What do you do when your SN child acts aggressively?

[Stephenie]

DS is 4 and has Asperger's and SPD. 

He tends to act violently when overwhelmed. This is often from Sensory overload. He also acts this way when he has an expectation and it's not met/ he thinks something will happen because it is routine and that routine is not followed. He also acts this way when he feels his space has been invaded. (IE  yesterday his sister (2) walked up to him, holding her hand out to him  when he was sitting on the sofa. He saw her coming and kicked her, very hard in the chest and she went flying across the room.) 

I have tried talking to him. I have tried time outs (which make things worse, he'll go into a full blown tantrum, throwing things, hitting/biting/ kicking everyone in sight) I've tried sticker charts for good behavior. Those work on increasing good behaviors, but do nothing for reducing violence. I've tried taking away toys, TV, etc and that increases poor behavior. I have, regrettably, yelled at him more times than I want to admit and that does nothing as well. Now his little sister is becoming increasingly violent with us because she is learning it from him. I am just so overwhelmed by it all.

What do you do when your special needs child acts this way? Has anyone had any success changing these behaviors? We try to prevent it, but we can't always. There has to be a better way. 

[FarmerBeth]

Does your son allow holding if it's from you when he has gotten aggressive?  This worked well with my oldest son who has sensory issues, and with some kids i worked with.  Others can get more upset, though.  Also, sometimes a "time with" works better than a time out.  Take the child away from the situation with you and do something together, like have him help cook or do a simple chore.  This is not rewarding the behavior so much as taking him away from a situation he can't handle and modeling a way to calm down.  Just make sure you have lots of "time with" at other times, too, so as to not cause him to act out to get attention.  Have very exact rules and when he is calm, discuss rules for different scenarios.  Like, "If your sister is so close to you it feels yucky, you can hold out your arm like a stop signal and say,'No, I want to sit alone".  It might take a long time to work, but the more you practice the more likely it can start to happen in real life.

[Stephenie]

Holding him makes it worse. He bites, kicks, screams until you let go. It worked when he was little but not anymore.

We do talk about it when he's calm, but I don't think he has the self control in the moment to process it. When he is calm he is a very strict rule follower, but when he's overwhelmed it all goes out the door. 

[FarmerBeth]

Will he come along with you out of the room to spend time with you or go to a calm place?  If he's really out of control, I think he needs to be away from the situation for the little sister's sake, but I doubt from your description he is ready to leave the situation without you helping.  My now 11 year old son who I must admit didn't have a problem with aggressiveness so much as a complete melt-down) at this point has himself trained to go to a calm place where he can relax when he is too overwhelmed, but we were many years taking him away from the situation to settle with us before he had the maturity to do this on his own.  It's not easy, and you'll have to take your time to see what works for you. 

You might have to also look at prevention.  Are some of the overwhelming situations ones that could be best avoided?  When you have a SN kid you have to pick your battles, sometimes.  Are the important people in your son's life aware of what sort of things trigger upset?  At two years old you can't expect your daughter to comprehend the need for body space that well, but you can begin to model it, like putting out your arm and showing that's how far away is comfortable for her brother when he's not getting hugs. 

We have similar problems with routine disruption, too.  Try your best to not announce an upcoming event until you know for sure it will happen.  Keep a comforting routine and try to forecast changes well in advance.  Give LOTS of time for transitions.  None of it is easy but it will come along given time.  You're doing your best, but you have a child who will need extra time to have his behavior change.  Lots of kids without special needs have a pretty hard time with aggressive tantrums, and your son may have more.  What I can tel you is that my child and other children i know who had more extreme problems with aggression, improved in the end.  It just might take the long view.

[joensally]

DS has SPD and used to be pretty rough when overwhelmed.  Have you tried heavy work?  When he's ramping up, give him a job that requires using big muscles (moving the laundry basket, for example) because this inserts a pause in the amping up and gives him some relief/regulation.  He can also try to make the room bigger by pushing on the walls.  When out, you can push palm to palm with him where he's trying to get your paired hands past a certain point - do it with smiles and jokes, and it's another pause and opportunity to re-regulate.

A huge part is prevention - really observing his signs that he's falling out of regulation, and to keep up with his sensory diet.  Has he been seen by an OT and received a sensory diet unique to him?

