Month: December 2020

A child’s aggressive behavior creates immediate reactions from those around them. Children with autism who find it difficult to communicate their feelings and needs will often act out aggressively whether their behavior is motivated by frustration, hypersensitivity to environmental stimuli, or a specific need. 

Because these types of behaviors are met with immediate reactions, they are unintentionally reinforced.

In this article we will learn more about the aggressive behaviors of autistic children and give you tips on how to deal with them. 

Why do autistic children behave aggressively

Children diagnosed with ASD struggle with understanding certain types of language and often do not have the ability to communicate their needs and feelings adequately. These aspects of their disorder may make them more likely to exhibit aggressive behaviors that children who aren’t on the spectrum.

When your child acts out aggressively, it may be because:

•       They feel overwhelmed by negative feelings. Children struggling with autism often experience anxiety and stress that they are unable to communicate to those around them. If a situation makes your autistic child anxious, they may act out to get you to remove them from the situation.
•       They are feeling bombarded by negative sensations from their environment. Many children diagnosed with ASD are hypersensitive to things like noise and touch. They may experience loud noises as painful or a burst of air hurt their skin. Responding with aggressive behaviors may be an automatic reaction to being physically uncomfortable for some children on the autism spectrum.
•       They may not understand what is going on around them. Since children on the autism spectrum have difficulty understanding idioms, figurative language, and nonverbal communication, they may struggle in situations where there are a lot of people or when things aren’t explained to them in a fashion they can understand. In this instance your child may act out aggressively out of frustration.
•       They may use aggressive behaviors to communicate their needs if they can’t make those around them understand what they need in a given situation. A child who is struggling and can’t make those around them understand their needs may act out aggressively. Although the reaction they receive may not solve the problem, the immediate reaction that a child receives when acting out in an aggressive manner does allow the child to feel that they have some control in the situation.
•       They may use aggressive behavior to get them out of a situation they don’t like. Children learn very quickly that one way to escape an uncomfortable situation is to act out in a way that will get them taken out of the situation. Even when a child is removed from an uncomfortable situation as a punishment, being removed from the situation is rewarding.

How can this aggressive behavior manifest

When your autistic child exhibits aggressive behavior it can come in a variety of forms. Your child may bite, scratch, kick, and/or yell at you or others. They may also scratch themselves, hit their head against an object, or punch themselves. Research indicates that children diagnosed with ASD will most often direct their aggression toward their caregivers.

Understanding aggressive behavior in autistic children

Children on the autism spectrum may have anger triggers that are associated with their disorder. Understanding the triggers that lead to your child’s aggressive behaviors will help you develop ways to deal with these unwanted behaviors. Triggers that your child may experience include:

•       Disturbing breaks in their typical routine. Children on the autism spectrum often become distressed when their routines are altered. Unexpected events may increase your child’s anxiety levels and create heightened feelings of confusion and being out of control.
•       Distressing sensory stimuli. If your autistic child experiences hypersensitivity to external stimuli, you may find that loud noises, jarring lights, or overpowering smells tend to set your child off.
•       Lack of sleep. Children diagnosed with ASD often struggle with sleep. Unfortunately that doesn’t mean that your child doesn’t need as much sleep as other children do. You will frequently find that your child will be more likely to act aggressively when they are experiencing poor sleep.

Dealing with aggressive outbursts from autistic children

Thankfully, there are many things you can try to help reduce your autistic child’s aggressive behaviors. Some of these include:

•       Identifying aspects of the environment that may be triggering your ASD child and developing strategies for dealing with external stimuli.

○       If your child is hypersensitive to  noises, you may find that having your child wear noise cancelling headphones in certain environments is enough to help them control their reactions to what is going on around them. Parents are apt to understand that a child may be distrubed by loud noises like fireworks or alarms.

However, it is helpful to understand that it isn’t always loud noises that can create issues for your autistic child. Often when children with autism are trying to concentrate in the classroom, they can be distracted by conversations or noises that you may not even notice. The frustration created by this constant distraction is enough to make many children act out aggressively. Often professional help may be necessary to help you identify why your child is acting out aggressively.

