My 5.5 year old wants to get hit by a car when he is upset

February 7, 2022 8:38 AM

Our son has autism and has been doing better but recently (after something has escalated, for example I didn't answer him quickly enough today in the car) he has been expressing that he wants to be dead, would like to get hit by a car, and makes attempts to run into parking lots when he is upset. Obviously we will call his psychiatrist but I wonder if anyone here has experienced this and can give ideas of how to help him.

We are currently in early intervention and have started psychological therapy once a week (only in the second week) and are waiting to join the autism program at the larger clinic where we live in continental Europe. Next school year he will be in a small school and then have a special theraputic daycare program. So I feel like we are on the right track. But I don't really know if these things are "normal" or if there is more going on. It seems to eventually de-escalate and he doesn't know how to really act anything out and at the moment he is happily watching cartoons, but goodness me WOW some of the things he's been saying recently. He says he doesn't want me to be his mother anymore and that he wants to live somewhere else.

This has only recently escalated so I have been hoping it was a phase but today it came out of nowhere and was more protracted so aside from making an appointment with our psychiatrist I wanted to reach out and see if anyone here has advice about how normal this is? What strategies could be used to calm things down? Do you talk about it much?

I get the chance to ask questions of therapists etc. But often I think of things later, and its hard to get through on the phone, etc. So hopefully I can get a little bit to think about here on how to approach it. I know I could take him to the hospital I mentioned but I am afraid to scare him because his local language abilities aren't great and we haven't been there before etc.

I guess I should go and take a look at the place? I guess I should also start keeping a better track of the incidents and what happened before and after and what helped/didn't help? I don't know, I'm just confused. And frankly, I am also very scared that this is just going to get worse and I want to be prepared.

I am very happy to hear any other advice or war stories.

posted by catspajammies to Health & Fitness (24 answers total)

Response by poster: ps- he just came for a deep pressure hug and I told him I loved him and asked if he felt better. He said yes, and I said I didn't think getting hit by a car was a good idea and did he think so. He said, no, and he wanted to see me run. So I definitely find this strange.
posted by catspajammies at 8:45 AM on February 7, 2022

Best answer: I'm wondering if the saying he wants to be hit by a car is some kind of awkwardly-expressed intense sensory seeking need that's not being met.
posted by needs more cowbell at 8:51 AM on February 7, 2022 [9 favorites]

He says he doesn't want me to be his mother anymore and that he wants to live somewhere else.

I mean, this is very typical childhood language. You also need to remember that when your 5 year old says he wants to get hit by a car, he doesn't have a tangible concept of what death means and it's not suicidal ideation. It's "wow" to you but you are looking at that statement in a very different framework than he is.

By all means, speak with whomever you like but these seem like very clear statements that your child is struggling in the moment with the frustrations of Very Big Feelings -- he is angry at you, or he is frustrated, or he wants something to be over. Developmentally, it is a good time to help him learn to name his feelings.
posted by DarlingBri at 9:15 AM on February 7, 2022 [13 favorites]

I wonder if some books on childhood development and psychology might help? Hyperbolic language and saying things like, I don’t want you to be my mother anymore are pretty normal. Obviously it matters what exactly it is that’s making him unhappy - normal kid stuff or serious stressors in his life.
posted by acantha at 9:25 AM on February 7, 2022

"he has been expressing that he wants to be dead" seems scary to me, even if he is very young. This NYT article talks a little about someone with a related experience.
posted by pinochiette at 9:27 AM on February 7, 2022 [5 favorites]

Best answer: This is very typical of my autistic kid who was much better able to articulate his big feelings than to regulate them. It’s also obviously not limited to kids with autism, but I wanted to validate that it might seem especially intense or specific or just outside the neurotypical norm if your kid is. My son used to say shocking and horrifying (to us) things that probably matched his feelings but were definitely …unusually vivid.
posted by chesty_a_arthur at 9:48 AM on February 7, 2022 [4 favorites]

The urge to run into traffic is included in the "high places phenomenon" - the urge to jump off ledges or bridges (or in my case an urge to run my thumb along the sharp edge of every can I open). The more anxiety you have, the more likely you are to experience it. No advice, just something to consider including when you talk to his counselor(s).
posted by headnsouth at 9:54 AM on February 7, 2022 [10 favorites]

If you can get in with an occupational therapist, they can be marvelous at helping find patterns and ways to regulate well before it gets to that point. When it does though, language like "I hear that you're very upset! You wanted me to answer faster. It's hard to feel [ignored/impatient?]. I can't let you [run/be hit by a car/die], but I can [give you a hug/squish you under a cushion/give you a pillow to hit/etc.], would that help?" to acknowledge what's behind it and offer an acceptable alternative that can meet the need that's being expressed. Don't try to talk him out of being hit by a car when he's still upset, just verbally/physically set a boundary that you aren't going to let that happen. Your conversation later sounds perfect for addressing that it's actually a terrible idea if taken literally, and that can also be a moment for brainstorming things that would help.
posted by teremala at 9:58 AM on February 7, 2022 [10 favorites]

Best answer: I agree with others that the intensity of the imagery reflects the intensity of his emotions in the moment rather than a desire to be dead for real. However, my fear (and I'm sure it is yours too) is that an impulsive child might do something in the moment that could be truly dangerous in ways that he doesn't understand or intend.

