to not know how to deal with DS? (Autism and Violence)

[1001Problems]

DS1 is 12. Over the last few years we have been wondering if he possibly has autistic traits but since puberty hit and then with the move to secondary school it is like living with Jekyll and Hyde.

We believe he has Pathological Demand Avoidance Autism - complete meltdowns triggered by requests/need to perform normal tasks. With DS this is homework and any household chores but is starting to escalate to things like getting dressed or putting shoes on. He is highly intelligent (in the 'gifted' category) hence it taking us so long to realise autism was the most likely cause, before the sudden violence in the last 12-18 months we just thought it was quirks of his gifted-ness.

The issue is his meltdowns are violent and directed at his siblings, mostly DD (10). He will then pummel DH or I if we get between him and his 'target'. It is now a regular situation for us to be barricading the younger children in a room while he beats us to try and get through.

I can find no help or information on what to do with a tween who physically attacks and keeps following you to keep attacking. Everything says 'back off, leave them to calm down' but he wont leave us! He keeps attacking until we get in the car and drive off leaving him home alone.

Has anyone got experience of this? Can anyone give some advice on dealing with this? DH and I are on our knees, our younger DC are scared of DS.

I have another appointment to talk with the GP, last time they sent us off for a 3 month wait for Teens in Crisis, 8 weeks of that to be told he doesnt have a problem, she wont refer him and that 'no-one will be interested in a family dynamic issue')

My two have autism and my youngest has been extremely aggressive for a number of years assaulting us, his 1:1, etc.
He is now 21 and has been determined by social services to not have capacity so we are beginning the legal process there

Things we do include - watching very carefully to see the signs that things are escalating and step in then.

Knowing what things are statistically more likely to have a bad outcome and avoiding them where possible.

If we have failed the two above then we remove ourselves. We have locks on our bedroom doors. It is better that he breaks things than injures us. I want to stress having to do this is very very rare.
We've done all the therapies and the training and calming, self soothing teaching etc but the problem is once he reaches the tipping point he is not capable of remembering or using any one that.

He is currently medicated. Including quetiapine, which is an anti psychotic that is proven to reduce aggressiveness in some young people with autism. Perhaps that's something to discuss with his gp. He's also on diazapam PRN and has a repeat prescription that allows for up to 3 pills a week.

Medication is not a cure, it's not a long term solution but it does have a place in the short term as part of a bigger strategy and is worth considering.

@1001Problems you could possibly try for a local young carers group too for dd? Do the rules about not going into others room apply for him as well?

Please dont leave him alone to deal with those emotions 😢
Why can't one of you remove DD and one of you stay with him until it passes, he will be so overwhelmed he should have someone there. All of you leaving sends a terrible message and I'm afraid it won't help the dynamics at all he will just come to resent you all especially his sibling. If you find you are in a situation of having 1 parent to two children and it kicks off then parent needs to make sure that DD knows when to back down and walk away instead of focusing on physically protecting her, stay with him, focus on him help him calm down he needs to be redirected, lead him into another part of the home, somewhere not too stimulating and somewhere he feels safe and wait for it to pass even if you have to sit in a room with
your back against the door, take him there everytime while your DD quietly removes herself, she has to take herself to sit somewhere and not get involved. He should soon learn to go himself when he feels the need to.

As for the physical stuff you really need to reinforce it while he's calm...there's no point trying to reason with him once he's already in that state. You need to help him identify what he's feeling before he attacks, make a plan to redirect let him have an input on this and agree some consequences will be put in place for hitting others and make sure other DC have some rules/consequences too so he's not singled out.

I would also avoid trying to communicate too much when he's having these episodes, keep instructions simple, do not get emotional and don't try to apply any punishments at that time just focus on helping him to get over it.

I'm not one for sending them to punch something else because I don't want my DS's thinking punching something will make them feel better.
We use sensory aides instead...theres loads out there, aggressive trampoline jumping or pushing against a wall/floor works a charm with one of mine, the other has a gym ball that he fling himself on and also likes to squeeze things. Basically our own ways to apply deep pressure techniques because they gave the same feeling that the child was seeking by attempting to hit.

It might be worth doing a sensory checklist to see if there's anything there that could help ?

