Aggression and Behavior in Autism

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Behavioral issues in autism may be one of the hardest issues for parents to manage. Children with autism may display extensive, long-lasting behavior. Therefore, understanding and troubleshooting these events can help a child and parent find coping mechanisms and solutions. 

Frequently, it is hard to tell the difference between a meltdown and a tantrum. Despite their similarities, they are handled differently. Here we focus on meltdowns and behaviors where your child is in a fight/flight/freeze state.

MeltdownTantrum
Reaction to somethingWants something
Not in control of actionsIn control
May be sensory overloaded/overwhelmedWatches for a response from others
May have an underlying medical causeStops when they get what they want
Continues with no attentionEnds quickly
Needs patience until calmCan be ignored

ABCs of Behavior 

  • Behavior is a form of communication.  
  • Ask yourself, "what is my child trying to tell me?"  
  • There are four primary functions of behavior 
    • Sensory stimulation 
    • Escape/avoidance 
    • Access to attention 
    • Access to tangibles 
  • It is essential to understand why the behavior is happening to manage triggers and teach coping strategies.  

Antecedent- what happened right before the behavior 

Behavior-what the behavior looked like 

Consequence-what happened after or because of the behavior 

Behavior analysts (BCBAs) and other certified behavior therapists can help you determine the ABCs of the behavior and develop effective coping strategies. 

Be proactive 

First, prepare your child and environment for the best possible outcome by taking proactive steps in advance. 

  • Learn your child's unique signs 
  • Minimize triggers 
  • Use visual supports  
  • Use Social Stories
  • Give choices  
  • Intervene early 
  • Refrain from blaming, questioning, or scolding 
  • Listen and acknowledge emotions 
  • Find a quiet, calm space to de-escalate

Manage the environment for sensory overload 

Every public outing involves sensory stimulation. By all means, take precautions to anticipate the triggers that your child may experience. 

  • Plan and be prepared for your child's triggers 
  • Use noise-canceling headphones 
  • Wear sunglasses 
  • Provide calming music or comfort items 
  • Stay out of crowds  
  • Distract and redirect 

Treat underlying medical conditions 

Medical issues could cause your child's behavior! Don't ignore them! Getting to the root cause of your child's behavior can help them feel better and, subsequently, behave better.  

Address communication deficits 

As stated above, behavior is a form of communication. Work with your child's providers to create a plan to help your child communicate more effectively.  

  • Limited communication causes frustration and feelings of being overwhelmed. 
  • Communication ability may be reduced in verbal people when they are overwhelmed or anxious. 
    • Alternatively, find a form of communication such as picture cards, AAC device, Sign Language or typing in these situations. 
  • Work with your speech therapist to explore a variety of modalities of communication.  
  • Read more about Speech Issues in Autism 

Puberty

With puberty, aggression may increase. If your child is experiencing an increase in behaviors during puberty, talk to your doctor. There may be several underlying factors impacting your child. 

  • Hormone imbalance
    • Increased androgens
  • Increased anxiety
    • Increased social awareness can cause anxiety. Counseling may be beneficial. 
  • Increased fatigue due to mitochondrial issues and growth spurts.
  • New onset of seizures or subclinical seizure activity.
  • Menstrual pain, cramps, or headaches.
  • Erupting 12-year molars or wisdom teeth pain.

Public School 

School is a common place for challenging behaviors to occur. As defined by federal law (IDEA), schools are required to evaluate and develop a plan to address problem behaviors. Parents have an essential role in the IEP process. They should be actively involved in any meetings discussing a child's behavior.  

  • IEP teams can perform a Functional Behavior Assessment (FBA) to determine the function of the behavior.  
  • From the FBA, the team writes a Behavior Intervention Plan (BIP) so that school staff has a consistent plan of action.  
  • Ask your IEP team what the district's policy is on restraints and isolation.  
    • Be very specific in the IEP of what the school can and cannot do regarding restraint and isolation.  
    • Positive behavioral supports are best practice and should be included in the IEP. 
  • Learn more from TACA's article Behavior Issues at School: FBA, BIP, Seclusion and Restraint 

Have a behavior plan for home 

Similarly, it is important to determine triggers and reasons for behavior at home by working with a behavior therapist or other professional. As a result, developing an action plan together with your providers will help you be prepared at home.

  • Keep the area safe and try to keep your child from hurting themselves or others 
    • At home  
      • Give your child space 
      • Lower lights 
      • Turn off sounds 
      • Talk quietly. Use fewer words. 
      • Create a sensory or calming area 
    • In public 
      • Find a calm, quiet area or go back to your car 
      • If your child is unable to move, ask others to give you space 
      • Give onlookers a "My Child has Autism" card 
      • Ask for help if needed 

Parents and caregivers 

Ultimately, parents and caregivers are the people most likely to de-escalate aggression or behaviors. Keep the following points in mind as you support your child.  

  • Remain calm and reassuring. 
  • Be empathetic and acknowledge feelings. 
  • Be patient. 
  • Teach self-regulation and coping strategies. This takes time and needs frequent practice. 
  • Learn self-regulation skills for yourself. 
  • Dysregulated parents cannot effectively calm their children. 

Remember: Your child is not misbehaving. Your child is struggling and needs support. 

Conclusion

Aggressive behaviors and challenging behaviors require a multifaceted approach. First, parents must prepare ahead of time for challenging behaviors. In addition, they should investigate root cause medical issues with their physician. Parents who prepare strategies and a plan for dealing with these behaviors have an easier time managing them.