Anger and Aggression in Individuals with Autism Spectrum Disorder

In reality, some children seem to live in a world all their own. They appear distant and very introverted, avoiding eye contact and shying away from other people even from their parents’ hugs. They may exhibit unusual behaviors, like flapping their arms, obsessively lining up their toy or turning around on their own feet. They are all too often children who have autism which is a condition that interferes with a child’s ability to communicate and interact socially.

As a result of these problems, individuals with autism spectrum disorder (ASD) can behave aggressively towards themselves, other people or even objects around them.

So, in this article, I will talk about what kind of behaviors they are in terms of anger and aggression. I will try to clarify differences and similarities between anger and aggressive behaviors in children with autism and in adults with autism. And moving on to effects of these anger and aggression on themselves and on people around them. Lastly, I will try to explain what kind of prevention methods or treatments should be used in order to reduce these behaviors and protect those individuals from themselves.

Aggressive Behaviors in Children with Autism Spectrum Disorder

Aggression and anger attacks in children with autism are mostly significant between 2 and 5 years of age. It is one of the most difficult situations for parents. In the aggression, which is accompanied by autism, the children can harm themselves, as well as damage the people and objects around them.

One of the prominent problems in Autism Spectrum Disorder is communication. Communication problems mostly lead to individuals have aggression. Children with autism cannot express their desires and wishes, cannot express the things they are comfortable with or cannot say that they are hurting. Because of this reason, they express themselves in those kinds of situations with anger and aggression.

Sometimes they can have an outburst, even tantrums, in a situation that is very insignificant from the other people’s perspectives. Because it could be very important according to them.

With the birth of children with autism, families start struggling with many problems. Behavioral problems are one of the biggest problems for families with children with autism. Self-harm, biting, scratching, head-banging, biting siblings and friends, kicking, and sometimes mild but often intense behavioral problems may occur.

Children with autism do not express feelings in the same way as normally developed children. Sometimes, they may express through aggressive behaviors towards other children, family members or even objects.

On the other hand, sometimes they could be aggressive toward themselves which is called “self-injurious behaviors”. They might hit, kick, throw objects or hurt themselves such as head-banging. There would be a lot of reasons why they behave aggressively. For instance;

  • Because of the lack of understanding of social cues, they can be unaware of what is happening around them. For example, when they may not understand what other people are saying, they can look at their faces without giving meaning.
  • Because of lack of speech skills and social skills, they cannot communicate about their own wants and needs. For example, when they cannot express that they do not want to do an activity or that they want a particular object from someone.
  • Because of being anxious and tense all the time. For example, when there are lots of people around them or someone hugs them without their permission.
  • Because of having sensory sensitivities, they are oversensitive to noise or they need for stimulation.
  • Because of lack of socialization, they want to escape from stressful situations, events or activities.

These are the basic examples of when children with autism become aggressive and have anger.

Struggle with aggression and anger in autism is very important at an early age. As the child grows, aggression can be difficult to cope with. The physically empowered child with autism may become more vulnerable or become more aggressive to himself and his environment. Even this situation shows the importance of early diagnosis and treatment of autism.

Understanding Aggressive Behaviours in Children with Autism Spectrum Disorder

First of all, you need to find out the cause. Then, eliminate the situation that causes aggression. If you couldn’t find the cause and the cause is unknown, so the cause may be physical pain. For example, if the child has a toothache or stomachache, the child is unable to explain the situation and can react aggressively.

Being afraid of the toilet, not being able to understand what is being said, not being able to talk, breaking out of the routine or not reaching something they want is among the reasons for aggressive behaviors.

It is very important that parents and educators should observe the child with autism very carefully. Also, it is important to find the reason for aggression with therapies and observations in the treatment of autism. Aggression can be observed in situations related to anxiety, fear, anger, insecurity, failure, and pain.

Understanding what the cause of aggression and aggressive behavior is very important. Because it can help parents and teachers to change or reduce these kinds of behaviors. ABC sandwich is the most useful method for doing that.

  • (A) Antecedents: triggers for aggressive or self-injurious behavior
  • (B) Behavior: the way the child responds to the trigger
  • (C) Consequences: rewards (or punishment depends on situations) for what your child gets out of behaving aggressively

Parents and teachers can work on the child’s aggressive behavior by changing either the triggers or the rewards the child gets from behaving aggressively or self-injuring. Understanding the child’s capability of maintaining communication is a very important step in order to find out the cause of aggressive behavior. When the child with autism cannot express feelings or cannot ask for what they need, they can exhibit anger and aggressive behaviors for communication and interaction.

