Is your child aggressive or violent? | Autism PDD
My 6 year old is scaring me. He started out as self injurous and would bang his head against me--but now he is punching, running away, choking. biting, throwing things.
I have a difficult time calming him and sometimes I cannot.
The psychiatrist said this is not uncommon and put him on risperdal.
Has anyone else gone through this? What should I do?
Sam was about 5 when I first noticed the self-injury behav. - mostly banging his head or digging his fingernails into his arm - when he was under great stress. Kindergarten was a huge challenge for Sam and there were times when he went after his teacher, hiting and trying to bite. I think I was kinda in shock when I first saw it as Sam had been the most calm, peaceful baby.
What I've learned since then is Sam has a somewhat predictable series of behavours that esculate under stress. I have mostly removed the stressors, of which many were sensory based. I have taught him stress management tricks - deep breathing, looking for the *big picture*, sensory diet, We still have the occasional outburst but the duration and severity is less.
The FBA is an excellent tool for finding out what's going on for your child.
mama to Sam 8 yrs PDD NOS OCD ODD PPD and Alex 2 yrs
We've had several FBAs done by the school psych but cannot really predict when it is going to happen. It appears the antecedent is him trying to avoid doing work in school (escape/avoidance) or not getting his way (which happens a lot in school).The school cannot figure out a way to calm him. If there were BCBAs in this state (which there are not) I'd use one. Unfortunately VB/ABA is not really popular in CO. I am so scared they will recommend a special program for children with emotional/behavioral disabilities which is not what he needs. Unfortunately there are no autism programs in our school district at the elementary level.
Cassidy's always been self-injurious... when she was 2, she'd slam herself into walls over & over & over; other instances have been choking (wrapping something around her neck & pulling tight), scratching, biting till she bleeds, pinching, stabbing with forks & pencils, etc. All of them have been sensory seeking so along with taking away the offending item & stating it's proper use (forks are for eating, etc.), we've given her something to replace it with. We have also found that her hands canNOT be bored. That is the #1 time she does these things. When she gets the least bit distracted, she tries to 'feel'...
But she'd never been aggressive to anyone other than herself (since it was such a sensory need) until recently. Just before her bday (she turned 5 a couple weeks ago) she started kicking & hitting us. Sometimes she would just be sitting there doing her own thing & then pop up & come punch one of us or pop up & go kick one of our cats. It was so strange, like she just went blank & HAD to do it. :( She got a punching bag for her birthday & we've gotten her to channel that into the punching bag & she's done great at home. But not so much in public... mostly in public though it's in response to 'something'. She creates order everywhere, especially in playdates & the other kids will try to 'play with her' (she reads it as messing up her order) so she'll push, hit or kick them away from her. We're having a heck of a time with that right now... :( She'll also bite anything she can when she feels the need to bite (not 'bite to be mean' but 'bite to chew on') and sometimes that can be someone's arm or shoulder - ouch! She's very adamant about not taking things others suggest (me or Daddy or her OT) that would help her if they are not 100% her decision. :p Has been a struggle!
She's not in school so we don't have that aspect... Good luck!
My 10 yr old was 6 when the self-injurious started...when he was 7, we put him on Risperdal, it helped alot, we also did cognitive therapy as well...meds are helpful, but therapy is a good idea as well...we weaned him off his meds this year with diet and osteopathic care, but within a month, he was so aggressive and hurting us every day, so we went back to meds and started with an anti-depressant, the OCD is much better...without meds, he just can't make good decisions and discipline strategies don't have any impact...I would use what you need too. I would consider meds if everything was out of control as a stop gap measure until his behaviours can be changed by behaviourial methods. I wouldn't just let meds do the all the work the "key" is finding differnet approaches and interventions to change the behaviour intrinsically and not just by mellowing out.
My oldest ds was on Risperdal for a year without any adverse effects.
I would personally do a FBA (functional behaviour assessment) first by a BCBA it will help identify what is triggering and how to change it, and what to do when this behaviour occurs. I've had a pincher, head banger, biter, thrower etc and FBA/BCBA strategies have GREATLY reduced these behaviours.
Yes, my 4 year old will sometimes get very frustrated if he doesn't get his way and head butt me or will sometimes go after his brother. When he does this i quickly lay him down on the carpet, He will then kick his feet and have a meltdown, Afterwards when he is calm i remind him that hitting , pushing biting is not acceptable.
My son also has a blankie, if i see he is getting frustrated or looking like he is going to bite himself or anyone . I will give him his blankie and he will bite that.
I think though it is very important to know when and why your child has these types of outbursts and meldowns and try to stop them before they happen. And also try teaching him other outlets.
