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Aggression

Disclaimer: This summary is based off of research conducted by Autism Treatment Network members. It is not a summary of the entire body of research literature available on this subject.

Aggression is a common occurrence in kids and teens with autism spectrum disorders (ASD). Aggressive behaviors can include tantrums, hurting oneself (hitting, biting, banging head, etc.), and hurting others [1] . Around 53-68% of kids and teens with ASD show signs of aggression, most often towards family members [2]. Young children are the most likely to have behaviors of aggression. In addition, aggression is more common in children and teens with autism who have sensory issues, tummy troubles, attention concerns, sleep problems, communication struggles, those who hurt themselves, and those who repeat things over and over [2] [3] [4]. Doctors can help by doing safety checks, looking for causes of aggression, going over treatments with the family (including possible medications), or sending the family to see a specialist. In addition, doctors need to make a treatment and safety plan for each family. This plan should be reviewed every three months to make sure it is still working well [5]. Two medications, risperidone and aripiprazole, are very good at reducing aggression in kids and teens with ASD. However, these drugs have side effects. There are other drugs available to treat aggression with fewer side effects, however these medications may be less effective [1].

Frequently Asked Questions

  1. WHAT DOES AGGRESSION LOOK LIKE?
    • Tantrums [1]
    • Hurting oneself
    • Hurting others
  2. WHEN DO WE SEE THIS HAPPENING?
    • 53-68% of kids and teens with autism show aggressive behaviors[2]
    • Aggressive behaviors are mostly shown towards family members and caregivers
    • Younger children are more likely to show aggressive behaviors [2][3]
  3. WHAT OTHER FACTORS ARE COMMONLY SEEN WITH AGGRESSION?
    • Sleep difficulties
    • Limitations with talking and communicating
    • Repeat thoughts or behaviors over and over
    • Sensory issues
    • Tummy problems
    • Difficulty with paying attention[2][3][4]
  4. WHAT CAN DOCTORS DO TO HELP?
    • Safety checks to make sure the patient and their family are safe
    • Look for reasons for aggression
    • Go over treatment options with the patient and their family
    • Think about using medications and accompanying behavior therapy
    • Send the patient and their family to see a specialist
    • Make a treatment and safety plan for each family that can be used at home and in the community
    • Follow up with each family every 3 months to see if the plan is working[5]
  5. WHAT SHOULD PARENTS DO?
    • Talk with your health care provider or therapist to learn about aggression.
    • If you are not sure, ask them what to look for. What information do they need from you to help your child/teen with their problems with aggression?
    • Keep track of any side effects from medications used for aggression – these side effects must be reported to and tracked by your health care provider or therapist [1].
    • Keep track of aggressive behaviors to help identify what may have triggered the aggression – for example if your child or teen didn’t sleep well the night before, or if they were feeling sick that day.

Additional Tips

Take your findings to your next appointment. Be honest with your doctor about safety concerns for your child/teen, yourself, and your family members. Health care providers can help you and your child/teen stay safe, lower levels of aggression, and may prescribe medications to help children and teens with autism have less aggression[1].


References