Autism & Aggression
As an autistic person and advocate, the number one question I get asked is “Why are people with autism aggressive?” or “What do I do about aggressive behaviors?” When I speak or train, the number one fear trainees express is aggression. Some of this fear is irrational and stereotypical. I have worked with individuals with autism since I was 8 years old (yep, that’s right, 8 years old!) and I can say, in all that time, working with hundreds of children and adults, the amount of times I have been hurt is considerably less than any of you would predict. Part of this is because I am trained to predict and prevent behaviors, and another part is because I am autistic myself. I can often recognize when another autistic is in distress a lot quicker than neurotypical people who do not know what it is like to be inside an autistic brain. Before aggression or behavior happens, a child or adult will display what I call “distress non-verbals,” these are negative changes in their body language and nonverbal cues, that may say “I’m anxious and getting agitated.” This is your warning sign, and as someone who works with a, or many, individuals with autism, you need to constantly be watching their nonverbal cues, body language shifts, mood shifts, et cetera. Autism impacts communication, so they may not always be able to tell or outright show you that they are getting agitated, so it is your job as someone who loves and cares for them to watch out for them, literally.
Back to the roots of fear… autistic aggression can be overstated! There were many negative stereotypes surrounding aggression spread in previous decades when autism was less understood. In the modern age, we know a ton about autism! (Yes, there are still so many things we wish and need to know, but we are much better off than many parents and caregivers were decades ago.) All that said, autistics do have higher rates of aggression than typically developing children, so at a certain level, your fears are valid. I believe that after reading this blog and learning why people with autism show aggressive behaviors, you will view their aggression differently, and may not even term it aggression at all. To change stereotypes, your mindsets, and to understand why we see increased behaviors or aggression in autism we must understand six factors: communication, sleep, emotional regulation, anxiety, precipitating factors, and impulse control. These six factors are the key to understanding why autistic people sometimes, or depending on the person, often, escalate toward violence.
Communication
Picture this: you are trying to get someone’s attention. You call their name, no response. You call their name louder, no response. You move in front of them, no response. What’s the next feasible step? Tap them on the shoulder. Now, let’s add a twist: you cannot speak. In this scenario, you would skip calling their name and maybe skip moving in front of them too, and go straight to tapping. This scenario is a reality for many non-verbal autistics, but to make this scenario more accurate, we need to add some things in. First, people with autism don’t have a good sense of proprioception. This is the brain’s ability to gauge one’s force, meaning many autistics mean to tap, but incidentally hit or slap because their brain cannot read the force they need to exert. Secondly, oftentimes non-speaking autistics who tap to get someone’s attention are misunderstood. I have seen time and time again where someone can’t understand what the autistic is trying to communicate, so they turn away defeated, and continue whatever they were doing previously. Now, the autistic has to get their attention again but they are frustrated; their tap turns into a hit.
As parents, teachers, friends, or advocates, if this happens to us we have to slow down and consider. Imagine, just imagine not being able to communicate your wants, needs, or discomforts. This hit says: “I’m hurting. I need medicine.” This hit says “I’m sad. Will you sit with me?” This hit says “I am frustrated.” This hit says “I need help.” If you were constantly trying yet failing to get your words across day in and day out, wouldn’t you be frustrated too?
You must remember that all behavior is communication. Every action, every non-verbal cue is telling you something. Yes, it can be frustrating to have to decipher their cues constantly, but wouldn’t you want that done for you if you were in their shoes? Additionally, patience is so important. If you can’t understand what they are trying to communicate the first time, bear with them and try again, and again. Wouldn’t you want someone to do that for you? Or would you rather them turn away and ignore you?
To conclude communication, let’s break down some common behaviors and what they are communicating.
-Toe-tapping: “I need movement.”
-Self-injurious behaviors: “I’m anxious.” “I’m uncomfortable.” “I’m upset.” “I’m tired.” “I’m frustrated.”
-Chewing/biting: “I’m hungry.” “I need oral stimuli.” (use chewy)
-Hitting: “I need your attention.” “Please move out of my personal space.” “I am frustrated with you but don’t have the words to tell you.”
Sleep
It is well known that autistics struggle with insomnia. Autistics spend less time in REM sleep, they have more challenges regulating their circadian rhythms, and they have lower levels of melatonin production., When people are sleep-deprived, especially of REM sleep, the most important stage of sleep, their brain is not functioning at its highest level. People with sleep deprivation are irritable, quick to anger, and are often unable to control their reactions. Autistics are consistently sleep-deprived! This translates to mood swings, learning, memory, and attention issues, and an inability to relax. It also affects their ability to control their reactions to emotions, changes, or adverse stimuli. The effects of sleep deprivation get even more complicated because most autistics do not have the means to deal with emotional adversity in the first place! Even when they do get adequate sleep. This is because of impaired emotional regulation, another deficit of autism.
Emotional Regulation
Emotional regulation is the ability to manage and respond to an emotional event appropriately. People with autism cannot do this. I struggle with this in my own life. It is embarrassing to realize that my emotional responses are often not “my age,” but I also know I can only do the best I can with the brain faculties I have.
When someone with autism experiences an emotional circumstance, our brain cannot slow down to think. We immediately panic and release. Most times this release is our brain unleashing a flood of emotions, often when we don’t want it to. An example of this is sobbing in public when plans change. We don’t want to show this vulnerability, but our brain doesn’t give us the choice. Our emotions act out because we cannot control them. Because of impaired emotional regulation, we act out at big things and small things, but our reactions can be disproportional. A little frustration can cause someone with autism to completely lose it, or in some cases act aggressively. Without emotional regulation, people with autism cannot de-escalate, so our brains default to releasing behaviors as a last-ditch effort to communicate the mental turmoil we are under. For some individuals, these released behaviors are aggressive.
