Autism Therapy: aggressive behavior

definition of aggressive behavior: Behavior or action that intrudes on others and may be harmful to others. Aggressive behaviors may be physical or verbal.

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Aggression and Tantrums in Children with Autism: A Review of Behavioral Treatments and Maintaining Variables
Journal of Mental Health Research, by Matson, J., published in 2009, summarized Sep 9, 2010

A problem-solving approach that is combined with applied behavior analysis (ABA) may be helpful for children with autism who have tantrums and aggression.

This article reviews research-based treatments for tantrums, and describes the strengths and problems of each intervention approach. The most common treatment approach for problem behavior is ABA therapy that is skill building in nature. It appears that the use of functional assessment makes it more likely that the ABA therapy will work. Many of the treatment studies also taught the child how to communicate. The author notes that brain (antipsychotic) drugs are being used more and more often for younger and younger children.


Assessment and Treatment of Excessive Straightening and Destructive Behavior in an Adolescent Diagnosed with Autism
Journal of Applied Behavior Analysis, by Kuhn, DE, Hardesty SL, and Sweeney NM, published in 2009, summarized Jun 3, 2010

Applied behavior analysis (ABA) may be helpful when teaching a child with autism to stop throwing things in the trash can.

Some children with autism spend a great deal of time straightening items and this may get in the way of living a normal life. Stopping or blocking the child from straightening has been shown to help stop the straightening behavior. Sometimes, though, stopping the child from straightening can make him angry and bring out aggressive behavior. This case study describes the use of ABA to help a 16-year-old boy with autism who spent a great deal of time placing items in a straight line and throwing them away. The treatment was able to help stop him from throwing things away, at least in front of staff and parents.


Functional Analysis and Treatment of Inappropriate Vocalizations Using a Speech-Generating Device for a Child with Autism
Focus on Autism and Other Developmental Disabilities, by Franco, JH, Lang RL, O’Reilly MF, Chan JM, Sigafoos J., and Rispoli M., published in 2009, summarized Feb 3, 2010

A speech-generating device may improve behaviors in children with autism who cannot speak.

This case report describes the use of a speech-generating device by a 7-year-old boy with autism. The boy could not speak, but he did make sounds with his voice. Sometimes the sounds were not appropriate. He also had problem behaviors; for example, he would use aggression when he wanted attention or wanted to play with someone. The boy was taught how to use multiple options on the device. He used the device on the playground and during gym. When he used the device, he had problem behaviors 0 to 20% of the total time (for example, while on the playground). Without the device, he had problem behaviors 40 to 80% of the total time. 


Risk Factors for Challenging Behaviors among 157 Children with Autism Spectrum Disorder in Ireland
Research in Autism Spectrum Disorders, by Murphy, O., Healy O., and Leader G., published in 2009, summarized Nov 16, 2009

Self-injury behaviors in children with autism may be more intense in children with severe intellectual disability than in other children with autism.

This study asked whether self injury, aggressive, and stereotypy behaviors were more common in some groups of children with autism than others. The researchers tested age, gender, therapy interventions, and intellectual disabilities. Age and gender were not a factor. Children getting applied behavior analysis therapy (ABA) had aggressive behaviors more often than other children, but the authors think that might be because children with behavioral problems are more likely to get therapy. Children with severe intellectual disabilities had more intense self-injury behaviors than other children with autism.


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Man Who Suffered Head Trauma Turns His Struggles to Helping Children with Autism

Jan 6, 2011

Greg Marischen, who suffered a severe head injury, returned from his therapy determined to use the same therapy methods for children with autism. Robert Melillo, a NY doctor improved on those cognitive and physical therapies to create Hemispheric Integration Therapy (HIT), which lead to the growth of Brain Balance Achievement Centers. Marishen now directs a center in Ohio that helps not only his two sons, but other kids with developmental delays. “The program is all about the plasticity of the brain. After aggressive therapy focused on the weak areas of the brain, it has the ability to rewire itself and make those connections,” said Marischen.

Read original article: Kettering Native Helping Kids wIth Cognitive Health


Medical Marijuana as a Therapy for Autism

Nov 23, 2009

A mom believes that her son with autism and aggression has improved behavior since beginning medical marijuana therapy. She tried traditional drug therapy with him, including risperdal, but that seemed to make him heavy, stronger, and still aggressive. The family contacted a medical cannabis doctor who agreed that a "speck" of marijuana given in a piece of fruit might help. His parents report, "It was an amazing experience, I'll never forget it, as we watched what happened, it was like 'He's back!' It was like all this anguish, pent-up rage and aggressiveness went away - it just calmed him down." Another mother with an autistic child who also had eating disorders gives her child a small bit of marijuana-infused oil in tea and cookies. She reported, "For the past year, he'd consistently had 30 to 50 aggressions in a school day, with a one-time high of 300. The charts for June through July, by contrast, showed he was actually having days-sometimes one after another-with zero aggressions." Doctors caution that more research needs to be done on marijuana as treatment for autism and many see drug therapy as a last resort.

