Surviving the Rage: The Autism Files

Surviving the Rage: The Autism Files

Speaking of rage, my son (diagnosed with autism at age 3) has had his fair share of tantrums and meltdowns (though he is pretty good now at age 10 and when angry will go to his room, mumbling and abusing everyone under his breath, to calm down on his own).

The boy was a screamer, fighter and a biter!

I remember one time when my son had lost the plot and started attacking me in the kitchen. He lifted up my shirt and bit me hard on the bare skin of my stomach. I asked one of his therapists why he did that, and she said ‘probably to get a better grip’ – haha!

I can laugh about it now, but there is something particularly upsetting about being bitten (worse than being hit). I am not sure why this is so – maybe it relates back to primal fears of being attacked and bitten by wild animals.

It is very easy, when your child is having a meltdown, to join in the fracas.  Emotions are high and it is difficult to think straight when chaos is having a field day.  Losing the plot was my forte, as I have a bit of a short fuse myself, and I would manage to make a bad situation much worse by yelling and carrying on. I needed a bit of time-out 😉

Over the years it slowly dawned on me that I must disengage from the battle. I was the grown-up and I must not take it personally. My child was biting/hitting/screaming at me, but this didn’t mean he hated me. He had lost control of his emotions and was using all weapons at his disposal. Fair enough!

Surviving the Rage

Remember, it is a bit too late once the rage is raging – better to intervene during the rumbling stage. But that is easier said than done, and if you have a child with Autism Spectrum Disorder (ASD), you will inevitably get an uncontrollable rage.

Safety first

The child in a rage has lost control and must be kept safe (and those around him/her must be kept safe). If possible, remove dangerous items (and things that might get broken). Remove all other people from the area, particularly at school (except the one or two people supervising the child) – this is not a spectator sport!

Keep calm

This is the bit I had trouble with 😉

Do not make threats, yell and try to dominate or tower over the person in a rage. This will inflame the situation, and make everyone feel worse. Reduce verbal communication (or stop talking altogether).

Disengage emotionally

Yeah sure 😉

The rage is about an incident or situation – not you personally. Also it is a good idea not to listen to any horrible things that they might say about you (you know the type of thing – ‘I hate you mummy so much, you are the most horrible mummy in the world, no, the whole universe and beyond …’). Try to disengage emotionally and think about something else, if possible.

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Note: If your child has a rapid increase in rage episodes or puts him or herself in dangerous situations, seek out professional assistance from someone who has expertise in ASD.

Stop the Rage: The Autism Files

It is common to hear parents describe a child’s meltdown or tantrum as ‘coming out of nowhere’. Indeed, outbursts of anger (even in adults) can seem to materialise from the ether. But of course, this is far from the reality. There are always signs or cues that the volcano is about to erupt.

Children and adults with Autism Spectrum Disorder (ASD) often have difficulty with anger – difficulty in recognising that they feel angry and inability to manage or deal with these feelings. Myles and Southwick* have described the Rage Cycle for people with ASD. They describe what happens when the person with ASD and those around him, fail to recognise the build-up of anger.

The three stages of the Rage Cycle include rumbling, rage and recovery.

Rumbling

It is important that parents and caregivers of children with ASD pick up on the cues that anger is building (the volcanologist monitors the mountain).

What are these cues?

There may be an increase in stereotypical behaviour and stimming, for example, fidgeting, hand flapping, rocking, grimacing, excessive chewing, tapping and other repetitive behaviours.

There may be an increase in verbal behaviours such as strange vocalisations or nonsense noises, changes in volume of vocalisations (mumbling, speaking under the breath or to themselves), swearing, making threats.

An increase in movement, such as walking in circles (circuits), pacing, or leaving the room/house to get away.

Rage

When the volcano erupts there is little that can be done to reduce the fallout. The child or adult has lost control, emotionally and physically.

The noise and destruction may include screaming, explosive impulsiveness, biting, hitting, kicking, destruction of property, and self-injury (e.g., head banging).

Recovery

The eruption may be followed by crying, sleeping, denial of rage, withdrawal into fantasy, and apologising.

What can be done to avoid the Rage?

The key point to the Rage Cycle is to intervene during the Rumbling stage. It is too late during the Rage stage (and during that stage you need to focus on safety – of everyone involved). These are some of the things you can do to prevent the Rage stage:

Walk (don’t talk)

Children with ASD (especially when stressed or getting angry) have difficulty with listening and processing words – LESS TALKING PLEASE! Let them walk to calm down. Make sure someone is accompanying them. Let them talk all they want to 🙂

Chill out zone

It is a good idea to have a space or room with low sensory stimulation where school children with ASD can take their work, when they need to calm down, cool down or chill-out.

Non-judgemental removal

Remove the child from the situation (in a positive manner) by involving them in a task such as delivering a note to a teacher in another classroom or giving something to Dad in the garage. They will feel important and the Rage Cycle is being interrupted or short circuited, as their attention is diverted to something more enjoyable.

Divert attention

It is often possible to divert the child’s attention from what is bothering them by producing interesting toys (eg., sensory toys like squeeze balls, toys that light up) – it is useful to keep a bag of special toys, that the child does not normally play with, in the car or in your bag, for emergency situations, such as shopping centres or doctors waiting rooms. A discussion of special interests could also be a useful diversionary tactic for the older child with Aspergers.

Schedules and routine

Never underestimate the importance of schedules and routines for the child with ASD. The use of such things as  visual schedules, diaries, calendars, lists and charts in their daily life provides certainty, predictability and a sense of security that goes a long way to reducing the anxiety that can feed into the Rage Cycle. Give plenty of warning to the child of any changes to the routine.

What else!

These are just some ideas on how to interrupt the Rage Cycle. As the child gets older it is important that they learn to monitor their own level of anger and have their own strategies available to manage this anger.

A simple technique is to have a visual 10-point scale of anger (where 10 is the angriest) which the child can use to identify their level of anger. This is accompanied by a list of effective anger-reducing strategies that the child has identified (eg., punch boxing bag, take a bath, play music, go for a hike, swim, get a massage, meditate, drink herbal tea, read a book).

When the child identifies that their anger is climbing up the scale (say 6­ to 7) they look at their list and pick an activity to reduce the anger. The list can be kept on a small card in their pocket or school bag or wallet for ease of access. This sounds simplistic, but that is the key – when a person is angry they stop thinking clearly and need simple, visual cues to assist them in managing their feelings.

There are a huge variety of workbooks on the subject of anger management – many written for children to read on their own or with an adult (I can assist with book lists if wanted).

Helping a child get in control of anger is one of the most important things a parent can do.

Best to get in early!

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* Brenda Smith Myles  & Jack Southwick (1999). Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns. (Autism Asperger Publishing Company).