"Blind Rage" in Children on the Autism Spectrum

"How can you handle an explosive child (high functioning autistic) who has tantrums and/or meltdowns that end up becoming violent in nature?"

Some children with Aspergers and High-Functioning Autism (HFA) are known for their “explosive” and “out-of-control” behavior. This is referred to as “blind rage.”

A blind rage is “blind” in the sense that the affected child may not be totally aware of his or her behavior during the rage episode.  It’s a feeling of intense and growing anger that is associated with the fight-or-flight response, but should not be confused with temper tantrums or meltdowns.

During a tantrum, the child is aware of his or her behavior and motives, whereas rage occurs in a semi-conscious state. Meltdowns are driven more by anxiety-related issues (e.g., sensory sensitivities), whereas rage is driven more by anger-related issues and a need to retaliate.

An Aspergers or HFA child with ADHD and/or ODD has an increased susceptibility to blind rage. Rage can sometimes grow to the point where the child is capable of doing things that may normally seem physically impossible. Children experiencing rage usually feel the effects of high adrenaline levels in the body. This increase in adrenal output raises the physical strength and endurance levels of the child and sharpens his or her senses, while dulling the sensation of pain.

Children in a blind rage have described experiencing events in “slow-motion.” An explanation of this "time dilation" effect is that, instead of actually slowing the perception of time, high levels of adrenaline increase the ability to recall specific minutiae of an event after it occurs. Since people ordinarily gauge time based on the amount of things they can remember, high-adrenaline events, such as those experienced during periods of blind rage, seem to unfold more slowly.

A child in a state of rage also loses much of his capacity for rational thought and reasoning, and may act (usually violently) on his impulses to the point that he may attack until he has been restrained, or the source of his rage has been “destroyed.”

A child in a blind rage may also experience tunnel vision, muffled hearing, increased heart rate and hyperventilation. She often focuses only on the source of her anger. Also, the large amounts of adrenaline and oxygen in the bloodstream may cause her extremities to shake.

==> Preventing Tantrums, Rage and Meltdowns in Children with Aspergers and High-Functioning Autism

Blind rage has three components:

1. The first component is the emotion itself, defined as an affective or arousal state, or a feeling experienced when a goal is blocked or needs are frustrated. For example:
  • Conflict over possessions, which involves someone taking the child’s property or invading his space.
  • Issues of compliance, which often involve asking or insisting that the child do something that she does not want to do (e.g., brushing her teeth).
  • Physical assault, which involves one youngster doing something to another youngster (e.g., pushing or hitting).
  • Rejection, which involves a youngster being ignored or not allowed to play with peers.
  • Verbal conflict (e.g., a tease or a taunt).

2. The second component of rage is its expression. Some Aspergers and HFA kids vent or express rage through facial expressions, crying, sulking, or talking, but do little to try to solve a problem or confront the “offender.” Others actively resist by physically or verbally defending their positions, self-esteem, or possessions in non-aggressive ways. Still others express rage with aggressive revenge by physically or verbally retaliating against the “offender.” Some kids on the autism spectrum express dislike by telling the offender that he or she can’t play or is not liked. Others express rage through avoidance or attempts to escape from the “offender.” And some use “adult-seeking” (i.e., looking for comfort or solutions from a parent or teacher, or telling the adult about an incident).

3. The third component of the rage experience is understanding (i.e., interpreting and evaluating) the emotion. Because the ability to regulate the expression of rage is linked to an understanding of the emotion, and because these kids’ ability to reflect on their rage is somewhat limited, they need guidance from parents and teachers in understanding and managing their feelings of rage. The development of three basic cognitive processes undergirds autistic kids’ gradual development of the understanding of rage:
  • Memory: Memory improves substantially during early childhood, enabling children to better remember aspects of rage-arousing interactions. Aspergers and HFA kids who have developed unhelpful ideas of how to express rage may retrieve the early unhelpful strategy – even after parents and teachers help them gain a more helpful perspective. This implies that adults may have to remind some these young people (more than once or twice) about the less aggressive ways of expressing rage.
  • Language: Talking about emotions helps them understand their feelings. The understanding of emotion in these young people is predicted by overall language ability. Parents and teachers can expect individual differences in the ability to identify and label angry feelings because the kids’ families model a variety of approaches in talking about emotions.
  • Self-Referential and Self-Regulatory Behaviors: Self-referential behaviors include viewing the self as separate from others and as an active, independent, causal agent. Self-regulation refers to controlling impulses, tolerating frustration, and postponing immediate gratification. Initial self-regulation in kids on the spectrum provides a base for parents and teachers who can develop strategies to nurture these kids’ emerging ability to regulate the expression of rage.

