Have you ever wondered about autism spectrum disorder and its relationship to anger? What can cause anger outbursts in children with autism? How can we help children with autism deescalate from anger? We will answer these questions and more, but first, let’s consider autism symptoms.
The symptoms related to autism spectrum disorder vary greatly among individuals. In addition, these symptoms fall along a spectrum, with some children demonstrating more severe symptoms compared to others. Generally speaking, individuals with autism will experiences some degree of the following symptoms:
- Difficulty with social interactions
- Poor eye contact
- Engaging in repetitive movements
- Gross motor delays
- Language difficulties-including language delays and repetition of specific words or phrases
- Learning difficulties
- Trouble with attention and problem-solving
- Emotional difficulties, including depression, anger, and anxiety
Anger is often an emotion that is associated with autism spectrum disorder. Most children with autism do not express their anger in the same way as typically-developing peers. This anger can be directed towards others, or towards themselves (called self-injurious behavior). Anger may manifest into aggression and could include hitting, kicking, biting, throwing objects, or hurt themselves – for example, by head-banging.
There are several reason children with autism might behave aggressively or hurt themselves because they:
- Have trouble understanding what’s happening around them – for example, what other people are saying or communicating non-verbally
- Have difficulty communicating their own wants and needs
- Are very anxious and stressed
- Have sensory sensitivities, like an oversensitivity to noise or a need for stimulation
- Want to escape from stressful situations or activities.
If you understand what causes your autistic child’s self-injurious and aggressive behavior, you can help your child learn to manage the behavior. You can do this by looking at what’s triggering the behavior and what your child is getting out of it. Try keeping a diary of the behavior for 1-2 weeks, noting what happens before and after the behavior. Understanding how well your child can communicate is also a key step in finding out what’s causing the aggressive behavior. When children can’t express feelings or ask for what they need or want, they might use aggressive behavior to communicate. It can be helpful to ask yourself, ‘Is my child trying to tell me something?’ For example, if your child doesn’t like corn flakes but can’t tell you, your child might hit you as a way of saying ‘Take it away, I don’t want it!’
Once there is a more thorough understanding of where the source of anger and aggression is, it is easier to identify potential strategies to address anger and aggressive behaviors. In this article, we will highlight our best strategies for dealing with autism and anger.
DEALING WITH AGGRESSIVE BEHAVIORS
You probably can’t prevent every outburst from your child with autism so, it’s important for you to have some strategies to deal with the aggressive behavior when it happens.
This is the first and most important thing. Most aggressive outbursts happen because your child has feelings building up and can’t communicate them. By managing your own feelings and staying calm and quiet, you won’t add your emotions to the mix.
LIMIT WHAT YOU SAY
During an outburst your child will be feeling very stressed. It’s hard to process what someone else is saying when you’re feeling stressed, and this is especially true for autistic children, who can have trouble understanding language. So it can help if you don’t say too much. Aim for short phrases or even just a couple of words – for example, ‘Sit down’ rather than “Come over here and sit down”.
MOVEY OUR CHILD TO A SAFER PLACE
For everyone’s safety, make sure your child isn’t close to anything that could be harmful – for example, shelves that could fall over or glass objects. A quiet enclosed space outside might be an option. You might also need to get other people to move out of the way for safety.
CONSIDER VISUAL CUES
Visual cues can help in these situations. For example, you might have a picture of a quiet place in your home that your child can go to.
SEEK HELP IF YOU NEED TO USE PHYSICAL RESTRAINT
If you find you have to use physical restraint when your child has an aggressive outburst, speak with your child’s pediatrician or a behavioral therapist about other options. Physical restraint can be dangerous to both you and your child, and can often increase your child’s anxiety and make the situation worse. Positive behavior support is always preferable to physical options.
AUTISM AND SENSORY PROCESSING
It is estimated that at least 80% of children with autism have some type of sensory processing disorder. Sensory processing involves taking in information from the environment, processing that information, and then meaningfully responding to the information.
Imagine you are in a classroom and someone calls your name. You are able to hear your name being called, recognize that it’s your name, and then respond as you feel it is appropriate. For children with a sensory processing disorder, this process is interrupted in some way within the brain.
For many children with autism, stimuli within the environment is over-processed or processed more intensely than it is for typically developing children. This is why many children with autism experience sensory sensitivities. They may be sensitive to any type of environmental stimuli, but some of the most common include loud noises, bright lights, crowded or busy places, etc.