DS1 that used to attack my DD actually benefitted from a bear hug (helped with the flying fists and gave me a few seconds to sort of push him in the direction I needed him to go) Sometimes he would just give in to the hug and sob, other times he would struggle but it gave DD time to get somewhere else, like completely out of his sight. DS1 also got given a giant heavy duvet to wrestle with while he screamed it out. I would say ages 9-13y were the most difficult, he is now 15 and regulates himself a bit better by first removing himself then either does laps up and down the garden or if he can't get out there' he basically has a tantrum in his room then comes back to us later, sometimes apologises, we'll have a drink then we'll chat about how we could have hanlded it better and praise what he handled well...it's not always perfect but he doesn't lash out at anyone physically anymore. Even outside of the home if anyone starts on him he simply walks away.

My other DS is younger and non verbal but I have learned to identify when I need to remove him from a situation...and I am still learning how best to support him.

It's not too late for you to learn what your son is trying to communicate to you.
Not to place blame but is DD saying or doing anything that is causing him to be so upset. I saw you mentioned he is a sweet and affectionate boy usually so I would wonder what the dynamic is between the two. I would try to get to the root of that first to be honest. In our case there was jealousy and feelings of inadequacy bubbling away so when DD was on a wind up DS1 just popped instantly!
We didn't realise at the time she had been saying snarky comments and teasing him when we were not in earshot, telling people his personal issues and getting her friends to tease him at school.
She was told that was not acceptable and received consequences for it.
They have both had to learn what "banter" is vs bullying.
If something like this happens and he has an aggressive reaction they will both receive a consequence and a lecture.

The focus must be on identifying when your DS is feeling overwhelmed and redirecting until he is able to understand and actually remove himself.
Anytime he is able to do this even if just for a moment be sure to praise him for it later.

Now is the time to work on these behaviours before he's a know it all teen because that will be a struggle!
I wish you good luck and lots of patience x

@BlackeyedSusan

Talk to DD. She has got to stop whatever it is that triggers him. If she does it deliberately she gets punished too. Be aware she may be neurodiverse too and may be stimming.

Keep them as separate as possible. Had to do that with mine.

What? I can't believe you've said this.

couture that only works if both parents are home at the time. Last night I was out with one of the DC at their hobby so DH was home with DD1 & 2. Obviously if we were both home I stay with him.

he wont tolerate hugs/contact. if you say nothing he screams that you're ignoring him, if you speak he tells you to shut up.

I am not strong enough to bear hug him from behind and hold him, he's only 6 inches shorter than me now. if you try and restrain him he starts to have a panic attack while trying to get away.

Please don't call the police on your neurodiverse child.

What are his triggers? Is it you asking him to do things? You saying no?

The language you use could be tweaked and would make an enormous difference to how your child reacts, so remove the direct demands from the language. Rethink the words you use to get him to do things that you want him to do, so phrases such as, ‘I wonder if ?’, ‘shall we…?’ and words such as ‘may’, ‘could’, ‘ would you like?’ ‘how about…?’ are much more effective than any mention of ‘must’, ‘need’ or ‘have to.’ try to avoid, ‘No,’ wherever possible.

Collaborate with your child.

Pick your battles.

For your DD’s sake she probably needs to be with the other parent when there’s not two parents around at home to intervene until you’ve worked out a plan to manage his behaviour. I rarely suggest families invite social services into their lives but in this case I would be tempted to seek advice from the children with disabilities team about keeping all your children safe.

theqentity DH and I are working really hard on the language used and I really try not to use the 'need' 'must' 'no'. when we phrase things as a question rather than a demand we get 'i dont know' and a sort of aimless, frustrated wandering around not sure what to do with himself. Suggestions of 'would you like a hug?' 'Can I get XYZ for you?' 'Would you like ABC?' just get met with shrugs and pacing - very anxiety-like. Not sure where we go from that point?

the only 'battle' i pick is 'no violence'. i literally do everything else for him. Homework is tricky because I dont force him to do it but he knows there will be consequences at school and that gets him wound up - he cant work out which is worse, having to do the homework or not having done the homework!

