A fellow Autism blogger, Emily, posted a blog recently about aggressiveness in people with an Autism Spectrum Disorder. She brought up concern that until 5 year years ago there hadn’t been studies done to identify why there was increased aggression in people who had an ASD. One of the few studies (you can read more about it here) trying to determine what caused the increase in aggression in that population resulted in three predominant factors. The people who had the most repetitive behaviors especially those related to routine, ritual, and self-injury tended to show more aggression than those with less repetitive behavior. The second factor was the level of social challenges the person faced, and the last factor was a higher family income. Those who have researched aggressiveness, those on the spectrum who have aggression accompanying their Autism, and those who support people with Autism and experience the aggression are all quite puzzled by it and are seeking answers. I am not a scientist or a neurologist, but I do have my own aggression issues when my routines are broken or my senses are overwhelmed. That being the case I have my own theory from personal experience about why those on the spectrum often have aggressive behavior that accompanies their Autism.
There is no way to understand aggression without first understanding the “fight or flight” response. This stress response is a primitive, autonomous response by the body to a perceived threat either externally or internally. The brain triggers the release of different hormones which allow the body to fight the threat or run from it, but the body cannot tell the difference between a threat of actual violence or the stress of modern-day that tricks the body into releasing these hormones. A neurotypical person may have this response after finding out about a deadline being moved up or being caught in traffic when they are late to work. The same hormones that prime the body to run or fight can quickly turn to aggression or frustration when there is no outlet to rid the body of the excess adrenaline—think road rage. My Autism comes with a heaping portion of anxiety, and it is common for those of us on the spectrum to experience a lot of anxiety daily with our difficulties in social interaction, sensory processing disorder, and our need for routine. That anxiety translates to stress which triggers our brains to start the process of the fight or flight response in the same way a neurotypical brain does but often to an even higher degree. If we can’t stim away our excess energy, effectively cope with our being overwhelmed, or remove ourselves from the cause of over-powering sensory input then wouldn’t it make sense for our stress hormones to translate into aggression also?
Temple Grandin has written about the different sizes and proportions of the brain in people with Autism verses neurotypical people in her book, Thinking in Pictures. The amygdala, the portion of the brain which begins the “fight or flight” response, she hypothesized was bigger in the people with Autism based on her own functional MRI scans, and it makes sense why. The constant overload of your own senses and the frustration and embarrassment from having challenges with social interaction that come with Autism (not to mention any co-morbid disorders also occurring simultaneously) cause almost constant anxiety and stress which would keep the amygdala constantly overworked. Even if the threat that triggers the “fight or flight” response is an internal one, the body reacts accordingly. The natural instincts present in all human beings begin even in young children and are present through adulthood making the age of the person with Autism mostly irrelevant. Age does, however, impact the way the person can channel the burst of energy after the initial reaction making adults seem less likely than younger children to have the same level of aggression in some cases due to better coping abilities. The study mentioned boys being more aggressive in their findings, but I imagine that has to do with both how the male brain is wired and how they were raised in a society that has unspoken rules about how males are supposed to act. While the male brain might be more prone to aggression, it certainly doesn’t exclude females from acting out.
The “fight or flight” response may be how someone on the spectrum experiences increased aggression, but it isn’t necessarily why. As the study concluded there were three things that seemed to impact just what caused the participants to become frustrated and physical. The first element was repetitive behavior and resistance to change. People with Autism like routines. A repetitive schedule is easy to manage, comfortable, and familiar in a chaotic world that makes very little sense. It is one of the few things that are controllable when the world is spinning out of our control. My routine is like an invisible security blanket which allows me to feel safe and comfortable especially when I run into challenges which trigger different anxiety points. I can use it both to keep myself organized despite my weaknesses in executive functioning which makes organization and time management difficult, and it helps me push myself throughout the day even when I get overwhelmed because I have a set time when work is over and if I can just make it until that time I will be okay. If a person breaks the routine or interrupts the schedule suddenly then what little comfort and control there was for the person with an ASD is gone. This inevitably spikes their anxiety and will literally cause the person to fight to regain their feeling of safety. A parent of a child with Autism may not see the problem in adjusting a schedule or changing a brand name item because they don’t rely on the extreme level of repetition and sameness their child does to cope. The child similarly will not be able to process the parent’s intentions in changing the schedule, but their aggression is reactionary to the person who causes the threat by changing the familiar routine. Adults may also become aggressive in frustration that their schedule is changing, but most likely it will be to a lesser degree than a child because there is experience in dealing with these unexpected changes from age. When possible it is always best to transition gently and allow time for a person of any age with an ASD to adjust to new tasks, places, and changes in their agenda. This will ease stress for both people and be less likely to cause aggression than with a sudden alteration.
The second element from the study was the level of social challenges present in the subject of the study. This seems to be less a fear reaction and more frustration in their difficultly communicating with others. The lack of communication could be due to physical obstacles, emotional blockages, or a complete breakdown of understanding between the neurotypical brain and the Autism brain. A non-verbal person, for example, may not be able to speak but they might be able to communicate with assistance through technology. Another example might be a young child who is normally speaking but shuts down due to a sensory meltdown or the miscommunication between what a person with Asperger’s Syndrome says and how a neurotypical person receives their words and tone. All these challenges are common with Autism, and it makes communication grueling. It is incredibly frustrating to be speaking the same language as someone and still not understand their intentions, their meaning, and their body language, and that is just classic verbal speaking. It is even harder when you have something to say, but your own brain and body won’t let you speak. Just because a person is non-verbal doesn’t mean they have nothing to say or that they don’t understand what people are saying to them. They simply need the assistive technology to help speak for them. Would you not be incredibly frustrated and have a tendency to become aggressive if you kept trying to tell someone in your own way how and what you were feeling but the person either didn’t understand you or completely ignored you? My own aggression is at its worst when I am facing my own challenges in communication. My frustration is not just because I struggle to speak when I am anxious, but also to effectively communicate how I am feeling even when I am not stressed. Sometimes my brain can’t process my emotions, and I am left feeling everything but with no way to understand what those feelings mean even inside my own head. If I can’t understand how I am feeling then how am I going to be able to tell someone else what I am feeling? This causes a cycle of reaction, difficult communication, aggression, and meltdown.
