other symptoms but it does decrease my anger outbursts. Most times I need to break from the problem and just spend some alone time. When it happens in a public place I will take myself away from the stress (usually crowds, noise, emotional stress).
    I need a routine in place for functionality but if it’s disrupted I have a mixture of emotions ranging from confusion, irritability and…I dunno, what’s the best way to describe an emotion of losing your emotions – depersonalisation?
    I’m still trying to work out what to do about the routines. I’m not a rigid with them as I usually was because when my favourite TV shows kept being taken off or shown on different days I kept having meltdowns and shutdowns over it.

    The best thing that will help me when I have angry outbursts is not to be yelled at and shown some understanding. Particularly the shutdowns too, which comes about when trying to hold my anger in. People think my silence is deliberate but I usually lose the ability to move or speak.
    I don’t like suprises too. I need to be told what will happen when it will happen. It’s difficult because I have a mum that is very spontaneous and impulsive.

  16. JudgeRoy
    October 7, 2011 at 5:51 pm

    P.S I really love this article. I’ve grown up with being told that I was just being a spoiled brat and even 10 years ago I would never had expected such an open minded post.

  17. October 7, 2011 at 6:25 pm

    My daughter doesn’t have as many, but I feel that is more due to our recognition of the early warning signs than anything else. Most of these kids exhibit clear signs. My daughter’s ticks and OCDs start to become more pronounced. Then she starts to yell when the ritual is disrupted by anything, and then she throws herself to the floor and just starts yelling and sometimes kicking. She tends to push her brother down more when she is on the edge of a fit. If we can catch it early enough, we can redirect her by giving her choices (calm down, leave, etc.). We leave it up to her when we can and most of the time we are able to continue as planned. Sometimes, however, we are not. There have been times where we have been forced to physically carry her from the building when we are at a mall or restaurant because her fit came on so quickly and so violently that allowing her to remain there isn’t good for her or others. I find that keeping my voice calm, steady, and quiet really helps. I may have to raise my voice once or twice to get her attention, but using a quiet, calm voice forces her to get quiet and calm so she can focus and hear me. It’s honestly harder to deal with the staring people, making their snide comments about “controlling that kid” than it is to deal with the fits my daughter has. I wish more people understood that sometimes it’s not about being a failing parent who can’t control a child and more about the child having a disability that makes that task a bit more difficult.

  18. MB
    October 7, 2011 at 9:18 pm

    My 10-yr-old son has Fragile X Syndrome and autism. He’s on meds (incl Risperdal) but they take the edge off for him – not take the behaviors away. We do a lot with prevention techniques and talking him through situations. It’s really hard once things have escalated to a certain point.

  19. Crystal
    October 7, 2011 at 11:38 pm

    Mine also ONLY has aggression issues in the classroom. This occured after an abusive incident from an aid. I have voiced my opinions, offered them help, and nothing. I’ll do u one better his TEACHER the main Special ED and only special ed Teacher in the school has no High School Diploma, but they appointed her to teach my son with Autism. Makes no sense, My Son also goes 3hrs a day, and is sent home at least 3days out of the wk. They have refused to let me help them in the school setting, they have refused services that would help them and my Child. Insinate that I am a liar and my Child is evil and needs meds for behavior. All his doctors laugh and say its not him. What is there we can do? Im fighting with everything I have which isnt much left. My Son is almost 8 and is very far behind, but has so much potential. They just choose to ignore that. If you have any insite Id gladly take it, Thank You for speaking out, something needs to be done. How do I go about getting my Child Home~Schooled and Taught threw my Home? Thank You again, anyone on here please if u have any advice. Im here to listen! My email is q.landyn@yahoo.com or u can even call me 573-604-2216. Its time we fight back, not that we should have to. Our Children are suppose to receive a Education regardless of needs, not whom the uneducated fools pick and choose. <3

  20. Quinton
    October 8, 2011 at 12:58 am

    i wish i could do more but i cant i hate the way there doing my and i hate seeing my wife it upsets her and her hands are tied shes having a hard time with this school the thing is that its a small town and its a “who you know thing” and its BS so if anyone has any pointers contact my wife crystal 573-604-2216 thank you.