○       If your child is hypersensitive to smells, you may find that allowing them to use lotions or hand sanitizers that have a soothing smell on their hands will help them to focus on the pleasant smell that they have control of rather than the offensive smell. Likewise, if you know that your child is triggered by a pervasive external smell like the smell of cooking fish, you may find that improving ventilation and the use of air fresheners will help to lower your child’s reaction to olfactory stimulation.

○       If your child is hypersensitive to glaring lights, you may find that something as simple as allowing your child to wear sunglasses in certain environments is sufficient to help reduce the likelihood that your child will experience enough discomfort that they act out aggressively.

•       Prepare your child in advance when there will be a break in their routine when you can.
•       If you take your child into a new environment where they are likely to find things confusing, take the time to explain what is happening and help them to avoid undue anxiety.

For example, the first time you fly with a child who struggles with autism, you may find that they are overwhelmed and confused. Taking the time to explain the process of travel step by step as you approach a new phase of the trip will help your child remain confident that they are safe. You will want to avoid giving too much information all at once to avoid overwhelming the child.

•       Help your child develop good sleep hygiene to support them in getting a good night’s sleep. Children on the autism spectrum will generally need more support to get a good night’s sleep than other children do. Developing a supportive night time ritual and helping your child deal with the things that interrupt their sleep can help them cope better with the stresses they encounter in everyday life.

How can you modify aggressive behavior of autistic children?

There are a variety of strategies and therapies that can help you modify the aggressive behavior of your autistic child. These options include:

•     Applied Behavioral Analysis (ABA) is a very well researched intervention that has helped many children diagnosed with ASD reduce aggressive behaviors. ABA therapy is based on learning theories and has been shown to be highly effective in helping children on the autism spectrum reduce negative behaviors. Specific aspects of ABA therapy have been found to be highly effective in helping reduce aggressive behavior in autistic children.

○       For example, Functional Communication Training (FCT) has been seen to help children on the autism spectrum to reduce aggressive behaviors when their behaviors are intended to get attention or are the result of the frustration of not being able to communicate their needs. A child may be taught to use gestures or pictures to communicate needs and obtain attention.

○       Functional Behavioral Assessment. This aspect of ABA therapy is very helpful in allowing parents and professionals to understand why a child diagnosed with ASD may be acting out in an aggressive manner. Once parents understand why their child is behaving in a certain way, they can develop a plan to deal with it. Although your child doesn’t have to be in ABA therapy for you to obtain a functional behavioral assessment, this assessment is a fundamental aspect of ABA therapy.

○       Reinforcement Strategies. There are several reinforcement strategies used in ABA therapy that have been found to help in the reduction of aggressive behaviors in children diagnosed with ASD.

•       Medications are a helpful alternative that many parents turn to to help their autistic child control aggressive behaviors. Research has found that a variety of medications have been found to help children on the autism spectrum deal with symptoms associated with their disorder. Some psychiatrists have prescribed antipsychotic medications or mood stabilizers to help control an autistic child’s aggressive behaviors.

Although there are many studies on using these medications to help children on the autism spectrum control aspects of their disorder, this option is often used as a last resort or when a child’s behaviors are very severe. Many medications are not appropriate for children under a certain age, and all of these medications have potential side effects that give many parents pause.

All parents experience stress related to the usual worries and tasks associated with raising a child. Unfortunately, along with the usual struggles with childhood illnesses, the rigors of school work, and the drama of childhood friendships, parents with children on the autism spectrum experience extra levels of stress and concern. 

Parents with children diagnosed with autism spectrum disorder (ASD) experience all of the stresses associated with having a child who struggles with special challenges. 

However, research indicates that parents with a child diagnosed with ASD experience a special level of stress that is more than the stress experienced by parents of children diagnosed with Downs Syndrome.

The added stress experienced by parents of children on the autism spectrum comes from:

•       The stigma of having a child with a visually invisible disorder. No parent of a child diagnosed with ASD has avoided the wilting glances and rude responses made by people who are unable to understand that their child’s behavior is not the result of poor parenting skills.
•       The self-injurious behaviors that many children on the autism spectrum exhibit. Repetitive behaviors like headbanging are not only dangerous to a child but are heartbreaking for a parent to witness. 
•       The issues associated with poor sleeping patterns and picky eating habits many children diagnosed with ASD struggle with. A child’s sleepless nights generally impact the whole family but at best they impact the primary caregiver. Likewise, picky eating often requires more effort and time to accommodate than feeding a child who can happily eat a wide variety of foods.
•       The financial problems associated with the challenges of raising a child diagnosed with ASD. Frequently one or both parents of a child with ASD will find that they need to take time from work to provide support to their child. Parents often must take time away from work to participate in appointments with specialists that support their child. 
• The development disorder, limited social skills and communication, and other symptoms of autism that come along with a child on the autism spectrum.