Make sure you ask for specific suggestions on how to handle your child in moment, especially if there is an imminent risk that the kiddo might impulsive act on the thought. (eg. you are actually in a parking lot when he says he wants to be hit by a car). Also, if this kind of specific behavioral intervention isn't the psychologist's specialty, see if you can a referral (often to an occupational therapist) to someone who is.
posted by metahawk at 10:13 AM on February 7, 2022 [3 favorites]

It sounds like you could benefit by having community with other parents of autistic kids. A general interest group like this one has some parents who have a similar frame of reference to you and lots who don't. Is there an online or in-person parent community you can access where more folks may 'get it'?
posted by latkes at 10:18 AM on February 7, 2022 [1 favorite]

I'm sorry, that sounds really hard and exhausting.

I'm not sure if this will resonate or not, but... We've been noticing some OCD tendencies in our (similarly aged) daughter; less immediately harm-oriented, but refusal to eat or drink unless certain criteria are met, counting/tics, etc. What we've started doing (based on our reading while starting her up in therapy) has been to name and externalize the source of those compulsions, to help her to differentiate between what she *WANTS* to do and what she feels like she *HAS* to do, and stand up for the former. So far, at least, we've seen some limited success in getting her to be able to tell the difference between her regular desires and needs ("I need to go to the bathroom") and her compulsions ("but Bossy Boots is telling me I can't"), and to advocate for herself ("You go to your room, Bossy Boots!! Stop telling me what to do!"). So it might be worth a try to personify some of the urges / big feelings, which could help child recognize them and pause? Like, hey, I don't want to run into traffic! That's [insert your favorite ridiculous name here] telling me something mean! I'm not going to listen to them!

We've also found that in the most worked up moments, what works best for us is to have some sudden, explosively ridiculous thing happen. "Look over there! Did the cat poop on the floor?? WHAT THE HECK!?!?" This might shake loose some of the locked-in feelings, and let you get out of a crisis moment. I honestly have a hard time doing this, but when I can, it often helps break out of a cycle that otherwise might be hard to stop ("I need to do this thing!" "No, stop!" "But I neeeeeeed to!"). Another version of this that we do is to start asking "hey, do you see anything yellow? .... ok, what about something green?" or similar type questions, again with the goal of distracting and helping to calm some emotions / get out of a big moment. Our daughter at least seems to generally welcome that, as (presumably, on some level) she ALSO realizes she's stuck in an unpleasant moment, but doesn't know how to get out of it.
posted by twigatwig at 10:26 AM on February 7, 2022 [5 favorites]

Best answer: Agree with chesty a arthur.
My son has ASD and was also early on very verbal, so expressive for his age that for a while it was even a problem because he was refused testing because the assessor thought this was a sign he cannot possibly have ASD.
Anyway, when he said stuff like that around age 6 (his used to say i will jump out the window) after the initial shock, i spoke with him about what he thought would happen after he jumped, and it became clear, although he said he wanted to jump in order to die, he had no concept of the permanence of death. He listened very careful and stopped saying he would jump to death.
For him it was a question of understanding in detail what would then happen. Especially that He and i would then permanently be separated. Now, obviously this would only work if you are comfortable being direct, and not if your religious belief is different.

However, it did not stop him from rage and beating, biting etc me. To this day we, together with his psychatrist and therapy work on how he can express rage.
One strategy that worked until he was about 8 or 9 yrs, was hitting pillows on a couch with an old tennis racket. We did it together, it also helped me.

