HELP FOR PARENTS OF CHILDREN WITH ASPERGER'S & HIGH-FUNCTIONING AUTISM

Education and Counseling for Individuals Affected by Autism Spectrum Disorders

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Aggressive Children on the Autism Spectrum: Advice for Parents and Teachers

“I’m an elementary school teacher in the Penfield Central school district. I have a young boy (age 7) in my class with high functioning autism that shoves other classmates impulsively. I have tried behavior modification. He will say what he did was wrong, and we will roleplay the proper way to handle his frustrations. However, he still pushes other students and is running the risk of being suspended. There seems to be no pattern or functional cause for these outbursts. I want to help this special needs student, but am running out of options. Does you have any ideas that may assist me!?”

The incidence of aggressive behavior in children with High-Functioning Autism (HFA) and Asperger’s (AS) is not uncommon – and occurs for a host of reasons. Faced with a world in which they find it difficult to interact socially, communicate clearly, and control their own emotions and behavior, young people on the autism spectrum sometimes respond with aggression toward others as a way to cope.

To be effective, interventions for aggression in HFA and AS children need to take the following factors into account:

1. Aggressive kids on the autism spectrum often don't even recognize – much less feel – the suffering of others. The lack of demonstrated empathy is possibly the most dysfunctional aspect of HFA and AS. Children on the spectrum experience difficulties in basic elements of social interaction, which may include (a) the failure to develop friendships or to seek shared enjoyments or achievements with peers, (b) the lack of social or emotional reciprocity, and (c) impaired nonverbal behaviors in particular areas (e.g., eye contact, facial expression, posture, gesture, etc.). Thus, one of the dynamics involved with your HFA student is the fact that, due to his disorder, he is not aware of the fact that he is actually “hurting” other students emotionally or physically at the moment he is pushing them away. Without that awareness, he sees no need to change his behavior.

2. Children on the spectrum suffer from “mind-blindness,” which is essentially the opposite of empathy and can be described as “an inability to develop an awareness of what is in the mind of another person.” Generally speaking, autistic kids are delayed in developing a “theory of mind,” which normally allows developing children to “put themselves into someone else's shoes” (i.e., to imagine the thoughts and feelings of others). Thus, kids with HFA and AS often can’t conceptualize, understand, or predict emotional states in other people.

3. Autistic children also suffer from “alexithymia,” which can be described as a state of deficiency in understanding, processing, or describing emotions, and is defined by (a) difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal, (b) difficulty describing feelings to other people, (c) constricted imaginal processes (as evidenced by a scarcity of fantasies), and (d) a stimulus-bound, externally-oriented cognitive style.

4. Most kids on the spectrum have difficulty processing everyday sensory information (e.g., sounds, sights, smells). This is called “sensory sensitivity,” and it can have a profound effect on a child’s behavior. “Typical” children process sensory information automatically without needing to think about it much. However, children with autism have difficulty processing everyday sensory information and are much more likely to become stressed or anxious – and even feel physical pain. This can result in difficult behavior. If the HFA or AS child gets sensory overload, he may experience a “meltdown” – or simply shut down. He experiences what is known as “fragmentation” (similar to being tuned into 20 TV channels at once).

5. For many kids with HFA and AS, aggression toward others is a powerful source of self-esteem, particularly if they lack other confirmation of their human worth. Kids with autism already know that they are “different.” Many – if not most – have already been teased, harassed, bullied and rejected by peers by the time they reach the 2nd grade. As a result, their self-esteem is exceedingly low. To compensate for this, many of these children will seek revenge in the form of aggression whenever they feel slighted. This is certainly not an excuse for aggressive behavior, but it does give parents and teachers some insight into a possible root cause of the dysfunctional behavior.

6. The HFA or AS youngster who engages in aggressive behavior often views the world as an unsafe place in which there are only victims and victimizers. Thus, they choose to be one of the latter (often times at an unconscious level). The power that is felt by hurting others – in combination with already numbed emotions – can make for a destructive mixture. Aggressive children almost always think of themselves as victims (e.g., of unfair teachers, of other bullies, of prejudice, etc.) and believe that their aggressive acts are therefore totally justified. If, for example, another student bumps up against them in the hallway, they may immediately take offense, certain that they were attacked. They can’t imagine that perhaps the bumping was just clumsiness on the other student's part or an attempt to tease that really wasn't hostile.