@1001Problems

theqentity DH and I are working really hard on the language used and I really try not to use the 'need' 'must' 'no'. when we phrase things as a question rather than a demand we get 'i dont know' and a sort of aimless, frustrated wandering around not sure what to do with himself. Suggestions of 'would you like a hug?' 'Can I get XYZ for you?' 'Would you like ABC?' just get met with shrugs and pacing - very anxiety-like. Not sure where we go from that point?

Sounds like the environment might be stressful to him, too noisy, messy, hot, cold? Maybe he needs you to leave him to it a bit more. Does he have a space to escape to?

He's smart but he's also deficient in a fundamental part of his understanding, and is actually peddling like mad underneath to compensate for it, which is incredibly mentally (and physically) exhausting. He's working twice as hard as neurotypical kids, all the time. No wonder he's stressed!

Oh I'm sorry I have just read the updates and just read the one posted at 10:21 please ignore what I said about DD I completely misunderstood.

Oh dear that's a different situation entirely basically sounds like he's assigned her as his "punchbag" poor girl, in that case I'd ask the school for a family support worker to be assigned they can help get you attention from relevant agencies though tbh in my experience a diagnosis makes little difference except access to certain things that my child never wanted to do.
I would even consider contacting a safeguarding team on behalf of your DD and make sure she has access to support.
What a difficult position you're in

Make a plan for the other dc- eg. if possible all leave quietly except one parent.
Make a plan and go through it with ds now- before the next episode.
Note down- What happens now?
What do we want to happen/What are we aiming for?
Example
1.Hitting/ hurting others is completely unacceptable. You must concentrate really hard on this as this is the most important thing. If your sister annoys you, go to your room immediately.
2.it is ok to feel angry and frustrated. Scream if it helps. Punch your punchbag if it helps. Twist a pillow / your duvet if it helps.

1. Reassure him that you will help him. Don't make excuses for him or his siblings. Keep repeating I am here, you are safe to your ds. He can't cope with any language when he is angry.

4.Do not physically or verbally respond in any way as he cannot understand when he is in the middle of an episode. 5.Turn yourself to present your back rather than face and soft organs that are more easily injured. 6.Move yourself to safety if things are being thrown. After an event talk through the plan again and amend as necessary. Keep repeating the plan and stay consistent. When he is angry you can say 'remember the plan' once it is embedded. Support the other dcs and get them on board with the support plan. You are all in it together. Good luck. Oh yes- you can refer him to CAMHS via the gp or SENCO at his school.

@1001Problems

theqentity DH and I are working really hard on the language used and I really try not to use the 'need' 'must' 'no'. when we phrase things as a question rather than a demand we get 'i dont know' and a sort of aimless, frustrated wandering around not sure what to do with himself. Suggestions of 'would you like a hug?' 'Can I get XYZ for you?' 'Would you like ABC?' just get met with shrugs and pacing - very anxiety-like. Not sure where we go from that point?

Maybe you're asking him too many questions? It's very hard to tolerate questions when you're churning up inside. Maybe 'I'm not going to give you a hug now, because you might not want it, but if you want one I'm here and would love to give you one'

he has his own room with playstation/dvd (his preferred activity)

Our house is mostly open plan downstairs, there are 3 other DC and a dog and I run a buisness from home - all of which were in place before we were aware of DS's difficulties - i'm not sure how i can do more at home in terms of providing space and calm? the other DC are always sent to the playroom or their rooms when DS is starting to act out.

The thing i find myself saying over and over to myself is 'if he'd just go to his room it wouldn't happen' as what it feels like he is doing is deliberately putting himself in a situation that will trigger him when he has a nice safe private room he could choose to go to instead! i know he cant control that, i know its not deliberate but that is how it feels.

He's seeking you guys to be his punchbags, literally. Because he knows that works as an outlet for his frustrations. He may need to be specifically shown or directed to more calming activities, as he doesn't have the tools to do so himself.

And you have to try and get to the bottom of his frustration, what is he not understanding or getting? He may be hiding this from you.

Try giving choices rather than open questions - a clear choice is far less anxiety inducing.