    • Tina
      October 15, 2011 at 3:00 pm

      OMG!!!! get a special ed advocate attorney and MAKE that school listen to you. I brought charges of abuse, neglect and harrasment up to my local school after my son, then 7 1/2 years old, became the victum of bullying from other students. He is very high functioning, but…and I say but because I have worked my ass off to get him the help he needs, deserves and is entitled too……You are the only one who knows how he truely is and what helps soothe or calm him in those instances where he melts down as ALL children do sometimes, not just those with special needs. I live in a small town too and damnit I MADE them help him….you gotta fight like hell but when you get an attorney involved, especialy a special needs advocate they have to address the problem…like i said my son ,who was normally kinda shy, was having violent fits about going to school. He would start worrying about school as soon as he came home…he was like no more mommy, no more today. I would tell him not today but tomorrow you go back. He would lose it. We would spend the entire night trying to calm him only to have the same stuff the next day. I knew something was going on because I am his mother and I know my boy….I have 5 children and my youngest is the autitic one. I see how he has blossomed since I stepped-in and made them listen. They now have a speech therapist(one with actual credentials) a special therapy room with a ball pit(my son asked them if they could get one) and a HUGE manual sent home to ALL students about the bullying policy. You know that I felt like the whole town must be against me because I was such an advocate for my boy, but I don’t care what anyone says…he is teachable, loving, caring, vocal(first word at 4yo) not on meds at 9 now, and thriving now that I have spoken-up for him. If this world were a level playing field then I would see what the school was trying to do, but its not and they knew my son needed the extra help. I spoke for him then and they are actually helping him now. GET FIGHTING MAD!!! That is your child and dont you ever, ever let anyone tell you he can’t, won’t or isn’t ever gonna be normal. I could ship him off to a special school for autistic kids but I want my son to reach his full potential and I will see him walk that stage at 18 and get his HS diploma. He makes it all worth the turmoil. I hold my head high and just keep telling myself over and over…….This is all for you, my little man!! Please reach me at tinakingsbury@rocketmail.com….I hear you and I understand how hard this fight is. My thoughts and prayers go out to you all.

  21. Julie
    October 9, 2011 at 12:56 am

    My son is a sweet and loving child. He has been on Risperidone (Risperdal) for 6 years. He also is seen by a neuro-psychiatrist, and special needs ped. He is 10 years old and non-verbal. He has a few signs which he can do. He can become very aggressive within the blink of an eye. Usually when told “wait”, or “no”. He wants what he wants that minute. His Risperdal was recently increased again to help with aggression. I am looking for any ideas to help him deal with his aggression. Lots of attempting to bite. He does alot of head banging of people and objects, scratching, and pinching. I find that as long as I stay calm, he seems to calm down himself more quickly. Also, I stick to the plan. If there is something we need to do, (example – put on shoes), and this causes a tantrum – I let him know that the aggression is not okay, and he still has to put on his shoes, etc. I am also working on more sign language, and some pictures hoping to ease his frustration. He is a big boy, and time is ticking. I have to find an answer that works for my son’s behavior before he gets much older. I can only imagine what he goes through on a daily basis, not being able to communicate as he would wish to. No wonder he is upset! I would be too!

    • My Hero Alex
      October 14, 2011 at 10:25 am

      Have you tried a picture schedule for routines? Breaking things down and visualizing the expectations can sometimes help especially for our non-verbal kids.
      Iphones and ipads have lots of apps that can help put schedules together, but if not avaialable grab a camera and shoot!
      Good luck,
      ~My Hero Alex

      • Julie
        October 14, 2011 at 5:19 pm

        Thanks So Much for the advice! I will look into a visual schedule, a an ipad.

  22. October 9, 2011 at 3:36 am

    hi everyone I’m a highschool student im not saying where but im worried about my self. i have been told that i have a learning proublum thats clearly to see in me i get really fustrated when i read and write, math is getting better i offtend cry when i have to high amouts of waiting. like when get my hair done in braids well be half way through and ill starting freaking out or i’ll cry and it bugs me. i would be washing my hair and get mad because my body will get all hyper i dont why. i’ll be in class and cant sit still forth nothing and the hands (pasiums) i spelled that wrong i’ll be reading my book go’s flying or i’ll be eating my hand would lock up on me idk call me weird but i feel theres something serious wrong with if i tell my mom she will think im saying it for attention come on mom im 16 i know my body better then you and i think i need to see someone but i cant say that so if anyone can please help me that would nice i have A.D.D and A.D.H.D

    • October 14, 2011 at 4:32 pm

      Mechele, good job on the blog. I suggest you talk with your mom, and possibly a school counselor or teacher, as they can help find more services to help you in managing your ADD and ADHD.

