Autism 203: “Addressing Challenging Behavior Part 2 of 2: Strategies for Home and School (2016)
Managing Aggression in Autistic Children
Aggression is a common symptom in autistic children. Learn what parents can do to help manage these difficult behaviors.
By Krisha McCoy
Medically Reviewed by Cynthia Haines, MD
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Being a parent to a child with autism can be challenging in many ways. Not only does autism lead to delays and problems with communication and social interaction, but it can also cause many behavioral problems as well. In fact, many autistic children exhibit aggression as a symptom of their condition. This aggression often manifests as unexpected outbursts of biting, scratching, kicking, hitting, or throwing objects at people.
Managing Aggression in Autism
When your autistic child acts out aggressively, it can make public outings and social situations difficult. Aggression puts an added stress on people who care for autistic children, and dealing with aggressive behavior can be extremely challenging for their parents, caregivers, and teachers.
In kids with autism, aggressive behavior is often used as a way to get attention, obtain something that they want, or get out of doing something that they don't want to do. And some kids act aggressively merely because they find pleasure in acting that way and watching others' reactions to their behavior.
If your autistic child’s aggressive behavior is interfering with his or her daily life, talk to your child's doctor. A doctor can assess the aggressive behavior; rule out other conditions that may be contributing to it, such as depression or epilepsy; determine which interventions may help; and refer you to a specialist, if necessary.
Behavioral Interventions to Treat Aggression in Autism
Certain behavioral interventions have been shown to be effective in decreasing aggression in autistic kids. Doctors, therapists, and other autism health care providers can train and coach parents and other caregivers to use techniques that can help prevent or limit aggressive behavior that is related to autism. These interventions are often based on a method known as applied behavioral analysis (ABA) and may include several different approaches.
Caregivers can learn strategies for preventing, reacting to, and stopping aggressive behavior in autistic children. The goal is to reinforce positive behaviors and decrease negative behavior, which can help your child learn to act appropriately in social situations. For example, parents who are accustomed to giving autistic children what they want when they act out aggressively will learn to reward their children only when they act appropriately. Caregivers can also learn about the warning signs that precede aggressive behavior, so that they can try techniques for curtailing it.
To be most effective, behavioral interventions should be performed continuously on a daily basis, so they require a great deal of commitment from caregivers.
Medications to Control Autism-Related Aggression
When behavioral interventions are not enough, medications may help. There are several medications that have been studied for their ability to reduce aggression in children with autism, including antipsychotic medications, selective serotonin reuptake inhibitors (SSRIs), and mood stabilizers.
The medication that has shown the most promise in helping to control autism-related aggression to date is an atypical antipsychotic known as risperidone (Risperdal). Studies have shown that risperidone can help reduce aggression and problems with conduct in autistic children. But since risperidone can be associated with excess weight gain and other unwanted side effects, the benefits of taking this medication must be carefully balanced against the risks.
Your doctor can help you decide which behavioral interventions or medications may benefit your autistic child most. It is important to work closely with your child's health care team to monitor the effects of any treatments, so that new interventions can be employed and the treatment plan can be adjusted over time as needed. With the right mix of behavioral interventions and medications, there is a good chance that your child's aggression can be gotten under control.
Video: Autism Parents & Anger
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