7. Aggressive behavior in children with HFA and AS is usually a result of anxiety, which leads to difficulty letting go of an issue and "getting stuck" on something. This is rigidity, and it is the most common reason for behavioral problems. Understanding your HFA student involves knowing the traits associated with the disorder and how they manifest themselves in everyday behaviors. How does your “special needs” student see the world, think about matters, and react to what is going on around him? Reasons for rigidity in children on the spectrum include:
  • a misunderstanding or misinterpretation of another's action
  • a violation of a rule or ritual; changing something from the way it is “supposed” to be; someone is violating a rule, and this is unacceptable to the autistic youngster
  • anxiety about a current or upcoming event, no matter how trivial it might appear to you
  • immediate gratification of a need
  • lack of knowledge about how something is done; by not knowing how the world works with regard to specific situations and events, the autistic youngster will act inappropriately instead
  • internal issues (e.g., attention difficulties, oppositional tendencies, depression, anxiety, other psychiatric issues)
  • the need to avoid or escape from a non-preferred activity, often something difficult or undesirable
  • the need to control a situation
  • the need to engage in - or continue - a preferred activity, usually an obsessive action
  • difficulty transitioning from one activity to another

The following video contains information that is especially important for teachers as they try to make sense of the HFA or AS child’s thoughts and behaviors:


Here are some specific strategies teachers and parents can employ to reduce aggression in children with HFA and AS:

1. Children with HFA and AS have difficulty expressing emotions. Sometimes stress over not being able to verbalize frustration causes aggressive behavior in these young people. For example, if the youngster is angry because he can't button his coat, but is unable to describe how he feels about lacking that skill, he may act-out aggressively. Examining the root problem and addressing it can help to curb aggression. Calm reactions on the part of the teacher or parent are important here.

2. Sometimes aggressive behavior is predictable. For example, does wearing a warm winter sweater cause the child to become upset? Maybe the fabric feels uncomfortable against his skin, or the smell of the drier sheet is offensive to him. Examine every component of a situation that seems to trigger aggressive actions and make the necessary adjustments.

3. If aggressive behavior has developed suddenly or has gotten worse over time, then find out if the youngster has a food allergy. Other factors to consider are environmental conditions, change in medication, or a change in the home or school setting. Some drugs contribute to aggression. Also, seasonal or food allergies can cause discomfort that the youngster can't describe, leading to extreme behavior.

4. When the youngster with autism acts-out, the family may blame him for ALL the family's dysfunction. Oftentimes, I will see a family that will present an aggressive youngster for treatment. This is the sacrificial lamb for the family's toxicity. Moms and dads need to examine their own behavior, and if need be, the entire family should seek counseling.

5. Medications are frequently used in the management of aggression, and current psychopharmacologic treatment strategies involve treating aggression as part of each particular syndrome. Before prescribing medication for aggression, the clinician should ensure that the child has a medical evaluation to rule out contraindications to treatment and to determine whether the aggressive symptoms may improve without the use of drugs (e.g., through the use cognitive-behavioral therapy). A psychiatric evaluation is also necessary to determine whether depression, anxiety, or other problems are present. Treatment of these conditions may also result in reduced symptoms of aggression.

6. Try to promote appropriate social interactions and help the HFA or AS student “fit-in” better. Social-skills training can take place both in the classroom and in more individualized settings. Approaches that have been most successful utilize direct modeling and role-playing at a concrete level. By rehearsing and practicing how to handle various social situations, the youngster can learn to generalize the skills to other settings.

7. Try to insure that school staff outside of the classroom (e.g., PE teacher, bus driver, school nurse, cafeteria monitor, librarian, etc.) are familiar with the HFA or AS youngster's style and needs. Those less structured settings where the routines and expectations are less clear tend to be difficult for children on the spectrum.

8. Teachers should take full advantage of the youngster's areas of “special interest.” The HFA or AS youngster will learn best when an area of high personal interest is on the agenda. You can also use access to the special interests as a reward to the youngster for successful completion of other tasks, adherence to rules, and meeting behavioral expectations.

9. Put as many details as possible into an IEP so that progress can be monitored and carried over from year to year. It may be helpful to enlist the aid of outside consultants familiar with the management of young people on the autism spectrum (e.g., psychologists, psychiatrists, etc.).

10. Most autistic students respond well to the use of visuals (e.g., schedules, charts, lists, pictures, etc.).

11. Kids on the spectrum can be fairly rigid about following "rules" quite literally. While clearly expressed rules and guidelines (preferably written down) are helpful, they should be applied with some flexibility. The rules don’t automatically have to be exactly the same for the autistic youngster as for the other students, because his needs and abilities are different.

12. Keep teaching fairly concrete. Avoid language that may be misunderstood by the HFA or AS youngster (e.g., sarcasm, confusing figurative speech, idioms, etc.) Try to simplify more abstract language and concepts.

13. If motor clumsiness is a significant problem, an Occupational Therapist can provide helpful input.

14. HFA and AS kids often don’t understand rigid displays of authority – and will themselves become more rigid and stubborn if forcefully confronted. Their behavior can then get rapidly out of control. Thus, sometimes it’s better for the teacher to simply back-off and let things cool down. When possible, anticipate such situations and take preventative measures to avoid the confrontation through presentation of choices, negotiation, and diversion of attention elsewhere.

