my step son is somewhere on the autism spectrum..were working on getting an exact diagnosis...but tonight when we told him it was bedtime he started slapping/hitting himself in the face/eyes REALLY hard! what should i do to redirect him???
I know quite a few children with autism (former students) who hit themselves when upset. Generally, I deal in the moment with preventing them from doing so, because it's not safe, and redirecting their behavior to something else. This may mean simply putting my hands in between their hands/head, or actually stopping them, or it might mean restraining them for a very short period, and then redirecting. I usually say a quick, firm "Stop" or "Hands down/off". Redirecting might mean a variety of things depending on why they are hitting - it could be helping them to squeeze something, hit one fist into their palm, jump up and down, use words, use photo cards.
If it happens on any kind of regular basis, I do an ABC - antecedent, behavior, consequence - chart each time it happens to figure out the pattern. What happens right before hand, what exactly is the behavior, and what is my response to it? This helps to figure out the trigger, the function of the behavior, and whether the response is appropriate or not.
The most important thing is to try to identify the trigger, so that we can stop whatever prompts the behavior. Then we need to look at our reactions to it and see if they work or not. Sometimes you only have to do this once or twice to figure out the A and C. Other times you have to do it for quite a few times.
Yes, he does. And he responds really well to a big bear hug until he gains some control again.
My kid does that. He did it a lot more when younger (and harder). With my child and I suspect many the more attention I gave to the behavior the more likely it was to be repeated.
Kids younger than 3 are unlikely to be able to generate enough force even when headbanging (which my son also did) to actually hurt themselves.
The hitting wouldn't concern me under age 3 except to hope to make it less likely in time. The headbanging all I ever did directly was move him to a safer place as if I hadn't even noticed what he was doing. I never called attention to either of those behaviors (or biting himself, digging at his skin, etc.). I did seek to distract but pretended I didn't notice the behavior itself.
|Toddlers don't seriously injure themselves from this habit.
Pain prevents them from banging too hard, but even if it didn't, children under 3 don't generate enough force to cause brain damage or neurologic problems. The front or front/side of the head is the most frequently struck. Toddler heads are built to take all of the minor head trauma that is a normal part of learning to walk and climb. Healthy infants and toddlers who are head-bangers grow up to be coordinated and completely normal children.
How can you get head-banging to stop?
Most children will outgrow the habit on their own. You can speed up this process by reacting to it in a matter-of-fact way. Pretend not to notice. And if it is part of a tantrum, do not give her whatever she threw the tantrum to get. When you notice her head-banging, you might be able to get her to stop for the moment by distracting her or engaging her in a different activity. By decreasing the amount of time she spends in this habitual activity, she will outgrow it more quickly.
About headbanging and autistic kids may well not outgrow it especially if it is sensory in nature but still was helpful in terms of how I responded. http://www.drgreene.com/21_578.html
I honestly think your child is more likely to reduce this in time since he's doing it when mad compared to for sensory reasons. Just what I've noticed. My child did it for both.
My DS Carter is just a few months older than your SS. He has hurt himself pretty regularly since he was a toddler, though he does much less serious damage to himself now than when he was small. Like JessSC, I've found that deep pressure is very helpful. His feelings are just so overwhelming to him sometimes and he acts out wildly.
William started banging his head at about 10 months and that continued until he was about three. For a while he had a bruise on his forehead from it at al times. We would usually direct him to a safer spot. at 2.5 he started biting and that got bad. He bit everyone but mostly himself and his brother. He bit himself until around 4.5 or 5. We redirected that because he would break the skin. He does hit himself now but not usually too hard. A lot of it is because he needs to express something and is having a hard time doing it.
I wanted to add that I too noticed that my son was more restrained/careful in general as he got older. He doesn't want to hurt himself and uses less force than when he was young. But that would depend likely on a child's pain threshold and tolerance/awareness.
Also, if I touch my son when he's mad he escalates. He also is a deep pressure seeker and loves what we call "squeezy hugs" but not when he's mad or very dysregulated. Then he needs space. So every child is different in that area. I only mention it in case your kiddo is like mine and you wonder what's up if that type of thing makes him worse rather than better in those moments.
My almost 4 year old does this. He is not autistic- but I was surprised to see it! He will leave a mark on his face. If he gets really upset at us. Sometimes I wonder if he does it because he knows he isnt supposed to hit other people, but he wants to hit something.
We just tell him to stop, and distract him, and he seems ok- but I am not sure if it would be the same for a child with autism (Im so sorry- I really dont know much about it, so if that sounded horrible, I sincerely apologize!)
OT strategies of redirect would be my suggestions. Usually things like that are sensory seeking behaviors, and if you can find something that helps fill that need in a non-harmful way, you can often stop the behavior before it starts. Some ideas: bear hugs, wrapping him up like a taco or sandwiching him inbetween two big pillows/bean bag chairs (have an OT teach you the right way to do this because it can be dangerous if done wrong...make SURE you don't cover the head), have him push against a wall, joint compressions (again, get an OT to help with this), clapping, stomping, jumping, weighted blankets/vests.
Just to add (again...I promise to stop) that for us we've had this as sensory seeking and also in anger/frustration. For sensory seeking behavior alternate deep pressure activities are helpful. And in fact as my son got older he would just ask for a squeezy hug or a head squeeze. Proprioceptive work really seemed to help.
But when my son is angry those same techniques make things much worse. Some adults, when they are in emotional states, don't want to be touched. If I'm angry and my husband tries to hug me I want to jump out of my skin. It makes the emotion that much stronger. My son is the same way and in fact as he's gotten older he's told me that when he's mad he wants to be by himself. His twin is the opposite in that he wants contact when he's mad. He seeks it out. (He's not a self injurer either...but I see that as not relevant in the seek contact/do better without it discussion).
Since the OP is talking about a child who is doing this in anger rather than as sensory seeking I think it's important to note that not all kids like proprioceptive input when angry.
My son hits himself, really hard, in the face too. He also pulls out clumps of his hair. He just turned 11, and it is getting worse with the combined onset of puberty and school demands. He does not do it too often at home, but the frequency is increasing... at school and during other stressful situations it is the worst. I asked him why he does it and he says it feels almost like a veil is dropped behind his eyes and he just can't think anymore. Smacking himself or other self injuring behaviors makes it clear for a moment.
For my son, touching him while he is so upset (unless it is me) seems to upset him even more. At home, I can see it coming and redirect him. When I see him getting very anxious or frustrated, it helps a lot for us to move to a quiet area if possible and take away the stressor. Talking in a calm, slow way and hugging him helps a lot... but only if he is not to the point of being really mad/upset/anxious. We tried all sorts of things to no avail... stress balls, breaking pencils, deep breathing. We have an IEP in place for redirection at school, which does not work too well because not all the teachers can see the incident building. However, we have had some success recently (I hate to even say that, since it might not work next week!) with removing privileges at home if he hits/bangs/pulls elsewhere.
My DS does it, and I just ignore it. I don't ignore it to be mean or anything, but through trial and error, we've learned that if we ignore it, he stops after 1-3 hits. If we give him any eye contact or attention for it or try to stop it, he usually gets more aggressive or he beats the heck out of his face once we stop the redirection. So for him, it's safer to just have it be ignored because he stops after much fewer hits.
Unfortunately, my 2 year old saw him doing it and now she does it just to copy him.
My youngest does this. Mostly when he is angry or if he has pain somewhere else in his body. He says that it makes a headache feel better for example. He is also someone who would absolutely flip out if I restrained him to keep him from self injuring. If I notice the intesity of the behavior increasing either in the amount or severity , we try to work on sensory activities at other times of the day when he is more calm.