Here are a couple links that might help you out.
http://www.autism-pdd.net/forum/forum_posts.asp?TID=1166& ;PN=1
I believe that proper behavior intervention plasn should be tried and adjusted to the best of our ability. And we should KEEP trying for awhile. But there may come a point where it is CLEAR that the individual child simply CANNOT control himself. A good child psychiatrist who is very familiar with autism should be able to help decide when that point it. Violence, either aggression toward others or self-injury, is a TERRIBLE drag on a child's potential. There is nothing else that will get them placed into a VERY segregated environment faster, and there is often NOTHING a parent can do. To me, this is dreadful because often the schooling suffers in those sorts of environments because SO much attention has to be paid to behavior. At the point where the child's behavior is CLEARLY negatively affecting his own life, not to mention the lives of those around him, medication probably ought to be considered. Risperdal has a long history of helping with violent urges. However, I am not a doctor, so I would strongly recommend going to a doctor who specializes in autism when and if you get to the point of considering medication.My son would not be able to function or learn at school if he wasn't on Risperdal. He started it at 5y. We decided on meds when he started attacking other kids and teachers and throwing chairs, tables, etc. I could handle the attacking of me--but not the attacking towards others and especially my baby. He had tied strings, ropes, etc(whatever he could find) around her neck when she was a baby. The cat also.
He was only self-injurous when no one was around for him to attack.
My son does this out of frustration, sometimes it's bad, sometimes not. He will either hit himself against something or pound his hands, slap his face or pull on something or someone.
He has a big comforter that he loves and it has weight on it. I give him that and he calms down. Or I just grabbed him and give him a really strong hug. I think that really helps him calm down.
Payne was dx Bipolar / ADHD/ epileptic BEFORE the PDD...then classic autistic labels - he was labeled PDD right before his hospitalization...and classic autistic earlier this year. His aggression has gotten better with more communication skills as well as a better understanding of the cause/effect with caregivers, school, etc. The biggest problem is he doesn't seem to understand consequences...and he is constantly testing. We use time outs in his room...every now and again I tell the staff at his mainstream daycare to give him a break in a quiet area for some 1:1 when they can...he can ask for breaks there or at school if he needs them and they don't ask him any reason why. He is doing better, but there are some days...
Between 3-5, my ds was extremely violent - so much that he had to be hospitalized. Risperdal was the cure for us also along with lots of behavior modification. He was in therapy at 3 and believe me, we used every technique out there for behavior modification but it didn't seem to lift a brow. After the hospitalization at age 5, the same techniques were used but with the risperdal and several other mood disorder meds which has calmed him big time. For such a tiny boy, he was stronger than superman and incredible hulk combined. We have tried to literally have him med free but we go back to the same boy even using the modifications. Between 3-5 I have had to put ds into my 'holds' to control his rages. I am proud to say they increased his risperdal in May of this year - and since he has not had a full blown rage!
At 9 1/2 he is much more stable though still gets very frustrated and aggressive - which is just another step we are working through. He is able to recognize his frustration level much more now and comes to mom and let's me know he needs his back scratched (which is a stress reliever for him) and we even bought a back scratcher for those times mom is busy and cant help him. We also constructed a tent in his lil' corner of his shared bedroom for him to go to when he needs his quiet time. Could type more here but need to get the boys to the bus stop.
Good luck and consider the medication. It's not a cure all but it is a step in the right direction.
My son sometimes is very agressive and violent he hits me on the face all the time he head buts me, gave me a black eye cut open my eye and gave me a blood nose the other day, but he isnt always like this i dont know what triggers it aw and now ive written it down i just relised how bad it sounds! I keep telling my self its not that bad! he does like to hit other kids. He used to hit himself alot too but that has seemed to calm down, he Kicks me alot and likes to press his head hard on me but i think he has alot of sensory issues we are waiting to see a OT So hopefully they will be able to helpReal quick here before off to work I go. Prior to the hospitalization he was dx'd with just ADHD (even now as I look back on all his assessments/evaluations I see all the red flags for ASD but they did not pick it up). At hospitalization they said ADHD with early bipolar disorder. This dx stuck with him until we relocated to PA (from NC) and had a new set of doctors (2nd set in PA are the ones that dx'd with ASD).
Have a good day all!
We went through the same things with Skylar, and his psychiatrist put him on Risperdal a few months ago, and it seems to have helped quite a bit. He still has his days, but they are not a severe as they were before the medication. The only side effect that we have had from using the Risperdal, is weight gain. They are starting the 5th week of school today, and already I have had to buy him more uniform pants and shorts twice not counting what i bought before school even started. All of the school uniforms have that "adjustable waist", yeah well that doesn't work for him. I finally found a shop here in town that carries the ones with the elastic waist in the back, and the elastic waste all the way around. So I got those and they are perfect.I would try the meds and see what happens, if after a month or so, you see no change, the doctor can always stop the medication.
