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How to Respond to a Frustrated Child on the Autism Spectrum

“Any advice for helping my child (high functioning) to manage frustration over seemingly small things? Even something as minor as losing a game of checkers turns into a major riot, which in turn aggravates me to no end.”

Young people with ASD level 1, or High Functioning Autism (HFA), are easily frustrated. Living in the "typical" world can be confusing, and they need to have someone there to translate and explain every day events to them. All kids get frustrated, and all kids need to learn to manage those frustrations. As a parent, your challenge is to communicate effectively and to try not to get frustrated yourself. Here's how:

1. When something irritates you, tell your HFA youngster what you are feeling so he can learn to recognize emotions in others and label them in himself. Then talk (out loud) yourself through the frustration so that your youngster can hear your “positive spin” on the situation  (e.g., “This is really not a big deal” … “I need to calm down” … “Relax and take a few deep breaths” … “It’s okay, I can deal with this”).

2. Any time you encounter frustration while in the presence of your HFA youngster, imagine that she will replicate your exact behavior every single time she is frustrated for the rest of her life—so proceed carefully! Take care not to raise your voice too loudly, or be disrespectful to others. If you do any of these things, make sure to tell your youngster that you made a mistake behaving in that way and need to make a better choice next time.

3. Make sure that your youngster is given a few opportunities to play with other kids in situations where close adult supervision is not required. Parents should be responsible for ensuring their child’s safety, but other than that, try to let your child and his peers work out problems among themselves. When kids play independently, they learn how to deal with frustration in ways other than letting grown-ups solve their problems.

4. Do not accidentally teach your HFA youngster that expressing frustration inappropriately (e.g., screaming or hitting) is a good way to get your attention, even if it is negative attention. Ignore these behaviors if they're not causing serious harm, and give lots of positive attention for times when your youngster handles a potentially frustrating situation in a healthy manner, and point out specifically what he did effectively. 
 

5. When you see your youngster become frustrated, try not to mirror that frustration in your own voice or behaviors. Instead, focus on staying calm and talking your youngster through the situation in a gentle voice, guiding him to mirror you. Acknowledge that he is frustrated, but stress the importance of continuing to try to do something that he may find difficult.

6. Give ample attention to acceptable behaviors so that your HFA youngster learns about positive consequences as well. Use a behavior chart as a visual aid to assist her in developing awareness regarding how she handles her frustrations. Place a sticker, happy face or star onto the chart whenever she remembers to manage her reactions in a positive way. Keep track of how many stickers she has accumulated, and reward her with a special activity once she reaches a predetermined goal.

7. Keep your youngster’s world as predictable and routine as possible. If HFA kids feel confident and secure in general, they will be able to handle minor setbacks and frustrations.

8. Look for opportunities to challenge your “special needs” child. Routinely ask her to do things that are slightly beyond what she has been capable of doing in the past. Do not jump in to help her. If you see her struggling, instead of immediately helping, try to prompt her by offering hints to make the situation easier. If she is really having difficulty and does not seem to be making any progress, break the task down into small steps. If necessary, guide her through (or even do the first step for her), and then back off again. Your youngster should be hearing the following phrase over and over again: “Try it yourself first, and if you have a problem doing it, I’ll help you get started.”

9. Use your youngster’s teacher as a resource. Ask for suggestions about how the school deals with frustration in students in general, as well as for specific tips about helping your youngster. The more that you can be consistent with what the school is doing, the easier it will be for your youngster to internalize the lessons that you and the teacher are trying to teach.

10. Help your youngster learn the important skill of “delayed gratification.” Autistic kids do not yet have the brain development or experience to effectively cope when they have to wait for what they want, so parents have to give them practice developing this skill. As much as possible, have your child wait for what she wants, even if it's just for a minute or two. Talk to her about how to distract herself while she is waiting for something.

11. Every evening, review the day with your youngster to discuss how she handled various situations throughout the day. Always bring attention to the positive behaviors she displayed during the day. Reiterate the consequences that occurred in different scenarios to help her understand how her behavior affected both herself and others.

12. If your son or daughter is an adolescent, remember that all adolescents struggle with testing limits, learning to make their own decisions, and learning to function independently. All adolescents struggle with making and keeping friends, with finding success at school, and even with the development of romantic relationships. Your autistic teen may be more frustrated than a “typical” teen, but he may not have the skills to handle those frustrations. So, set appropriate limits while trying to give your teenager some leeway to function independently.




An ASD youngster can grow frustrated when an obstacle arises in his effort to achieve a goal. However, frustration can prove a valuable emotion; it can motivate the youngster to surmount the obstacle with an extra spurt of determination and initiative. Parents can use the techniques listed above to help their “special needs” children deal effectively with day-to-day frustrations.
 

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

==> Videos for Parents of Children and Teens with ASD
 
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By

The Easily Discouraged Student on the Autism Spectrum: Tips for Parents and Teachers

"I need some ideas on how to build some confidence in one of my students who has been diagnosed with autism recently (high functioning). Now that he knows he has this condition, his self esteem has taken a turn for the worse. He won't even hand-in assignments because he's sure (in his mind) he will get an 'F' (which he does for not handing it in), which just reinforces his negative view of himself."

If you have a youngster with Asperger’s (AS) or High-Functioning Autism (HFA), you’ve likely experienced some aggravation over the numerous outbursts and unexpected meltdowns brought on by an unexpected trigger.

However, many of the triggers that result in behavioral issues may be directly related to the child’s frustration over not being able to complete a certain task or perform to his or her self-imposed expectations. This can, in turn, contribute to feelings of discouragement that result in the child “giving-up” (i.e., refusing to give things a second try).

The easily discouraged AS or HFA child may exhibit any or all of the following:
  • a general pervasive mood of unhappiness
  • a tendency to develop physical symptoms or fears associated with personal or school problems
  • aggressive and even violent behavior
  • difficulty building or maintain interpersonal relationships
  • discipline problems at home and/or school
  • inappropriate types of behavior or feelings under normal circumstances
  • lack of social-interaction skills
  • low self-esteem
  • mild to severe defiance issues toward parents, teachers, and other authority figures
  • severe academic and/or social frustration
  • trouble bringing emotions under control

There are two schools of thought when it comes to the education of the easily discouraged child. Some educators believe the Least Restrictive Environment (LRE) is in the “mainstream” classroom, while others believe the LRE should be in an environment that gives the correct amount of structure for that individual youngster. No matter where the youngster is placed, the right techniques can help in the right kind of environment. Research has shown that AS and HFA kids do best in an environment that is predictable, stable, and structured. These kids need help in frustration-management and self-control through coaching, modeling, and teaching.



