Autism and anger

[Shhh123]

Hi everyone,
I’ve posted before but really could use some advice.
My son is 7, diagnosed ASD, global development delay and sensory processing disorder also ADHD suspected. We have experienced every challenge you can possibly think off. The current phase is anger and frustration. Day in and day out. We just cannot control with the amount of hate he seems to hold inside him sometimes, and this can sometimes stem from something tiny or nothing at all. He can hold a grudge on something that’s happened months prior. He can communicate effectively now, we had originally believed it was down to lack of communication or understanding but he can express exactly what he wants and feels with his PECs picture board and verbally. He is lashing out physically and verbally. He is a tall, strong boy and not far away from being the same height as me. This terrifies me. He is already so strong and powerful, if his behaviour continues as he ages, how can I help him? I can no longer physically remove him from situations due to him being too heavy. This results in me only taking him anywhere when I have other adults with me. My elder son suffers and misses out quite a lot. He regularly lashes out physically and can be very very rude, not just to me or his dad but everyone. None of this is learnt behaviour from us. Not perfect parents and of course we are only human and do occasionally raise our voices but we are both very patient and would never dream of saying a lot of the hurtful things he says when angry.
How to do possibly punish a child for his behaviours when we can’t determine what is done? Removing things does not work. He gets angrier. Timeouts? He doesn’t understand to concept. Giving him warnings? Doesn’t work as I get a lot of verbal abuse back. Calmly explaining how certain behaviours are inappropriate? He doesn’t grasp the concept and continues to get angry. We’ve tried breathing exercises, outdoor intervention, meditation
We have tried everything possible. Read every book or article, spoken to gps, his teachers (attends a brilliant SEND school) I’ve even taken an online course on autism and communication to see if we can understand his world a little better. I love him with my whole heart and it’s killing me I just want to help him. I’m physically and emotionally drained from the continuous behaviour. It’s affecting my relationship with his dad and our eldest son who just resorts to staying in his room as to not collide with his brother. I’m desperate. I just want to run away and hide. I physically don’t know what else I can do/try. Nobody seems to be able to offer any help or advice….my GP actually tried to prescribe me with antidepressants or anxiety medications, believing it was me not coping. It breaks my heart as each night he cries and hugs me and tells me that he is sorry and his brain tells him to be this way.
If anyone has any tips or advice it would be greatly appreciated xxx

[Headfirstintothewild]

Have you been on a NVR course? Some find that useful. You may have already looked at them but some people find Ross Greene’s The Explosive Child book, The Out of Sync Child book &/or Yvonne Newbold’s resources useful. Do you have any sensory equipment?

Keeping a detailed diary can help spot triggers and try to de-escalate before reaching crisis point. Punishment won’t work and is likely to lead to an escalation.

How is DS’s sleep and eating? Does he take any medication?

Have you had social care assessments? Would an SN buggy or wheelchair for when DS reaches tipping point help you outside the home.

Sounds like an early review of the EHCP is needed too. Does it have any therapies in it currently?

For DS1, have you spoken to your local young carers service? Sibs has a helpline.

[Shhh123]

Thank you for your message.
No have not taken part in an NVR course, but I will definitely take a look into that!
Thank you for your recommendations, I’ll be looking on Amazon to see if those books can give me any support.
yea we are aware of his triggers and he used to communicate so effectively using his emotion picture board that we still use however he seems to go from 0-100 miles per hour and sometimes it’s as if he doesn’t even realise himself. Its really quite tricky.
Little man’s eating has always been a difficult one as his diet is very limited. We have seen GPs and dietitian and a paediatrician who both agreed that because he eats one thing from each food group, and does eat something and is not loosing weight, that everything is ok and that we should just keep trying new foods.
sleeping can be a challenge also. It takes a very long time and very strict routine for little one to fall asleep and then he has always been an early riser. And no, my son isn’t currently on any medication.
We had considered a buggy or support for those times he struggles but is a very very independent young man and he would definitely not take to one, we tried when he was younger but much prefers to walk.
At school he has a range of therapies, he currently has speech and language, one to ones to help with his frustration, hydro therapy and rebound therapy (trampolining) but nothing outside of school.
Thank you, I had not realised there was support for siblings. There is a 5 year age gap and my eldest adores him but it does have a knock on effect.

[Headfirstintothewild]

Will DS take a multivitamin?

If you are already under a paed or CAMHS I would request medication to aid sleep. Melatonin is normally the first one tried. If DS isn’t already under secondary care, I wouldn’t request a referral. Most GPs won’t initiate treatment. (Once other things have been tried there is also medication that helps some with anxiety &/or challenging behaviour.)

Sounds like DS needs OT and some therapeutic MH provision.

[Shhh123]

Yes he happily takes a multivitamin each day and we’ve just mastered getting him to help make and drink smoothies so at least I know he gets a little goodness into his diet.
He was under a paediatrician however was sent a letter stating he was to be discharged as he now had his diagnosis and was receiving his therapies through school so was a little disheartened. It does sometimes feel as though I’m just not listened to.
We never really thought about going down the medication route to be honest but at this point, I think it’s worth me having a little chat. I just want to help my boy. I see him struggling and it’s absolutely heart breaking. We are so lucky as he has the most loving side and can be so affectionate. I am hoping that within time, these challenges settle for him. It’s just knowing where to start.

[Headfirstintothewild]

I would definitely request a referral to paeds or CAMHS. If specifically looking at medication to aid sleep, you could request a referral to a sleep clinic. There will still be a wait, but in some areas it is quicker than waiting for paeds or CAMHS.