Parents need to ask themselves, in the case of unclarity, whether their child is trying to tell something or not. This question will be very helpful to understand. For example, if the child does not like corn flakes but cannot tell that, the child might hit parents at home or at teachers at school as a way of saying his/her desire.

There is another important point in order to understand anger and aggressiveness. Caregivers should give answer some questions in order to clarify the problems. For example, whether it is going through the day or at intervals, whether it is more situational or not, whether the behavior is observer rarely or very often and whether the aggression towards only a particular family member and a particular gender.

Managing Aggressive Behaviors in Children with Autism Spectrum Disorder

The frequency and intensity of anger and aggression seizures adversely affect the learning quality and also life quality of children with autism. Therefore, it must be solved. The causes of anger and aggression should be found and eliminated. In the case of anger or aggression, the child with autism should not be ignored.

It should be noted that aggression is a way of expressing a situation in which the child with autism is uncomfortable. With the help of good observation, what the child wants, and what their expectations can be determined clearly.

While trying to change problem behaviors, the child should not be put in a hurry, the child should not lose confidence in parents or teachers. The behaviors should be changed step by step.

In order to make calm the child with autism, caregivers should start with choosing one behavior at a time. They need to focus on one behavior during the crisis. For example, working on turning around themselves behavior while crying.

After choosing the behavior, caregivers identify triggers and reward of the behavior. They can keep a diary of the aggressive behavior for 1 or 2 weeks for identifying triggers and rewards. It could be a good idea to include 2 weekends in the diary. Because family routines and behaviors could be different on weekends and weekdays. Even more, maybe the child would be in kindergarten on weekdays and would be at home on weekends, so the child probably exhibits different behaviors.

And then, it is time to make changes. Once caregivers know what is triggering the aggressive behavior and what the child with autism is getting from it, caregivers can use the information in order to make changes. There could be lots of ways to do that. For example;

  • Organizing predictable and applicable routines
  • Using picture timetables for understanding daily routines
  • Prepare the child with autism in case of changing routines (5 minutes warning, using pictures, social stories, etc..)
  • Having clear communication with the child and giving clear instruction such as using only one request and instruction at a time
  • Using language, symptoms, and pictures that the child could understand
  • Teaching the child how to ask for things he/she wants, needs and desires verbally or nonverbally depend on the child’s capability
  • Planning for situations that it might be difficult for the child
  • Setting up gradual introductions to the environment, taking precautions against overstimulating
  • Ignoring the child’s protest calmly, on the other hand, when the child is doing the right thing, giving plenty of praise as a reward

It should be kept in mind that one reason for aggression might be to try to attract the attention of the parents. Parents can make a list of situations in which their children become aggressive. In this way, the negativity can be removed. Instead of entering crowded places with a child with autism who overreacts voices or noise, one of the family members can do routine family stuff alone like shopping.

During the situations expressing anger and aggression, it is effective to take the child to lap and try to calm him/her down. It should be known that many things can be changed with balanced and consistent behavior training. Moreover, support must be obtained from an expert. It should be noted that parental support is very important in order to change behaviors.

For not hurting themselves or people around them in situations when the child behaves aggressively, parents take their children with autism away from the environment. This place should be isolated from any stimulation that leads to anger or aggression for them. Besides removing from the environment, parents can try to hold the children without harming them and themselves, until they become calm.

The child with autism might find it difficult while switching one activity to another. They may hit their head on the wall when someone tells them it is time to put away their toys before having lunch. Caregivers should give them a warning before. This will give them time to finish what they are doing.

In some situations, children with autism feel frustrated and need help to overcome this feeling. For example, a child with ASD has been playing with a doll and the doll’s leg comes off. Then she starts to scream immediately. And, she starts to scratch herself. If you help her by fixing the doll, this activity makes her stop hurting herself. After making her stop, parents or teacher should teach the child how she displays her frustration in another way such as by saying, signing or showing a picture in order to tell when she needs help.

When one day the child with autism came to the teacher and suddenly started to hit him, the teacher tried to understand what is going on. The child hit him and screamed. The teacher asked some question in order to understand what the problem is but the child did not understand because of communication deficits. Then the teacher showed his stomach and asked whether he is hungry. He bought food and gave to the child. After that day, whenever the child starves, he shows his stomach to the teacher and wants food from him.

