You may be chatting as a family and suddenly, your autistic child reacts out of character and you simply can’t understand what triggered him/her. Autism is complex and diverse; individuals on the spectrum express themselves in a variety of confusing ways that can often leave you asking: “how can I help my child when I don’t know what is wrong?”
Some children with autism experience impulsive aggression where they “act out” in situations where you can’t figure out the trigger or reason for their behavior. This article unpacks what impulsive aggression is in children on the autism spectrum and how you (as a parent) can help your autistic child manage his/her impulses into more adaptive, functional behavioral responses.
Let’s break it down: aggression and impulse control
To understand what impulsive aggression is, we need to look at the two words/concepts separately. Aggression can be a consequence to an impulse, but what about the impulse is causing the aggression?
What is aggression?
Children with autism experience a variety of associated symptoms. These vary across individuals but some characteristic traits include difficulties in social communication and social interaction, as well restrictive and repetitive patterns of behaviors or interest according to the DSM 5. Some children may have maladaptive behaviors such as aggression, self-injurious behavior, and/or tantrums.
Aggression is defined as acting out of anger in a way that results in hostile or violent behavior. In autism spectrum disorder (ASD), the frequency and intensity of aggression depends on environmental and physiological influences. Influences in the environment could be noise, large groups of people, and anything in the environment that could trigger stress or anxiety. Some physiological influences could include sensory stimuli or defensiveness, or pain a child may be struggling to communicate, to name a few.
There are three types of aggression, namely, reactive aggressiveness, reactive-inexpressive, and proactive relational aggression. Reactive aggression can be verbal and physical types of aggression; reactive-inexpressive presents in a form of hostile behavior and finally, proactive relational aggression is an aggressive form of behavior damages another person’s social status or relationship i.e. spreading false rumors. If aggression is not regulated, it can impact a child’s quality of life, stress levels, plus availability of educational and social support.
What is impulsiveness or impulse control?
Some children on the autism spectrum may struggle with impulse control, and this results in demonstrating aggressive behavior. Other than autistic children and adolescents, those with attention deficit hyperactivity disorder (ADHD), personality disorder, borderline personality disorder, antisocial personality disorder, intermittent explosive disorder, bipolar disorder, and conduct disorder can display impulsive aggressive behavior.
Suppose you’re doing a task and feel stuck not knowing how to proceed; this may cause frustration and stress. It is often easier to step away from the task and regroup before attempting again. It is also normal to feel frustrated and overwhelmed in moments where you may not have control or something just isn’t working. For most “neurotypical” individuals, as well as some “neurodivergent” individuals, this response isn’t foreign. However, you find that some “neurodivergent” individuals react in ways that would seem “unnecessary” in situations that for others can be easily brushed off. Such is the case for children who struggle to resist urges or impulses. Feelings of frustration and anger that are usually easy to manage tend to be overwhelming for some children with autism and other conditions.
What causes impulsive aggression?
The reason behind impulse control problems is often related to executive dysfunction. Executive function is a set of cognitive skills such as planning and organization, time management, behavioral inhibition, multitasking, reasoning and problem solving that regulate higher-order thinking skills. Essentially, your ability to relate to, assess, and formulate an appropriate response to situations in our day-to-day activities is granted by executive functioning.
Consequently, difficulties with executive function cause a variety of behavioral issues. In some cases, impulse control issues occur among autistic children and can cause behavioral problems such as aggression due to the child’s inability to regulate emotions such as sadness, anger, or frustration.
Tips for parents: how to deal with impulsive aggression
During an impulsive aggression episode, your child may not respond to direction and might act harshly towards you (as a parent) or their teacher. Your child may become violent to those around him/her or towards him/herself (self-injurious).
For parents whose child may experience impulse aggression, here are some tips to help manage your child’s behavior or get it under control.
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Strategies or programs to implement
ABA—Applied behavior analysis
- Through the ABC’s (antecedent, behavior and consequence) of ABA, the antecedent (what happens before the behavior) and the consequence (the response) can be manipulated to train self-control
- The goal of ABA is always to manipulate behavior from one that is maladaptive to one that allows the child to become more functional and engage effectively in his/her environment
Functional behavior analysis (FBA)
- The basic understanding of FBA is that every behavior has a purpose and it is aimed at understanding what is the purpose of this behavior
- The assessment helps to define the behavior and thereafter a behavior intervention plan (BIP) is created to address the behavior issues and establish impulse control
- An FB analysis firstly seeks to define the behavior i.e. rather than saying that the child is “disruptive”, it rather explains what happened during that behavior
- The next step is to provide information of the moment; the “where, when, and how often?”
- It is followed by asking “why?”. Why is the child acting this way? and lastly, draft a plan; normally, this is done by creating a behavior intervention plan
- Under ABA, there’s a method called differential reinforcement. The goal of differential reinforcement is to encourage appropriate behavior by either taking away a reinforcement or giving one
- Positive and negative reinforcement can also be used.
- Reinforcement strategies have the common goal of increasing the occurrence of an adaptable and socially acceptable behavior
Functional communication training
- This type of training is very common with autism
- It identifies the purpose of the negative behavior and thereafter teaches the child a more appropriate form of communication
- It helps to teach the child more socially acceptable behavior and response strategies
Other ways to target impulse aggression
Encourage stimming behavior
- We all have a stim; for some it can be a click thing you do with your pen when you’re working and trying to focus or when you’re seated and your one leg does that shaking thing—which is mostly unconscious until someone points it out to you
- Stimming can be a self-soothing behavior; for autistic children, it can be in the form of hand-flapping, repetitive movement with an object he/she is particularly attached to or covering one’s ears
- Whatever your child’s form of self-soothing is, let it be. It could be the one thing that prevents him/her from an impulsive aggression episode
Understand your child’s triggers
- There’s always a reason for every behavior
- Observe your child’s behavior and learn what happens before the impulsive aggression episode happens
- Your child may just be trying to communicate with you or, he/she is seeking attention
It can be overwhelming to witness your child’s aggressive moments and not understand why he/she may be “acting out”. As a parent, the first step towards understanding is to listen to your child. Listening isn’t always taking note of what’s communicated verbally—through actions, a child can communicate a lot. We can get so busy in our lives that we forget to pause before we react.
There are several strategies you can put in place to help children on the autism spectrum. It’s important to do your research and never stop learning!
Fitzpatrick, S. E., Srivorakiat, L., Wink, L. K., Pedapati, E. V., & Erickson, C. A. (2016). Aggression in autism spectrum disorder: presentation and treatment options. Neuropsychiatric disease and treatment, 12, 1525–1538. https://doi.org/10.2147/NDT.S84585
Yamasaki, K., & Nishida, N. (2009). The relationship between three types of aggression and peer relations in elementary school children. International journal of psychology : Journal international de psychologie, 44(3), 179–186. https://doi.org/10.1080/00207590701656770