With homework might school let him have the option of doing it there, after school or during lunchtime? If he has the option - don’t do it/no consequences or do it in school it could take a lot of stress away.

somethingischasingme thank you, thats a really nice clear list. yes i can see that we need to stop trying to plug holes and go back and build a new boat from scratch. make a plan that at the first sign of a falre up everyone follows the plan. that is really helpful thank you for listing it like that.

theqentity sorry, those were examples of phrases i might use, not that i use them all at the same time/one after the other. I do try to just repeat 'i love you and I'm here' but sometimes I get to frazzled to stay on the script.

I would just sack he homework off altogether.

Tell school he won't be doing it for the foreseeable because of mental health concerns.

Tell him he doesn't have to do it and he won't get into trouble.

It is t work it. That's a battle you can choose not to fight.

“ it feels like he is doing is deliberately putting himself in a situation that will trigger him when he has a nice safe private room he could choose to go to instead!”

Because once he’s reached that point it’ll feel so much better/easier to have that outlet and release the stress.

There’s a point where meltdown becomes inevitable. If you can catch it before that point you can divert it, and slowly reach him to recognise the signs and divert it himself.

For now you need a plan for the whole family, once it gets to x point, everyone goes to their rooms for quiet activities - maybe sounds unfair on them but until ds can recognise the signs himself and take himself off there’s no choice, they all need to be safe.

Agree with the PDA website and Yvonne Newbold as good resources.

We actually did a course from yvonne which covered siblings issues a bit (for my son)

One thing i remember was finding a safe place for your daughter, so maybe the playroom she can lock herself in and having a kit of stuff ready for her to grab. It might have a nice snack a fresh magazine, the tablet charger, a drink etc, a cosy blanket You might have to be barricaded in with her.

Obviously you want to tackle it happening but in the interim its just practical to have thought where is she safe, how can i make that more.

I would also recommend some sort of sibling together thing they might enjoy. Lots of therapeutic farms do sessions where siblings can grrom a hourse or play with a goat together.

He has to learn that violence towards other people is not acceptable. Walking in to a room where your daughter is and pushing or kicking her for no reason is not acceptable and there has to be a consequence for that behaviour.

Ah sorry I missed your earlier reply to me. I agree with @Ibizan, there is more to do on insight. Someone annoying him is his interpretation of why he has this horrible feeling inside him, but maybe there are other reasons for that feeling. Sell it to him that identifying some of these is a really good thing, because often they might be things you/he can change. Whereas you're always going to be his annoying mum and he's stuck with you! And yes, if he is walking up to her sister and punching her that is clearly not acceptable and would be a good route into challenging that "her being annoying" opinion.

The "0-100" is something I'd always thought my DS did, but actually it was that we were all missing the "getting wound up"/amber state because of his interoception and expressive communication difficulties.

Do be aware that winding up an autistic child to lash out is a really common playground bullying technique. It's not victim blaming to say that if your son has been on the receiving end at school, he might be very reactive to any sniff of it at home.

@Mamamia7962

He has to learn that violence towards other people is not acceptable. Walking in to a room where your daughter is and pushing or kicking her for no reason is not acceptable and there has to be a consequence for that behaviour.

Once he’s reached that point though he’s using his siblings as a tool to release. It’s not acceptable, but consequences, particularly for a PDA child at this point, will be counterproductive and likely to prolong the meltdown or kick one off again. Far better to focus on avoiding that altogether. Once it’s happening it’s too late.

Put your effort into finding preventative strategies and slowly teaching them to your son so he can use them for himself.
Starting at a point of consequences for past behaviour (even if it’s only minutes in the past) is a road to hell when PDA is involved.

Couldn’t read and run, although don’t have time right now to post a long reply. I just wanted to say we’ve been through this. DS is an intelligent, quite talented boy, diagnosed with Asperger’s (HFA) at 5, but got an additional diagnosis of PDA at 10.

11-15 was the peak age for violent meltdowns for us. Made worse by the fact that by 13 he was well over 6 ft and very strong, so doors were kicked off, DH sustained a black eye at one point, my you get child was scared of him and my mental health was shot to bits. Very, very hard on all the family. I understand ❤️

The good news is that he’s 18 now and has completely changed over the last couple of years. Very laidback, rarely gets angry, never violent. Still has challenges, but the anger and violence have dissipated and the anxiety at the root of it all is much more obvious (and much easier to help him with!).

There is hope!

I’ll come back later with some suggestions for things that helped us 💐

You get = younger child