Aggression Management in Autistic Children

Written by F.D.



Introduction


Parents today are facing challenges in taking good care of their children as they need to balance out between spending time with their children and their daily lives. Sometimes, parents have to handle their children’s aggression when they feel unhappy or do not get what they want. Aggression can be summarized as a type of behavior that is threatening or likely to cause harm to anyone which can be physical, like biting a person or hitting someone with an object or verbal, like threatening another person. Several studies show that individuals with intellectual disabilities and co-morbid Autism Spectrum Disorder tend to demonstrate aggression more frequently compared to those with only Intellectual Disabilities. Meanwhile, certain factors tend to predict aggression levels for normal developed children. However, those factors are rarely seen in determining aggression levels for children with ASD, for example, gender doesn’t influence the prediction of aggression levels of children with ASD compared to normal children.


Aggression has become the main cause of negative outcomes for autistic children like deterring social relationships, placement in a more restrictive school or residential environment, physical intervention and increasing risk of becoming a victim of situations. Furthermore, aggression can also lead to school staff and teachers’ burnout in having to teach autistic children, causing a ripple effect on the quality of education given. Aggression also has an adverse effect on caregivers or parents taking care of their autistic children including an increase in their stress level, financial difficulties, lack of support services, and overall negative impact on the family’s daily lives and well-being.


In this article, we will explore how parents can manage aggression in their children with special needs. There are several methods that parents can utilize in order to manage their autistic children’s aggression. Before the children’s behavior becomes tough to control, parents should observe precautionary signs of their children’s behavior. One such method to observe children’s aggressive behavior is the ABC Sandwich method.


The ABC Sandwich Method



Example of ABC Chart (Taken from Sec-3 Lec-2 ABC Chart (Antecedent Behavior Consequence) by Parenting Skills for the Real World)


The ABC Sandwich method comprises Antecedents, Behavior and Consequences or ‘Rewards’ whereby each step has their own characteristics. Antecedents are any factors that ‘triggers’ the aggressive or self-injurious behavior. For example, an autistic child is showing signs of stress when he or she wants a bottle of milk but when the parents refuse, the child starts showing tantrums. Parents should keep a sharp eye when their children start to feel uneasy. They should start by identifying what is the catalyst that causes the child to show signs of stress.


Behavior is the way that the special needs children respond to the trigger. For example, a child looks distressed when he or she is triggered by not getting the milk. From looking at the child’s behavior, parents should see how their child reacts to the trigger in order to recognize the sign of aggression better.


Finally, consequences or ‘rewards’ is what their child gets from behaving aggressively. This could include the children being allowed to go on with a favourite activity or to leave a stressful situation. For instance, parents would get stressed enough that they would give in and give their child what he/she wants to satisfy the child. From this aspect, parents should think of the consequences of their reaction to their child’s behavior of distress.


To ensure the most effective utilization of the ABC Sandwich method, parents can work on their child’s challenging behaviour like aggression by altering either the behaviour’s triggers or the ‘rewards’ from the behavior. The 1st step in utilizing the ABC Sandwich method towards special needs children is to choose a behavior for the parents to focus on. The behavior they have chosen needs to be progressively managed in order for the ABC Sandwich method to be fully effective.


Once the behaviour has been chosen, parents should then identify the children’s triggers and rewards from the behavior that they have chosen to alter. In order to navigate their children’s trigger and rewards, a special diary of aggressive behavior can be used to record the progress of how their children react to the trigger and rewards. The diary can be done for 1 to 2 weeks including 2 weekends. The purpose of including 2 weekends to the diary is to differentiate the behaviour between weekdays and weekends. Thus, parents are able to recognize the best actions to change the rewards or reactions from the identification. Here’s an example of how the diary works.


Example:

  • Difficult Behavior: Child rolls around while crying

  • When: 3pm, May 4th

  • Where: Inside the house

  • What happened before behavior: Tried to give him some vegetables

  • What happened after: We briefly tried to soothe the child, but ended up not giving vegetables.


Once all aspects of what triggers the behavior and what the child is getting from has been identified, we can gather all the information from the research to make changes. There are several precautions that their parents should take note of in utilizing the ABC Sandwich method.

Firstly, parents are advised not to spend too much time figuring out why their autistic children are having aggression issues as there might be some things parents would not know when it comes to how their children behave. The next advice is to only search for the obvious triggers which are triggers that are easy to track on or are obvious. Parents should not overanalyze the factors which can cause parents to ignore other important aspects of the reasons for their child’s aggression which makes controlling their child’s aggression a lot more difficult. For example, if parents know that the loud noises are the cause of the emotional breakdown, they should just remove the noises. However, if the immediate trigger is not obvious, leave it. Another reason for going for obvious triggers is spending excessive energy looking for a single trigger, which could be hard to detect, means less energy invested or helping, responding, and distracting.