Techniques to help children with Aspergers and High-Functioning Autism learn to deal with blind rage:

1. All of us exhibit some "signs" just as we begin to get angry. So, it’s actually fairly easy to identify the “rage signs” in a youngster with Aspergers or High-Functioning Autism. For example, you may detect a certain "look in the eye," a tone of voice, or a tightness in the child’s body. Thus, your first course of action is to help your youngster observe these signs right at the onset of rage. Once Aspergers kids can identify the early signs of their rage, they can also learn to diffuse it by self-soothing techniques (e.g., walking away, taking full and vigorous breaths).

2. Train your youngster to respond to your "signal" (e.g., a hand motion) to stay calm. Give that signal as soon as your youngster starts "stewing" about something. If your Aspergers youngster is too young for such self-control techniques, use distraction as soon as you notice her exhibiting a rage sign. A distraction, in order to be effective, has to be of interest to the youngster (e.g., suggest to her "let's ride a bike" or "let's play ball").

3. Teach your kids to talk about how they feel. Give them a language to express their feelings. If they are too angry to talk or don't have the words to express their feelings, ask about the feelings relevant to the specific situation. For example, "Do you feel rejected?" "Hurt?" "Let down?" …etc. When your youngster expresses the feeling behind her rage (e.g., embarrassment or rejection), suggest some other ways to look at the same event that might not be embarrassing or humiliating.

4. The thought, "It's not fair," is a big rage-arouser for many Aspergers and HFA kids. If that is the case, ask them, "Do you feel you are being treated unfairly?" When your youngster answers the question, listen and don't rush to negate his feelings.

5. If the youngster refuses to be distracted or engaged in dialoguing about her rage and starts yelling, stomping or breaking an object, impose appropriate consequences. But have these consequences in place ahead of time to serve as a guideline. That means that you have discussed them with your child beforehand and written them out for future reference. Armed with a list of consequences (which preferably consist of withdrawing privileges or charging the youngster a "penalty"), moms and dads should encourage their child to choose such alternatives as doing something else, walking away, or talking about the rage rather than acting out of rage.

6. How about your own rage in response to your youngster's rage? You can set an example of rage control for your youngster. No teaching technique is as effective as a parent "modeling" for the youngster with his or her own example.

7. One thing that makes many moms and dads angry is to see their youngster challenging their authority and defying them. Sometimes it may appear so, but that may not be the intention of the youngster. For example, a child may be too unhappy to be told ‘no’ because he or she wants something so badly. Of course, you shouldn't give in to the child’s demands, but try to understand what might really be his or her intention.

8. Some kids on the spectrum get upset when they know they made a mistake. Instead of admitting their mistake, they act out in rage to deflect the attention off them. If you realize that this might be the case, it's helpful to say to your youngster, "Everyone makes mistakes. I am okay with it. Don't feel so bad about it."

9. Aspergers and HFA kids that lash out at others should be often reminded of such consequences as losing privileges at home, going to the Principal's office at school, and being restrained.

10. If the rage outbursts occur in relation to the siblings, and you didn't observe the whole interaction from the very beginning, it's better to impose a penalty on both siblings.

==> Preventing Tantrums, Rage and Meltdowns in Children with Aspergers and High-Functioning Autism

11. Some of these young people get angry because they don't have appropriate peer-interaction skills. For example, they don't know how to join in a conversation or a game. They abruptly try to get in. When resisted or rejected by peers, they explode. Teaching appropriate social skills can go a long way to avoid such negative encounters.

12. Parents can establish a home environment that reduces rage and teaches tolerance. For example, they can set a personal example for their son or daughter that "big people do apologize” and “it's graceful to loose and try again.”

13. Parents and teachers can use guidance strategies to help these kids express angry feelings in socially constructive ways. These kids develop ideas about how to express emotions primarily through social interaction in their families, and later by watching television or movies, playing video games, and reading books. Some have learned a negative, aggressive approach to expressing rage, and when confronted with everyday conflicts, resort to using aggression at home or in the classroom. A major challenge for parents and teachers is to encourage Aspergers and HFA kids to acknowledge angry feelings and to help them learn to express anger in positive and effective ways.