As with any diagnosis that results in increased stress levels, financial challenges, and endless commitments to meetings and appointments, parents of children diagnosed with ASD often hope for a cure. 

A cure implies that the continuous work of complying with treatments and interventions can be ended once and for all. Although this may seem like a good goal for any issue that limits a child, it is seen as offensive to many people who work with, live with, and love those who are diagnosed with an autism spectrum disorder.

What is autism?

Autism Spectrum Disorder (ASD) is a disorder associated with deficits in social skills, communication abilities, and relationship skills. Individuals diagnosed with this disorder will also exhibit, or have previously exhibited, repetitive patterns of interests, behaviors, or activities from an early age. People diagnosed with ASD can vary in their abilities, thus the disorder is considered to exist on a continuum. Some people diagnosed with ASD will need considerable support in everyday life, while others will be identified as gifted in some areas.

 Autism Symptoms

ASD is often diagnosed early in a child’s life. Parents are generally the first to identify issues that their children are struggling with the disorder. They may notice any of a variety of signs that their child is struggling with ASD. These signs may include:

•       Their child doesn’t make eye contact when talking to them. Most people will make eye contact when communicating with one another. We generally see young babies making prolonged eye contact when people talk to them. If your child doesn’t make eye contact it may be an early sign that something isn’t quite right.
•       Their child doesn’t point to things of interest to them. Most children will point to attract your attention to an object if they have a question. However, children on the autism spectrum are unlikely to point to the object they are asking a question about or talking to you about. You may first discover this simply due to the fact that you are often uncertain of what object your child is talking about.
•       Their child doesn’t look at an object when someone else points to it. If you notice that your child doesn’t turn to look at objects that are pointed out to them, you may want to explore the reason why.
•       Their child doesn’t seem to understand other people’s feelings. Children diagnosed with ASD are often viewed as rude due to their inability to understand the way that their words or behaviors impact others. If you notice that your child behaves in ways that seem careless of the feelings of others, you may want to explore further.
•       Their child doesn’t talk about their feelings. If your child doesn’t talk about their feelings, particularly when you see behaviors that look like they are the result of strong emotions like anger, you may wish to look into this further.
•       Their child doesn’t respond when people talk to them but will respond to other noises. Children on the autism spectrum often experience a hypersensitivity to noise. If you notice that your child has no difficulty hearing but does not seem to take in, or respond to, voices, you may wish to look into this further. 
•       Their child doesn’t like to be cuddled or hugged. Children on the autism spectrum often dislike cuddling. If your child seems to avoid cuddling, or only wishes to cuddle at specific times, this could be a clue that they are struggling with symptoms of ASD.
•       Their child repeats the same behaviors or phrases and words over and over. For example a child with ASD may mimic a phrase or repeat what others say like an echo. If rather than communicating in an appropriate way, you notice that your child is repeating your words or using a standard set of words frequently, you may wish to explore further.
•       Their child doesn’t engage in pretend play. Children on the autism spectrum may spend a great deal of time setting toys in a specific order, but they may not engage in play that requires imagination. For example, a child with ASD may set their dolls up in an ordered line but will not play at feeding or caring for them.
•       Their child may show a great dislike for changes in their daily routine. Most children enjoy a break in their day to day routine. If, however, you notice that slight changes in daily routines upsets your child, you may wish to consider whether this could be a sign of something more.
•       Their child may react more acutely to sounds, tastes, and the feeling of things like clothing than other children appear to. If your child displays difficulty tolerating things like new shoes, the seams in socks or clothing, tags in their clothes, or specific types of food, it could be an indication of hypersensitivity associated with ASD.

Can autism go away?