  23. Shanavia
    October 9, 2011 at 4:02 pm

    I think entering your child into karate classes may help them understand that being aggressive should only be used as a defense mechanism. This may help them to deal with stress or other problems in a safe way and in a safe environment.

  24. Crystal
    October 10, 2011 at 3:45 am

    Michelle Smith, Sweet<3 Im no doctor or anything of the sort but Id say u need to go to a doctor and have some test done. You are not weird. I think maybe theres something more that they havent diagnosed, or possibly if ur taking med's for add, and adhd they are causing u to have these side effect. If ur Mom isnt listening, u might want to speak with a school counselor or someone else that can help u. I wasnt having the problems u are, but was having several issues in school, my parents and teachers all thought I was being "defiant" not wanting to do the work. Turns out I have a learning comprehension problem. Not important. Anywho, Please see someone, U may even ask ur Teacher to speak with her. God Bless U and Thank U for sharing, I hope u get these issues solved soon. <3

  25. Kathy Silverstein
    October 11, 2011 at 4:05 am

    A combination of behavioral techniques and medication is probably what works the best in most cases. All I know from my own experiences is to start slowly and try all other options before you try medications like those. I hear you reccommend them highly, but I was on Abilify, the second medication you mention, and I got awful side effects from it and no positive effects whatsoever. Of course, my parents were at the time under some impression that it could help my sensory issues, when that is really not what it is marketed for. They didn’t want me to stop it even after I complained of adverse side effects, so I was truly miserable for 2 weeks until I finally begged my doctor to let me stop. I know you have to give medications time to work, but if your child is complaining of severe side effects, it’s not the right one. That was about 5 or 6 years ago this happened, and I don’t think I will ever forget it.

    As you say, not being able to express your feelings leads to anger, frustration and meltdowns – and for some, aggressive behavior. Look at the second half of this article I found – it backs up a lot of what you are saying, about how behavior being a form of expression. http://www.aspergerssociety.org/articles/42.htm

    My parents often thought I was acting out just for attention and thought that if they ignored me, the behavior would go away. For me, it was the worst thing they could do, because I was in distress. When they ignored me, I felt more alone, more distress and my behavior escalated dramatically. Find out what is causing the behavior, and show your child you understand – that is what works for me. (I am a 27 y/o with Asperger’s.)

    • Kristy
      October 13, 2011 at 5:13 am

      I loved your Comment, Kathy. Thanks so much for your input! I have tried ignoring my son’s behaviors at times, so it was an eye opener to hear how that made you feel. My son does seem to calm down a lot better if I just take him aside and talk with him. I let him know that I understand the situation, and his emotion (whatever it may be… anger, frustration, disappointment…) I think it also helps him to put words to what he’s feeling. He does not communicate much verbally right now. However, he is talking more and more each day as we work with him and try to find ways to show that we understand what we do… I just wish I understood more. I love that autistic people are willing to come on here and share their views and experiences. It helps us parents, who have little clue, so very much!!

    • Betsy M
      October 13, 2011 at 11:57 am

      Kathy, I totally agree w/your statement: “A combination of behavioral techniques and medication is probably what works the best in most cases.” And GOOD psychiatrists, depending on the situation, would probably recommend trying “all other options before you try medications.” If a situation is dire (patient threatening to harm him/herself or someone else) &/or behaviors are severe, however, medication might need to be tried as a solution more quickly, perhaps in combination w/behavioral techniques.

      As the parent of an 18-y-o daughter w/PDD (pervasive developmental disorder; highest-functioning end of the autism spectrum), I wished her child psychiatrist would’ve tried stronger Rxs earlier. I understand Drs’ hesitation to do so, b/c they prefer to treat problems w/the least invasive procedure possible, but I would’ve preferred if we had tried Risperdal (which helped w/aggression, but at first caused significant weight gain, but then tapered off) or Abilify (which I don’t think was available until the year after she was on Risperdal). Hindsight is 20/20, tho, & we think her Dr is one of the best, & are very thankful for him. (The reason for wishing he had Rxd a stronger Rx sooner is for the problems her behaviors those around her, especially our family, but also herself.)