15. Classroom routines should be kept as consistent, structured and predictable as possible. Students with autism usually don't like surprises. They need to be prepared in advance for changes and transitions (e.g., schedule breaks, vacation days, etc.).

Teachers need to educate themselves about autism spectrum disorders – and how it affects behavior and the learning process. Without a clear understanding of HFA and AS, teachers will not understand the affected child’ motivations or behaviors. Actions that are clearly a part of the disorder can be confused with defiance and dealt with inappropriately. Oftentimes, the child on the spectrum who is acting-out with aggression or other forms of behavioral problems is not making a concerted effort to be oppositional, rather he is trying to cope in a world that feels hostile to him.

Teaching Social Skills and Emotion Management


COMMENTS:

•    Anonymous said… Absolutely. My daughter was having the same issue and come to find out the kids were teasing her.
•    Anonymous said… Could u maybe try to explain that because he has so much amazing energy that you could really use his help with an extra job you need some help with. Keep him extra busy , stimulated something that will help redirect the energy but also keep him engaged feeling great but that he is in control of himself and the situation( this being a healthy way)
•    Anonymous said… Draw two stick figures, one is labeled with your student's name. Show the other figure pushing your student. Ask him how his stick figure feels. Make it visual. I hope this makes sense- It works great!
•    Anonymous said… Emotion coaching - to allow you to make a connection with the child to find out what is going on in their world, it highlights that you care what they are going thru before you jump to the conclusion of what has happened.
•    Anonymous said… Have you incorporated Sensory Breaks into his school day? My son needs large muscle motor input breaks to regulate his mood. i.e.: the teacher has him carry to filled jugs of water to the office each morning, he also " gets" to help pull down the tables in the cafeteria and push them up at the end of lunch, he does pull ups and stairs when he is fidgety and sometimes pushed the book cart around in the library. These are things OT can help schedule throughout a student's day that are calming
•    Anonymous said… He is copying what is done to him behind teacher's backs. Or he is responding to these kids. These kids just are able to hide it better. Once a kid was pinching my daughter behind her back where I couldn't see. She finally admitted to it, why my daughter was hitting her.
•    Anonymous said… Honestly, sometimes I am happy she knows how to push back and doesn't take crap from anyone, but i know don't lay your hands on people.
•    Anonymous said… I agree that it is probably a reaction to something. Is it always at a certain time ie in line, when he's physically close to other kids? Could be a sensory thing ie reaction to light touch or pushing, or sensory seeking,or reaction to kids words, looks or taunts. Having had 2 of my 3 kids bullied, mean kids know how to stay under the radar.
•    Anonymous said… I found a boy i helped with at school would do this to remove people from his personal area, he would kick and push people who walked past him, i found if i moved him to the side of a foot traffic area, preferably more than an arm/leg length, and gave him another form of sensory distraction, in his case it was holding one of my braids or an earring so his touch was occupied he was able to focus more on the task without having the impulse to 'touch'(kick and punch) other people that happened to venture past him
•    Anonymous said… I love that you are asking here for advice... my son went through hell at primary and was always blamed in incidents .. he wasn't diagnosed until high school ... usually other children knowing his triggers would sneakily do something then sit back and watch the drama knowing my son would be sent home or suspended.. breaks my heart as I was always asking him to apologise ... now he finds it hard to deal with authority
•    Anonymous said… I'll bet that technically his behavior is not aggressive but rather is reactive-- at least in HIS mind he's protecting his space or defending some line. Or, as Trina outlines above, frustrated at others stepping out of line.. Aspies tend to have very linear thinking, and are big on following rules, so adults need to teach them to live within a "no touch" rule, and provide an alternate behavior to diffuse the frustration. Oh, and meds may help lengthen his fuse.
•    Anonymous said… It could be a sensory issue. What if he had some time in a motor room or by himself to take a break and do some wall push ups? Scheduled breaks to decrease sensory over load before it occurs work better than randomly waiting until you ( or he) think he needs a break.
•    Anonymous said… My 10 year old is this way with younger brother. I just hope it never happens at school.
•    Anonymous said… My daughter does this exact thing, no matter how many times we all try to explain, she can't see to control it....
•    Anonymous said… My daughter used to get enraged with the kids around her at that age because they weren't following directions. She would follow the rules but others around her would be talking or turned around-touching walls or art hanging from the walls. She would usually start by stating the rule to them quietly; offering to help them but she would end up screaming at them. She had a couple of kids who were button pushers and they would make faces at her. I would try moving him to the front of the line or give him a job in line that requires carrying something for the teacher or himself. I'd prefer a child not have a fiddler or something out of the ordinary as the goal is to learn age-appropriate behaviors that they can continue to refine.
•    Anonymous said… My daughter was the same, from primary where the boy nxt to her poked her with a pencil then laughed when she lost it in class to being beaten up in college for her smart mouth instead of just walking away  :( And no amount of trying to explain to teachers worked either