According to recent research, children can somewhat outgrow their diagnosis of ASD. However, research by Shulman, D’Agostino, & Lee indicates that many of these children will continue to need some type of early intervention such as therapeutic or educational support. 

While full recovery from a diagnosis of ASD may not be possible, there are many ways that parents can help their child to live with the effects of their autism diagnosis. Parents can help their child diagnosed with ASD to thrive by:

•       Developing structure and safety in their child’s life. Safety is often an issue for children on the autism spectrum. Establishing a safe space for your child to go when feeling overwhelmed supports their feelings of safety and security while limiting the possibility to the child harming themselves.
• Signing your child up for ABA therapy. Applied Behavior Analysis therapy give your child the skills so that they can live more independent lives and participate in their communities
•       Connecting in non-verbal ways. Learning functional communication skills allows you to engage your child in a way that is beneficial to you both. Learning to use alternatives to verbal communication, be that sign language, bodily gestures, or pictures  will help you to engage with your child on a level that you may not have previously been able to. Finding a way to communicate with your child will support your relationship and improve both your child’s sense of belonging and your confidence as a parent.
•       Finding help and support. There are many professionals, organizations, and groups that can help you find information, treatment options, services, and a sense of community. The more support you and your child have, the better you will be able to limit your feelings of stress and find your way to enjoying the special relationship you have with your child. 

Does autism worsen with age?

Longitudinal studies have found that about 10% of children diagnosed with ASD show a dramatic improvement by the time they reach their mid-teens. The proportion of children who show marked improvement tend to improve their verbal skills early on and have a high initial verbal intelligence quotient. These research findings may have significant implications for identifying what skills to help your child focus on improving today.

Indeed, research indicates that children whose parents are engaged in their treatment early on show better verbal and daily living skills in their teen years. However, the improvement that many people see in their teen years tends to stop as they transition out of the school environment.

This may be explained by two specific events that occur at this time in a child’s life. First, the teen is leaving the structure of the educational environment which many individuals find highly beneficial. Second, many individuals on the autism spectrum lose access to support when they reach adulthood. You may find support in community agencies and higher education supports to help fill this space as your child transitions out of the child support system.

Although many individuals will see a reduction in their ASD symptoms in their teen and early adult years, research indicates that in old age individuals who have an autism diagnosis may see a reduction in their ability to function. In old age, these individuals may show decreased interest or understanding of how their behavior impacts others and their ability to function well may decrease back to childhood levels.

Is mild autism reversible?

As stated previously, there is currently no known cure for ASD. However, research indicates that symptoms of the disorder can be reduced through the use of behavioral therapy and other treatments. For individuals who exhibit mild symptoms or high functioning autism, it is possible to control the symptoms that create difficulty for them.

Interventions, especially early intervention, for issues associated with speech and behavior like speech therapy, occupational therapy, and behavioral therapy can help individuals with mild symptoms of ASD develop skills that allow them to improve their functioning to the point where they may no longer meet clinical criteria for the autism diagnosis. Older children may be able to control some of their symptoms through the use of medication.

Likewise, medical treatment for many of the symptoms associated with ASD can be medically treated in adolescents. Adolescents who exhibit symptoms similar to those of attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and oppositional defiance disorder (ODD) may be prescribed medication that can help them control these symptoms.

Does autism run in families?

Autism is known to run in families. However, heredity does not completely explain who will develop ASD. According to the Autism Society, individuals who have a genetic vulnerability are more apt to develop ASD than those without such genetic issues. Exposure to harmful substances during the mother’s pregnancy and certain medical conditions are also more likely to result in a diagnosis of ASD.

The latest research to help autism

It can be very difficult to get a clear picture of the best ways to support individuals diagnosed with ASD by searching the research. Recent research studies look at a wide variety of elements. Much research focuses on single cases or low sample sizes making it difficult to determine the overall importance of specific strategies. There is also difficulty comparing studies as many studies focus on the improvement of a specific skill.

However, there is always research being performed on aspects of ASD as it impacts so many members of our society. Some of the recent research findings include the use of brain imaging and larger sample sizes. Some of the best recent research findings are provided below.

