About aggressive behaviour and self-injury in autistic children and teenagers
Autistic children sometimes express their emotions through aggressive behaviour towards others. Sometimes their aggressive behaviour can be directed towards themselves. This is called self-injurious behaviour. They might hit, kick, throw objects or hurt themselves – for example, by head-banging.
Autistic children might behave aggressively or hurt themselves because they:
- have trouble understanding what’s happening around them – for example, what other people are saying or communicating non-verbally
- have difficulty communicating their own wants and needs
- are very anxious and stressed
- have sensory sensitivities, like an oversensitivity to noise or a need for stimulation
- want to escape from stressful situations or activities.
Understanding aggressive behaviour in autistic children and teenagers
If you understand what causes your autistic child’s self-injurious and aggressive behaviour, you can help your child learn to manage the behaviour.
You can do this by looking at what’s triggering the behaviour and what your child is getting out of it. Try keeping a diary of the behaviour for 1-2 weeks, noting what happens before and after the behaviour.
Understanding how well your child can communicate is also a key step in finding out what’s causing the aggressive behaviour. When children can’t express feelings or ask for what they need or want, they might use aggressive behaviour to communicate.
It can be helpful to ask yourself, ‘Is my child trying to tell me something?’ For example, if your child doesn’t like corn flakes but can’t tell you, your child might hit you as a way of saying ‘Take it away, I don’t want it!’
One way to manage your child’s aggressive behaviour is by changing the triggers for the behaviour. Our article on managing challenging behaviour in autistic children explains how to do this.
Dealing with aggressive outbursts from autistic children and teenagers
You probably can’t prevent every outburst from your autistic child. So it’s important for you to have some strategies to deal with the aggressive behaviour when it happens.
This is the first and most important thing. Most aggressive outbursts happen because your child has feelings building up and can’t communicate them. By managing your own feelings and staying calm and quiet, you won’t add your emotions to the mix.
Limit what you say
During an outburst your child will be feeling very stressed. It’s hard to process what someone else is saying when you’re feeling stressed, and this is especially true for autistic children, who can have trouble understanding language.
So it can help if you don’t say too much. Aim for short phrases or even just a couple of words – for example, ‘Sit down’ rather than ‘Lachlan, come over here and sit down’.
Move your child to a safer place
For everyone’s safety, make sure your child isn’t close to anything that could be harmful – for example, shelves that could fall over or glass objects. A quiet enclosed space outside might be an option. You might also need to get other people to move out of the way for safety.
Consider visual cues
Visual cues can help in these situations. For example, you might have a picture of a quiet place in your home that your child can go to.
Seek help if you need to use physical restraint
If you find you have to use physical restraint when your child has an aggressive outburst, speak with your child’s paediatrician or a behavioural therapist about other options. Physical restraint can be dangerous to both you and your child, and can often increase your child’s anxiety and make the situation worse. Positive behaviour support is always preferable to physical options.
Managing self-injurious behaviour in autistic children and teenagers
Working out what your autistic child is trying to tell you with self-injurious behaviour can help you decide how to manage it.
For example, your child might find it hard to switch from one activity to another. Your child might bang their head on the floor when you tell them that it’s time to put away the train set before dinner. You could try warning your child five minutes before you need things packed away by showing your child a photo of washing hands and sitting at the table for dinner. This will give your child a warning, plus time to finish up and pack away.
If your child has been doing a puzzle for 10 minutes and starts to pull their hair, your child might be trying to let you know that they want to do something else. Offering your child a new activity might stop the hair-pulling.
Your child might hit themselves because they want you to look and talk to them. Giving your child attention will stop the self-hitting. The next step is teaching your child to get your attention in another way – for example, by saying ‘Mum’ or coming to you and showing you a help card.
Your child might be feeling frustrated and need help. For example, your child has been playing with a doll but the leg comes off, so your child starts to scream and scratch themselves. If you help your child fix the doll, it will stop the self-injurious behaviour. The next step is teaching your child to show frustration in another way – for example, to say, sign or show a picture to ask for help.
A note about responding to self-injurious behaviour
Giving your child what they want can strengthen the behaviour and make it more likely that your child will behave in the same way in a similar situation in the future.
A better long-term strategy is to:
- prevent the behaviour by avoiding situations that trigger it
- teach your child to express needs in a more positive way
- ignore self-injurious behaviour and reward your child when they express things in a more positive way.
Getting professional help
An experienced professional like a psychologist can help you understand and manage your child’s aggressive or self-injurious behaviour. This might be particularly helpful if you’ve already tried other strategies without success.
For example, the professional might use functional analysis to work out why your child is behaving aggressively or is self-injuring. Then the professional might create a positive behaviour support plan that includes strategies to reduce the behaviour and teach new behaviour.