Assessing social skills is very important for understanding emotional problems.  Observations of the AS or HFA youngster’s behavior with friends, classmates, and grown-ups in natural settings (e.g., special education classroom, lunch room, recess, etc.) can provide information about social skills and relationships that is crucial when reporting on a potential emotional disturbance case. Observing behaviors during social skills instruction or role-playing situations provides a more direct method for measuring specific social areas (e.g., social problem solving, social reasoning, etc.).

==> Resource for Teachers: Teaching Students with Asperger's and HFA

The following strategies can be highly effective with children exhibiting frustration and other emotional problems in the classroom:

1. Ask – don’t tell: If the child has a positive relationship with the educator, it may be effective just to “ask” that the unwanted behavior stop due to the problems that it’s creating in the classroom. In this way, no consequence or reward is intended or implied; rather, it’s just a simple, straightforward request from teacher to student.

2. Teach problem solving skills: Help the AS or HFA child to solve his own problems, and reinforce responsibility. By doing this, you imply that the child is not a helpless victim, that he is powerful and can take control of many aspects of his lives. Ask leading question, such as: What is the problem? What have you done so far? What else can you do? What is your next step?

3. Change of environment: Remove the AS or HFA child from a stressful situation before inappropriate behaviors occur; however, be careful not to inadvertently reward the other child (or children) who may be instigating the problem.

4. Impromptu change of activities: If an activity is not successful, change it as quickly as possible. Try to always have a backup plan (e.g., moving from an interactive game to something like Bingo that requires no interaction). This can be done smoothly when a group is becoming over-stimulated. At other times, offering a choice may be more effective (e.g., the children can choose to cover information orally through discussion, or copy notes from an overhead projector).




5. Bonding: Connect with the “special needs” student at a very personal level by discovering as much as possible about him. Find out more than just his challenges – discover his strengths and interests, too.

6. Intentional ignoring: Behaviors that are exhibited for the purpose of attention-seeking and don’t spread or interfere with safety or group functioning may be effectively terminated through intentional ignoring; however, this strategy should never be used with aggressive behaviors. The classmates of the AS or HFA student may need to be taught to do this as well, because peer-attention can be even more powerful than adult-attention for some kids.

7. Forget about “attitude”: Do not criticize the “easily discouraged” child for having a bad attitude. Of course he has a bad attitude! His attitude reflects his experience. For a child that has experienced a lot of frustration and discouragement in the classroom, to have a “positive attitude” about school would be unreasonable. Nonetheless, the “special needs” child is often scolded for his poor attitude. Change his experience from frustration to success, and his attitude will follow – and so will his behavior.

8. Kick start: When it appears that the child is beginning to feel frustrated, assist him with the difficult section(s) of a task or assignment.

==> Resource for Parents: Teaching Social Skills and Emotion Management

9. Do a success review: When the child does experience success, talk about what effort made that success happen, specifically, and insist on pride in that effort and the increasing level of skills that follow.

10. Nonverbal signals: If the child is calm enough to respond, has a positive relationship with the educator, and is free from uncontrollable impulses, a nonverbal cue (e.g., softly snapping the fingers) might be all that is needed to assist the child in regaining focus.

11. Learning from mistakes: Teach the child to learn from – rather than feeling defeated by – mistakes. Reaffirm that “learning from making mistakes” is often the best form of learning.

12. Rearranging: Change the seating arrangement or the small-group assignments of children to avoid specific behavioral problems; however, try to do this in a non-punitive and undetectable way.


13. Restriction of tools and space: Rather than taking away certain items that distract after the child is already engaged with them, keep them out of sight from the start. This is crucial when meltdowns escalate to unnecessarily dangerous or reinforcing proportions due to a lot of extra items being available for breaking and/or throwing.

14. Use of distraction: Change the activity or tempo, comment on the child’s work, or ask about a known interest related to the assignment if the child shows signs of frustration or restlessness. Be sure to do this BEFORE off-task behavior occurs.

15. Use of humor: Humor can often stop unwanted behavior if it’s used in a timely and constructive manner. (Note: sarcasm, even of a friendly nature, is not an appropriate use of humor for AS and HFA students).

16. Use of proximity and touch: Move closer to the child experiencing frustration, or place your hand on his shoulder. In this way, you are showing support in a nonthreatening way; however, when using this strategy, avoid using it as an opportunity to point out inappropriate behavior. Also, comment positively on any move toward compliance.

17. Use of routine and structure: Schedules and routines are often overlooked by teachers when considering behavior-management interventions. Knowing what to do – and when to do it – provides a sense of safety, structure, and predictability for children who may not experience such structure in other areas of their lives.

In a nutshell, here’s how can you break the cycle of frustration and resultant discouragement. The “special needs” child must: 
  • Never feel anonymous
  • Learn the satisfaction of hard work done well
  • Learn the pleasure of mental involvement
  • Have clear evidence of accomplishment attributable to skill and effort rather than luck or easy work
  • Feel valued and cared about
  • Experience a classroom that is free of negative competition and peer-pressure
  • Be with grown-ups who like him – and demonstrate it
  • Be taught to take himself seriously as a learner

By

Understanding the Triggers Behind Outbursts in Autistic Children and How to Address Them

Navigating the complexities of Autism Spectrum Disorder (ASD) often involves understanding and addressing emotional outbursts in autistic children. These outbursts can be challenging for both the child and their caregivers. By delving deeper into the specific triggers that lead to these emotional reactions, we can develop more effective strategies to support autistic children in managing their emotions and behavior.


#### Common Triggers for Outbursts


1. **Sensory Overload**: Many children with autism experience heightened sensitivity to their sensory environment. For example, a child may find themselves overwhelmed in bustling places with bright fluorescent lights and loud, unpredictable noises. The cacophony of a school cafeteria or the chaotic atmosphere of a shopping mall can lead to sensory overload. Signs of this distress might include covering their ears, tightly closing their eyes, clenching their fists, or withdrawing physically. Identifying these early warning signs can help caregivers intervene before an outburst occurs.