As for TOs - we did "time-ins" here.  Our house is set up that the bottom step is sort of in the middle yet out of the way.  It's the perfect spot for someone to sit and regain their equilibrium.  A lot of the time I sat with him, not talking.  Just being with him, or rubbing his back (a sensory input that DS loves) while he regained some peace.  THEN we talked about what had happened and the things he could have done differently, then apologies/making it right with the harmed.  We did this just when he needed to chill, even without having harmed anyone so it wasn't a horrible place that he resisted when raging - it was where he came back into equilibrium.

It's important to teach him how to regulate himself so that he can manage in his own life to the best of his ability.  Some great resources are How Does My Engine Run and The Incredible 5 Point Scale.  Some of Brain Gym is good, along with kid yoga DVDs.  I'm currently re-reading Smart but Scattered which is about Executive Functioning and gives real tips how to develop these skills.  Improved EF skills help a child who is struggling with sensory issues as well.

[Stephenie]

We do work really hard at prevention, but not everything can be prevented. Something as simple as cutting the tip off of his carrot has set him off before. Or saying I'd make him X for lunch and finding out it's gone when I get to the cupboard.

The problem with time ins for us is that usually, he's just hurt his sister. I don't want to leave my injured 2 year old to go be with him while he calms down while she cries alone. You know?

RE sensory needs, we do work some of that into our day and he's really good at telling us when he needs input of some kind (IE he wants to push things or needs to spin) but I could try more. We're on a waitlist to get him back into OT, but he's had it before so we're fairly knowledgeable.

What I really want is a way to reprimand him in some way that's useful.... maybe that sounds wrong, but we spend a lot of our lives walking on eggshells trying to make sure he stays calm and it still doesn't work... I know that we can not prevent all of it. We just can't. It's caused a lot of issues for him and our whole family and I really want to get a handle on it so that he can be seen for some of the many wonderful things that he is instead of this one part of him. I need a method of coping with the behaviors when they do happen that sends a clear message to him that it is not ok without setting him off further, something to do in the moment he's just knocked his sister over, bit me, etc  before the tantrum comes.

I will check out the books. Thank you both for your recommendations here, I don't mean to sound ungrateful. I am just having a very hard time with it all at the moment.

[Emmeline II]

Originally Posted by Stephenie 

 Or saying I'd make him X for lunch and finding out it's gone when I get to the cupboard.

I think this can be prevented; train yourself to always check the cupboard first and then offer from what is available. Accompanying this is to say "maybe" more often instead of "yes".
 

[joensally]

Originally Posted by Stephenie 

We do work really hard at prevention, but not everything can be prevented. Something as simple as cutting the tip off of his carrot has set him off before. Or saying I'd make him X for lunch and finding out it's gone when I get to the cupboard.

The problem with time ins for us is that usually, he's just hurt his sister. I don't want to leave my injured 2 year old to go be with him while he calms down while she cries alone. You know?

RE sensory needs, we do work some of that into our day and he's really good at telling us when he needs input of some kind (IE he wants to push things or needs to spin) but I could try more. We're on a waitlist to get him back into OT, but he's had it before so we're fairly knowledgeable.

What I really want is a way to reprimand him in some way that's useful.... maybe that sounds wrong, but we spend a lot of our lives walking on eggshells trying to make sure he stays calm and it still doesn't work... I know that we can not prevent all of it. We just can't. It's caused a lot of issues for him and our whole family and I really want to get a handle on it so that he can be seen for some of the many wonderful things that he is instead of this one part of him. I need a method of coping with the behaviors when they do happen that sends a clear message to him that it is not ok without setting him off further, something to do in the moment he's just knocked his sister over, bit me, etc  before the tantrum comes.

I will check out the books. Thank you both for your recommendations here, I don't mean to sound ungrateful. I am just having a very hard time with it all at the moment.

I know.  This is hard.  I spent a lot of time exasperated and upset when DS was your son's age.  It's A LOT better these days, as I've learned strategies, and he's learned strategies.  DD is older and it was still awful seeing her punched by her overwhelmed brother.  I'm sure it's far worse when she's a toddler.

I don't think that there's a short term solution that leads to him being able to moderate his behaviour - he needs to learn self-regulation strategies.  He's not choosing to irrationally over-react - it's a rational reaction from his over-sensitive POV.  When DS got older and had better ways of describing how he felt it was very interesting.  This wasn't an issue of vocabulary, but rather of emerging self and other awareness.