At this point, anything is worth a shot.
Good luck and keep us posted.
When your children were hospitalized, did they say that your child probably also had a psychiatric dx too?
I know what you mean about a Superman in such a tiny package. That's our son, too. The fact that he is SO uncoordinated is a blessing...
We have put him on the meds. I am just not sure whether it is autism or something else in addition tot he autism.
Tyzoa, You are right. They are looking at a self-contained class for children with emotional/behavioral disabilities, which right now I am against b/c that is the only program that they have where my son will "fit"
[QUOTE=nick'smom]My 6 year old is scaring me. He started out as self injurous and would bang his head against me--but now he is punching, running away, choking. biting, throwing things.
I have a difficult time calming him and sometimes I cannot.
The psychiatrist said this is not uncommon and put him on risperdal.
Has anyone else gone through this? What should I do?
[/QUOTE]
We've went through that...he was actually admitted into the children's psych ward for 2 weeks last Feb. He's on Risperdal and that has helped him tremendously. Make sure you stay on top of his meds and have a FBA and BIP done at school ASAP!
What about trying to find out why they are doing the selfinjurious behavior! Parents need to realize that there is more to a behavior than just a behavior. WHY is he doing this, what prompted the change. Is he bord, he is frustrated at what ever, did we start something he may have trouble with, WHAT prompted the behavior! Then once you found the behavior trigger as they call it, then you can figure out from there what you can change or possibly change about them. Example My child starts to cry and becomes self injurious when he waits for a period of time. We know he has transition problems so we set a timer when to get ready so he is not waiting so long. We write on the calender what days are for what and times. This lessens the anxiety and he moves better through the transition
Hello to All,
I am new to this site...have never blogged before about our situation. My Kyley is 5 and has been diagnosed with PDD-NOS 2 years ago. She has been in school (preschool and pre-k) and has continued to have a problem hitting her friends and teachers. She has started Kindergarden (Aug 07) and is now hitting her teacher. She takes risperdal for the past year and while it is helping, she still is struggling. The school called and said that if she hits her teacher again that they will have to "suspend" her for the day.
I was afraid of this...being a public school versus a private childcare center. I am scared that they will not let her stay at this school. I do not know what to do. We do have an appointment with her psychiatrist this Wed. because he wanted to see her a month after she started school. This is my first time to deal with a child with special needs. Any help or advice would be greatly appreicated. Has anyone tried any other medications? Our symtons are tantrums and being physical with others. We have all the support in place, a TSS worker. BSC, OT and speech thereapy. She has an aide assigned to her through the school too. The school belives in full inclusion.
Thanks in advance for your thoughts and help.
Donny has some pretty serious aggressive behaviours.
He was put on Risperdal at age 4, prior to him coming to live with us, for
aggression and self-injury. This was before he had any diagnosis
(he was diagnosed with severe classic ASD when he was 5). Back then, he
would head butt, kick, hit others whenever he was frustrated (which was
often, since he had no expressive language and very limited receptive
language). He was actually being abused at this time, which really
contributed to his acting out, but rather than first explore the function
of the behaviour (communicating distress over being abused), he was
just straight away put on meds. Donny also used to head bang, smash
out glass windows with his head/face, and pick his skin until it bled.
Through behavioural methods and maintaining his Risperdal dosage, we
managed to get his aggression under control within six months of his
moving in. This was by teaching him alternative communication (both
spoken language and PECS), by rewarding times when he DIDN'T aggress,
and by having very clear, very consistent consequences for hitting or self-
injury (immediate no-nonsense, no-interaction timeout). We also, of
course, tried to eliminate triggers and give him coping skills so he
wouldn't be triggered.
Unfortunately, as Donny developed Bipolar Disorder, the aggression
returned. He's on a bunch of medication, and we are able to *mostly*
control the aggression at home between that and our approach. School is
a different story - there are too many variables, and he just can't function
there. These days, Donny punches, scratches, grabs, kicks, bites, head
butts, and spits. He has started throwing items (chairs once!) at people
as well. He will slam his head/face into things, punch himself in the
head, pull on his ears, bang his fists on things, rub his face on things,
scratch himself on the face, and/or dig his nails into his arm until it
bleeds.
Donny's 10 1/2, around 85-90lbs, and only getting bigger. This
behaviour can be really scary to someone seeing it or hearing about it for
the first time.
