One of the common symptoms in children with autism is aggressive behavior. Aggression can occur in many different ways. Physical aggression can be directed toward you, other children, the child him or herself, or even toward inanimate objects. Furthermore, aggression in autistic children isn’t limited to physical behaviors but also extends to verbal aggression too.
Whether physical or verbal, aggression in an autistic child can be very upsetting and potentially dangerous. For this reason, autistic children who display aggressive symptoms require more supervision in order to prevent them from injuring others or themselves.
Naturally, parents don’t want to simply let this aggression continue and have to deal with it as it occurs. Therefore, efforts are being made on many levels to discover different ways to cope with aggression in autistic children and to decrease or at least curb its incidence.
Often, the first options to reduce aggression suggested by doctors is medication – particularly if the aggressive episodes seem especially hazardous to the child or those around him or her. Keep in mind that the United States Food and Drug Administration (FDA) has not yet approved any medication that specifically treats autism. However, success has been witnessed in using drugs designated for other conditions in order to lessen the aggressive symptoms of autism.
It should be noted, though, that every individual reacts differently to medications, and while some children may respond very well to a certain dose of a drug, others will have a completely different reaction. The process is highly individualized and takes careful observation, measurement, and work with a health care professional in order to avoid any of the potential side effects or interactions.
Recently, it has been the anti-psychotic medications – specifically those which have been approved for schizophrenia treatments – that have produced the most favorable results in autism aggression reduction. For example, a 2002 study called “Risperidone in Children with Autism and Serious Behavioral Problems” (McCracken, J.T, M.D., McGough, J, M.D, et al.), published in the New England Journal of Medicine, examined the impact of Risperdal (Risperidone) on aggression in children with autism. At the end of this 8 week study, 69 percent of the children given Risperdal were said to have either “much improved” or “very much improved”, in comparison to only 12 percent within the placebo group.
However, many parents do not wish to medicate – or further medicate – their children with anti-psychotic drugs. These drugs do come with potential negative side effects and can be dangerous if overdosed. Therefore, alternatives are often sought. Working with your child’s doctor can be very important in this process. To try to alter behavior, parents should pay very close attention to exactly what is happening before and during an aggressive episode. It is important to try and identify trends that lead to an outburst of aggression.
For example, some parents find that their children will suddenly become upset while having their teeth brushed. There are many activities that go on during tooth brushing and each should be considered when assessing what caused the aggressive reaction. Is it opening the mouth wide? Is it the feeling of bristles against the teeth, gums, cheek, roof of the mouth, or tongue? Has the toothbrush gone in too far and hit the gag reflex? Is saliva pooling near the back of the mouth (causing a drowning sensation)? Is it drooling? Is it the smell, texture, or taste of the toothpaste? Is it the foaming of the toothpaste? Is it the sensation of spitting or swallowing saliva and toothpaste?
Every element needs to be examined and tested to see if the situation can be improved. For example, trying different kinds of toothbrushes with softer bristles, a different shaped head, or different textured bristles, or different flavors of toothpaste or gels. Different brushing techniques should also be tried to avoid various sensations, and saliva levels in the mouth should be carefully monitored.
Similarly, other children react not to a sensory sensitivity, but as a result of feeling upset or frustrated from something that they cannot verbalize. For example, a child who tries to tie his or her shoes but who has not yet developed the skills with which to do so might feel very frustrated and become unable to express the root of the frustration and instead react aggressively. When under stress, speaking clearly can be a huge challenge for autistic children and they often revert to the behaviors of younger children instead of saying what they want.
It should also be considered that if aggression has suddenly developed or worsened, there might be an allergic reaction to foods, environmental conditions, medications or a change in home or school environment. Drugs may have potential side effects including aggression. They may also interact with other drugs being taken by the child. Furthermore, seasonal allergies or food allergies may cause discomforts in an autistic child to which he or she is very sensitive and cannot properly verbalize, leading to aggressive behaviors. It is important to examine all possibilities to root out the problem.
The most important thing to remember once your child has become aggressive is for you and those around you to stay calm and talk quietly.
If appropriate, remove objects that your child could hurt themselves or others with. Ask other people present to leave the room or give your child space, but make sure you or another responsible adult stays. Never leave your child alone.
Should your child be in an appropriate environment try to avoid saying anything as this can be inflammatory and can prolong the aggressive behavior. By staying calm and quiet your child may stop their behavior more quickly.
Of course, it is also possible for a child to be displaying autistic symptoms and traits without truly being autistic at all. It is important to make certain that a misdiagnosis has not occurred by considering alternative mental disorders that can present with the same or similar behaviors.
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