DS's Aggression Getting Out Of Control

[bippityboppity87]

My DS is 6 and has been referred for ASD. We've already had one apppintment with a paediatrician who highly suspects ASD. As well as his teachers and speech therapist. Forms had been filled out also which scored highly. It's currently gone to a multi disciplinary team and we have been told it could be up to a years wait to see someone from CAMHS

However, his aggression is getting worse and I don't know what to do. It's escalated to being physically violent to both me and his dad. Punching, pinching, scratching to the point he's drawn blood on our arms and bruising. It can be quite frightening. Or if he's not doing that, smacking his head off the pavement. I often have to physically restrain him

It's usually triggered by an unexpected change in routine or a food change. For example today I put my foot down and said we were not going to the park after school because of his behaviour. It was bad. Then he gets himself so worked up he nearly gives himself a panic attack

More recently when he has one of his meltdowns, he's started saying he wants to kill himself or wants me to die and swearing. Which is scary as well

I really don't know what to do My stress levels are through the roof and I'm really struggling to control him. Can I ring the gp and explain the situation and see if we can get seen quicker? As I really can't go on like this. I also have adhd, so having to deal with that on top of his behaviour is getting too much

Are school providing any support?

Have you kept a detailed diary and done ABC charts to try to spot the initial trigger? For example, what was the trigger for the behaviour at school?

Has DS been assessed by an OT?
Have you had social care assessments? A carer’s assessment for you and an assessment via the disabled children’s team for DS.


There’s nothing to lose by calling the GP and CAMHS to try to see if you can be seen sooner.


No nothing like that. At parents evening they said they didn't think he needs 1:1. But at school he doesn't act like that, so I don't think they understand the full brunt of it. It's when he comes out of school he explodes

Look at Yvonne newbolds fb group and website for some tips, think it’s now called newbold hope

Here
www.newboldhope.org/

It’s not uncommon for DC to hold it together at school and explode at home, it’s called the coke bottle effect. It is a sign of unmet needs at school. If school was easier for DS home life is likely to improve. Even if the school don’t think DS requires 1:1 they could offer other support and interventions e.g. a nurture group or Lego therapy or emotional literacy… Are you in Scotland? I am asking as some services and processes are country specific.

It’s worth seeing whether you can self refer to OT, in some areas you can. Not all areas commission sensory OT on the NHS but it’s worth a referral anyway for other support. Do ask for social care assessments, too.

Yes I've heard of the coke bottle affect. I think that's what's going on here. He masks at school then just explodes. He doesn't open up easily, so it takes me a while to pry any info out of him once he's calmed down. He did say today that the fire alarm went off in his school, which upset him as he hates loud noises (still trying to get him used to hand dryers in toilets) and cried a lot

I didn't take him to the park today as I thought I need to stick to my guns and I explained I know you're frustrated, but you need to learn other healthy coping mechanisms when you get upset. Hitting and punching is not acceptable, neither is swearing and name calling

I felt bad though, as I don't know if I'm doing the right thing, because if it is because of his Autism, I don't want to punish him for something he can't control and make it worse. It would be like me getting punished for being continuously forgetful because of my adhd. I really don't know

Yes we're in Scotland @LargeLegoHaul

Thank you that's useful @Morph22010

I'm also wondering if it's because it's a change in routine being off on school holidays the past 6 weeks and going into a different environment has set him off. He's always had a bit of short fuse, but this is the worst I've seen him. He went back to school on Wednesday

bippityboppity87 I have a ds8 who can be violent too so I understand how difficult it can be and I don't have all the answers

Even though school don't think he needs 1:1 have they put in any other support for him? What's the equivalent of an EHCP in Scotland? For instance, today they could have warned him about the fire alarm (if it was a test) and given him some ear defenders to wear. Small things like this can make a big difference for some kids, though some require much more obviously.

For many autistic people, routine is key to them navigating their day and knowing what to expect. If your ds is like this and is used to going to the park after school then it's likely that a change will trigger a meltdown, especially when after-school is already a difficult transition for him. Not taking him to the park is not helping him learn other healthy coping mechanisms, it's just a punishment for his prior behaviour. Something that might work with a NT child (though this approach is not recommended by any child psychologists) but will not help a ND child learn new skills.

I'm no expert but I expect that the self harming means that he doesn't like getting so out of control, it makes him feel terrible, but he cannot help himself. Any teaching of coping skills needs to be done when he is calm and not in the moment and it takes a great deal of time and persistence. You also have to learn which battles you are going to pick.

Sorry if any of this sounds preachy, it's not my intention. I hope that you can be seen by CAMHS quickly, but it sounds like how effective they are is a bit of a lottery.

Open’s post is excellent.


In that case, have you spoken to Enquire? They will support you to ensure DS receives the support he needs. They also have information on their website. The Scottish equivalent of an EHCP is a CSP, although it’s slightly different.

Has DS tried ear defenders or noise cancelling headphones? If DS can’t cope with hand dryers using the disabled toilets would help him.

Going back to school is likely to have exacerbated the situation even if it wasn’t the trigger.