[sleepworkmum]

oh my. I am so sorry you are going through this and I can totally relate. DD, 9, is ASD and has been having increasingly angry outbursts for the last few years, culminating in such violence that I had to take her to my mums for two weeks to separate her from her brother and father, who all the anger was directed at. We had to hide the knives.

This might all be really obvious to you already from your own experience and reading, but:

The first thing to remember is that, especially with ASC, all behaviour is expression of emotion or an unmet need. Do you know what he's trying to express?

The second thing that helped us is that we reframed meltdowns as panic attacks. You cannot sanction or punish panic attacks. You need to identify and solve whatever it is that's making him 'panic'.

With my DD it was about safety and specifically safety of school. Her ASC experience means that school is a very scary place where she feels very unsafe to the point that it becomes a matter of survival for her. The violence was therefore her survival instincts kicking in, as well as unleashing all the pent up panic she stores up during the school day.

The time at my mum's and taking DD out of school for a few weeks has really really helped us. She is due to go back to school after the easter holidays after not being in since February and I have no idea how that's going to play out. But we've only had two meltdowns in four weeks - it used to be two a day. She is much calmer and better able to communicate.

It also sounds a bit like all the therapies at school (what a great provision, by the way) might be treating the expression of his ASC, rather than helping you to adapt his environment to meet his ASC experience and needs.

[Shhh123]

Thank you for your message. It’s reassuring to hear from another parents who know the struggles.
We have had times before where I felt my son just needed space from me and he has had a sleepover at his nans house for a night or two which does give us time to breathe and regroup, but this is not very often due to my mother in law having a disability where her mobility isn’t great and it is unfair if my youngest has a meltdown.
we have been extremely lucky with his school but I do agree with your point. They do focus a lot on treating the expression of ASD and not so much adapting the world around him. I agree to some extent as the big wide world will be an even scarier place as he gets older if I shield him from everything.
why is mum guilt always playing a huge part :(

[CasadeCoca]

Abandon punishment. You'll destroy your relationship as you'll be treating him punitively for things he cannot yet control. There is no logic or benefit to applying sanctions to a child for things they lack the developmental capacity to do differently. He is not choosing to do this. His executive functioning will likely be similar to a 4-5 year old at best. As @sleepworkmum says you need to reduce the discomfort in his environment/lower demands and then he will be more regulated. Which may mean family life has to be further adjusted and that school need to make further modifications too, as he may be accumulating stress in that environment which he feels safe to let out at home.

@Shhh123 is right about a diary and understanding triggers.

You sound like you are doing lots of positive things in order to understand DC. Focus on the quality of your relationship and finding moments of connection and joy - they go a long way, and minimise negative feedback - he'll be getting a lot of that in his wider environment and that will fuel distress and undermine his self-esteem. Does he have special interests he can engage in to the extent he'd like to?

Personally I'd push for the ADHD assessment, or perhaps go private if funds permit, as medication can reduce the challenge to a degree.

Have you got an EHCP? It could include therapies and also OT support on sensory issues?

[Shhh123]

Thank you for your message.
Your message makes so much sense and has made me re-think my tactics. Sometimes it takes an outsiders view on things to put it into perspective.
I could write a list as long as my arm on the positives too, he can be an absolute joy and of course I adore him. I think a lot may just be my understanding and my coping mechanisms and have got myself into a bit of a rut and need to re-adjust to help him.
in regards to his special interests he loves swimming and he does have one to one swimming lessons during the week which is great for his energy levels. He loves to dance but we are yet to find a suitable club as it was very overwhelming for him. We have tried athletics and football also, all SEND groups but he just struggles in those environments, yet we long for him to do something he loves!
We do have lots of family days out but usually open spaces that we are familiar with.
ADHD has always been on my mind, his teacher last year didn’t agree but this years is almost certain. We are currently building evidence at home and school to go towards the assessment.
My son is at a specialist school with an EHCP, we had a review not so long ago and we discussed all of the challenges to which they have been absolutely amazing. We really are so lucky to have the school support yet there are still some things I believe we need to address. Maybe it’s worth me setting up another meeting.

[CasadeCoca]

Good luck - it is so hard.

Meant to say - have you come across the concept of natural consequences? A way of using things that go wrong to explain consequences in a non-punitive, non-shaming way, that reduces escalation.

My DC was late diagnosed (complex needs but presentation confused professionals). Consequently we had years of people suggesting inappropriate behavioural interventions, which I think he experienced a bit like torture, as he simply didn't have the capacity to do the the things he was being expected to do. It corroded trust between us and has taken a time to rebuild that.

[sleepworkmum]

A book I found really helpful in switching my (and DHs) mindset on how to understand meltdowns is Low Demand Parenting by Amanda Diekman. You might already have this.

if he loves swimming, is it possible to double down on that?

[Shhh123]

Hi,
We definitely try our best to de-escalate when I sense a change in how little man is feeling. Usually we can spot a change and redirect his attention using the art of distraction. However recently it has been 0-100 and before we’ve even had the chance it’s happening. I even took him to the GP to have an overall health check done just in case we are missing something. Does he have a tummy ache or ear ache and just can’t communicate it effectively. But all was clear!
My main fear is that of all the advice I’ve taken over the years and the didn’t things we have tried may have confused him. We have really challenging phases where I’m constantly online googling ways to help us all through them so maybe this has confused things. And of course everybody parents in a different way so what works for one child definitely doesn’t work with all.

Thank you for the book recommendation, I’ll dive into that one too!

We did try to double up on the swimming but we have found that doing too much after school, he struggles with as he masks a lot whilst out and so his home time he usually finds very challenging at first as he lets everything out! Both positive and negative and then just sometimes wants his own space and time alone so he just found it too much going in and out in the evening. This could possibly explain why the other clubs weren’t right.