That said, once you get used to it, and learn to manage it as best as can
be, it's not such a big deal. Don't get me wrong, I'm not a barrel of
laughs after a big incident where I've had to defend myself against him.
But life goes on. Our lives aren't all about the aggression or his
disability. Aggression when he can't cope is just part and parcel of
Donny. We do what we can to alleviate it, we make sure we know how to
defend ourselves and be safe (hubby and I both have training in this
area), and we get on with our day. Donny hits people. He also hugs them
I like to focus on the latter.
Sorry, went off on a bit of a tangent there - it's something I've been
thinking about.
I guess what I'm trying to say is, many of our kiddos do have aggressive
or self-injurious behaviour. Many, maybe even most, of those who do,
will eliminate this behaviour almost completely through behavioural
supports and/or medications. For the small group that don't, it's not the
end of the world, or even the end of quality of life.
HTHYou need to WRITE an request for a Functional Behavior Assessment (FBA) get a Behavior Intervention Plan (BIP) written for her ASAP!
She is hitting for lack of communicating. My little one did that and still does for that matter - from time to time. We use PECS when he is getting upset. He has a tent in his class that he can go take a break for up to 5 minutes and then comes back out to work. If he hits he is sent to time out. When we were having probs with him hitting - I told the teacher to be a DRAMA queen about it - he didn't realize it hurt her. So - as we were doing at home they were making a BIG deal out of it for him...not on paper, but acting it out...KWIM? Her risperdal might need increased as well? We have Payne on prozac b/c he gets REALLY overstimulated in a group...that has curbed the hitting as well.
Yes, we had AWFUL results on that. We did REALLY well on the Risperdal. It might work for her, but .5 mg is low dose...don't blow it off if he wants to go a little higher. Payne started when he was 3 on it at .5 2x a day and went up to 1 2 x day within a week...building up to it. The abilify and the seroquel (in the same class, but not the same thing) were not strong enough for him.
ETA - Trust in your dr is a WONDERFUL bond. Why are they making such a big deal of the hitting? Not that I don't completely understand but they do understand that she has a disability and that is part of it...I think they are making excuses for some reason.?
She has a behavoir plan and she has a "chill out" corner (with sensory items) in her classroom that she goes to when she is making bad choices or just needs a break. They will not tolerate the hitting...and this is the way they want to go on this. She was expelled from a childcare center when she was three and then we found a great childcare center that really worked with us and helped us through the process. I am greatful to them!!! But they said that when she starts public school we are going to have problems...and here they start
I trust her psychiatrist..he is great... and we will see what he says or what he thinks...We have increased to .5 risperdal. I dont think he will increase again. I think he will chnage the meds to abilify.
Has anyone ever used this med.?
My 14 year old is very aggressive. He was in the hospital in June and was admitted into the hospital this past Wednesday. He has had self injurious behavior since 5. The behaviors range from picking or biting himself or pulling his hair. As he hit the teen years, along came destruction of property and running away. He is 6ft 200 hours and looks mad or mean frequently.
He was on Risperdal for a several years, then Abilify for the last 2-3 years. In May we reduced the Abilify and I think that lead to his hospitalization. They added Prozac to the Strattera and Adderall and increased the Abilify to the original dose. Will these Rx, we saw a reduction in the anger, aggression, and self injurious behavior over the summer. He was dreading high school for unknown reasons. This is his first year in High School and now the anger, aggression, and self injurious behavior is back along with oppositional defiant behavior too. He says people expect too much of him.
He was refusing to do his work in class or would bite himself until he bled to leave the room and go to the nurse’s office or bathroom to wash the blood off. At home we had homework battles. He would hide the books or the homework notes. I think he could do most of the work if he tried.
At our last Psy visit the doctor told me get him to the hospital the next time he had an outburst. He thought Dorian would serious hurt himself on someone else. I was surprised that on admission, Dorian said on a scale on 1 to 10, he would give himself an 8 for being sad. I thought that was really high. He also said he was a 2 for suicidal thoughts.
Now the doctor wants to take him off the Abilify. She said too much of a good thing can be bad. And now the Abilify may be causing all the bad behavior.
Taking him to the hospital has really turned out to be a good thing. I think I would have waited because we started Depakote. And I wanted to see if that would make a difference.
If you are really concerned about you child, please seek help. I will add that we have taken Dorian to the hospital before and they said he wasn’t bad enough yet. The two times we called the police, the hospital has accepted him.
