Growing with Autism
July 14, 2011 12:30 PM   Subscribe

So my autistic son is now 9 years old. How do I (a 5'0" woman) stop him (a 4'6" tornado) from physically harming me?

For the record, I (and his teachers and therapists) don't think he fully understands how other people feel pain. What happens is that he gets upset about something and it seems like he can't express it; his reaction, when I try to calm him down, is to punch and kick. (The punches don't leave bruises, but the kicks do. When he punches me in the eye, it does tend to hurt.) Of course, it all hurts emotionally, even though I know why he's doing it. This doesn't happen often, but he's getting bigger every day, and I'm not.

I'm asking for any advice, especially from the MeFites out there on the Autism spectrum or who's kids are, because I am out of ideas. We've tried brushing/combing/scratching, squeezing, positive reinforcement, negative reinforcement, verbal and visual preparation for what's going to happen at "big" events, removing him from overwhelming situations, and quietly reminding him, with specific keywords, about appropriate behaviors in particular places. He sleeps with somewhat heavy items on top of him, like an animal filled with bean-bag filling, a giant Cars pillow and a Tomica box. (The Tomica box isn't heavy, but I kept it so we'd know how to put the damn track together again after he deconstructs it, and now he loves the box more than the track.) He is mostly verbal now, but still exhibits some echolalia and is exceptionally literal.

His teacher, who is wonderful, has mentioned a weighted vest, but wants to view that as a very last resort.

So what can I do now, to get my normally affectionate and lovable son to stop hitting and kicking?
posted by mitzyjalapeno to Human Relations (14 answers total) 4 users marked this as a favorite
Does he take any medication? My 8-year-old, who has Asperger's syndrome, has had success with some drugs that are normally prescribed for ADHD, and I know of other autistic kids who are on low doses of mood stabilizers.
posted by Daily Alice at 12:52 PM on July 14, 2011

Is he on any medication?

It sounds like my son (11, also on the spectrum) is very similar, but not quite as severe. He is also 5'4 and growing fast, I have many of the same concerns.

We're exploring counselling, and for the first time, he's on a mild medication that seems to have helped some. If you'd like, memail me. I may not have many answers but I definitely understand.
posted by lemniskate at 12:55 PM on July 14, 2011

Best answer: Would compression clothing help?
posted by bolognius maximus at 12:57 PM on July 14, 2011

Response by poster: Yes, I forgot to say that! He's on Tenex, the generic version, and we've noticed huge improvements. Last week, I was late giving him his dose, and there was a noticeable difference.
posted by mitzyjalapeno at 12:57 PM on July 14, 2011

Response by poster: bolognius maximus, is that like Under Armour?
posted by mitzyjalapeno at 1:05 PM on July 14, 2011

Exactly. Here's a link for an online store that has similar stuff, but you could go to Dicks Sporting Goods and get compression shirts there.
posted by bolognius maximus at 1:10 PM on July 14, 2011

Response by poster: That's first on the list, then. Thank you.
posted by mitzyjalapeno at 1:18 PM on July 14, 2011

Best answer: I'm a special education teacher and I recommend you take a crisis prevention class that specially works with kids on the spectrum. A certain amount of sped teachers are required to have this training, and it's very effective. You'll feel more confident and able to handle physical outbursts but even better is the amount of training you'll receive on how to stop something before it happens.

I'm 5'6", 135 lb. and I work with teenage boys (with emotional/behavioral disabilities) who can outweigh me by 100 pounds, and at least once weekly I need to restrain someone. The class gave me the tools and the confidence to do it without even thinking.

Also, I'd look into an private OT consult; they can give you some great ideas for body calming and body control issues.
posted by kinetic at 2:12 PM on July 14, 2011 [8 favorites]

I apologize if I'm speaking out of turn as I do not have an autistic child, but in the book How To Talk So Kids Will Listen and Listen So Kids Will Talk, one mom of an autistic kid recommends drawing anger, as in scribbling it with crayons.
posted by Addlepated at 2:15 PM on July 14, 2011 [1 favorite]

I think kinetic has it right, you want to get ahead of this and do what is necessary to keep yourself and your son safe. I also agree that OT can make a big difference.