If the child with autism has been doing a puzzle for 15 minutes and starts to pull mother’s hair, the child might be trying to let the mother know that the child wants to do something else rather than a puzzle. The mother should offer the child a new activity and new activity might stop the hair-pulling.

Sometimes a child with autism wants the individual around him to look at him and talk to him. If this desire could not meet, he might hit himself for drawing attention. Going next to him will stop him from hitting himself. He will understand that he takes attention. After this point, the next step would be teaching him to get somebody’s attention in another way such as saying that person’s name or coming next to that person and showing a help card in order to clarify what he wants.

If the caregiver gives the child with autism what they want, it makes the aggressive behavior stronger and makes it more likely to occur. It means the child will continue to act exactly in the same way in more or less the same situations.

For a better long term effect, there are some steps to follow. For example, caregivers need to diminish the aggressive behavior by avoiding trigger situations, the child should be thought to express needs in a more obvious way, caregivers should ignore aggressive behavior when the child exhibit and reward the child when he/she expresses himself/herself in more positive ways.

These processes could be a very difficult and challenging task for both caregivers and children to follow without professional help.

Anger and Aggressive Behaviors in Adults with Autism Spectrum Disorder

Adults with ASD may be more prone to these stressful behaviors and emotions compared to normally developed adults as children with ASD. These feelings also can be made worse by having difficulties in communicating feelings of disturbance.

Family members, partners, co-workers, and friends, basically people around the one with autism, may struggle to understand these behaviors, because as you can see it is a very hard task. While understanding and excepting that their loved one has problems controlling anger and understanding its effects on other people, it gives them the opportunity to begin to respond in ways that will help to manage these behaviors.

In some cases, the adult with autism may not understand and accept that they have anger issues and they blame other people around them. Obviously, this situation can create conflict within the people around them. So, that person needs to learn how they express their feelings. It may take lots of time. That person needs to realize and unnderstand they have anger issues and problems.

Even though there are some common causes, each person shows this anger and aggression in a unique way. It is important to make consideration of all possible influences because it could be challenging to identify the cause of anger. These influences could be relating to the environment itself, changes in daily life; physical state and mental state, and how well the person with autism is treated by those around them.

Adults with Autism Spectrum Disorder use different anger management methods rather than ADC Sandwich Method. Successful self-management of anger includes becoming motivated, self-awareness, awareness of the situation, levels of anger, coping strategies and developing an anger management record.

Becoming motivated; identifying the reason behind managing anger more successfully and identifying benefits that expected in everyday living from improving anger management.

Self- awareness; becoming more aware of personal thoughts, behaviors and physical states which are associated with anger and aggression. It is an important step in order to notice the early signs of becoming angry.

Awareness of situations; becoming more aware of the situations which are associated with them becoming angry and asking other people around them in order to describe situations and behaviors they have noticed.

Levels of anger and coping strategies; keeping a record of events that triggers and associated levels of anger and aggression. Different levels of anger and aggression can be explored and observed. Some strategies help to overcome or reduce the feeling of anger and aggression.

As an example of levels of anger and coping strategies; listing the situation, clarifying the level of anger on a scale on 1 to 10, some coping strategies depending on the people’s need. Moreover, Stop- Think techniques is a simple and effective technique for reducing the level of anger and aggression.

There are some other strategies and techniques in order to avoid the feeling of anger and aggression. These are Stop- Think technique, relaxation techniques, self-talk methods, ısing visual imagery, attending anger management classes, creative destruction or physical activity techniques and Cognitive Behavioral Therapy (CBT).

On the other hand, it is not always possible to apply those. There should be always a safety plan for situations where individuals feel they cannot control their anger because their anger will be more violent than normally developed individuals’ behaviors.

In a personal safety plan, there are some gradual steps to follow in order to reduce anger, aggression, and anxiety.

  • Planning ways to become distracted from the stressful situation such as carry a magazine
  • Explaining to another person in the environment how they can be helpful to solve the problem
  • Leaving the situation or leaving from the place if it is possible
  • Having a phone call to a friend or a crisis Centrex for talking about the cause of anger or aggression
  • Avoiding situations which are associated with a high risk of becoming angry
  • Making changes to daily routines and surroundings such as by avoiding driving in peak hour traffic
  • Exploring the benefits of using medication with a doctor or psychiatrist to overcome anger or aggression

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