2. **Communication Difficulties**: Expressing thoughts and emotions can be particularly challenging for autistic children, who may struggle with verbal communication. This can lead to immense frustration, particularly in situations where they need to voice their feelings or needs. For instance, if a child is in pain or discomfort but cannot articulate what is wrong, they may resort to an outburst as a way to express their distress. Utilizing visual communication aids or alternative methods, like picture exchange systems, can empower children to express themselves more effectively.


3. **Changes in Routine**: For many autistic children, routine offers a sense of security and comfort. Unanticipated changes, such as a variation in the school schedule, a last-minute change in family plans, or even a different route during a daily commute, can disrupt their sense of stability. The anxiety stemming from these changes can quickly escalate, causing frustration and leading to outbursts. Preparing the child for upcoming changes through visual schedules or social stories can help ease transitions.


4. **Emotional Dysregulation**: Autistic children may experience emotions with greater intensity than their peers, making it difficult for them to manage feelings of anxiety, sadness, or anger. For example, a simple disappointment—like not being able to play their favorite game—might trigger an overwhelming emotional response. Teaching coping strategies for managing intense emotions is essential. This can include creating a "calm-down" corner equipped with soothing items like stress balls, calming visuals, or a cozy blanket.


5. **Social Situations**: Engaging with peers can often pose challenges for autistic children due to difficulties in interpreting social cues and norms. An invitation to a friend's birthday party might seem exciting but simultaneously intimidating. If a child misreads a social interaction, such as a misunderstanding during play, it can lead to feelings of isolation and frustration, resulting in an outburst. Practicing social interactions in a safe environment can help children build confidence in their social skills.


#### How to Address Outbursts


1. **Identify Triggers**: Keeping a detailed log of when outbursts occur can highlight patterns and specific triggers associated with them. Note the time of day, environment, and emotional state leading up to the outburst. This careful observation will help develop tailored interventions that suit the child's unique needs.


2. **Create a Structured Environment**: Establishing a predictable daily routine can instill a sense of security for autistic children. Visual schedules can be a powerful tool, showing clear representations of daily activities. Additionally, preparing the child in advance for any changes by using social stories can ease anxiety, providing them with a sense of ownership over their routine.


3. **Teach Emotional Regulation**: Provide children with a set of coping strategies to manage their feelings constructively. Techniques might include deep breathing exercises—such as inhaling for a count of four and exhaling for a count of six—or activities that encourage self-soothing, like squeezing a stress ball or practicing yoga. Making these strategies a regular part of the child’s routine can help them utilize them effectively when needed.


4. **Provide Sensory Breaks**: Integrating scheduled sensory breaks throughout the day can help prevent overwhelming situations. These breaks can involve quiet time, sensory play dough, or a designated calming area equipped with noise-canceling headphones and weighted blankets. Allowing the child to engage in calming activities can serve as a proactive measure against sensory overload.


5. **Use Clear Communication**: Simplifying and clarifying communication can significantly reduce instances of frustration. This could mean using short, direct phrases, supplemented by visuals or gestures that help convey messages. Providing consistent language around expectations can help the child feel more secure in their understanding of what is happening.


6. **Model Coping Strategies**: Actively demonstrate how to cope with challenging emotions in everyday situations. This might look like verbalizing your own frustration when encountering a minor setback, stating, “I am feeling upset because the traffic is bad. I will take a few deep breaths to feel better.” This kind of modeling provides a tangible reference for children, showing them healthy ways to handle frustration.


7. **Involve Professionals**: Collaboration with professionals, such as occupational therapists or psychologists, can offer tailored insights and strategies that address the child’s specific challenges. These experts can assist in developing individualized plans that incorporate effective coping tools and sensory integration techniques.


8. **Stay Calm and Consistent**: Remaining composed during an outburst is crucial. Acknowledge the child's feelings without raising your voice or showing frustration. A calm demeanor can reassure the child and set a tone of safety. Establishing consistent responses to behavior can help them internalize boundaries and expectations.


### How Engaging with Stories of Autistic Children Can Foster Understanding


In a world that thrives on diversity, nurturing empathy and understanding towards individuals with Autism Spectrum Disorder (ASD) is crucial. Engaging with the deeply personal stories of autistic children serves as a vital pathway to cultivate that empathy. These narratives—whether conveyed through books, films, art, or direct experiences—offer insight into their unique challenges, perspectives, and triumphs, ultimately allowing us to bridge the gap of understanding and foster inclusive communities.


#### The Transformative Power of Storytelling


Storytelling is one of humanity’s oldest traditions, serving as a bridge across cultures and experiences. It has the profound ability to transport us into the lives of others, enabling us to perceive the world through their eyes. For autistic children, sharing their stories can unlock a treasure trove of insights into their lives, allowing others to grasp the complexities they navigate daily. These stories often showcase:


1. **Everyday Challenges and Victories**: Narratives detailing the daily lives of autistic children can illuminate the myriad struggles they face. For example, a story narrated by an autistic child might describe their overwhelming experience in a crowded school hallway filled with loud noises and bright lights. Readers can gain a visceral understanding of their anxiety as they navigate this chaotic environment. Furthermore, tales of small victories—like successfully engaging in a conversation or participating in a class activity—can highlight their resilience and determination.


2. **Vivid Perspectives**: Autistic children often interpret the world in remarkably unique ways, bringing fresh insights that challenge conventional thinking. For instance, a child might express a profound appreciation for patterns they observe in nature or a fascination with intricate detail in everyday objects. A story that captures these perspectives not only emphasizes their creativity but also encourages others to see beauty in diverse forms of cognition.


3. **Emotional Depth**: Engaging stories resonate on an emotional level, allowing readers to connect with feelings of joy, frustration, loneliness, or pride experienced by the child. A poignant narrative about a child’s cherished moment—like finally making a friend at recess after overcoming social hurdles—can evoke deep empathy and inspire readers to reflect on their own experiences of connection and acceptance.