Distraction and Redirection


The ABC Sandwich method is not the only method that can be used for parents in controlling their special needs children’s aggression. There are several other methods that have the same effectiveness as the ABC Sandwich method too such as distraction and redirection. Distraction and redirection are two important keys in quick crisis resolution. In this method, parents should utilize some sort of deflection for their children’s anger issues to ensure that their children do not trigger their aggression. Thus, it is easier to keep an electronic list of items (example: deep breathing exercise and listening to music) that can be used as distractions on a cell phone for quick access. For children who need more support, they should be redirected immediately to a distraction whether it is a space or activity rather than endlessly finding the cause for their aggression. Examples of redirection include using toys and pleasurable food.


Use Picture Schedules and Timetables


Another way to observe the special needs children’s triggers and rewards for aggression is to organize predictable routines like using picture schedules and timetables. These schedules can be used to detect the pattern of the child’s feelings and social expressions throughout the day. Schedules can utilize the use of pictures for children to clearly understand what they should do. For example, giving a child a five-minute warning using a picture of a clock as a warning. The pictures can also be used to give instructions to the children and practice how to identify social cues and facial expressions.



Example of Picture Schedule (Source)


Nowadays, there are apps for tablets and mobile phones to create schedules that are high quality and easily understandable for children with special needs. When making the schedule, parents should spend some extra time making the transition to reduce the anxiousness of children. For example, spend some extra time for the child to be prepared before visiting their grandparent’s home. Bring a timer if the child finds it difficult to adapt to changes in their favorite activities. Using the timer, parents can set the time for each activity and let their children know when the activities are over. The timers are also helpful in notifying their children when they will leave the house.


Enable Smoother Adaptation to Changing Environments


In ensuring effective aggression management, parents should know that it is easier to change environments than to change the behavior of their special needs children. For instance, if the autistic child is always having emotional outbursts when grocery shopping, consider changing the place where the parents shop. Special needs may feel more comfortable if the shop or shopping malls cater the treatment for special needs children. For example, Sunway Putra Mall Malaysia is the first and only autism-friendly shopping mall in Malaysia as they provide ample facilities for special needs children.


Parents should carefully plan when their children are exposed to change so the resulting potential outbursts are manageable. Thus, ensuring their strategy planning for controlling their children’s aggression can be done with several pieces of information obtained in advance. When adjusting to the new environment for their special needs children, parents should avoid environmental changes that might increase the chance of outburst. For example, going to a noisy place that may overstimulate or stress their special needs children. Parents should also set up gradual introductions to environments that are overstimulating to avoid causing their children to over-react.



Look out for potential medical illness


When parents detect aggression issues with their special needs children, another factor to look into is medical illness. For example, for those children with severe autism, they may struggle in communicating verbally with others. Their anger, agitation, or irritability may be caused by pain, fatigue, or physical discomfort that they are experiencing. Thus, parents should observe any changes in sleep habits, appetite, bowel or bladder movements. From these observations, parents could identify whether their children are ill.


Look out for potential mental health issues


Besides medical illness, underlying mental health issues could be another factor causing aggressive behavior in special needs children. In some possibility, special needs children might be suffering from mental illnesses like depression, anxiety, and ADHD. In this case, parents should consult with specialists or therapists so a thorough and careful evaluation can be done. Parents should consult doctors or health experts in determining whether medications are required. Talk-based therapy focusing on coping strategies and managing stress is another way of handling mental issues faced by special needs children.


Join or Seek for Support System


Besides being a means to get tips and insights on how to handle their special children’s aggression, a support system also provides community support that is crucial in reducing the stress caregivers or parents have to face in managing their children’s aggressive behaviors. A good support system can also provide a safe place for parents to talk about their feelings and share ideas in managing their children’s aggression. There are a number of support groups that you can choose from, including in social media as well.


Facebook Support Groups:


Conclusion


In conclusion, handling aggression for special needs children can be tough for parents, especially when they need to balance between their work responsibilities, personal life and handling their children. Sometimes, special needs children tend to stick to their own perception and would find it hard to adapt to changes. However, aggression management is necessary as it will help mental development significantly and enable special needs children to learn how to control their aggression. Successful aggression management would be beneficial in helping special needs children adapt to new and unique environments which is essential for their school, university and work adaptation.


Additional Content:

References:

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