The best thing anyone can do for someone on the spectrum is to let them have as much time as they need to respond. They can collect their thoughts and process the entire question or statement before answer hastily and only taking the portion they understood into account. If someone is more comfortable communicating in writing or through pictures than by speaking then let them use their more comfortable methods of communication. There is not one right way to communicate, and it is vital for people on the spectrum to be able to communicate in whatever way they are able. Patience goes a long way in helping them feel comfortable and at ease.
I am not going to focus heavily on the last element in the study that deals with the higher income of the families as a reason why there might be more aggression. There could be any number of reasons why that was a factor. Those families could have had more access to the study being done. The parenting styles might be different between those with higher incomes and those with lower incomes because of the greater diversity in needs, accessibility, and family dynamics. Those with higher incomes may be less present in their children’s lives because of more pressure in their work responsibilities or a disconnect between the family, teachers, therapists, and aides in communication of the child’s needs. There are too many variables to really understand why the income of the family was a prevalent factor.
The last thing I would like to do is set up a situation in which aggression quickly escalates because of a change in routine and failure to communicate effectively. This is just a fictional example, but I hope it might give some insight into how aggression is manifested in a seemingly minor event.
An eight year old boy with Autism is playing a video game at his usual time after school. His mother tells him he needs to turn off the game because they need to leave to pick up his older sister whose soccer practice was canceled due to a threatening storm. He argues that he normally has thirty more minutes to finish his game, but the mother is in a hurry to pick up her daughter. She tells him they need to go and begins to turn off the television as the boy is playing. He becomes aggressive and throws his game controller, and it breaks. She scolds him for breaking his game controller and begins to put on his shoes while he continues cry and lash out at her.
From the mother’s perspective her son becomes angry and aggressive at the instruction to put up his game. She wonders why her son, who is normally quiet and busy with organizing his toys and reading about dinosaurs has become almost violent because of a simple change in plans that she cannot control. Without knowing what is going on in her son’s mind she is limited to her own experience that when her parent’s asked her to stop what she was doing to leave the house she would do so out of respect for her parent’s. She might even feel guilty momentarily about raising her son to be disrespectful or disobedient.
The son, however, is struggling to decompress after a particularly difficult day at school. The video game is comforting and allows him an activity to both begin to unwind and process the day he has had. He isn’t fully aware of what has caused his day to be so overwhelming because he doesn’t yet understand his own Autism symptoms. He has no verbal way to express his anxiety and therefore can’t tell his mother that he needs time playing his game to feel better. When his mother steps in front of the game to turn it off he is suddenly panicking at the lack of transition time between tasks. He knows he will lose all the work he has done in the game, but he also loses the stability and comfort he was feeling while playing. Now he will be forced into a quick transition without warning and no new correction of schedule. He has no way of processing his mother’s intentions by this point as he is in the beginning stages of a meltdown and cannot communicate in detail what he is feeling. His brain is already overloaded and without the ability to communicate he lashes out, maybe unconsciously, to fight to retain his comfort zone and shut down the threat of renewed barrage of sensory and emotional input. It is almost an impossible situation for both the son and mother because of the necessity of a quick change in plans, but the best solution would be to take an extra 3-5 minutes to help the child calm down and if possible reestablish a schedule or positive reenforcement that the video game will be waiting as soon as they get home or that they will be able to do another soothing activity like getting a favorite treat. Stability and structure are the two goals to focus on when dealing with routine changes–much like a weighted vest helps with sensory overload, a routine helps combat unplanned chaos.
As far as discipline and consequences for aggressive behavior: children might not be aware that their aggressive coping mechanisms are seen as negative and not appropriate, or they may not understand the full impact of their actions during a meltdown. They may not be able to process the long-term consequences of breaking their game controller in frustration because they are solely focused on the present emotional overload. They can’t foresee in the moment if they break the game controller they will have no way to play their game or that someone will have to pay to replace the broken one with one that works. Parent’s should definitely address these issues, but not during a meltdown. Positive reenforcement for non-aggressive behaviors are one way, and assigning responsibilities after the situation has returned to a calm stage for any actions that resulted in hurt feelings or broken items is another. Regardless of intentions or where the aggressiveness stems from, it is one of the responses which needs to be addressed fairly early. Gentle yet consistent “behavioral modification” will help with alternative coping mechanisms or channeling the aggression into other activities to allow for them to live a healthy and independent life.***
I hope this helps give insight into the complexities behind the aggression that is often tied to the Autism Spectrum. It is just one of the many things that are difficult to understand and incredibly challenging both for people with and without an ASD, but with compassion, patience, and awareness those challenges can be met and overcome.
If you would like to read more from Emily Springsdorf’s blogs you can check those out here!
If you would like to read more regarding the human body’s “fight or flight” response you can check that out here.
And if you would like to know more about the study mentioned in the beginning of the blog you can check that out here!
Thanks for reading!
***I do not have experience in behavioral therapy. I am only giving my insight for what I know regarding my own experiences and work with younger children (on and off the spectrum). Any and all behavioral therapy should be done with the guidance of a trained professional or done with personal parental discretion.