On the meds front, you might want to ask your psychiatrist about Risperidone (Risperdal). Even at a very low dose which has a low risk if side effects it can sometimes make a big difference.
posted by cosmac at 2:30 PM on July 14, 2011

Response by poster: Thank you, everyone.
posted by mitzyjalapeno at 2:38 PM on July 14, 2011

I work with kids who have autism and I--quite literally--feel your pain. If you haven't done it already, I highly recommend Nonviolent Crisis Intervention training. It deals with practical, hands-on, safe interventions for those times when someone is trying to hit you or needs to be removed from a situation, and it also spends a lot of time on ways to handle the emotional impact of being the object of someone's aggression.

That said, do you know what some of his triggers are? (Loud noises? Bright lights?) I've had great success with teaching my students to tolerate various triggers by exposing them to said trigger in tiny increments (i.e., five seconds of a noisy room, etc.) and reinforcing them like mad when they don't get aggressive. The goal is to gradually increase the increment so that they can handle frustrating/overwhelming situations as they arise.

Does your son have any specific strategies in place to help him deal with frustrating situations? (Deep breaths, squeezing hands, punching a pillow, asking for a break, etc.) If he's a literal guy, he may be very receptive to a concrete course of action to follow when he feels upset. I would also include teaching him to say "I'm mad!" or "I'm scared!" or whatever is appropriate, since as you said, he's having a hard time expressing himself.

By now you probably know the antecedent/behavior/consequence routine...any chance that aggression allows him to escape or to get attention or to access preferred items? Is it possible that he needs sensory input (for instance) but only gets it after he's been hitting and kicking?

When you come up with a plan to address this issue, make sure that everyone who deals with him, from his therapists to grandma, is carrying out the plan consistently. All it takes is one well-meaning person to derail it by doing their own thing.

My apologies if I'm asking about avenues that you've already explored. Feel free to MeMail me if I can help in any way.
posted by corey flood at 2:59 PM on July 14, 2011 [1 favorite]

I had charge of an autistic kid with violent tendencies. I always carried a heavy quilt with me that, during a violent outburst, I would wrap her in and tightly swaddle her while holding her from behind. The blanket kept me safe and the tight compression calmed her down. Be careful of the backward headbutt.
posted by Foam Pants at 3:18 PM on July 14, 2011

Definitely get training on safe restraining. I have dealt with larger kids in violent outbursts, and it's not just protecting yourself - they may try to hurt themselves during the outburst, or other children. Far better you know how to safely hold them down until there are other adults to help or they're calm enough to respond to other methods, than you, they or another child get hurt.

I felt absolutely horrible, the worst parent ever, the first time I had to pin down my son. By the end of the month, I could do it calmly in public because I wasn't getting my face bashed or bitten, and that made me a much warmer parent, not being afraid of my child's violence, and made it easier for my son (not autistic, but traumatised) to move on. The few times he did manage to hurt me, my pain and his shame (when calm) was worse than the anger he felt about being restrained. He did not want to be restrained during the violence, but he did not want to be a violent person even more when he was calm.

We've used weighted blankets, not a vest though. If you can borrow one, why not try it?

I would have loved getting sympathetic training on restraints - it's a scary thing to do the first time, because you're worried you'll hurt them, but it helped to practice and see on myself that it wasn't painful, just really annoying.

I got sedative meds for him once for a travel period because there was no way I could risk a large violent kid on an airflight, but you have to balance that. I wouldn't have relied on sedation over restraining day-to-day, but it's something to consider if you're going to be unable to safely restrain him in a high-risk place.

Good luck! You'll probably get lots more useful stuff from parents of autistic teens but I just wanted to add that I was scared of my kids, and embarrassed that they would hit me, and that it did change when I saw how much quicker and with less damage things went with restraining. Hopefully, this will be a phase that you can eventually manage with non-physical interventions.
posted by viggorlijah at 2:17 AM on July 15, 2011 [1 favorite]

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