#### Immersive Engagement with Stories


To truly immerse ourselves in the stories of autistic children, consider these specific and impactful approaches:


1. **Literature and Visual Media**: An extensive array of literature exists, from children’s books featuring relatable autistic protagonists to documentaries that celebrate their lives and experiences. For example, engaging with a beautifully illustrated children’s book that portrays a day in the life of an autistic child can provide younger audiences with relatable characters and situations, fostering understanding. Documentaries that offer firsthand accounts allow viewers to experience authentic emotions and perspectives, creating a deeper connection to the subject matter.


2. **Artistic Expression**: Art serves as a powerful medium for autistic children to convey their inner thoughts and emotions. Engaging with their creative expressions—be it through paintings, music, or theater—can transport audiences into their minds. Attending a gallery exhibit that showcases autistic artists or participating in music sessions led by autistic children can powerfully illustrate their experiences and amplify their voices. Such interactions foster appreciation for their creativity and the diverse ways they engage with the world.


3. **Community Events and Interaction**: Participating in community events that center around autistic children can facilitate authentic engagement. Examples include workshops, panels, and open forum discussions where families and autistic individuals share their stories. These events allow for in-depth discussions and the opportunity for community members to ask questions, share experiences, and learn from real-life narratives, promoting a culture of understanding and support.


4. **Digital Platforms and Online Narratives**: The rise of social media and digital platforms has empowered many autistic individuals to share their voices in unprecedented ways. Following autistic advocates, reading blogs, or viewing personal vlogs provides immediate access to the thoughts and experiences of autistic children and their families. These online narratives can debunk myths, challenge misconceptions, and educate the public about the realities of living with autism.


#### Cultivating Inclusive Environments


Building empathy through understanding is not enough; it is essential to transform that empathy into meaningful action. Here are some ways to create more inclusive environments for autistic children:


1. **Establish Safe Spaces**: Schools, community centers, and workplaces should prioritize creating environments where autistic children feel safe to share their experiences. Initiatives that promote autism awareness and provide resources for understanding autism can promote respect and inclusivity, paving the way for healthy dialogues about differences.


2. **Implement Peer Support Systems**: Pairing autistic children with neurotypical peers in structured buddy programs can enhance mutual understanding and compassion. This approach helps cultivate friendships through shared experiences—both the joys and challenges—creating connections that transcend verbal communication and fostering a supportive environment.


3. **Advocacy and Active Awareness Initiatives**: Engaging with stories is merely the starting point. Active advocacy for autistic individuals can be achieved through awareness campaigns, workshops, and community discussions that emphasize their needs and celebrate their contributions. This proactive approach encourages ongoing dialogue and education, reinforcing the importance of understanding and supporting both children and families impacted by autism.


Immersing ourselves in the stories of autistic children serves as a profound means of building empathy and fostering understanding within our communities. By embracing their unique experiences, perspectives, and emotional journeys, we can create a more inclusive world wherein every child—regardless of neurodiversity—feels valued, understood, and accepted. Let us commit to listening to and uplifting their narratives, advocating for their needs, and celebrating the diverse tapestry of humanity that enriches our society.


 
 
More articles for parents of children and teens on the autism spectrum:
 
Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

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Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

Click here for the full article...

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Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

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Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

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Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

Click here to read the full article...

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Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

Click here for the full article...
 
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A child with High-Functioning Autism (HFA) can have difficulty in school because, since he fits in so well, many adults may miss the fact that he has a diagnosis. When these children display symptoms of their disorder, they may be seen as defiant or disruptive.

Click here for the full article...
By

Dealing With Your Child's Frustrations: Tips for Parents of Kids on the Spectrum

"I would like ideas on how to deal with my (HFA) son’s frustrations. He will either dig his heels in and refuse to do what he is supposed to do, or he shuts down and then we have a time away so he can get himself together to discuss the problem. It seems he works himself up over things that are not that big a deal."

Children with High Functioning Autism (HFA) and Asperger's (AS) overreact to crowds, confusing situations, sensory stimuli, and situations in which they are asked to do things they don’t want to do. Situations or problems that seem minor to most of us are a “big deal” to those with the disorder because they don’t know how to handle them.

Low frustration-tolerance originates from the youngster’s dysfunctional and irrational beliefs. Behaviors are then the result of avoiding frustrating events which, paradoxically, lead to increased frustration and even greater mental stress.

Low frustration-tolerance occurs when the youngster gets upset and has an unwillingness or inability to tolerate the necessary short-term discomfort that is sometimes required for long-term gain. The opposite of this would be HIGH frustration-tolerance. High frustration-tolerance is simply the ability to tolerate or cope with discomfort and hard work in the short-term in order to achieve one's long term goals.

Removing your son from a stressful situation and giving him time to calm down is an excellent idea. Then if he is willing to discuss the problem, you may be able to help him learn how to handle a similar situation in the future. His frustration and stubbornness are due to the anxiety he feels and his inability to handle situations ...he can’t help those feelings.

Generally, there are two therapeutic approaches to working with the anxiety seen in kids on the autism spectrum. The first is cognitive psychology, which is an approach that focuses on the child’s mental processes (e.g., problem solving, memory, language, etc.). A cognitive psychologist will want to know how your son perceives and solves his problems.

A cognitive psychologist will be able to help your son figure out exactly what triggers his anger. The psychologist will help him change the negative environment that fuels his anger and develop various age-appropriate techniques for coping with anxiety.

The psychologist’s recommendations might be simple (e.g., lowering lights and sound levels), or it could be more complex, and therapy might become long term. In addition to cognitive psychology, medication may be recommended for your son. A psychiatrist can prescribe medications that will help reduce your son’s frustrations and reduce his anxieties.

Please note that antidepressants like Zoloft and Prozac have been prescribed for HFA and AS kids, but they have also been known to cause serious problems. Ask the psychiatrist to explain all of the behavioral changes and discuss the possible side effects of any medication that is prescribed.

The second approach for helping your son - and one of the most frequently recommended interventions for kids with the disorder - is for you, as a parent, to make his life structured and consistent. If he has chores to do around the house, they can be done on a certain day and at a specified time. He can leave for school at the same time every day, and he can be expected to return home at a certain time every day, also.

Structure can be built into his life for recreational activities, in addition to his school obligations and chores. If he enjoys video games, a time can be set aside that is predictable for the both of you. He can complete school homework and chores while looking forward to the recreational time that he knows will occur at the same time every day.

