My autistic brother is aggressive

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My brother is very low functioning autistic. He is non verbal so we never know what bothers him.

He has periods where he can be very aggressive towards others and/or himself. He pulls other people's hairs and pushes them. He bites himself and scratches himself all over the body.

Lately, his aggression is starting to lean more and more towards his family members. He laughs when he hits us. It seems like he does it for enjoyment rather than out of anger.

Does anyone else here have a compulsion to hit other people without feeling any anger towards them or anything else?

And on a separate more important note, we're considering putting him on meds. If anyone here has had any experience with meds, please let us know if it affected you positively or negatively or if it had any impact on your aggression at all? We trust people who actually had experience with autism more than we trust professionals, so as his family we'd like as many opinions as possible.

Thanks,

A family who is struggling.

How old is he?

I am on an antipsychotic intially for schizophrenia, but my psychosis is vastly less than it used to be. My psychiatrist kept me on the medication because when she tried to withdraw it, my autistic meltdowns / challenging behaviour got so severe that I couldn't be safe on my own.

HOWEVER. If he gets side-effects he won't be able to tell you (non-verbal), so that could be tricky unless he uses AAC or PECS or whatever.

Although I do hear of low functioning non-verbal autistics finding low-dose meds helping.

I'm not really sure. It's helped me.

He is 10 years old.

What meds are you on and do you get any side effects?

I am not a doctor so please don't go and ask a doctor to prescribe my medication without balancing all the pros and cons.

I'm on Olanzapine.

I put on 14kg on Olanzapine. I sleep 9 (sometimes 10 on non-uni days) hours a day on it because it is sedating. I get postural hypotension. I don't really get any other side-effects because I've been on it for 6 years. Although I think my tics are Olanzapine-induced.

I have read and heard of LFA being put on antipsychotics, but they pretty much always end up on very low-to-low doses.

I used to be on Clomipramine for OCD and autism symptoms too but that went really badly so I'm not on it anymore.

I'm sorry to hear that your family is having such a tough time. It certainly isn't easy when someone you care about (and who cares about you too!) is causing pain and confusion.

Does your brother show these same sorts of behaviors at school at all? If so, what do the teachers there do? Did he hit, bite, and scratch anyone--family or not--when he was younger?

I have some suggestions, but I'd like to know more about your situation.

He used to hit strangers too, but he mostly hits people he's familiar and comfortable with. He loves his teachers in school very much and he hits them too. At home and at school we have a safe space for him when he's aggressive. He calms down after a while of being there. But he still hits us when we try to get him dressed or when we just go out for a walk (we stopped doing walks because he's out of control now).

He can't be in the safe room all the time. He hits us even when we just open it to give him food. Showering him is a nightmare in itself.

Edit: he started being aggressive when he was about 7 and he's 10 now.

Last edited by psot2 on 15 Oct 2014, 3:13 pm, edited 1 time in total.

If you're going to try an atypical antipsychotic, watch him very closely for signs of being in pain. They can cause debilitating large-muscle pain-- I've been there and done that; if it happens, being non-verbal won't be a barrier to noticing it. He will have difficulty lifting his legs enough to walk, lifting his arms enough to use them, there will be screaming when he has to dress/undress, et cetera. It is AGONIZING-- if you are even half-alert, you won't miss it.

I'm not sure how you watch someone who is non-verbal for cognitive impairments; for me, losing the ability to verbalize things was the biggest sign that my brain was shutting down. Take very careful inventory of the skills he has-- if you see them declining, it will be time to try something else.

Good luck. I hate to see anyone on that stuff-- but sometimes it is necessary. A ten-year-old bent on hurting you can be pretty dangerous.

I'm high-functioning and wasn't aggressive for non-anger reason (outside of the roughhousing that most kids do). I am on psych meds for other things, though. It's really trial and error with side effects. I've been on meds that made me sleepless and meds that made me always tired, meds that increased and decreased my appetite, and meds that caused motor tics. Now, I'm on the right balance.

OP I strongly believe exposing any child to an aggressive sibling for whatever reason is child abuse. His siblings have a right to live a life free from being terrorized. I suggest you consider placement for your son until he stops this behavior, or his siblings become old enough to defend themselves from him.