      It’s a blessing that you are able to communicate about your experiences, to help parents better understand what their kids on the spectrum might be experiencing. If I may ask, how old were you when you were able to communicate your needs (being ignored made you feel more alone) clearly? I suspect there are a lot of kids on the spectrum who aren’t able to figure out why certain things their parents do (i.e. ignore them) bother them (i.e. make them feel more alone) – they just know they’re miserable & act on that.

    • WMontele
      October 14, 2011 at 10:26 am

      We used lithium orotate (the naturally occurring mineral salt, not the synthetic drug used for bipolar disorder) on my 11 yr. old son in place of the drug risperdal and it helped SO MUCH! We want to avoid drugs because of some of the side effects, some of which are irreversible (who wants to mess w/ a brain that’s already out of sync?) Other very helpful therapies – neurofeedback and the Masgutova Method.

  26. WMontele
    October 14, 2011 at 9:34 am

    Lithium orotate helped my 11 yr. old son A LOT! We used lithium orotate in place of risperdal because we were extrememly uncomfortable with the side effects of this drug and what it might do to my son’s already dysfuntional brain. DO NOT confuse this naturally occurring mineral salt with the synthetic lithium used in very high doses for bipolar disorder. Studies show that communities with highest amounts of lithium in their water supplies have very low crime rates. I also take lithium too, very calming!

  27. My Hero Alex
    October 14, 2011 at 10:20 am

    My non-verbal son will be 15 on Halloween (go figure) and we have been through it all. Best advice- designate “chill spot” in classroom so child can learn to self-regulate w/aggression and calm on his/her own- make sure it is used BEFORE major aggression. We use a gaming bean bag chair and a simple stress ball item and discuss with teacher BEFORE school begins to decide on placement and strategy. Best case scenario, teach child to initiate “break” by sign, PECS, or in our case, Alex curls his tongue and teacher asks “Do you need a break?”. Child will re-engage when ready and it is not a manipulation tactic no matter who tries to tell you that. I have 15 years of practice -parents are the experts.
    Also -try a sensory diet throughout day. Scheduled input as non-evasive as a head rub to using the ttreadmill, weighted blanket, sensory room, bouncy ball, etc. Discuss with OT and make sure it is followed every day at same time schedule if child is regimented. Never allow recess to be taken away from child for poor behavior- they are starving for input and will help with anxiety and aggression.

  28. Megan Pioch
    October 14, 2011 at 9:29 pm

    Hi. I’m probably going to receive a lot of flak for this. I have a 19 yr old son with autism and partial trisomy 22 (an addition on the chromosome). My personal opinion is this:
    Rage is an elemental, primal emotion. I think it’s one of the first emotions a person displays. Our children need to know what rage is, then learn HOW to express it correctly. If you ignore and redirect, then you’re not addressing the aggressive behavior and getting it to stop. Our children need to learn how to express their frustration, anger, & rage in a way that tells us how they feel without the aggression. Don’t ever think your child doesn’t understand what they’re doing. Our children know what they’re doing. The hard part is in provoking the response (deliberately), then giving them a consequence that makes them stop the behavior. For example – My son used to bite his knuckles until they bled, hit himself in the head, slap his hand, and spit. When he bit his knuckles, I placed a spicy condiment in his mouth. Every time he bit his knuckle, I gave him more of the spicy condiment. I wasn’t angry, and I didn’t say anything other than, “If you’re going to bite yourself, you’re going to get this ________ in your mouth.” I was completely in control of myself, and the situation. I provoked him after a while deliberately. When he raised his hand up to bite himself, he looked at me, then put his hand down. He began making the connection that IF he did something that wasn’t appropriate, THEN the consequence wouldn’t be pleasant. I used different things for different behaviors. One by one they went away – permanently. The reason I provoked my son was because I believe that Life will present our children with challenges, changes, and chaos. We need to teach our children the skills they need to identify the emotion, realize aggressive behavior isn’t going to help, and then be open to learning another coping mechanism. It’s like the fires at the Kuwaiti oilfields. They couldn’t use water. They couldn’t ignore it. They used dynamite to blow up the oil mine, putting out the fire. In a sense, I did the same thing. When my son realized aggressive and self-injurious behaviors would result in something unpleasant happening, he began to cry – not knowing what to do. THEN, I taught him how to handle frustration and anger (he verbalizes), nervousness and fear (he counts up to a set number – 100, 500, 1000, etc. Something with a start and a finish that’s concrete). I also taught him to take deep breaths (counting up to ___ deep breaths) to relax. When he gets in a situation, he now has appropriate tools that are not self-injurious or aggressive. It works. I don’t have to worry about calls from teachers asking me to pick him up from school. Also – I did this when he was young, and I occasionally still do it today so that it serves as a reminder to him.
    In this article, I think Dr. Wallace describes what we used to call the ABCs – Antecedent, Behavior, and Consequence. The biggest issue today is in developing a consequence program. Most professionals won’t admit to it or address it. We have children who don’t fit the norm of parenting. Using a “Time Out”, a spanking is ridiculous, and grounding is pointless. In many states, Heaven forbid if you try to teach your child right from wrong by using an alternative mode of discipline. Yes, I said the word. It’s not right to allow a child to bite you or anyone else. If you have other children who are “normal”, would you allow that child to bite someone? If you don’t allow the “normal” child to bite someone, why on Earth would you allow your autistic child to do that? Hurting others is wrong. Period. How do you teach that to your child? I used alternative methods to teach my son right from wrong. He doesn’t hit, spit, bite, pinch, kick, or punch anyone. He doesn’t bang his head, hit himself, pinch himself, bite himself, or slap himself anymore. I taught him there’s a better way. It was rough – I won’t kid you. However – it’s better to blow out that rage when your child is young and you can control your child instead of avoiding it and having a child who hurts you when they’re bigger, stronger, and older.
    Always remember – our children are going to have to cope with their emotions when we’re dead. Medications can run out. Your child might not have the luxury of having the time or a place to collect him/herself. It’s not normal to see people in 90 degree weather walking around in the community with weighted vests. Allowing the child to do behaviors that aren’t appropriate by giving them massages to calm them down only rewards the behaviors. Our children need to learn how to live in the chaotic event that is life. We’re not always going to be there to translate for them, and to explain to people what’s going on. They have to learn self-regulation. How will they learn if everyone avoids or redirects them? I’m not going to allow my son to tantrum when he’s in his 50s and I’m in my 70s. He’s not going to hit or bite or spit at me now – or ever.
    Good luck to All of you. Our road is rough, and you’re not alone. Respectfully –