For the time-ins, I would try introducing them when another adult is there so that one can help him chill while the other attends DD, or when he's freaked but hasn't harmed anyone  If it works when you're alone with the kids, bring DD with you and cradle her in your lap (this may not work, but worth a try).  By the time DS was 4 or 4.5, he could be directed to the bottom step and he would go as he knew it would help him get through the storm of emotions.  I could stay with DD and attend to her, and then join him.  By the time I got there, he'd usually have calmed a bit and we could engage in social, empathy and self-regulation coaching "ok, I understand that you felt that way, but hitting is never acceptable.  how does your sister feel do you think?  what could you have done differently (this is a range of pre-loaded strategies)?  ok, what could you do now to make it right with your sister?"  Note, all of this talking happens once the storm is largely passed.

Another thought - when DS meltsdown (he largely internalizes now rather than externalizes), it's usually a final straw sort of thing.  The "minor" thing that sets him off is usually the proverbial straw and he's already amped up about something that happened earlier.

If he's falling out of regulation regularly, I would up the sensory activities to see if it helps.  GL.  This is hard and frustrating stuff.

[Stephenie]

Thank you Joensally. I am probably looking for something that does not exist. Nothing is probably going to make it better in the short term. I'm just super burned out. He also quit sleeping again recently and boy am I  overtired. I'm sure that's added to his outbursts. Hopefully it is all easier in time with lots of hard work. 

[Stephenie]

UGH. I left the room for 40 seconds and I heard a scream, I  came back to find DD's face all bloody and DS sitting next to her calm as can be while she bleeds and cries. I yelled at him. Everything in me knows I shouldn't, but in the heat of the moment, I did. I feel awful, DD feels awful and DS is trying to keep his space from me.

[QueenOfTheMeadow]

Originally Posted by Stephenie 

UGH. I left the room for 40 seconds and I heard a scream, I  came back to find DD's face all bloody and DS sitting next to her calm as can be while she bleeds and cries. I yelled at him. Everything in me knows I shouldn't, but in the heat of the moment, I did. I feel awful, DD feels awful and DS is trying to keep his space from me.

I wish I could give you a real hug. We've been through this only at an older age. My son started getting violent about things when he was 9-10 years old. We tried all the things you are mentioning, plus he's on a gluten, casien, egg free diet. He's in counseling. On all the supplements that are reccomended by the doctor, etc, etc.

When things started to escalate, we finally just realized that we could not in any circumstances leave him alone with his younger brothers. It sucked! We had to be ultra vigilent at all times, even when he seemed fine, because his mood could change at the drop of the hat. We did it to protect him and to protect his brothers.

We did end up putting him on medication, because I had to pick him up at school when he was 10 and he shoved me...hard. Then I had to practically drag him out of the school. We got half way home and his rage turned to guilt, and he started sobbing that he needed help and he didn't want to hurt anyone. Heartbreaking. Now your son is still young, so I'm not suggesting meds, but for his own sake and your dd's you can not leave them alone together.

Again, many many many hugs. It's not easy.

[Emmeline II]

Originally Posted by Stephenie 

Thank you Joensally. I am probably looking for something that does not exist. Nothing is probably going to make it better in the short term. I'm just super burned out. He also quit sleeping again recently and boy am I  overtired. I'm sure that's added to his outbursts. Hopefully it is all easier in time with lots of hard work. 

For the sleeping you could try melatonin.

[Stephenie]

I think we're coming to that, not leaving them alone together. It's hard because she's his little shadow and loves to be with him at all moments in spite of the fact that he hurts her. Gets hard when I have to do something out of the room for a minute, but I guess I will just have to take her everywhere with me like I did when she was a baby. Thanks for the hugs, even if they are online. :) 

[Stephenie]

Originally Posted by Emmeline II 

For the sleeping you could try melatonin.

We use it already. It's not working right now. 

[QueenOfTheMeadow]

Originally Posted by Stephenie 

We use it already. It's not working right now. 

I was using melatonin with my middle son who has trouble sleeping, but I got a couple of samples of rescue remebly sleep from a vendor at work, and it was even more effective! He loves it, and for a kid who has night terrors and mild anxiety, I'm thrilled to have him come down and ask for a spray of it! If it makes a differenct forhim, it would probably help during the day too, if he's getting really rigid about something.