The death theme/selfharm ideation returned last spring, age 12, but as by then he had a very clear understanding of the permanence of death, eventually i ended up having to admit to the pediatric psychiatric ward for treatment, which was successful, and he is now on an antidepressant.
posted by 15L06 at 10:53 AM on February 7, 2022 [12 favorites]

I don't know, give him a soft toy car (like a Disney Cars plushie) that he can hit himself with so he can get his anger out? That's just the first idea that came to mind. Sorry if that's stupid.
posted by kschang at 12:01 PM on February 7, 2022

Best answer: Your son may be experiencing Tourette-like impulses to do forbidden things — not just things he's told not to do, but self destructive things he himself does not want to do at a very deep level:

The new work homes in on Tourette syndrome — a motor and tic condition — and three diagnoses that often present with it: More than half of people with Tourette also have obsessive-compulsive disorder (OCD) or ADHD, and up to 20 percent have autism. Because all four conditions can involve impulsive and compulsive behaviors, some scientists have proposed that they exist along a spectrum, with ADHD on one end, OCD on the other, and autism and Tourette in the middle.

Very much like the "high places phenomenon" headnsouth brought up earlier.
posted by jamjam at 12:20 PM on February 7, 2022 [2 favorites]

Best answer: I would like to gently say that it is a common myth that young children don't understand what they're saying when they talk like this or don't really mean it. This is an area of my expertise. (Source: I teach other therapists about suicidal ideation in young children.) Some children don't "mean it," but more young children than we would expect do understand concepts like the finality of death and know what it means to say they want to die. Please reach out to me via memail if you want some resources as I'm happy to provide them.
posted by fairlynearlyready at 12:54 PM on February 7, 2022 [22 favorites]

Best answer: Children as young as 5 have acted on suicidal talk(see above). Make sure he knows it hurts, a lot, and is terribly permanent. It takes a while for young people, especially boys, to learn impulse control. Tell him you love him, help him find ways to get rid of anger, hurt and energy, exercise can be a balm. Thank him for telling you how he feels, encourage him to keep doing that. Ask him to promise not to harm himself. So many people dismiss kids when they say serious things; you're doing the right thing to recognize his feelings.

You sound like you're doing a great job with a kid whose needs are intense. It's hard. Make sure you get support, too. That's not easy, but I want to recognize that you need it, even if it's hard to find.
posted by theora55 at 3:06 PM on February 7, 2022 [5 favorites]

Best answer: I think it's very good that you're taking this so seriously and looking for outside help. It could be a random group of extreme statements but it could also be a sign of something more serious and worrisome. I am neurotypical but was sexually abused at age 7 and also have OCD, and the combination of the two is likely what lead to suicidal ideation at age 8 and then a slew of compulsions at age 9 that felt like hell. I am doing well now but I had some really hard times in my life due to (previously) undiagnosed and, therefore, untreated PTSD and OCD.

I don't know what it is for your son -- maybe something happened, maybe he's got anxiety over the changes in his life, maybe it's just part of a developmental phase -- but getting that outside support is the right choice. And YES to telling him you love him a lot, that you'll find a way to feel better together even if it takes a few tries, and giving him those hugs that make him safe! I hope you all find insight and then a good solution soon. You surely will, and I am sure everything will work out!
posted by smorgasbord at 5:18 PM on February 7, 2022 [2 favorites]

Best answer: I would definitely try tracking his days- wakeup time, meals, activity, poops, locations, meltdowns. A quick way to do it is with photos- snap a pic when each thing is happening. Not necessarily a pic of him- but like:

a pic of your hand opening his bedroom door in the morning,
the closed bathroom door when he’s using the toilet,
His breakfast plate,
Him running at the park,
Grocery shopping,
Playing quietly,
Whatever he watches onscreen,
A pic of your own foot when he has a meltdown (easy to do quickly without him feeling surveilled or embarassed)
Etc.

Then at night, go back through the photos and jot down his daily schedule, using the time stamps from the photos. Maybe patterns will emerge. Look for loud or bright environments, changes in routine, if having to pee or poop exacerbates other negative feelings (it sure does in neurotypical kids...) , etc.

I would also suggest you add some autistic adults to the social media accounts that you follow, so that you can understand more about autism from the autistic person’s perspective. The hashtag #ActuallyAutistic has a lot of valuable insight.
posted by nouvelle-personne at 5:24 PM on February 7, 2022 [1 favorite]

I would like to raise the possibility that your son is speaking legitimately and truthfully, and does not need a hospital or psychiatrist, but rather needs to be taken seriously.

My partner is autistic, she did similar things as a kid e.g. threatening to jump out of moving cars. The reason she did that was because her parents were doing things that hurt her and punishing her for having meltdowns and exerting so much control over her that she really had no other way of expressing that they were hurting her and that it was so painful that death was preferable (it was, she was speaking truthfully and legitimately). It was the only thing that they would actually listen to.

The thing is... society is an utter absolute hierarchical bullying oppressive mess. We live deeply screwed up disconnected lives. All of the social roles we learn since birth have power hierarchies woven into them. With autistic people you have to throw all of that away and relate on a direct animal level. That likely means recognizing that there is a violence embedded and encoded in our ways of life and ways of relating, and it might prompt a really deep overhaul. You need to understand that due to your size and power relative to your son you have the potential to be both incredibly calming and incredibly terrifying. And society teaches us to be terrifying by default so most of us have work to do here.