I can say from our point of view - the Abilify DID cause Payne to be more injurious and abusive towards our fuzzies...the risperdal took all of that away when we put him back on that. Wow...I can see where he could be in a few years....we did a med cleanse a few months ago and so we are starting fresh...30 days ago, we started with Invega (long-acting Risperdal)...this is sooo much better thatn Risperdal...he takes one pill in the morning and he is set for 24 hrs....what a relief not to be dosing all day long....3 weeks ago we started Zoloft and that has helped the most....the next step will be a stimulant again (he isn't doing very well in school)...Invega is brand new and is only made in 3mg, 6, 9 and 12 mg...3 mg is similar to 1-2 mg of Risperdal...I mentioned earlier that my ds was on lots of meds. I see others have also listed risperdal - so I thought I would take this opportunity to just list ALL the meds my son is on:
Morning: Concerta (36mg), Risperdal .50mg, Depokote 125mg
Lunch: Ritilan 10mg, Risperdal .25mg
4pm: Risperdal .50mg, Depokote 125mg
Bedtime: Risperdal 1mg, Depokote 125mg, Tenex 1mg
Yes, he is on alot of meds, but so far this has worked for him. This regimen has been in place since May, 2007 and I know from past experience it will change again with time. I am told once the hormones kick in that everything will need to be adjusted again - almost like starting over which I am not looking forward to. It took years to finally get 'everything just right' if you know what I mean. I am a true advocate on behavior modifications also - without that - the meds would not work alone. I currently use a point system to reward behavior - and if they have so many points at the end of the day they get to stay up 1/2 hr later (which for them is 8:30). They look forward to it so much. I find immediate rewards work better than having them wait all week. Now if they have an awesome week it is usually rewarded by letting them sleep wherever they want (except with mom) on Friday and Saturday night. I mention this only b/c others continue to have problems with the outburst/rages. I will say his worse age for this was between 5-7. We are in a calm down period now (outburst maybe 1 week compared to 3-4 daily). Good luck!
Here I'll break it down for you here:Risperdal (for aggression) 2mg tablet - 1 1/4 in morning and lunch, 1 at bedtime
Lamictal (anticonvulsant/mood stabilizer) 200 mg - 1 in morning, 1/2 lunch and bedtime
Prozac (OCD/stimming) 10mg - 1 morning, 1 lunch
Clonidine (ADHD/impulsiveness - he can't take stimulants) 1mg - 1 in morning, 1/2 at 2pm and 1/2 at bedtime
These have helped tremendously FOR US...how they'll work for you guys I don't know b/c our kids are more/less experimental even though FDA approved. No one knows EXACTLY how these will work. We didn't have Payne on medicines until we tried other things first. He was put on anti-convulsants at 2...they coincidentally took care of his bipolar/PDD aggressions until he outgrew the dose...at about 3.
My 10 yr old has been so aggressive for years...he had been on Risperdal from 7 -10 and it was ok, but it didn't help enough!!! The OCD came out of the woodwork and the dr said that if Risperdal doesn't do it, then an anti-depressant can help if the aggression is stemming from OCD-like behaviors and that's what was happenning to him....it's hard to figure out when they are little, we were spinning in circles for years with his behavior and nothing made any sense to him until Zoloft!!! [QUOTE=Donny's mom]Donny has some pretty serious aggressive behaviours.
He was put on Risperdal at age 4
Through behavioural methods and maintaining his Risperdal dosage, we
managed to get his aggression under control within six months of his
moving in. This was by teaching him alternative communication (both
spoken language and PECS), by rewarding times when he DIDN'T aggress,
and by having very clear, very consistent consequences for hitting or self-
injury (immediate no-nonsense, no-interaction timeout). We also, of
course, tried to eliminate triggers and give him coping skills so he
wouldn't be triggered.
Donny's 10 1/2, around 85-90lbs, and only getting bigger. This
behaviour can be really scary to someone seeing it or hearing about it for
the first time.
HTH[/QUOTE]
I'm glad you put all of that in there. Payne's 7 and over 4 1/2' tall and around 65-70#...when he comes at you violently - it can be very unpleasant for everyone. We often do as Donny's mom put in her post. YOU MUST BE VERY STRUCTURED ABOUT PUNISHMENT - NO ROOM FOR DISCUSSION - at least at first. Payne will turn that leniency against us! When we put him in time out - he is told to go to time out and the reason...no eye contact...no whining...no more talking until time out is done. We set a timer in the kitchen and if he talks it gets reset. The time that Payne was hospitalized is when he had me (5'8" good size girl and my 6' 220# dh SCARED of what he would do to himself or us...I had him in a basket hold begging the dr on his cell phone for a tranquilizer! It is and can be scary but once you find out the triggers, etc you learn to know what to expect and how to "nip it in the bud"
We already do all of that...We know why he does things...we just correct them.
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