A 2010 survey of 1,380 children with autism, conducted by Stephen M. Kanne and Micah O. Mazurek, found that 68% displayed aggressive behavior with their caregivers and 49% with non-caregivers. Other studies have shown lower percentages. But the bottom line is that aggressive behavior is common among children with autism, and it can be bad: biting, kicking, breaking things, head banging, and on and on.
What are the responsibilities of us autism grandparents regarding aggressive behaviors of our grandchildren? Can we be helpful? Can we do things that can lessen the aggressive behaviors?
The answers of course depend on our relationships with our grandchildren’s parents or guardians. But regardless of those relationships, we can and should learn some of the fundamentals about aggression among children with autism. In many cases we grandparents, because we’re often not as emotionally stressed and involved as are our grandchild’s parents, can have a more objective view of, and can provide more helpful activities for, our grandchild’s aggressive behavior.
Following are 10 things that can be helpful to grandparents.
It is important for us to know that our grandchild’s aggressive behavior is usually an attempt to communicate. Our grandchild is trying to tell us something, trying to get us to understand something. She is either nonverbal and thus unable to talk, or if verbal, she doesn’t know how to explain it in words.
When our grandchild is in our care, we can conduct an “assessment” of the aggressive behavior. Assessment is most helpful when it is accomplished in careful detail. This means documenting each aggressive behavior, documenting when each episode begins and ends, determining what was happening just before and just after (location, persons present, environmental happenings, etc.), and what happened to apparently cause it to stop. It also includes documenting what YOUR actions were before, during, and after. We can keep a “diary” over a long period of time (a week or two for frequent aggressive behavior, a month or two if it’s infrequent). And, if possible, video the aggressive behavior as often as you can. Assessment also includes determining times/locations/happenings when aggressive behavior almost never happens!
Grandparents can help determine what things “trigger” our grandchildren’s aggressive behaviors. This determination can be confirmed by an analysis of our multi-week assessment. Did aggressive behavior usually occur when there was a change from one activity to another? When we tried to hug our grandchild? When the television was turned on or off? Any of a zillion things can trigger aggressive behavior. It can be as seemingly simple as irritation from a scratchy label in an article of clothing, or as vague as a weather condition. Again, a careful assessment can often help determine the triggers.
Because we grandparents are often not as emotionally involved (both positively and negatively) with our grandchildren as are their parents, we are often better equipped to “handle” aggressive behaviors. We can remember to do the five main things that are most important during aggressive behaviors: stay calm (don’t rush around, don’t raise our voices, etc.), say as few words as possible (“Sit.” rather than, “Thomas, come over here right now and sit yourself down!”), move to a safer and quieter place if possible (no shelves to knock over, no crowds of people), perform physical restraint only if absolutely necessary (physical restraint can be harmful to you and your grandchild and it can increase anxiety and make everything worse), and give praise or positive reinforcement when the behavior ends.
We grandparents can help determine – by analyzing our assessment – what our grandchild “gets” when he discontinues the aggressive behavior. Does he get to continue doing something that he enjoys (TV show, favorite food, etc.) that had to be stopped? Does he get to leave a stressful location or situation (leave the grocery store, leave the park, leave the kitchen, stop a learning or therapy session)? Obviously if his aggressive behavior results in something he wants, he will do it again.
After we are equipped with our “assessment,” we can try to shape our grandchildren’s aggressive behavior towards positive future behaviors by doing a few things when they are in our care. We can express praise when our grandchild responds to a normal “trigger” with NON-aggressive behavior. And, as much as possible, we can ignore aggressive behavior by not “giving in.” (Not turning the television back on, not giving another piece of favorite candy, not leaving the store, etc.) Every time we “give in” to aggressive behavior it provides reinforcement that our grandchild can use aggressive behavior to get the same result.
Accompanying item SIX above is our ability to help our grandchildren prepare for things that normally trigger his aggressive behavior. For example, if turning off the television is a trigger, we can give him an advance heads-up: “In 5 minutes we will turn off the television. In 4 more minutes. Only 3 minutes left . . .” A visible timer – such as many cell phones offer – can be a visible notice of the time limit and countdown. And/or we can show him advance photos or picture boards that demonstrate the “trigger” that is forthcoming: a photo of him brushing his teeth, a photo of food being served, etc. We can understand that sudden and/or unexpected events and people and changes in schedule, etc. can trigger aggressive behavior. And we can be receptive to, and provide choices. For example, rather than saying you must eat your broccoli, we can offer a choice between three vegetables. Or telling him he must prepare for bedtime in a certain order – use the toilet, wash hands, wash face, brush teeth – we can allow our grandchild to choose his own order.
We grandparents can be understanding of, and attentive to, the fact that aggressive behavior can be the result of any of a number of medical conditions: as straightforward as a tooth that hurts, and as complex as epilepsy; that medication is indeed effective for some persons who exhibit aggressive behavior; and that although many types of therapies are offered, ABA therapy has been widely proven to be the most helpful therapy in most cases. And we can be champions for the fact that medical assessment should be ONgoing, and that it shouldn’t stop after one physician gives a clean bill of medical health.
What about teenagers and/or young adults? We grandparents have more experience in long-term scenarios than do the parents of our grandchildren, and thus we can better understand that it’s NEVER too late to start giving attention to alleviating the aggressive behaviors of our grandchildren. We can understand the value of celebrating the tiniest of positive steps and accomplishments, and can realize the importance of looking at longer-term goals rather than short ones: for example, By six months from now we will have identified the most significant triggers for the aggressive behaviors. Etc.
Regarding aggressive behavior (as with most else in autism), praise and positivity rules! One autism professional recommends at least 8 praises for every 1 negative comment. So for every time I tell my granddaughter “Stop that!” I need to praise her 8 times for other things. Every time I catch her doing something good, I need to smile and clap and hug her. Every time she makes it through having to turn off “Paw Patrol” on television without being upset I can praise her for it. Every time she brushes her teeth all by herself I can praise her. Every time she sits attentively while I read a sentence in a book to her while I point at the words I can praise her for doing so for that one sentence. Generally our grandchildren on the autism spectrum progress much better when being reinforced with praise than by scolding, etc.