Read original article.


Palmtop Helps Non-Verbal Kids Communicate

Apr 14, 2008

A portable computer weighing about a pound fits into Kayle Coutie's palm and allows the non-verbal child with autism the chance to communicate. Kayle, a student at Bloorview Kids Rehab in Canada, received a Palmtop his anger and aggression lessened. Pre-programmed with phrases and sentences, the Palmtop enables Kayle to let his family know his needs. There are several useful features: a word prediction function that offers words once Kayle has typed the first three letters; and settings that contain pictures and words. For example, "if he clicks 'school' and 'is it time for' it will speak that whole question." Therapists caution that each non-verbal child's specific needs should be assessed before selecting a single solution.

Read original article.


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Please comment on this autism topic.

Responding to Tenex - Intuniv (guanfacine)

Sep 30, 2011 by Anonymous

We've used Tenex since my son was almost 4 in combination with Abilify (which we recently stopped). He is 8 now and weighs 125 lbs and is almost 5ft tall.. It has been amazing in helping him with the hyperactivity without sedating him or him a zombie. We tried the extended release version (Intuniv) but my son processes things very quickly and it didnt work well for us. We have found that giving him 1mg 2x per day and 2mg at bedtime with Melatonin (5mg) have increased his sleep. One thing to note about Melatonin is that it can cause night terrors so if thats happening you may need to switch to something else. Im not sure that using benadryl long term is good for our kids but you do what works and the dr is ok with. We also keep on hand ativan (he tends to have issues with anxiety ie drs appts, grocery shopping etc.) and clonazepam for long trips and severe aggression. The ativan and clonazepam are used sparingly. My son knows what his meds are, what they are for and can tell us if he needs something (he is rx'ed the tenex for am, lunch and bed but if he doesnt need it then he doesnt take the noon dose). Its been a long road to get him from non-verbal to verbal (still some delays but he can hold a conversation) and is now actaully quite social. His medications help allow him to be who he really is and dont just mask the problems that he has.


Responding to adults with autism

Sep 12, 2010 by Anonymous

I would be very interested in research studies which have focussed on the use of social stories and video-modelling for adults with autism who have aggressive outbursts when triggers to anxiety and frustration are hit.  My son responds very well to social stories and these have helped him to accept many difficult situations in life which in the past would have caused him huge anxiety.  But it has not been possible to help him cope when he is not prepared in time for situations which tend to trigger his frustration and on these occasions he can be very difficult to manage for the short time period of the outburst - these outbursts are very extreme, happen very quickly, and since teenage years often result in someone nearby being physically assaulted, or property being smashed.  Once this assault or smash has taken place he calms down quickly, so medication isn't particularly effective for this.

 

If anyone has information on strategies which have helped minimise such behaviours in young adults (he is 22 years old) I would love to know of them.

 

Thanks


Responding to Thorazine (chlorpromazine)

Aug 13, 2010 by PWSMom

In 2006 the FDA approved risperidone for the specific treatment of aggression and irritability in people (inc children) with autism, yet you have posted an expert opinion also from 2006 that anti-psychotics are not useful in treating autism. Please review your information. Risperidone is an anti-psychotic and has been found to be effective in treating patients with autism who are easily agitated and frequently aggressive. While I can not speak specifically to Thorazine, the professional opinion used to back up the information is outdated and no longer correct. 


Comment added from Healing Thresholds: Note that rarely is scientific consensus achieved in one year. Moreover, scientific consensus rarely occurs as the result of a regulatory decision (FDA approval). At Healing Thresholds we summarize medical research as it occurs and we provide the date of the medical research/medical opinion. We inlude both mainstream and alternative views as long as those studies/opinons have been subjected to the scientific peer review process. We encourage all readers to consider the date of the research/opinion (and the source of the research/opinion) when evaluating how the results relate to their own child's therapy program.


Aggressive Behaviors

Apr 25, 2009 by Anonymous

I am a provider of Home and Community Habilitation to developmentally challenged individuals. Recently we began working with the brother of a long term client,both are autistic. While the one brother has come quite a long way, in the time that we have had him,the other is much more severely affected. The newer client has behaviors that I'm not sure how to address. When his parents are present the behaviors are less or do not happen at all. He spits towards me ,throws items at me and is starting to grab and try to twist my arm. This happens when I'm only in the same room with him and not requiring anything of him. If anyone has ever dealt with this type of aggression I would appreciate any input.


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    • Synonyms for aggressive behavior include: aggression, aggressions, aggressive, aggressive behaviors, aggressive behaviour, aggressive behaviours
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