To better understand how anger is related to sensory processing, let’s consider the analogy of filling an empty cup.
Consider a child with autism who has just arrived at school and is told that he has to wait in the gym with his peers before entering the classroom. This child has sensory sensitivities and his morning included: waking up late to his loud alarm, putting on a shirt that was a little bit too tight, and being rushed through his morning routine because he was running late. Little by little, the empty cup we are referring to is filled by each sensory challenge he experiences. When he arrives at school and has to wait in a crowded, noisy gym, he has reached his capacity and his cup is now overflowing. This child will likely react with anger, as his environment is too over-stimulating and his ability to cope has been maximized.
In order to address sensory processing concerns, it is best to visit with an occupational therapist, who can work with each individual child to develop a unique sensory diet. A sensory diet is an individualized plan that outlines a child’s sensory needs and ways to get needed input. A sensory diet might include things such as:
- The use of a weighted blanket to sleep at night
- Using a weighted vest or lap pad during a certain routine
- Engaging in heavy work activities, like pushing against a wall or engaging in heavy jumps
- Eliminating known sensory triggers from environments, such as dimming lights, wearing tagless clothing, keeping living environments clutter free and minimal, etc.
As mentioned before, each child will have their own unique sensory needs and a sensory diet is often the first place to start when addressing potential anger or aggression issues.
EMOTIONAL REGULATION AND COPING SKILLS
In general, children with autism have difficulty with emotion regulation. This skill set involves recognizing an emotional state or feeling that is occurring, being able to evaluate the outcome of reacting to the emotion, and moving forward by reacting and being able to cope with any negative feelings associated with the situation.
Children with autism often have difficulty with planning and judgment skills and therefore, emotion regulation can be challenging. In addition, being able to seek out appropriate coping skills when encountering an intense emotion is another skill set that can be tricky for children with autism.
When regulating emotions and subsequently utilizing coping skills is a challenge, anger and aggression are common behaviors.
Here are some of our best tips for helping kids with autism address emotion regulation and coping skills:
- Use a program, such as the Zones of Regulation, as a way to teach self-regulation, self-awareness, and body cue signs. Many children with autism do not have the verbal ability to describe how they are feeling spontaneously. Programs, like the Zones, give children a way to communicate internal feelings, which is often the root cause of anger. In this program, four colored “Zones” are used to describe various states of arousal, including low, just right, almost out of control, and out of control. The program systematically teaches children how to recognize what their body is telling them and how to use coping skills when needed. An occupational therapist has the skill set to work with your child using the Zones program and help develop a corresponding home program.
- Be aware of sensory needs. Work to develop coping skills based upon these needs. A coping skill is a tool that someone uses to return back to a state of regulation. As discussed above, sensory processing is a critical component to consider when addressing anger and autism. When helping a child develop coping skills, sensory needs should always be considered, as they are closely intertwined. For example, the use of a weighted lap pad could be a helpful coping skill and also meet the sensory needs of the child. Other coping skills might include a fidget or resistance ball, deep breathing, mindfulness activities, muscle relaxation, etc.
- Develop a menu or list of options for coping skills. Once sensory needs are determined, it is most helpful to have a menu or option list of coping skills. It might be beneficial to have this available as a visual to the child. This menu might include coping skills for a different emotions (sad, angry, anxious, etc), internal feeling states (hot, heart is beating fast, tired or low energy, etc), or situations (when plans change, when I’m at my desk at school, at home in my room, etc). This ensures that a variety of contexts are considered and that the child has a number of effective options available.
It is important to note that a child is likely to be most successful when they are given the right tools or vocabulary to address what they are feeling internally.
Research has shown that body cue identification is crucial for addressing coping skills, especially for children with autism and other special needs.
A trained professional, such as an occupational therapist, can help develop a systematic treatment plan to ensure the child’s sensory needs are being met and that emotion regulation and coping are complementing the unique sensory needs.
Anger is often associated with autism, however it is important to consider the complexities related to why a child with autism is expressing anger. In general, sensory processing and emotion regulation abilities are the root causes of anger and aggression in children with autism.
A trained health professional, such as an occupational therapist can assist with assessing and making recommendations related to autism and anger or aggression. We hope this blog provided you with valuable information related to autism and anger, including seeking out additional expertise if needed for your child.