Aggressive Behaviour - help needed

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I have a 13 year old daughter with Autism who started puberty 3 years ago. Since then she has become very aggressive. I have tried serequel, zopax, risperdal and nothing seems to work. Lately she has had sleeping problems and so started on melatonin which has brought out huge sensory issues. Can anyone offer any assistance? I am desperate

Maybe some physical activity could take the edge off. Billy, my girlfriend's 10 year old aspie, is just starting, and I find he has better weeks when I play with him outside, going on nature walks and such.

I second that! My daughter tends to act out more out of boredom or nervous energy. I think of her more like a boy in that way - if I can redirect her energies to sports, activities, anything physically exhausting, she is MUCH happier and more well-behaved.

Definitely find something physical (most likely NOT team sports or anything organized), and give serious consideration to DROPPING any medication ideas permanently. I've heard horror stories of medications CREATING aggression issues in pubescent kids, so get them out of the mix. You need to know your "real" daughter right now. Melatonin should be OK, however, just proceed with caution.

Go back to the basics: discover her triggers and mitigate them. She may need a lot less stress, a lot less expectation, and a lot more calm / quiet. She may also need to reacquire some stims, as these are self-calming and can help someone with AS self-mitigate. Much of what comes out as behavior issues in our kids is actually environmental, so work on that side of it.

Finally, you could discuss diet changes with her and see if carefully eliminating one potential sensitive food at a time might make her feel better and more in control of herself. Don't force it; at this age she should sign onto the idea or it should be skipped. I know the science is sketchy, but when you are desperate, a few "can't hurt" type experiments are worth trying. If you aren't on that road already.

x2

And as an unrelated aside:

Hey, you guys are still together and you're still weathering the storm with Billy! Great to hear. You've had a really positive influnce on that little aspie's life Jimbeaux and I'm glad you're still taking the time to come here and help others with your good advice.

Have you tried asking her why she is becoming agressive? Medication wont do you any good if there is something triggering the aggression which isn't being taken care of properly. Likewise, have you practiced any self regulating techniques? It is somewhat hard to give useful advice when your first post just says, "Help my daughter is aggressive and meds aren't working." More information would be useful.

Could she be being bullied but unable to tell you or does no one take her claims seriously or is she punished for standing up for herself? I was EXTREMELY agressive at that age too and no one taking me seriously about the bullying I received constantaly was a major factor for my agression.

Hey ViperaAspis! Thanks!
Yes, took a knee, and she said yes! After asking her parents' and son's permission of course.
We are moving in together in three weeks, just as soon as school is over. Mom and I are getting him his own computer next month, so no more stress over sharing mine when I have to work.

I'll tell you, I learn SO much when I come here! Both from the Parent's board and the General board. Good to get both sides, you know?

Anyway, thanks again!

Thank you for all your comments. My daughter is non verbal so cannot tell me what is going on. The aggression started when puberty set in and has been the same ever since. She was taken off all meds as I did not feel that they were doing any good and would also have reactions such as retracing and ocd behaviours. She was kicked out of School in March this year as they cannot handle her behaviour. I have not been able to find her placement since then as there are not many Schools in South Africa that cater for children with Autism. She has been coming to work with me since then and has been so much better, except for the sleeping. Things have got so much worse since starting on the Melatonin, which I have now also stopped. The only form of "medication" is her two monthly injection to stop her from menstruating - this I have to do because she cannot handle the sight of blood.

When she was at school she was anxious and aggressive everyday and lashing out, put her hand through a window twice, banging her head against the wall etc. Before puberty set in, I could always find a trigger for behaviours, but now I do not know what the triggers are anymore. It is sometimes almost like a thought out of nowhere and then she lashes out.

I have done the gluten/casein free diet for 3 years and recently done the bio-scio testing which shows very few food substances that needed to be eliminated that are toxic for her. The main things that came through was emotions that she is dealing with. It shows that she feels jealous for others achievements, angry at someone however shows no sign of abuse. So how to get to the bottom of the anger feelings when she can't communicate? I talk calmy to her and explain things nicely, boost her self esteem etc (she gained 17kg in one year after puberty). Hope this gives more information to comment on.

Well, for starters I would suggest trying to find some method of communication. It doesn't exactly have to be words. There are other options like makaton (a form of short hand sign language) and PECS (a picture based system). Both of those are relatively simple to learn, at least compared to speech.

If you don't know what those are then you can look here: http://www.makaton.org/about/about.htm
And also: http://www.pecs.com/

As you said yourself, it is hard to get to the bottom of things when the other person can't communicate.

Beyond that, the school environment seems to be not working out well for her. If she is getting into problems every day at school, but seems fine at your work, then I would guess that there is something problematic about the environment of school. Since I don't go to her school I don't know what the problem is. But I do wonder if she wouldn't be better off staying at home. I don't want to come across as saying that your daughter doesn't deserve an education, but it seems to me that when she attends that school the only thing she is getting is stress, not an education. In that case it might be better just to leave her at home during the day because she could at least avoid unnecessary stress.