Your son is becoming easily frustrated over things that he perceives as too challenging. You can provide a “wrap-around” treatment for him by surrounding him with a psychologist that he can talk to, medication he can use to reduce anxiety (if warranted!), and a predictable home environment each day.


 


Comments:

 Anonymous said...
We have the exact same problem with our 14-years old ASD son. Even the psychologist couldn't get him to talk (AT ALL), and this psychologist is known as an autism expert and well-loved by his clients and peers in our area. We should probably try another doctor, but money is tight and insurance doesn't cover it and we were frustrated with that first attempt which lasted an entire school year. The second piece of advice, to give our son a routine schedule, is what we need to do. His life is quite routine, and it's the disruptions that are so hard because in any life there will be interruptions and disruptions. We will work on being even more consistent, however, and we REALLY need to get better at allowing him screen time as a reward. This Aspergers stuff really makes me work harder at being a better parent!

Anonymous said...
I have a 17 yr old son with HFA/ADHD, His routine now is constant unexpected change and as our life is a struggle to plan anything because something ends up changing. I found this was a struggle in the beginning & a few difficult moments but now that he is older I now realize this turned out to be a benefit because now his routine is kaos & he has learned to work with it. Just in case here is some back ground. My son was quite low functioning in the beginning he started off non verbal and by kindergarten could form 3 word sentences.He was not aloud to attend more than 2.5 hrs of school a day until Grade 6, by grade 9 he was on the honour roll, by grade 11 he was on the high school football team, He now will be graduating with his peers. I am a single mom and have never been able to afford the ABBA therapy or much of anything else his therapy consisted of a neighbors daughter who was beyond a blessing to us who was going to university & grew up with a special needs uncle. Prayers, Love, discipline & learning the language of Autism was what I used.

Anonymous said...
I still though have a son that won't talk about how he is feeling, this became a challenge when my daughter went through medical distress with having to call 911 over 60 times. My son explained when my Nana passed during that time that he new who should feel sad & he would miss her but beyond the moment of being told he didn't have the same response to feelings like we did they were dealt with then gone,

Anonymous said...
I have a pretty structured routine for my son (who will be 15 in a couple of days) and for the most part he does fairly well with small disruptions to the routine. The issue's we are having is when it comes to social functions. If we are able to, we try to find a quiet out of the way place for him to go and sit when he gets over whelmed, but I don't know how to help him with the white noise, or how to help him deal with the crowds of ppl. He is able to handle public school fairly decent, but it's fairly structured in the school setting as well, but at wedding's or charity events, it's chaos and I don't know what do to help.

Anonymous said...
We have a "chill out" list. He helped us make it. Its a list of things for him to do to, well, CHILL OUT! swing, wear his weighted vest, color, play with the cat, run, take a walk, etc. You get the idea. He can help make the list when he's calm and thinking clear. Sometimes we pick from the list, and sometimes we just tell him to go pick from the list. so far so good....

Anonymous said...
We suggest ways for our 13 year old to chill out. Also, before going out like to a restaurant or such, we have him make a "plan B" just in case "plan A" doesn't work out.

Anonymous said...
My daughter does the same thing. I try to talk in a low monotone just to make sure she stays calm. Then I'll pose several solutions and then let her choose...right or wrong. And, as always, just be there for them!! It's frustrating on our end too!
 
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Self-Soothing Techniques for Kids on the Autism Spectrum

“I have a 5 year old with high-functioning autism. Whenever he encounters something frustrating, it’s like he ‘flips a switch’. He will go from cheerful and engaged to mad and yelling in one split second. I'm not sure if this happens simply because he encounters something hard, or if it is a buildup of frustration over time that results in a big meltdown when he finally hits his tipping point. Maybe he misses his anger cues throughout the day, and that causes a flood of emotions when he confronts something particularly frustrating. Are there some ways to teach him to calm himself so that he doesn’t get to the point of exploding?”

Most kids with High-Functioning Autism (HFA) and Asperger’s (AS) struggle with low-frustration tolerance. Frustration is a powerful emotion, and their reactions can be intense in the moment. “Typical” children usually know when their anger buttons are being pushed. And many of them know what they need to do to work through something frustrating in a fairly appropriate manner. However, children with autism don’t enter this world with a pocket full of frustration-management skills. These skills must be taught.



Apparently your high-functioning autistic son experiences low-frustration tolerance and anger-control issues. Use the strategies below to (a) prevent emotional outbursts and (b) help calm your child down once he has launched into a tantrum or meltdown:

1. Use calming music.

2. Try fish oil. It has a calming effect.

3. The repeated act of chewing and sucking provides agitated kids the necessary oral sensory input that helps them relax. This is why some kids will chew the inside of their mouth when they feel agitated. Replace this destructive habit by giving your son food that requires repeated chewing (e.g., celery, carrots, and other crunchy vegetables). He can also chew gum or taffy to help him settle down. Or give him a smoothie to drink using a straw.

4. Teach your son what calm behavior looks like by showing him you can be calm, too.

5. Taking a mini-vacation with guided imagery. Guided imagery is a powerful relaxation tool for HFA and AS kids that pulls their focus to positive thoughts, all the while encouraging creativity. You can check out books on this technique at your local library if you want further information on the subject.

6. Try aromatherapy!

7. Some parents find that reducing or eliminating certain foods from the diet goes a long way in calming the HFA and AS youngster. If your son is a finicky eater, you will need to supplement the diet to make sure he has the fuels needed for his body to function well. Starting the day out with a healthy breakfast balanced with proteins, fats and carbohydrates is important. Keep your son away from caffeinated drinks and anything with added preservatives, coloring and sugar. Also, get in the habit of offering plain old H2O. With plenty of bottled waters that offer fruit flavors and vitamin enhancements, getting kids hydrated is easier now than ever before.

==> How to Prevent Meltdowns and Tantrums in Children with Aspergers and HFA

8. Remove your son from the stressful situation when possible. Lead him to a quiet room or a secluded spot.

9. Allow your son to play in a warm bath or dig in a sandbox. Agitated kids with autism experience a calming effect from the variety of textures.