[Stephenie]

Thank you so much for the suggestion. I am going to go look for some tomorrow! 

[joensally]

Stephenie, I'm sorry that happened today!  As for the yelling - meh.  Parenting a child with additional needs is quantitatively more difficult than parenting a typical child.  Period.  It's tough, and no one is perfect. 

Melatonin is a funny thing.  Paradoxically, if it's not seeming to be as effective, reduce the dosage.  We use the liquid drops and can adjust to partial mgs as needed.  We also have 3 mg time release capsules and I give DS about 1mg in applesauce as his issue is staying asleep more than getting there.

Rescue Remedy comes in yummy pastilles, a spray and tincture.  Warning about the tincture - it's bitter and my SPD kid won't go near it.

I highly recommend the Kurcinka Sleepless in America book.  I found I was doing things that were undermining our sleep efforts, things that weren't obvious to me at all.

[QueenOfTheMeadow]

Originally Posted by joensally 

Stephenie, I'm sorry that happened today!  As for the yelling - meh.  Parenting a child with additional needs is quantitatively more difficult than parenting a typical child.  Period.  It's tough, and no one is perfect. 

Melatonin is a funny thing.  Paradoxically, if it's not seeming to be as effective, reduce the dosage.  We use the liquid drops and can adjust to partial mgs as needed.  We also have 3 mg time release capsules and I give DS about 1mg in applesauce as his issue is staying asleep more than getting there.

Rescue Remedy comes in yummy pastilles, a spray and tincture.  Warning about the tincture - it's bitter and my SPD kid won't go near it.

I highly recommend the Kurcinka Sleepless in America book.  I found I was doing things that were undermining our sleep efforts, things that weren't obvious to me at all.

Have you tried the kids tincture that's in glycerin? It should be less bitter. They also now have these little round capsules that melt under the tongue, that seem to be sweeter than the regular tincture.

[Stephenie]

Originally Posted by joensally 

Stephenie, I'm sorry that happened today!  As for the yelling - meh.  Parenting a child with additional needs is quantitatively more difficult than parenting a typical child.  Period.  It's tough, and no one is perfect. 

Melatonin is a funny thing.  Paradoxically, if it's not seeming to be as effective, reduce the dosage.  We use the liquid drops and can adjust to partial mgs as needed.  We also have 3 mg time release capsules and I give DS about 1mg in applesauce as his issue is staying asleep more than getting there.

Rescue Remedy comes in yummy pastilles, a spray and tincture.  Warning about the tincture - it's bitter and my SPD kid won't go near it.

I highly recommend the Kurcinka Sleepless in America book.  I found I was doing things that were undermining our sleep efforts, things that weren't obvious to me at all.

Thanks for your post. It is just so hard... and I logically know that I can't be perfect, but I really don't like screaming at my kids. 

I haven't found a time release without soy or citrus in it yet, and he has sensitivities to both. He has problems with both going to sleep and staying asleep and I would love to find something that would keep him asleep as well. 

I read sleepless in America, but DS was much younger then. I will have to try again. 

[StephandOwen]

Wow, your ds sounds a lot like mine was at that age (minus the younger sibling.... we were too terrified to have any more kids until just recently).

One thing that we did that worked REALLY well with my ds was setting up a "quiet spot". For ds, this is his closet in his bedroom. We transformed it into a quiet spot piled with pillows and blankets with glow in the dark stars on the walls and glow in the dark planets hanging down from the wire shelves in the closet. There is also a poster on the door that shows different emotions. When ds started getting out of control we would (calmly!) bring him to his closet. We wouldn't engage in the argument. It was simply stated "it looks like you need some quiet time. I'll help you get there". Then we would take his hand (or sometimes carry him if it was really bad) to his closet. We would NEVER close the door on his closet (though he often would) so it was NOT a punishment. It was a place for him to calm down. We always told him "when you're calm and can talk to us, please come find us" and we would leave. He would calm down 98% of the time. As he got a little older we simply had to say "it looks like you need some quiet time" when he started getting out of control and he would go to his closet himself until he had calmed down. Having this quiet place that was HIS (we didn't go in there unless he invited us in) really seemed to help him a lot. After he had calmed down he would come find us and we would talk about what had happened.

Anyway, it won't work for every child but if you can try to find a safe crashing place that is just his (nobody else allowed) then that might help.