Being the parent of a child with autism is a challenge. While we try so hard to find ways to overcome the issues that come with autism, we sometimes forget that other problems associated with normal development and associated with other psychological and physical conditions can develop in tandem with autism. This is the boat I found myself in this year. However, after stepping back and evaluating the situation I found solutions to the new issues that have developed with my pre-teen autistic son.
Autism and Aggression
One of the biggest problems that parents with pre-teen and teenage kids with autism have is with aggression. Aggression can take on many forms including self-injury, physical assaults on others, spitting and screaming. In my son’s case the problem was mostly bursts of hitting and out of control behavior that lasted about ten to fifteen minutes at a time. What was confusion about this behavior was that it was sudden, it seemed to be triggered by an unknown cause and it occurred only during specific times of the year. When my son was younger I really didn’t pay much attention to this problem as he was small and I could defuse the problem by drawing his attention to something else, however, now that he was older and significantly bigger than I am, the physical assaults were more serious and dangerous.
In order to find a solution I went online and looked for possible causes and treatments for autism and aggression. What I found was that aggression in pre-teen kids was very common and that many parents were looking for answers. One answer that I found was the drug risperidone. This is an anti-psychotic drug that has been very affective at minimizing severely aggressive behavior displayed in kids with autism. However, it has a few side affects such as weight gain, fatigue and drooling, which, according to research, will generally decrease over time.
While anti-psychotic drugs can be an affective way to treat severely aggressive behavior, it is not the right, or only treatment option for everyone.
Autism and Depression
While my son’s aggressive outbursts were concerning, I didn’t feel as if they were triggered by a psychotic episode. The seasonal nature of these outbursts caused me to consider a second option, seasonal depression. Research has shown that kids with autism, especially high-function autism, are more susceptible to affective disorders such as bipolarity and depression. When I learned this I looked at my own family history, which has depression trends on both sides of the family tree. This realization, along with a more objective evaluation of my situation and the fact that aggressive behavior can be triggered by depression, led me to believe that this was the cause of my son’s outbursts and not a psychotic disorder.
With these pieces of information in hand I started researching treatment options for depression linked to autism. Most of the research that I read showed that depression linked to autism tends to be associated with irregular serotonin production. This means that the most affective treatments are going to use anti-depressants that address serotonin levels. However, most of the drugs that are designed for this purpose have been shown to cause thoughts of suicide in kids under 16 years of age.
Because of this risk factor I decided to find an herbal treatment that would help to support normal serotonin production and utilization. I found one herbal product called Nerves Formula (sold by DHerbs). This product contains St. John’s Wort, Lavender and Valeria rot, along with other ingredients, that have been traditionally used to relax, sooth and stimulate a balanced emotional state. I mixed one capsule into mash potatoes three times a day and gave it to my son. I was surprised at how quickly it helped to relax him and stabilize his moods.
Multi-causal Factors
With his mood stabilized the physicalness of his outbursts subsided, but he still was initiating confrontation with repetitive verbal cues. Okay, I thought, there is something else that is going on here. Then it hit me. My reactions to his outbursts had established a cause and effect relationship that he depended on to get something that he wanted, in this case a new Slinky. Before when a physical outburst occurred I would try to defuse the situation by offering a new Slinky in a box, a prized reward. While this would temporary solve the problem at hand it reinforced the negative behavior which gradually intensified.
This new “a ha” moment was a breakthrough. The aggressive behavior that I was trying to eliminate was caused by more than one factor. The physical side was triggered by an emotional disorder that was corrected with herbal supplements, while the behavioral trigger was caused by my own reinforcement of negative behavior. To correct this problem I would need to (1) stop reinforcing the negative behavior, (2) find ways to defuse the physical tension that developed when he became frustrated, and (3) establish positive behavior.
Step one was accomplished by simply taking control of the situation and my own behavior. When faced with a negative demand for a Slinky I would ignore the request and try singing while turned away from my son. This signaled to him that his behavior would not get a “rise” out of me, and the singing helped to (1) keep myself focused and relaxed and (2) keep his mind from locking into frustration mode. The second step was to use defuse physical tension, which often leads to hitting, pinching and self injury, by using joint compression, deep tissue massage and light touch. The final step was to take control of the conditions under which rewards were distributed. I would now require a polite request for treats such as “I want Slinky, please.” (You can adjust this according to how your child communicates.”
Conclusion
Trust me, I know what you are thinking. Completing these steps is not easy to do and they were not successful immediately. However, try to keep in mind that behavior is a work in progress and that it is constantly evolving. There really isn’t a quick fix to any behavior problem. Instead you have to take small steps to manage it the best you can and try to avoid making mistakes that will set you back.