10. Take your son for a walk. Not only does walking burn off toxic energy, the repetitive thump, thump, thump of feet hitting pavement brings the mind back into focus.

11. Put together a "Boredom Box" that provides creative outlets for your son. Fill this box or plastic storage bin with paint sets, coloring books, crossword puzzles, modeling clay, jewelry making kits, and other artistic areas of interest. Some HFA and AS kids bore easily, and their fast spinning minds need extra stimulation. In the absence of nothing better to do, they will lean on their own devises. You don't want your son doing that. Better that he draw than set the cat on fire (lol).

12. At the time of the inappropriate behavior, be sure to limit your talking to “stating the rule and consequence.” Lengthy debates, explanations and arguments should be avoided at this time. Also, ignore complaints from your son. Further discussion about the rule and consequence can be done at a later time when things have calmed down.

13. Offer your son verbal alternatives to his angry outbursts. For example, “Maybe you could have said this. Why don’t you try that next time?” If trouble is brewing, remind him by saying, “Use your words” – and be sure to praise him when he does (perhaps via a Reward Chart with a happy face for every day he doesn’t act-out when frustrated).

14. Sometimes it is best to leave a child to work through a tantrum by removing yourself from the situation. However, you should always ensure that your son is in a safe environment and not able to hurt himself.

15. Many HFA and AS kids do not know HOW to calm down or even what “calm” feels like. Explain this to your son and discuss it frequently.

16. Listen to your son’s point of view about a particular rule. When appropriate, consider making changes to the rule based on your son’s reasoning. This doesn’t mean you are “giving in” to his demands, rather it means that (at times) you will negotiate with him on a rule and reach a compromise.

17. If possible, find a space in the house to designate as a relaxation space. It does not have to be a large space, but it does need to be away from high-activity areas. This little corner (or even a portion of a walk-in closet) can have a beanbag chair and a few books, coloring books, or other quiet time activities. Encourage your son to go to this space when he becomes upset (but never make this a place of punishment). This special spot in the house is a positive place where he can go to settle down, sort things out, or just hang out when he needs to be alone.

18. Kids who see aggressive or violent behavior played out on TV or in computer games tend to be more aggressive when they play. If your son is consistently aggressive, limit his exposure to it in the media. If he does see it on TV, explain that hitting isn’t a nice way to act and doesn‘t solve problems. Reinforce the message by choosing storybooks and TV shows that promote kindness.

19. Help your son to identify the warning signs leading up to an outburst. He can even make a list of these warning signs and post them in a visible location. If your son is aware of what these signs are, he can then practice a breathing and counting technique.

20. HFA and AS kids thrive in homes that provide routines, consistency and structure. These kids especially need structure and schedules to feel secure in their surroundings. For them, a more "military" approach to routines works better. Waking up, eating meals, doing homework, and bed times should all occur at about the same time every day.

21. Help your son work out what he’s feeling. After he has calmed down from a tantrum, gently talk him through it. Ask him what was bothering him and why (e.g., “Did you think I wasn’t listening to you?”). Your son needs to be taught how to label and manage his feelings, especially frustration and anger. In order to do this, he needs an emotion vocabulary – and you can provide that by asking questions such as, “Were you upset?” … “Did you feel unhappy?” … “Were you frustrated?”…and so on.

22. When your son is beginning to get upset (assuming he doesn’t mind being touched in those moments), give your son a mini-massage. Touch is very important to most kids. Massaging your son’s temples, giving a shoulder rub, or lightly running your fingers through his hair may calm him quickly.

23. While providing structure and consistency are important skills for you to use with your son, it’s also important to be aware of the importance of allowing him some independence and autonomy. As often as is appropriate, allow your son to have opportunities to make his own choices and decisions, respect his choices and decisions, and allow natural “real-world” consequences to occur (when safety is not an issue, of course).

==> How to Prevent Meltdowns and Tantrums in Children with Aspergers and HFA

24. Identify the early warning signs that your son’s frustration level is building up. HFA and AS kids often don’t recognize frustration. In fact, many times they act out before they realize what happened. Identifying early warning signs helps these young people become more aware of their feelings, which in turn gives them more opportunity to control their responses to these feelings. Some common cues that indicate a child is getting upset and about to lose control include: unkind words, the tone of voice changes to whining or yelling, tensed body, squinting, rolling the eyes, restlessness, withdrawal, unresponsiveness, being easily provoked, pouting, noises with the mouth such as growls or deep breathing, increased intensity of speech or behavior, and clenched teeth.

25. If your son doesn’t have the verbal skills to assert himself in a non-aggressive way, then teach him. Children love “pretend play,” and you can use that to teach your son how to react to the things that tend to trigger his anger. Role-play a situation that would normally have your son going into meltdown, and work out how he can resolve it without getting mad and screaming.

26. When your son gets to the age where he can write proficiently, have him try journaling. This is an excellent way to untangle his frazzled mind and get things off his chest. It will allow him to spill his internal stresses outside himself and onto paper. When the timing is right, develop a daily habit of having your son write a paragraph or two about anything that comes to mind. Eventually, he will get to the guts of what is going on inside of him. Then he can rumple or tear the paper up and throw it away. These private internal thoughts are not for you or anyone else to read, however. So, respect your son’s privacy and let him know he can write anything down without fear of reprimand.

27. Allow your son to perform some heavy chores (e.g., vacuuming, moving objects, cleaning windows and cabinet doors, etc.). This helps him focus on completing a necessary task while using his energy in a constructive way. Heavy chores or intense exercises allow kids to experience sensory input to different muscles and joints.

28. Eliminate clutter in your son's environment to help structure and focus his energies to prevent repeated outbursts.

29. Teach your son to take a break from the difficult situation and to get alone for a few minutes. One of the healthiest responses to frustration at any of its stages is to step back. During that time the child can rethink the situation, calm down, and determine what to do next. Stepping back can help your son stop the progression and determine to respond differently. The length of the break is determined by the intensity of the emotion. A child who is simply annoyed may just take a deep breath. The child who is enraged probably needs to leave the room and settle down.

30. Do not speak in an agitated or annoyed voice to a frustrated child, because this aggravates the problem. Keep your voice calm while instructing your son in concise sentences on what he can do to calm down. Also, you can dim the lights so he receives less sensory input from surroundings that he may feel are harsh and which may further distract him.

