When I was a young mother with a newly-diagnosed autistic toddler, a woman came to my home to talk to me about her adult son with autism. What is interesting is that I do not remember who put us in touch or even her name. But she came for a visit, I suppose because I was just starting the journey, and she was a street-wise traveler. She shared some very frightening stories about her son. Our visit was not very helpful; it actually terrified me.
She told me that once her son reached puberty, his episodes of rage were so pronounced that he began chasing his siblings around the house with knives. For the protection of her other children, and because she didn’t know what else to do, she eventually had her autistic son removed from her home. He was taken to a special group home for disabled teenagers. She went on to describe that in that home her son was provided with “romantic encounters” with call girls, without her knowledge. I was so dumbstruck I didn’t know what to say. Here I was, watching my little boy play on the carpet and envisioning a bleak, dark future.
When my son Kyle’s tantrums became unmanageable, my fears about his future increased. Would he also chase his siblings around the house with knives? Would he have terrible bouts of rage that I couldn’t control? It’s true that some parents must cope with this frightening predicament. So I wondered what help was available for them, besides sending their sons or daughters to live somewhere else. (Although in severe cases, that may be necessary as a last resort.) Here are some suggestions:
- Promote language. Rage episodes tend to be worse in children who are non-verbal or very limited in their ability to speak. Imagine how frustrating it would be to need or want something, but nobody understands you. Combine this with the brain-wiring problems of an autistic child, and it’s a recipe for angry outbursts. Once my son Kyle’s language began to develop, and he could communicate his wants and needs, his terrible bouts of rage decreased dramatically.
- Have a medical evaluation done. In a non-verbal child, rage could be a symptom of undiagnosed pain. Your child could be experiencing pain or discomfort that he can’t convey to you. Perhaps he has a toothache or an earache. I heard about an autistic boy who died because his appendix burst, and nobody knew what was going on. Also, rage can be connected with seizure activity. You wouldn’t want to discipline or give mood-altering medication to a child who is acting out because of pain.
- Use an extinction technique. Your child should never receive a reward for rage. Remember Helen Keller, whose mother was giving her candy because it calmed her tantrums down? She was actually reinforcing her daughter’s bad behavior. You may be doing the same by giving your child a comfort object, food, a lot of attention, etc., when he’s upset. Unless your child is dangerous, there should be limited or no response to rage. It should not profit your son or daughter in any way.
- Medication can be very helpful. Temple Grandin, an expert in the treatment of autism (and she’s autistic herself) has made the following suggestions:
- For directed rage, where your child becomes hostile toward a particular person, situation, or place, a low dose of a medication such as Risperdal can help.
- For random rages, Depakote (divaloproes sodium) or Depakene (Valproic Acid) can be prescribed. Random rage which is not particularly triggered by any certain thing is caused by small seizures in the brain.
- For undirected rages where your child breathes heavily and sweats, this can be dangerous. Propranol may be a good option.
- Children on the spectrum who have Aspergers or are high-functioning are sometimes prescribed Prozac to help keep anxiety and moodiness in check.
The rule of thumb with medication is that a dramatic positive affect should be seen. If there is little or no change, or the side affects are troubling, it should be discontinued. Ideally, your child’s medication should significantly reduce his rage. Work closely with your child’s physician and resist frequent medication changes. I’ll be writing more about medicating autistic kids in a future blog.
Horror Stories vs. Reality
Interestingly enough, Kyle, who as a toddler would scream, bite himself, and get hysterical, has become calm and tranquil in adolescence. All my fears about his supposed bleak future did not materialize. So don’t listen to the stories of other parents and assume that your child is doomed to the same fate. Each one is an individual and you will have to deal with behaviors on a day-by-day basis. If your child has frequent episodes of rage, don’t sit at home, imprisoned by the outbursts. Explore every option to seek help and “make a lot of noise” about the matter until you get the assistance you need.
Kristyn Crow is the author of this blog. Visit her website by clicking here. Some links on this blog may have been generated by outside sources are not necessarily endorsed by Kristyn Crow.