You say that she has some low self esteem issues, and that is a pretty reasonable assumption. I somewhat doubt that her low self esteem is due to her weight. She is more likely struggling with her inability to do as well as others, which is also combined with the teasing of other children. My best guess is that your daughter was being teased, or bullied quite a bit while at school. It is just human nature for children to pick on and insult those who are different then them. And when kids start puberty the teasing and bullying gets a lot worse.

I would also try to get her something to do which she can make a hobby out of. This is for two reasons. For starters, it is something to do which she can enjoy. And when she spends time doing things she enjoys she is stressed out less. Also, when she does well at her hobbies, she gets a sense of accomplishment which boosts her self esteem. I know that having hobbies has worked out wonderfully for me. I don't know what sort of thing your daughter would be interested in, but I do suggest video games. They are easy to set up, simple to use, simple to learn, and very fun to play. The online video games can also offer your daughter a chance to play with and interact with other people in an enjoyable and non threatening way where she isn't getting constantly bullied.

If you still want to go the medication route then you probably want to avoid the anti-psychotic medications like serequel and risperdal. Anti anxiety medications like SSRIs (http://en.wikipedia.org/wiki/Ssri) are often times safer and may help with your daughters anxiety. I am not exactly fond of medicating people when you don't know the exact cause of their behavior, but sometimes if the cause cannot be determined, it is worth while.

But for starters, I would get your daughter a hobby, and leave her at home for a bit to see if her demeanor improves.

We have tried PECS and Makaton over the years with little success. I have also tried Prohexal which didn't help at all. This is why I am so desperate as I seem to have gone full circle and nothing seems to help. I so want to try and help her as I hate to see her go through such high levels of anxiety. Her rages include ripping of clothes from underwear to shoes as well as banging her head, smacking and scratching herself. I really do appreciate all the comments but have tried everything and nothing works. I feel totally helpless.

Her own clothes?
I have a cousin who's autistic and non-verbal, and she has sensory issues with clothes. They were worse when she was a teenager; it was nearly impossible to get her to wear anything. Could something like that be contributing to your daughter's rages?
My cousin's mother had some special clothing made for her that has no seams, and that helped a lot.

Who_Am_I Yes her own clothes. I know she hates labels so always ensure those are taken out. I have tried different fabrics, different colours and styles. Some evenings she wakes up from sleep and starts ripping the bedding (duvet covers and pillow cases). She has literally trashed everything in her room that she only now has a bed and curtains and thats it.

Have you tried weighted blankets and other calming devices? Does she have a swing or trampoline that she enjoys? It sounds like she is experience severe sensory stress and does not know how to deal with it. A large part of that may be internal, as her body changes, and that you cannot really stop, but you CAN make the outside environment as comfortable as possible, reducing every possible outside source of stress (noise, light, smell, etc), and offer her activities that help her self-regulate. Also, see if quiet conversation from you on things she might be feeling helps her tap into and understand what she is feeling.

I wish I could offer more. Perhaps we can find one of our non-verbal adult women to come into this thread and share something of what that period in their life was like. We have a few that are members, but they don't wander into every thread ...

Below are some posts from one of our less verbal adult members, who is currently studying nuero-science as a graduate student. I asked her to read your post to see if she could help.

Last edited by DW_a_mom on 20 May 2010, 6:46 pm, edited 1 time in total.

Hi Blass (& Welcome to the Wrong Planet), Your dilemma is curious - I am sorry for the troubles. I cannot know what's wrong, of course, but from what you posted her situation is dire. Since she's now a 'young adult' teen she could seriously injure herself or another and safety is the primary concern. You indicated she's not in school as a consequence. So, at the most basic level she may need extra help from a skilled medical profession. Her aggressiveness could have a real physical/biochemical cause and that needs to be addressed right away.

Whilst the suggestions given here are great, seems your daughter may have additional needs that may be outside her Dx of autism. That she's not able to communicate is harder but I imagine she's in great distress inside. Not to be presumptous, but could have her assessed, in-depth, and right away? If there is not a facility near your home, travel may be a good investment since your daughter is danger. Although most any parent would be reluctant, you might consider hospital care, at least for a time, until she can better control her behavior. What is curious is that this aggression began at puberty and that can mean there's something else wrong. This must be incredibly hard for you as well since she may not be able to be left alone for any length of time. If she should injure herself (or another) the damage could be forever an additional impairment and why I think she needs outside treatment now. The medications you listed are really potent mix and a skilled medical doctor should proceed with her care at this point. Unsure, but sometimes autistics (classic autism, especially) are seizure-prone and this may be a factor.

I think your daughter is really at risk. That must first be addressed before you can work on her other needs. I think you must be a very caring mother and this shows in your post, plus you shared with us what's happening. I think the 1st thing: Contact a skilled medical doctor (or hospital you trust); tell them what you told us. Good luck to you both and I imagine intensive treatment could make the difference so your daughter can then progress. But her immediate safety is Number 1.

I've thought about what you posted - so sorry for what you're both experiencing! This is urgent. Thus, needs to be treated as an emergency situation for safety reasons. There's a great Wrong Planet member from South Africa (alphabetania, sp?), she may know of a resource but your daughter needs immediate mecial care right now. Let us now how she's doing (and you too). Best wishes, Blass.