Responding to Verbal and Physical Aggression in Autistic Children

Short answer: don’t. 

From what I’ve learned, handling autistic aggression takes two forms: prevention and non-reaction. Prevention involves about 1,000 parts, so I’ll be slowly dissecting that for a long time. Non-reaction is the part that will be our “drip” this week. 

When asked in and interview how one should respond to autistic children with aggressive behavior, Dr. Barry Prizant, author of Uniquely Human: A Different Way of Seeing Autism, advised that we first need to understand the why of the aggression. He says:

“I have found that very often in my consulting, a student will be called aggressive, and when I actually observe an instance that meets the definition of aggression, such as striking out against another person causing physical harm, that there are other triggers. It might be that the child is touched unexpectedly and the child almost reflexively strikes out if they’re very tactilely defensive. If we define aggression very narrowly, in terms of the child intending to hurt others rather than simply engaging in behavior that may result in harm to others, we have to look at the purposes or function of the behavior… For example, Ros Blackburn, a well-respected speaker on autism, was considered aggressive when she was young, but it was only caused by social variables. If Ros was in a noisy, busy room and needed to leave, anyone who tried to stop her wouldn’t be seen as a person. She would see them as a six-foot chunk of wood and would knock them over to get out of that room because she was in her fight or flight mode.”

I believe this conceptualization characterizes Evie well. Physical and verbal aggression are not her typical modes of getting what she wants when she is well regulated (think repetitive asking, whining, and maybe even growling). Verbal and physical aggression come out in her when she is either melting down or on her way to a melt down. Aggression is her response to a situation that her autistic brain can’t handle.

Because of the way an autistic brain develops, a person on the spectrum has severely deficient regulation skills. In other words, an autistic person is physically incapable of controlling their emotions the way neurotypical people do (article explaining more of this linked here). Dr Barry explains that “due to the neurological challenges, many people with autism are much more likely to reach that fight or flight survival level, and yet we still see it as behavior that is under the child’s or person’s control.”  This is perhaps one of the hardest shifts that parents of autistic children have to make.

So, now we understand the autistic brain (poor emotional regulation and quick entrance into fight or flight) underneath the autistic behavior (verbal or physical attacks).  Now we come to the question: How should it be handled?  Dr Barry gives some advice to school teachers that I think is also instructive for parents and other caregivers:  “I think prevention, of course, is the way we need to go. Now for those students who do demonstrate physical aggression, even after preventative supports are put in place, staff members need to be trained on a hands-off approach as much as possible. This teaches educators how not to throw gasoline on the fire, while keeping the aggressive students, as well as other staff and students, safe.”

Adding physical, verbal, or corrective input to an autistic person who is already maxed out on what they can process and respond too is like pouring gasoline on a fire. Doing so is reinforcing the need to fight.  The autistic person feels threatened and enters fight mode, so you then fight them, and their brain feels justified in aggression and thinks “see they are threatening me! They are fighting me! I need to fight!”  It should be noted that it is not just reciprocal aggression that could be seen as a “fight”. Any type of engagement can be perceived as a fight by an autistic person. Trying to reason with an autistic person can feel like a threat because you are trying to reason them into something that is causing their autistic brain extreme discomfort (remember the things that cause extreme discomfort to autistic brains are very different from, and much more abundant than, what would make us feel this way).  It would feel threatening if someone was nicely trying to tell you to let him hold you under the water, right?  It wouldn’t calm you down, it would reinforce the need to fight. 

In summary, when physical and verbal aggression starts to surface, it is a pretty sure sign Evie is inching toward fight or flight. There’s a spark— don’t throw gasoline on it. Don’t respond. Deal with the non-negotiables, ensure her and everyone else’s safety, but go as hands off as possible with her. Don’t reinforce the need to fight. Don’t react or respond. 

Let’s look at a real life example. We recently had an incident with watermelon. Evie wanted to get her own watermelon from the serving bowl while friends and family were over for an afternoon barbecue. Evie generally isn’t allowed to dish her own food because she has very poor decision making skills and wastes a lot of food. I told her I would dish it, and she could have six pieces. She wanted more than that, so I told her that when she was finished what she was given, she could ask for more.  She started calling me names (“filthy beast”, “fool”, “monster”) and tried to rip the spoon out of my hand. After that came the shoving and kicking in an attempt to get me to drop the spoon. Eventually she was having a full blown meltdown. More on the causes (and preventions) of the meltdown later (spoiler alert: severe cognitive rigidity), but for now, let’s focus on what I should have done differently. What I did wrong: I engaged her.  I addressed her aggression because I was embarrassed. I tried to get the spoon away from her. I tried to remind her why she couldn’t dish her own food. I entered the battle. I reinforced the need to fight. What I should have done: let her keep the spoon and simply remove the watermelon bowl so she didn’t have access and then let her sob and cry and yell at me until the fire died out.

Responding in this way, or perhaps I should say *not* responding in this way, is a hard thing to do because it feels/appears to others as either cold, lazy, or permissive. It’s not. Her brain works differently than a typical child’s brain, which as we have seen above means that the cause and solution to the meltdown are also going to be different. In short, I have to respond differently than I always thought I would as a parent. If other people don’t like it, it’s because they don’t get it. That’s okay, because I do, and I want to help, not hurt, her.  I want to deprive the fire of her disregulation of oxygen. I’m the firefighter, and I have to do what I know is best for her even if others think that it makes more sense to try to blow out the fire because they once blew out candles on a cake. My Evie girl is a bonfire, not a candle.