Someone I know who used to care for a lower functioning autistic guy said his family used to give him a cannabis brownie every day (they had a medical permit), and it helped with aggression.

^^^^

Yeah, well. Sometimes that's easier said than done.

Cut them a break. They're WORKING ON IT.

Perhaps the safe room isn't working. I've used a safe room before in my work with a child who has Fragile X syndrome, and I think that if your brother is or "has to be" in there long enough that you need to feed him in there, then your family needs to get better professional help and develop another plan. If he's hitting you when you open the door, that might be out of simple anger for being in there for too long!

I know it's difficult to deal with your brother when he's hurting himself and you, and you're smart to work to minimize it now, before he gets bigger. Meds might indeed help, but as others here have said, it can be VERY hard to fine-tune, even for people who can tell you how they feel, so they can't be the only source of help.

If he's laughing when he hits or bites you, it might be because he enjoys the reaction he gets from it. Some of the aggressive students I've had over the years got a kick out of seeing a teacher get irritated or shout "OW!", and I think that some others might have just enjoyed the physical experience and sensory input, kind of the way some people like playing a drum or petting an animal. Obviously, we had to let them all know that what they were doing absolutely wasn't okay, but the way we did that depended on a lot of variables and, perhaps most importantly, everyone doing it the same way so the kids didn't get confused or more frustrated, or single out one or two people to "pick on."

Just thinking out loud here: hitting you while you're doing self-care stuff could mean a lot of things, like not wanting to wear a certain piece of clothing for some reason, not wanting to do whatever comes *after* getting dressed, not liking the sensation of water--or the temperature of it--on his skin, or wanting to dress or bathe himself more independently (even if that just means pulling a zipper up). Of course, if he had a really bad experience in the past while doing a certain activity, that could be bothering him still.

We also remind ourselves and each other, especially when things get really tough, not to let the child be defined by their aggression--that there's more to them than that.

Please let me know if this helps.

I understand there's more to them besides their aggression. I also have experience of being nearly punched by an Autistic man at an Autism group. The problem is normalizing this aggression or making reasons for it. No one js going to be understanding if a boy pulls their daughter's hair, and they shouldn't have to be. My issue is when our advocacy tramples on the safety of others. I have lived through years of dissociation, being convinced I had no right to react in fear when other Autistic people violated my boundaries. It took me watching horror films to realize I wasn't a bad person for havig fear.

Now that I calmed down my concern is about the legacy of having your fear invalidated and reasoned away. It can put eople at risk of accepting abuse. I don't know how I'd be able to live knowing at any time my brother could attack me. Even worse being shamed or punished for defending yourself from them. It creates a sense of your body no longer belonging to you, a feeling I've heard is common among assault victims. I don't understand why the siblings should have to understand the unreasonable.

VioletYoshi: I'm sorry you've had such miserable, frightening experiences and that you've been made to feel so bad for simply being afraid of absolutely genuine risks! I don't expect anyone to sit passively while they're being injured, and I don't know anyone who would expect you to, either.

If you're saying that *I'm* trying to justify aggressive behavior, I think I've been misunderstood. I'm not making excuses for what some of my students have done, or for what OP's brother has done; just speculating on the *reasons* behind their actions. No one, anywhere, ever, should have to live in fear for their safety, and that's exactly why I'm sharing what I've learned from my own experiences and education. (BTW: I'm not selling myself as an expert!) I, too, have been hit, bitten, kicked, scratched, head-butted, punched in the throat and more, but I've put myself into these potentially dangerous situations by choice; I know how to protect myself, and I can quit my job if I want to. (I don't.) Not everyone has such options, and I'm fully aware of that.

Since you mention advocacy, though, I want to say that a lot of people "out there," who know nothing about what it's like, think that a few of the students I've had should, without a second thought, be thrown into mental hospitals or other institutions, doped up to a state of near-obliviousness, never to be seen again. They think they're evil or crazy. I care deeply about those children and the adults they will be, and want to make places like those a last resort for as many children as possible. Even if some of them aren't able to change their behavior enough, at least we can say that we tried our best.

I wish you well.