Susan's Blog

Monday, January 13, 2014

Autism Mommy Swami: Aggression??

The Swami had an email today from a lovely mom whose young tween was going through some difficulties with acting out aggressively. She wants to help him with whatever is bothering him. She was also concerned for the siblings’ feelings.

Dear Lovely Mom,

Nat went through an aggressive/destructive period from 9-11. At the end of that period, there were four changes in his life that may have contributed to things getting much better:
1) Spring came at last (never underestimate how seasonal and light change affects us all, especially sensitive guys like Nat.
2) He started Special Olympics (gymnastics, which was perfect for him because it was a team and a sport — exercise is great for helping us all feel good. Gymnastics is also highly individual and structured).
3) He switched schools, to a private autism school with very small classes and a lot of consistent responses to his behaviors. No cruelty, just warmth, structure, redirection, time out, and consistent expectations.
4) He started a very low dose of Resperdal. This is contraversial but helped in Nat’s case. Resperdal is a psychotropic med and has some serious but rare side effects and must be used only under the care of a psychopharmacologist. We have found that meds helped Nat (Clonidine and a tiny bit of Resperdal) because they provided a calming “buffer” that slows his response down a bit so that he has a moment to gain control over a reaction (and over possible aggression). Plus, over time, he experienced responding without aggression and relearned his responses on a neuro/behavioral level. I still highly recommend that this is a last resort, that there are reasons for the aggression that must be ferreted out!

Social stories could help explain to him what is going on in a given difficult interaction for him. They may also really help the siblings understand, too, as well as talking about and validating their confusing emotions.

I would also continue to probe reasons behind the aggression. It turns out that gastrointestinal issues affect the autistic population at a higher rate than the neurotypical one! It is worth your while just to make sure he is not sensitive to dairy or gluten, because these sensitivities can cause discomfort and pain and a nonverbal guy would have trouble letting you know. I’m not saying just do the GFCF diet, which is difficult, but to take him to a pediatric GI who can at least test for dairy intolerance (it’s an easy, non-invasive test).  Actually, a doctor can help rule out any pain or illness or discomfort!

I have also heard from adult autistic friends that subtle light flickering or contrasts, even, can be highly disturbing to them. Some people have found that light-tinted sunglasses worn in a classroom might really cut down on behaviors because it would counteract the light issues. Also, if you find he does not like to look at your eyes, that could also be because their shine and contrasting color causes discomfort. You could try wearing sunglasses yourself when talking to him!

Pain and sensory issues are factors that should not be overlooked in our nonverbal guys! It’s all too common that our professionals prescribe ABA, which is fine but not the answer to everything, when maybe it is a matter of stomach pain or gas, noise or light!

Hope this helps!