Our Best Strategies for Dealing with Autism and Anger

by Shea Brogren, MOT, OTR/L October 05, 2020

Anger & Autism Blog Post

Have you ever wondered about autism spectrum disorder and its relationship to anger? What can cause anger outbursts in children with autism? How can we help children with autism deescalate from anger? We will answer these questions and more, but first, let’s consider autism symptoms. 

The symptoms related to autism spectrum disorder vary greatly among individuals. In addition, these symptoms fall along a spectrum, with some children demonstrating more severe symptoms compared to others. Generally speaking, individuals with autism will experiences some degree of the following symptoms: 

  • Difficulty with social interactions 
  • Poor eye contact 
  • Impulsivity
  • Engaging in repetitive movements
  • Gross motor delays 
  • Language difficulties-including language delays and repetition of specific words or phrases
  • Learning difficulties 
  • Trouble with attention and problem-solving 
  • Emotional difficulties, including depression, anger, and anxiety 

Anger is often an emotion that is associated with autism spectrum disorder. Most children with autism do not express their anger in the same way as typically-developing peers. This anger can be directed towards others, or towards themselves (called self-injurious behavior). Anger may manifest into aggression and could include hitting, kicking, biting, or throwing objects. 

There are several reasons children with autism may experience intense anger or aggression, including: 

  • Difficulty communicating needs or emotional states 
  • Difficulty with receptive language, including comprehending requests or commands and understanding what others are communicating non-verbally 
  • Sensory sensitivities that can lead to overstimulation 

Once there is a more thorough understanding of where the source of anger and aggression is, it is easier to identify potential strategies to address anger and aggressive behaviors. In this article, we will highlight our best strategies for dealing with autism and anger. 

Autism and Sensory Processing 

It is estimated that at least 80% of children with autism have some type of sensory processing disorder. Sensory processing involves taking in information from the environment, processing that information, and then meaningfully responding to the information.

Imagine you are in a classroom and someone calls your name. You are able to hear your name being called, recognize that it’s your name, and then respond as you feel it is appropriate. For children with a sensory processing disorder, this process is interrupted in some way within the brain.

Sensory Processing Disorder

For many children with autism, stimuli within the environment is over-processed or processed more intensely than it is for typically developing children. This is why many children with autism experience sensory sensitivities. They may be sensitive to any type of environmental stimuli, but some of the most common include loud noises, bright lights, crowded or busy places, etc. 

To better understand how anger is related to sensory processing, let’s consider the analogy of filling an empty cup.

Consider a child with autism who has just arrived at school and is told that he has to wait in the gym with his peers before entering the classroom. This child has sensory sensitivities and his morning included: waking up late to his loud alarm, putting on a shirt that was a little bit too tight, and being rushed through his morning routine because he was running late. Little by little, the empty cup we are referring to is filled by each sensory challenge he experiences. When he arrives at school and has to wait in a crowded, noisy gym, he has reached his capacity and his cup is now overflowing. This child will likely react with anger, as his environment is too over-stimulating and his ability to cope has been maximized. 

In order to address sensory processing concerns, it is best to visit with an occupational therapist, who can work with each individual child to develop a unique sensory diet. A sensory diet is an individualized plan that outlines a child’s sensory needs and ways to get needed input. A sensory diet might include things such as: 

  • The use of a weighted blanket to sleep at night 
  • Using a weighted vest during a certain routine 
  • Engaging in heavy work activities, like pushing against a wall or engaging in heavy jumps 
  • Eliminating known sensory triggers from environments, such as dimming lights, wearing tagless clothing, keeping living environments clutter free and minimal, etc. 

As mentioned before, each child will have their own unique sensory needs and a sensory diet is often the first place to start when addressing potential anger or aggression issues. 

Emotion Regulation and Coping Skills 

In general, children with autism have difficulty with emotion regulation. This skill set involves recognizing an emotional state or feeling that is occurring, being able to evaluate the outcome of reacting to the emotion, and moving forward by reacting and being able to cope with any negative feelings associated with the situation.

Children with autism often have difficulty with planning and judgment skills and therefore, emotion regulation can be challenging. In addition, being able to seek out appropriate coping skills when encountering an intense emotion is another skill set that can be tricky for children with autism.

When regulating emotions and subsequently utilizing coping skills is a challenge, anger and aggression are common behaviors.

Here are some of our best tips for helping kids with autism address emotion regulation and coping skills:

  • Use a program, such as the Zones of Regulation, as a way to teach self-regulation, self-awareness, and body cue signs. Many children with autism do not have the verbal ability to describe how they are feeling spontaneously. Programs, like the Zones, give children a way to communicate internal feelings, which is often the root cause of anger. In this program, four colored “Zones” are used to describe various states of arousal, including low, just right, almost out of control, and out of control. The program systematically teaches children how to recognize what their body is telling them and how to use coping skills when needed. An occupational therapist has the skill set to work with your child using the Zones program and help develop a corresponding home program.
  • Be aware of sensory needs. Work to develop coping skills based upon these needs. A coping skill is a tool that someone uses to return back to a state of regulation.  As discussed above, sensory processing is a critical component to consider when addressing anger and autism. When helping a child develop coping skills, sensory needs should always be considered, as they are closely intertwined. For example, the use of a Harkla weighted lap animal could be a helpful coping skill and also meet the sensory needs of the child. Other coping skills might include a fidget or resistance ball, deep breathing, mindfulness activities, muscle relaxation, etc. 
  • Develop a menu or list of options for coping skills. Once sensory needs are determined, it is most helpful to have a menu or option list of coping skills. It might be beneficial to have this available as a visual to the child. This menu might include coping skills for a different emotions (sad, angry, anxious, etc), internal feeling states (hot, heart is beating fast, tired or low energy, etc), or situations (when plans change, when I’m at my desk at school, at home in my room, etc). This ensures that a variety of contexts are considered and that the child has a number of effective options available. 

It is important to note that a child is likely to be most successful when they are given the right tools or vocabulary to address what they are feeling internally.

Research has shown that body cue identification is crucial for addressing coping skills, especially for children with autism and other special needs.

A trained professional, such as an occupational therapist, can help develop a systematic treatment plan to ensure the child’s sensory needs are being met and that emotion regulation and coping are complementing the unique sensory needs. 

Final Thoughts

Anger is often associated with autism, however it is important to consider the complexities related to why a child with autism is expressing anger. In general, sensory processing and emotion regulation abilities are the root causes of anger and aggression in children with autism.

A trained health professional, such as an occupational therapist can assist with assessing and making recommendations related to autism and anger or aggression. We hope this article provided you with valuable information related to autism and anger, including seeking out additional expertise if needed for your child. 


References

Cibralic, et al. (2019). A systematic review of emotion regulation in children with autism spectrum disorder. Research in autism spectrum disorders, 68 

Shea Brogren, MOT, OTR/L
Shea Brogren, MOT, OTR/L

Shea Brogren, MOT, OTR/L, is an occupational therapist with over three years of experience in pediatrics and child/adolescent mental health and has also worked as an adjunct lecturer at the University of North Dakota. Shea has a special interest in program development and developed and implemented occupational therapy programming at a residential treatment center for children. She now practices in an outpatient setting.

Her primary area of interest involves working with children who have experienced developmental trauma. Shea has advanced training in SMART treatment (Sensorimotor Arousal Regulation Treatment), the Zones of Regulation, using sensory-based interventions to address trauma, infant mental health, attachment, and arousal regulation related to trauma disorders.


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