    • Crystal
      October 18, 2011 at 4:05 am

      Megan, I’d like to say Thank You for sharing your story. Idk that I agree with the hot sauce tactic. However if it worked for u thats great. I will say this though and Im eager to know of ur other strategies. If u’d email them to me. We arent having the issues at home. It all is happening in the school. I know who, when, and where it started, but having difficulty getting rid of it. His Teachers ignore beyond belief, hes sent home daily. It ridiculous and out of control. “In School”. Home is a whole new thing, usually calm. Sometimes silly. But hes 7 not 20 and School treats him like a criminal. Any Suggests would be appreciated. Ive sought several different agencies and such for help. With the same results. Also the all use the same techniques. Please email what worked for u. q.landyn@yahoo.com

    • Stormy
      November 1, 2011 at 12:00 pm

      Thanks for your input. I have a similar situation and we have been trying to figure out how to deal with it. My brother (35 yrs old) has Down’s Syndrome and does not communicate well. He has always had a slight autistic side, but over the past year the autism side has excellerated tremendously. He was always a loving, kind, sweet guy who kissed women’s hands & was just so sweet. After 2 surgeries last year, the autism side just took over and his whole demeaner changed 180 degrees. It has been a rough year. His health is better now, but I think the whole memory of it is overwhelming to him. He started out being aggressive toward my mother and I (both caregivers) and after I sternly and aggressively let him know that he was NOT going to hit us that part stopped and it turned internal. He hits himself in the head, scratches himself, bangs his head, spanks himself on the butt, which to my knowledge he has never had done as he was always the baby of the bunch and was given everything and didn’t ever really need to be spanked growing up, other than a slight slap on the hand every now and then when he we really young and had touched things that would hurt him or those types of things.

      We have a psychiatrist that we have been seeing since May, but haven’t really seen any help in that direction as of yet. I would like to know your strategies that helped with the hitting and biting of himself.

      Any suggestions you or anyone else could give would be greatly appreciated.

  29. Tina
    October 16, 2011 at 5:30 pm

    Does anyone out there have issues with depression/BiPolar in their child as a dual diagnosis? My son is showing signs and symptoms of the disorder and my older son/ his biological brother is bipolar and takes meds. I am just worried that he may need meds and I don’t want him to suffer from bipolar without treatment options. My world is crazy right now with all that is going on and now this too. I need to hear some feedback. Please!

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