31. HFA and AS kids often pay little mind to the effect their behavior can have on everyone else. If your son hits, bites or kicks, get down to his level and calmly ask him how he would feel if someone did that to him. Prompt him to give it some thought by saying things like, “If your sister kicked you like that, it would hurt you and make you cry.”

32. Do not tolerate aggressive behavior in any way, shape or form. As with every other aspect of parenting, consistency is paramount. The only way to stop your son from being aggressive is to make a House Rule that aggression is not acceptable.

33. Deep breathing is an easy technique autistic kids can use to defuse anger. Show your son what to do by placing your hand on your belly and getting him to do the same while taking in three deep breaths. The hand on the belly serves as a handy visual cue that you can use to remind your son to take a step back from what’s bothering him.

==> How to Prevent Meltdowns and Tantrums in Children with Aspergers and HFA

34. HFA and AS kids have difficulty remaining calm in a hectic environment. Clearing the clutter and taking a "less is more" approach to decorating can reduce the sensory overload. Your son’s bedroom especially should be free of clutter. Use plastic bins to organize and store all those little plastic treasures (that we parents commonly refer to as "junk") and small toys. Open the curtains to provide natural lighting. Keep posters and wall hangings to a minimum. Paint your son's bedroom in calming muted colors instead of bright primary colors.

35. Check your own stress levels, because most kids are often emotional barometers for their parents. Before you can calm down your son’s anxiety, you must first learn to calm down your own first. Lead by example, because you can’t put out a fire with another fire.

36. Allow your son to use his negative energy in a fun way (e.g., jumping, spinning, running, climbing, swinging, play-wrestling with pillows, punching a punching bag, etc.).

37. Your son will learn to manage anger and frustration by watching the way you manage yours. The irony is that an aggressive youngster can often be a major trigger for parents to explode. Deal with this situation as soon as possible, using a calm voice to express how you feel rather than yelling. And just as you expect your son to apologize for bad behavior, get into the habit of apologizing to him if you lose your temper inappropriately.

38. Lastly, if your son’s aggressive behavior is disrupting your home and putting family members or others at risk, and he reacts explosively to even the mildest discipline techniques, see your doctor. He or she may be able to refer you to a child psychologist or counselor (preferably one who specializes in autism spectrum disorders) who can teach you new ways of interacting with your son that will help you manage his anger and frustration more effectively.

The goal of self-soothing techniques is to reduce both the emotional feelings and the physiological arousal that frustration causes. Your son can't get rid of - or avoid - the things or the people that upset him, nor can you change them, but he can learn to control his reactions.





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Teaching Your Autistic Child Alternatives to Temper Tantrums

“My 5 y.o. son Noah (with high functioning autism) will tantrum over all things big and small. If he is the least bit frustrated over something – well look out, because ‘it’s on’!  Not uncommon for him to have a dozen tantrums in a day. I would be happy to just get that cut in half. Any tips for the chronic ‘tantrum-thrower’ would be greatly appreciated. Thanks in advance.”

The best time to teach your son alternatives to throwing a tantrum is immediately after he has one. Once Noah has settled down, you and he should have a talk while the memories of the episode are still fresh in his mind.

Your son threw the tantrum because he was frustrated or mad. Don't get into the issue of why he was “out of control.” Focus on the tantrum itself, explaining to Noah that the behavior isn't appropriate. Then teach him what he should do instead when he feels upset.



Here’s a simple method that often works when done the right way:

1. First describe the behavior. For example, "You felt frustrated and threw a tantrum. You were throwing things, screaming and kicking the walls." You say this so your son will understand exactly what you are talking about.

2. Then you explain that tantrums are not proper behavior. Make sure that you are clear that the tantrum is “bad” – not your son. Say something such as, "Tantrums are not appropriate behavior. In our family, we don't kick, scream or throw things. That behavior is not acceptable."

This will have an impact on Noah, because like most children, he really does want to do the right thing and please you. You can help him by explaining that tantrums are the wrong thing to do when feeling upset.

As a side note, don't worry about using big words such as "inappropriate." If you use big words with Noah, he will learn big words. If you use only little words, he will learn only little words.

3. Next, give your son some alternatives. For example, "I know you felt frustrated and angry. When this happens again, what you do is say, “I'm angry! Can you say that?" Have Noah repeat the phrase after you.

==> How to Prevent Meltdowns and Tantrums in Children with Aspergers and HFA

4. Lastly, review what you have said. For example, "What are you going to say the next time you're angry?" Get Noah to repeat the phrase, "I'm angry!"

Then say, "The next time you're angry, are you going to scream?" Your son will probably say or indicate "no."

Then say, "The next time you're angry, are you going to throw things?" …and "The next time you're angry, are you going to kick?"

End up with, "Tell me again what you're going to do the next time you're angry."

You will have to repeat this discussion many, many times. It takes a long time for a youngster on the autism spectrum to learn how to control a tantrum and reach for alternatives instead.

Hunger + Tiredness + Low-Frustration Tolerance = Tantrums

Although the triggers for tantrums vary widely, the causes are often very simple, tiredness and hunger being the biggest two.  Low-frustration tolerance is usually the third major trigger. Tantrums can occur as your son tries and fails at new tasks and struggles to express his frustration in an appropriate manner.

When tiredness and hunger are at play, you may have noticed Noah’s frustration level go from 0 to 100. If so, this is your cue to remove him from the situation and try to get him fed and rested.  When tiredness and hunger are NOT at play, you may still notice your son’s frustration level gradually building up. This is why it’s important for him to learn to recognize when his uncomfortable emotions come into play.

When your son learns to identify when he is starting to feel frustrated, he can then learn to take advantage of the other alternatives. But, this requires having an understanding of his emotions. You will want to focus on nurturing your son’s self-awareness with respect to his feelings. Make it your goal to help Noah reach a place where he is able to pause and self-reflect – even in the grip of intense emotions – then constructively answer two questions: “What am I feeling?” and “What do I need?"

