Children with autism are often misunderstood. What may be perceived as an angry outburst might be rooted in communication difficulties, anxiety, and stress.
People with autism are often creatures of habit who like predictable structure and schedules. A disruption to routine, unplanned changes, and trouble communicating effectively can all lead to outbursts of anger and aggression.
Autistic children may lash out in anger when they are unable to express themselves. Aggressive or self-harming behaviors can also be patterns of repetitive actions that are hallmarks of autism.
While autism-related anger and aggression can be scary for everyone involved, therapy can help a lot. By improving communication and social skills, and regulating potentially harmful repetitive behaviors, therapy can help to reduce aggressive actions and help people with autism to better regulate their emotions, including anger.
In many cases, applied behavior analysis (ABA) is used to reduce the frequency of this behavior.
Anger, Aggression & Autism
People with autism have more trouble with aggressive outbursts than their neurotypical peers. In neurotypical children, boys tend to exhibit aggression more frequently than girls. But girls with autism are just as likely to express aggression as boys on the spectrum.
Anger and aggression are common across all levels of the autism spectrum. Children who struggle with more substantial social and communication issues, as well as those who engage in more repetitive behaviors, are more likely to have problems with emotional regulation and aggressive actions.
Anger and aggression can be one of the most problematic issues related to autism. It can lead to difficulties at school and home, and result in harm to the child and others. Aggression can be directed outwardly toward caregivers or peers, or it can be self-directed in the form of self-harm.
One of the most important roles of a parent is to keep their child, and those around the child, safe and healthy. When a child with autism frequently struggles with anger and aggression, it’s important for parents to learn what triggers these outbursts. Once the triggers are identified, methods to manage them can be implemented.
Forms of Anger & Aggression
Anger and aggression can take the form of:
- Temper tantrums.
- Destruction of property.
- Self-injury, including things like head banging or hair pulling.
Aggressive behaviors can create many additional issues for someone with autism, including:
- Decreased quality of life.
- Limited access to educational and social support.
- Increased stress levels.
- Further behavior problems.
Aggression as a Method of Communication
Problems with verbal and nonverbal communication are some of the main indicators of autism. When a child is unable to effectively express what they want, it can lead to frustration, anger, and eventually aggression.
Aggressive outbursts can signal that an autistic child does not want to do something, or they are unhappy with changes in their schedule, environment, or routine. They may have a tantrum and destroy the room in response to an unexpected change in their daily regime.
Aggressive behaviors can be directed toward a peer who disrupts an autistic child. They may be directed at a caregiver for trying to move a child from one activity to another.
Anger related to autism is generally impulsive. Aggressive behaviors are not thought out ahead of time. It’s the child reacting in the moment.
Aggression can be used as a tool for an autistic child or adolescent to get what they want. For instance, aggressive outbursts can lead to the child getting to engage in the repetitive behaviors in which they are seeking comfort. In some cases, these repetitive behaviors can be potentially harmful in and of themselves, such as head banging against a wall.
Autism commonly co-occurs with other issues, including medical problems like gastrointestinal problems and sleep difficulties.
Autistic children who feel sick or tired, who are in pain, or who suffer from anxiety can have additional difficulties controlling their anger, which can manifest into aggression. These issues are compounded with the standard communication and language deficits associated with autistic individuals.
Just like with neurotypical people, underlying issues can trigger anger and aggressive outbursts among those with autism. These issues include:
- Undiagnosed mental health issues, such as anxiety or depression.
- Sleep problems.
- Medical issues.
- Overwhelming sensory stimuli.
- Breaks in routine.
Identifying these triggers for aggressive behaviors is the first step. Parents, teachers, therapists, and caregivers can reduce the likelihood of these triggers, reducing the frequency of aggressive events. Therapy can then help the child learn how to better manage their emotions.
Treatment & Prevention Measures
Treatment for aggression related to autism depends on the cause. It will not look the same for everyone.
If aggressive outbursts are related to an underlying medical or mental health issue, specific medical and mental health interventions can help. Medications can address gastrointestinal concerns and sleep issues as well as help with mood and anxiety disorders.
Beyond pharmacological interventions to address medical issues, therapy is crucial. Therapists can teach children how to prevent anger from escalating into aggression. Children can learn how to recognize their own triggers and ways to regulate their emotions. This often involves expressing their feelings in other ways that aren’t violent.
Behavioral interventions, such as applied behavior analysis (ABA) therapy and cognitive behavioral therapy (CBT), can help with emotional regulation, coping skills, and anger management.
CBT helps people to recognize their feelings and how they are directly connected to their actions in order to support positive change.
ABA is considered one of the most successful interventions for helping children with autism learn desired behaviors through positive reinforcement.
Applied Behavior Analysis to Manage Anger & Aggression
ABA has been proven to be effective in both reducing aggressive behaviors and eliminating them altogether. It is a highly flexible intervention that can be used in conjunction with other therapies, though it can also be used as a standalone method of treatment.
In a nutshell, ABA uses positive reinforcement to shape a child’s behavior. The therapy can teach coping skills for emotional regulation and methods for communication that do not result in aggression. This can help a child learn more effective ways of communicating instead of resorting to harmful measures.
- Improve social skills.
- Enhance self-reliance, build self-care abilities, and promote independence.
- Increase academic performance and cognitive abilities.
- Boost communication and language skills.
- Advance motor functions.
As a highly adaptable intervention, ABA can be used in a variety of settings and be specifically tailored to the individual. The earlier treatment begins, the better a child can learn and apply more effective coping and anger management skills.
- Signs and Symptoms of Autism Spectrum Disorder. (August 2019). Centers for Disease Control and Prevention (CDC).
- Aggressive Behavior Problems in Children With Autism Spectrum Disorders: Prevalence and Correlates in Large Clinical Sample. (September 2014). Research in Autism Spectrum Disorders.
- Aggression in Autism Spectrum Disorder: Presentation and Treatment Options. (June 2016). Neuropsychiatric Disease and Treatment.
- Aggression in Children and Adolescents With ASD: Prevalence and Risk Factors. (October 2010). Journal of Autism and Developmental Disorders.
- Understanding Aggression in Autism. (December 2014). Spectrum.
- Repetitive Behaviors and ‘Stimming’ in Autism, Explained. (January 2020). Spectrum.
- My Child Is Sometimes Aggressive- What Can Help? (September 2018). Autism Speaks.
- A Review of Behavioral Interventions for the Treatment of Aggression in Individuals With Developmental Disabilities. (March-April 2011). Research in Developmental Disabilities.