14. Create a safe emotional climate. A healthy environment permits these children to acknowledge all feelings – pleasant and unpleasant – and does not ‘shame’ rage incidents (e.g., “You should be ashamed of yourself for acting this way!”). Healthy environments – whether at home or at school – have clear, firm, and flexible boundaries.

15. Encourage them to label feelings of rage. Parents and teachers can help children produce a label for their rage by teaching them that they are having a feeling and that they can use a word to describe. A permanent record (e.g., book or chart) can be made of lists of labels for rage (e.g., angry, mad, hot, irritated, annoyed), and the child can refer to it when discussing angry feelings.

16. Encourage them to talk about rage-arousing interactions. These kids better understand rage and other emotions when grown-ups explain emotions. When these kids are embroiled in a rage-arousing interaction, parents and teachers can help by listening without judging, evaluating, or ordering them to feel differently.

17. Help your youngster develop self-regulatory skills. Parents of children on the autism spectrum do a lot of “child-regulation work" (i.e., doing things ‘for’ their child rather than ‘with’ their child). This is because parents know that their child has a very limited ability to regulate emotions. As Aspergers and HFA kids get older, grown-ups can gradually transfer control of the self to their kids, so that they can develop self-regulatory skills.

18. Model responsible rage management. They have an impaired ability to understand emotion when adults show a lot of rage. Adults who are most effective in helping kids manage rage model responsible management by acknowledging, accepting, and taking responsibility for their own angry feelings, and by expressing anger in direct and non-aggressive ways.

19. Use books and social stories about rage to help them understand and manage it. Well-presented stories about rage and other emotions validate a kid's feelings and give information about rage. It is important to preview all books about rage, because some stories teach irresponsible rage management.

20. Special needs children that are guided toward responsible rage management are more likely to understand and manage angry feelings directly and non-aggressively and to avoid the stress often accompanying poor rage management. Parents and teachers can take some of the bumps out of understanding and managing rage by adopting the positive guidance strategies listed above.

Resources for parents of children and teens on the autism spectrum:


•    Anonymous said... I just booked an appointment for my daughter to see a specialist about her out of control rages, we're talking, growling, hitting, screaming, breaking, etc. multiple times a day at home, school, etc. Taking her off dairy has made a big difference. Her brother, who has ADHD and Asperger's, has finally turned around this year from out of control to the best behaved because of parent training, behavior therapy, and medicine. However, what is rigidity of thought frustration in a boy changes to emotional explosions in his sister. Feeling confidant because brother has become so successful.
•    Anonymous said... i'm not a fan of meds, especially for the young ones, we kept encouraging better ways to express feelings, use your words, take deep breaths, count when frustrated, 2+ years of consistently encouraging this has paid off, but what also had a big impact on turning things around for the better was identifying the triggers (rigidity of thought, crowds, loud noises, peer interactions), getting special accommodations at school, and having an IEP at school for occupational therapy and extra assistance at busy times (when he struggles to cope). I'm talking about serious ear piercing or destructive tantrums that can last well over an hour, even a couple hours. (not just the average child tantrum), we've managed to help him cope so much better now, and he's happier at school for it. A rage tantrum now might last 5 to 10 mins as we or a teacher will guide him down, they happen far less these days. I highly advice reading up on what you can do and using all the school resources you can to help your child. Also once you learn the triggers you can avoid some, go to park at times when it's most quiet, plan swim lessons before the pool opens, find the quietest beaches, small playdates, avoid crowds etc.
•    Anonymous said... My son has developed these within the past several months. It's tied in with his OCD. We're not supposed to talk about medication here.....but from what I understand this is the best solution for this type of problem. Really the only potential solution.
•    Anonymous said... This is my son, does anyone have any suggestions to curb these 'blind rages'.
*   Anonymous said... My son is 10 and his behavior has regressed in the past year. He has OCD which triggers his rage. The "attacks" are mentally and emotionally draining on every member of our family, and that is putting it very mildly. His pychiatrist has suggested he be put on Abilify, and after years of resisting this particular drug, we are being forced to try him on it I'm not happy about it AT ALL, but can't see any other solution.

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