•    Anonymous said… my son is the same age and does the same thing. He is in an EC class. Rewards don't work for him. All of his teachers since preschool agree that rewards do not work for him. My son only has 7 kids in his class and is not being bullied. I know a lot of kids are. My son does get suspended for any pushing offense.
•    Anonymous said… My son was like that, HFA now 8. He felt he should take things into his own hands, like he was on par with adults. I think the main cause behind it though was was suffering with high anxiety at the time between sensory difficulties and struggling to cope in the normal school environment without and support (prior to any diagnosis). I believe over time it has improved but reality is though children with AS can be easy targets in school, whereby other children deliberately target them to frustrate them in order to receive a reaction- as was in my son case some of the time. Other times it was misunderstanding a social situation. I would say since he was support with part time SNA, Resource hours, visual schedules, Movement breaks, OT as well as overall others adults having a better understanding of his needs he is generally less likely to behave in this manner (I guess he hasn't got the same level of anxiety). I also completed a social story about adults being in charge. And most importantly when my son finally did approach a teacher or member of staff about a grievance he was listen to and it was addressed. When he does this I make a point of telling him well done, highlighting that this was the best option and we discuss the "what if" had he not done so. Bear in mind typically he would have difficulties expressing his angry verbally, restraining him self from reacting and was normally in Trouble with the staff for his physical behaviour! Eventually things did change, but we still have moments, more so at home on hitting when tired, frustrated etc
•    Anonymous said… My son will explain to me (when he's calm) what instigated it, there could have been an incident that occurred some time ago but there is always a trigger
•    Anonymous said… My son's aggression vanished once the teacher implemented Sensory breaks every 1-2 hrs. Swueexing TheraPutty is also a nice break, chewing gum , bouncing on a therapy ball or minitramp.. It just might prevent a suspension
•    Anonymous said… My suggestion is to investigate whether or not the other kids in the class are doing things that trigger his behavior. Many times a spectrum kiddo with react to something like name calling or other types of bullying by becoming aggressive and sadly, many times, the focus is only on the spectrum kiddo. As care givers (and I count teachers in that category as well) we have to broaden our thinking. Consider how you might want to behave if your co-workers treated you differently by bullying you in some way. Now consider how a child has less ability to control their emotions. Talk with him maybe do a timeline of the last couple of days in class to see if you can find a trigger to his behavior. I do a linear timeline like "So you got to school and what did you do first?" "And then what happened?"... and so on. You might be surprised at what you find when you explore his world a little more closely. Social isolation and harassment can make people of any age become aggressive and most kids on the spectrum are treated vastly different because they behave differently. Also consider what his options are if he is getting mistreated by classmates. For instance, does he have the option of having sensory breaks? Does he have a person he can go speak to about things that make him upset outside of the classroom? Does your school have a "safe room" for kids to go to when they're feeling overwhelmed or angry? All of these things make a child feel as though they are welcome and cared for in the school environment and all too often schools don't take the time to make small adjustments that provide a more inclusive environment for everyone. I appreciate that you care enough to put the question to the group. I hope some of my suggestions are helpful.
•    Anonymous said… Other kids do things to my son in class that frustrate him. High functioning autism is hard because we forget how sensitive they really are. The smells, the sounds, even how something feels can throw them over the edge. Parents have to be involved with home intervention as well. It takes a village.
•    Anonymous said… reward system for not shoving is necessary. He won't learn anything just by reminders, he does not have the empathy or social skills to understand his affect on others, he just does what comes naturally. A social story is a start, but definitely needs a reward system to make him feel motivated to change.
•    Anonymous said… The issue is sometimes it's just rage. They have no control. They don't even remember whats just happened sometimes. Its not behavior. It's a response.. prevention is better than a cure. Triggers can be something not so obvious.. over stimulation, irritation... learning the triggers is hard because they're not always obvious but its the only way  :(
•    Anonymous said… The only person my 10 year old high functioning aspie is aggressive with is his older brother. He happens to be a button pusher and knows every single button to push. Start watching for the subtle ways your student's buttons are being pushed. They are there I promise.
•    Anonymous said… There may "seem to be" no cause, but get someone to actually watch the class for a while and you might find some kid is very sneakily winding them up while no one is looking. It's surprisingly common. Apart from that look fir triggers, other kids too close, background noise, florescent lights. Neurotypical folks gave no idea just how maddening those things can be.
•    Anonymous said… Watch what the other kids are doing to him. Observe. You may see whispered taunts, them making faces at him, anything to get him into trouble for this. "Accidentally" shoving into him as they walk past.

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