For example. If you don't answer a kid when they make a bid for attention, as you described in your intro, that kid feels psychically abandoned, like they themselves are being blocked out, ignored, and effectively killed. If you act even a little bit defensive, escalating tensions rather than soothing them, trying to control the kid's response or get the kid to do something or start talking about the kid's feelings as if the fault is somehow with them, you drive the knife deeper into their soul. The only thing you can and should do is become 100% soft and gentle.

You need to become the warm blanket that wraps around him. Make your voice soft and soothing. Stop everything that you're doing - if you're driving, pull over. It doesn't matter if you're going to miss a doctor's appointment or miss a flight, whatever, you have to stop everything. Dim the lights, remove sounds. Act and speak calmly and very deliberately and very confidently. Say "it's okay", place a gentle hand firmly on their shoulder, that sort of thing. Wrap them up in a blanket if they have one. Play some soothing sounds that he likes. Sing to hijm. Don't ask him questions or ask him to make any decisions, don't be like "do you want your blanket", just act, but above all act gently. Think of yourself as a sea urchin and your son as a balloon. Or yourself as a bull and him a china shop. Any sudden aggressive action, emotion, movement, sharpness in your tone, etc, will hurt him terribly. Any deliberate, calm, soothing action will comfort him. Don't bother with hospitals and psychiatrists. This is an animal-to-animal thing, it is between you and him.
posted by PercussivePaul at 5:52 PM on February 7, 2022 [8 favorites]

war stories.

if you don't believe me that violence is encoded in the way we relate, look at the way we talk about raising an autistic child. Like it's a war. It's not a war. So that instinct to not take him to the hospital because it would scare him --- that's the animal instinct, that's what you need. Build your entire universe around that.
posted by PercussivePaul at 5:57 PM on February 7, 2022 [3 favorites]

Best answer: Came here to say what jamjam said! I have Tourette Syndrome (primary diagnosis) and, as part of my collection of associated comorbid conditions, autism. It's a very, very common combo, even if someone doesn't have both with enough severity for doctors to notice and offer a full-fledged dual diagnosis.

I have very disturbing, violent tics, especially when I'm stressed....but even sometimes when I'm just spacing out and relaxed enough that tics start slipping out.

Examples:
I want someone to kill me
I want someone to strangle me
I want to be murdered
I'm going to kill myself
I want to kill myself

I really freaked out a new roommate who I hadn't disclosed my condition to once by screaming that sort of thing while I was doing the dishes.

You know when people on TV make a mistake, and they mutter "Stupid, stupid, stupid!" Or when you remember something you're deeply ashamed of, and you curse or cringe? That's honestly how it feels. It's a vocalization of stress, not something I'm planning or intend to do.
posted by Juliet Banana at 9:04 PM on February 7, 2022 [5 favorites]

Response by poster: Thank you everyone for your answers, some of them especially resonated with me. Especially the ones that described that feeling of stress and wanting to jump off something high or saying something distressing because I feel like that myself sometimes but its such a fleeting feeling that I never really thought about it. I also appreciate the answers reminding me about the developmentally normal stuff, its just that he is so miserable so much of the time that the "normal" part gets lost and on these occasions, while it may be normal to say you hate your mom, when it happens at the same time that they are trying to run into traffic and saying they want to die- well- I think that sucks and that's why its so.... tough. So... wow.

Thank you everyone!

Also, while I appreciate the answer that questioned his need for a psychiatrist I think I would be negligent not to do everything I can to help him reach his full potential and I definitely get the impression that our psychiatrist is on his side and there for HIM and he deserves that, and we've made sure to protect him from situations that wouldn't have been in his best interest. These supports take a long time to set up and its better to set them up when everything is going well, rather than wait until you realise you definitely need help but there is a one year waiting list.
posted by catspajammies at 5:34 AM on February 8, 2022 [3 favorites]

Response by poster: Oh and we did some weighted blanket and deep pressure this morning so hopefully that was helpful!
posted by catspajammies at 5:39 AM on February 8, 2022 [1 favorite]

Response by poster: Hi everyone! I just want to update, he is feeling a lot better and after the continuous quarantine periods have tapered off and he is in his routine and we are relaxed about making him do things outside of the home (not too many trips to busy places like the zoo, actually not doing that at all, nor too many trips in one day) this has gotten better and not an issue at the moment. Hopefully not again.
posted by catspajammies at 7:38 AM on June 22, 2022 [6 favorites]