When it comes to coaching your son in managing his emotions, you will want to follow some basic ground rules for healthy discussions on the matter:
  • Consistently prove to your son that it’s safe to share his feelings with you. Whenever and however Noah reveals his emotions (e.g., through angry outbursts or tearful whispers), it’s important that you remain calm, keeping your own responses and emotions in check.
  • Explain to your son that emotions are not right or wrong, including frustration and the subsequent anger. However, what is right or wrong is how he behaves when he is upset in this way.
Best of luck!



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

==> Videos for Parents of Children and Teens with ASD
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Aspergers Children and Biting

Understanding the developmental factors that contribute to biting behavior in children with Aspergers and High-Functioning Autism (HFA) can help moms and dads make environmental or programmatic changes as necessary to minimize the behavior. Guidance to kids who bite should be provided with the goal of helping them develop inner control of their feelings and actions. A quick and consistent response at home can help kids who bite learn to express their feelings in words so that they can become better able to control their behavior.

Why Do Children With Aspergers and HFA Resort To Biting?

1. An attempt to gain sensory input: Many Aspergers children experience sensory difficulties, so it can be helpful to consider the possible sensory functions of particular behaviors. Chewing and biting are proprioceptive activities (i.e., they provide sensory input to the proprioceptive system, which regulates what different parts of the body are doing at different times). Biting can also provide oral stimulation and may provide pleasant or even necessary stimulation to this sensory system.

2. Communication difficulties: For children who may not be able to communicate their wants, needs, and emotional states effectively, biting can be an extremely effective way of letting parents know that something is not right, and is therefore a very useful and powerful form of communication.



3. Developmental stages: The mouthing of objects is a normal part of development. Very young kids put various objects in their mouths to explore the size, shape, and texture of the objects. This normally becomes a problem if the youngster continues to mouth objects frequently past the age of 18 months or so. However, a youngster who missed the initial mouthing phase due to sensitivity in the mouth area or medical issues may have to go through this phase later.

4. Frustration or distress: Sometimes biting can be an expression of sheer frustration or distress in response to a range of different stressors and challenging situations. It is important to remember that life can be exceptionally overwhelming at times for kids with Aspergers and HFA, and that sometimes, the child may engage in a behavior that is a response to this.

5. Learned behavior: Children learn from experiences that they have had, and they use this information to determine how to behave in the future. If they find that behaving in a particular way brings about a good outcome, then they are more likely to behave that way again in the future. Some children might also appreciate the physical or emotional reaction of others in response to biting. The child may enjoy the sound of a raised voice or the sense of control created by behaving in a way which brings a predictable reaction from parents.

6. Toothache or jaw pain: In some cases, biting may be a response to physical pain, in particular tooth or jaw ache.

What Can Parents Do About Biting?

1. Anger management and relaxation training: Some children with Aspergers and HFA may experience difficulties managing emotions (e.g., stress, anxiety, frustration, etc.), which may lead to behavioral outbursts like biting. It is helpful for these children to learn how to identify the physical cues or bodily sensations which indicate that they are becoming agitated, and then to develop alternative, more appropriate activities to assist them to calm down. For example:

• aromatherapy
• asking for help
• counting to ten
• going for a walk
• jumping on a trampoline
• listening to music
• playing on a computer
• swinging
• taking a bath
• taking a few deep breaths
• thinking positive thoughts
• walking away from the scene
• …and any other type of redirection to pleasant, calming activities

2. “Chewables” are cylindrical pieces of rubber tubing (non-toxic, washable and latex-free) that can be sucked or chewed on and provide good resistance for children who need the sensory input provided by biting. Research has shown that “chewables” appear to provide a calming, focusing and organizing function and act as a release for stress. Alternatively, parents may put together a bag of items that provide a range of sensory experiences (e.g., raw pasta, dried fruit, etc.), which the child can be re-directed to.

3. Communication difficulties: Encourage your child to use alternative forms of communication (e.g., visual signs or symbols). Use a range of symbols that he/she can carry around to communicate basic needs (e.g., 'yes', 'no', 'stop', 'go away - I need space', 'I’m in pain', etc.).

4. Environmental modifications: Try to plan for situations that the child finds challenging and make necessary adjustments to the environment. For example:

• increasing structure through the use of timetables or schedules
• maintaining familiar routines where possible
• minimizing unpleasant sensory stimuli
• reducing the number of people

5. Frustration or distress: Frequently remind your child of anger-management and relaxation techniques – especially when he is calm.

6. Functional analysis: Finding the cause of why your child bites is critical in determining the best way of responding to the behavior. For example, if the biting is an expression of frustration, the focus of intervention will be on teaching the child alternative and more appropriate ways of coping with frustration. A good way of determining why a child may be engaging in a particular behavior is to keep a record of behavioral incidents. Some children may be able to communicate their reasons for biting, either verbally or through the use of visual strategies.

7. Improve communication: Assist the child to develop alternative, more appropriate ways of communicating his/her wants, needs, physical discomfort and emotional states. Visual strategies can be very effective, because they can be used in a broad range of situations – and are particularly useful for indicating physical pain or communicating emotional states. Also, social stories can also be helpful in describing why it is not appropriate to bite and by outlining what the child is able to do instead.

8. Increase sensory opportunities: If the child is biting to gain sensory input, then it is important to provide alternative and more appropriate ways of meeting this need.

9. Reinforce appropriate behavior: It is important to pay attention to instances of behavior that you want to encourage to help the child learn that other, more appropriate ways of behaving lead to positive outcomes. Rewards can take the form of:

• preferred activities
• small amounts of favorite foods or drinks
• tokens
• toys
• verbal praise and attention

Clearly name the behavior that you are rewarding, and ensure that rewards are provided immediately after the behavior that you wish to encourage.

10. Respond quickly and consistently to incidents of behavior: Keep responses to biting behavior to a minimum by limiting verbal comments, facial expressions and other displays of emotion (these may inadvertently reinforce the behavior). Speak calmly and clearly and keep facial expressions neutral.

11. Rule out medical and dental causes: Ensure that the child is not biting as a response to physical pain (e.g., toothache or jaw ache). Arrange a check-up with the dentist to rule out any possible physical causes for the behavior.

12. Sensory issues: Re-direct the child to alternative sensory activity such as “chewables” or a “bag of tricks” with edible items. Also, redirect the child to another activity, and praise the first occurrence of appropriate behavior. Maintain physical space and closely supervise the child following an incident of biting.

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