The National Institute for Health funded a 2019 study that found a connection between the cerebellum of rodents and their ability to process rewards and social behaviors. It is believed that this finding will help to deepen the scientific understanding of how the brain works in those diagnosed with a variety of conditions including ASD, as abnormalities in the cerebellum have been previously linked to ASD. Scientists are interested in seeing if in[uts to the cerebellar neurons could impact social behaviors.

In a 2018 study on neurofeedback, it was shown that children diagnosed with ASD who received neurofeedback while playing a picture puzzled game exhibited spontaneous activation of their social brain circuitry. These findings were seen in the functional magnetic resonance imaging (fMRI) scans of the participants. The findings were further supported by the parental reports of improved social behaviors among the children in the study. These findings imply that covert neurofeedback may have potential as an intervention for those diagnosed with ASD.

In other research studies it was found that an individual’s guts may play a role in the development of ASD. Though the reported study had a very limited sample size (18), researchers indicated that there was a 45% reduction in ASD symptoms in the study’s participants. A 2020 study of children 3-6 found that children treated with bumetanide showed improvement on the Childhood Autism Rating Scale when compared to the control group.

A 2017 study found that functional connectivity magnetic resonance imaging (fcMRI) may help predict the risk of children as young as 6 months in developing ASD by the age of 2. This finding is consistent with the belief that changes occur in the brain of a child before behavioral changes are seen. Such early detection could support early diagnosis and interventions thereby improving the outcomes for children at risk of developing ASD.

ABA therapy is an effective treatment method used to improve the independent living and social skills of children with autism spectrum disorder (ASD). 

With the care and guidance of trained ABA therapists, your child will be able to see significant improvements. But what exactly does an ABA therapy session consist of? And how do you best prepare for training at home? 

Below, we tell you what to expect from ABA therapy and how to set up your home to ensure optimal learning conditions for your child with autism. 

What Is In-Home ABA Therapy?

Applied Behavior Analysis or ABA is a form of behavioral therapy that focuses on changing unwanted behaviors and reinforcing desirable ones. ABA therapy provides targeted treatment based on the child’s individual strengths and weaknesses. 

Developed by Norwegian-American psychologist Ivar Lovaas, ABA therapy has been successfully used to help children with autism and related developmental disorders since the 1970s. It has been proven highly effective in helping children with autism develop and progress. In fact, research shows that ABA therapy is the most effective form of autism treatment with more than 90% improvement rate. 

What is ABA therapy used for? 

ABA therapy is used to build and improve social and communication skills in addition to daily living skills in children with autism. These skills include:

• Activities of daily living (feeding, dressing, bathing)
• Potty training
• Following directions
• Understanding social cues (facial expressions, body language)
• Social skills (initiating conversations, responding to questions)
• Reducing problematic behaviors like tantrums
• Basic academic and pre-academic skills.

What methods are used in ABA therapy? 

In general, ABA therapy breaks down each of the essential skills into small, concrete steps. It then builds toward more significant changes in functioning and independence levels. Each ABA therapy session consists of a combination of play, direct instructions, various activities, adaptive skills training, and parent guidance.

ABA therapy typically uses positive reinforcement in the form of rewards and other incentives. When a desirable behavior is followed by a motivator, like a special toy or activity, children are more likely to repeat the action. Over time, this method can encourage positive behavioral changes in children with autism.

What are the benefits of in-home ABA therapy?

In-home ABA therapy can either supplement or completely replace facility-based care. Having ABA therapy sessions at home has numerous advantages: 

• It allows for more flexible scheduling.
• It enables your child to practice and learn new skills in a non-threatening, familiar environment.

• It facilitates parent/caregiver training, which is an essential component of ABA therapy. 

What Is In-Home ABA Therapy Like? 

The in-home ABA therapy has three stages: intake, assessment, and treatment.

Intake

The Hidden Talents ABA coordination team conducts an initial interview to verify your child’s eligibility for ABA therapy. You can expect them to ask questions about your child’s developmental history, problem behaviors such as aggression and tantrums, any prescribed medications, speech and occupational therapy, and previous ABA treatments.

Assessment

Our Board Certified Behavior Analysts (BCBA) will assess your child’s communication along with academic and social skills to develop a detailed individualized treatment plan. Based on this assessment, they will also make a recommendation on how many hours of ABA therapy your child should receive. 

Treatment

Once the treatment plan is developed, your child will be assigned a team consisting of one or more ABA therapists and a BCBA. The composition of the ABA treatment team will depend on the number of therapy hours. Your child can have anywhere from one to four ABA therapists who are regularly supervised by a BCBA. The team will work together to deliver a comprehensive treatment and adapt the plan as needed to ensure continued progress. 

The therapists will monitor your child’s progress towards set goals by collecting data during each therapy session. Our BCBA experts regularly meet with both therapists and family members to review this information, which allows them to plan ahead and adjust teaching plans, the intensity of therapy, and learning goals as needed. 

How Long Is an ABA Session?

An ABA therapy session can last anywhere from 2 to 4 hours. If your child receives several therapy sessions per day, therapists will be rotated every 2-3 hours to keep things fresh and interesting and hold your child’s attention longer. 

Preparing for In-Home ABA Therapy

In-home ABA therapy requires careful preparation. Our professional therapists are trained to provide in-home services and will assist you every step of the way. 

Here are some tips to get you started:

• Choose a dedicated therapy space. It can be an office, a playroom, or any other location where your child will be able to focus on learning new skills. 
• Let the therapist know about your child’s special interests, favorite toys or activities. These can be used as motivation and reinforcement during sessions.
• Show your child any changes you made in the room before starting the therapy to make them feel comfortable and safe.
• Create a consistent schedule and let your child know what to do when the therapist arrives. Make sure to review this routine before each session.
• Prepare your child for the session. He/she should be awake, fed, and have a dry diaper or pull up. Also, make sure that your child is not actively engaged in a favorite activity as it may be used as reinforcement during therapy. 
• Make a list of questions to ask your therapist before the start of the first session. The effectiveness of ABA therapy for children with autism is shown to largely depend on parents’ involvement, particularly when it comes to speech and social interactions. Clear communication between parent and therapist is a must.
• At least one adult is required to be at home during ABA therapy. It is important that you or another responsible person don’t leave the house while sessions are taking place and that you are available at all times.
• You should avoid interrupting or joining the session without discussing it with your ABA therapist first. You are free to observe the therapy, however, if a problem behavior occurs, you should let the therapist handle the situation.
• There is no need to offer your therapist food or drinks while they are at your home. It’s also worth keeping in mind that therapists are not allowed to accept gifts.

How Should You Set up Your Home So That It Works Best for the Therapist and the Child?

Since in-home ABA treatment requires that your child has therapy sessions at home, it’s essential to provide a comfortable, distraction-free space that stimulates learning. Here’s how to create an environment where your child can concentrate and where therapists can best do their job: 

• If you have the possibility, designate a specific room or space in your house that will be used exclusively for therapy sessions. Your child should think of this space as the “therapy room.” 
• Keep the therapy room simple, calm, and completely free from distractions. The therapy room should ideally not have a TV, computer, or other electronic devices.
• Prepare a child-sized table and chairs to make the environment as pleasant and secure as possible for your child.
• Have a dedicated therapy box or basket for storing ABA therapy tools such as puzzles, flashcards, stacking toys, reinforcement items, sensory toys, or any other items your therapist may need to use. Your child shouldn’t have free access to these items outside of the sessions so that they remain associated with therapy.
• Be clear about your expectations from the start to make sessions seamless and more efficient. Inform the therapist about any home rules like the “shoes off” policy and let them know if there are certain rooms or parts of your home that are off-limits for your child. Also make sure to take into consideration your therapist’s special needs like pet allergies, for example.

How Do You Get ABA In-Home Therapy Services?

If you are interested in ABA in-home therapy for your child with autism, start by speaking with your pediatrician or another medical provider about the ABA treatment. They will help you decide whether this type of therapy is right for your child. If necessary, they will also write a prescription for ABA treatment for your insurance.

The second step is checking whether your insurance company covers the cost of ABA therapy and what your benefits are. Most states, including Georgia, require insurance coverage for autism services. Be sure to compare different providers when choosing a plan for your child to get the best coverage possible.

Feel free to contact us for more information about in-home ABA therapy or to request an intake evaluation. You can call us at 404-487-6005, send us an email at info@wordpress-765752-2798792.cloudwaysapps.com, or fill out our contact form, and we’ll be in touch with you as soon as possible.