Anxiety
If you are a regular here on my blog, you are familiar with the astronomical rates of anxiety in the autistic mind. When you combine anxiety with impaired emotional regulation, you significantly decrease the likelihood that coping skills or de-escalation strategies will be effective. Additionally, anxiety contributes to brain chaos. I define brain chaos in my blog “Autism’s Barriers to Friendship” as:
…the confusion we feel from constantly misunderstanding communication, dealing with anxiety and other mental disorders, guessing how our brains will react to the sensory stimuli around us, and trying to regulate our emotions. Brain chaos stems from a lack of control. We cannot control our inability to understand communication, we cannot control our anxiety, we cannot correctly interpret sensations, and we cannot control our emotions. Having autism is a constant, draining, and uncomfortable state of lacking control.
When you pair brain chaos with the ever-present and consuming anxiety of an autistic mind, plus its tendency to hyperfixate, you get a never-ending wheel of anxiety. When one is anxious, their barriers fade away as their brain tries to isolate and eliminate the anxiety, so they often lash out or act on impulse instead of thought. Anxiety-induced aggression in autism is a call for help. In most children that I work with, it is easy to pick out their anxiety-induced behaviors. For example, one day I was trying to put a child’s socks on to leave for a fun, but new, event. Everything was going well and I had been preparing this individual for where we were going, when we were going, and what we would see and do there. But, as I put on his remaining sock, I said “Okie dokie, we are almost ready to go to _____.” Almost immediately after I said this, the individual scratched my arm. Then he stared at me, trying to communicate through his eyes (he is non-verbal) now that they had gotten my attention with the scratch. The look I saw on this individual’s face was sheer terror. He was anxious to go to the event! So when I reminded him that we were going soon, his anxiety got the best of him and his brain released an impulse, reaching out and scratching. This also worked as a means to communicate. He successfully got my attention so that I could see the fear on his face. I could see that he was communicating nervousness and discomfort towards the new event.
I can comfortably say that most times an autistic has been aggressive toward me, it was a situation like this. Anxiety-induced aggression can be hardest to handle because it happens suddenly and can be unpredictable; we never know when their anxiety will get the best of them. But, there is one thing that can help us identify if, and when, it could happen, and that is precipitating factors.
Precipitating Factors
Precipitating factors are adverse circumstances that build throughout the day or week and slowly eat away at one’s emotional regulation or impulse control. Here are some common precipitating factors for autistic individuals:
-Sensory stimuli (bright lights, loud noises)
-iPad/TV/phone dies or is unavailable
-Routine changes
-Comfort clothes are not clean
-Ran out of comfort foods (i.e. chicken nuggets)
-They fail at a task
-Someone touches them unexpectedly
When several precipitating factors happen in one day or one week, the autistic becomes more susceptible to losing control. Why? Autistics already begin with little emotional control (brain chaos and impaired emotional regulation), so when multiple adverse things happen in a short period of time, their brain simply cannot handle it. They melt down, shut down, or act out aggressively. This is their brain going into fight, flight, or freeze mode as it tries to sift through the discomfort and overwhelming stimuli. The brain may also release, whether emotionally like crying, or physically like aggression.
Impulse Control
In my book An Autistic’s Guide to Autism, I define impulse control as “...a prominent executive functioning challenge autistics face. It is the inability to resist sudden urges and temptations.” You can imagine how impulse control, or rather, the lack thereof, may lead to aggressive behaviors. Their brain does not stop to consider consequences, it just acts. Oftentimes you know when an autistic’s impulse got the best of them because immediately after they hit someone, they show remorse and say “I’m sorry.” I have seen this many times. They wish it didn’t happen, but it was out of their control. Impulsivity is a huge challenge for those on the spectrum as it can harm others or themselves. If an autistic acts on an impulse, say jumps into a pond, they may not recognize the danger and the result can be devastating. (Did you know that drowning is one of the leading causes of death for autistics? Autistics are 160 times more likely than neurotypical people to die of drowning. ) To summarize impulse control, you should know that 1) they did not mean to, and 2) they did not have control. Impulse control can be significantly improved through medications like SSRIs and atypical neuroleptics like clozapine and risperidone.
. . .
So, are autistics aggressive? More than the average population. Are all autistics aggressive? No. Why are they aggressive? Communication, sleep, emotional regulation, anxiety, precipitating factors, and impulse control.
Interestingly, there is a correlation between autism levels and rates of aggression. Think back to communication. As the level of autism increases, the ability to communicate decreases, which is why level 2 or 3 autistic show more aggressive behaviors than level 1s.
When an autistic is aggressive, they are not trying to be aggressive, their autism is resorting to aggression. This is their brain using a tool. (Yes, aggression can be an effective tool.) Because autistic brains don’t have other, more acceptable tools to use, (because of their atypical faculties or wiring), they resort to aggression. This is one of those times where you want to think about the individual and their autism as separate entities. The individual is not at fault for aggression, the impairments associated with their autism are.
If after reading this, you are still nervous about aggression, I have a few pieces of advice. Firstly, slow down and consider: i) what happened before the behavior, ii) what was their behavior, and iii) how did they act after the behavior. You must remember that behavior is communication, so your first thought should be to figure out why the behavior happened. This question is often synonymous with “What are they trying to communicate?” If you view behaviors this way, I hope you will not be angry or discouraged at their aggression but empathetic towards their attempts to communicate, whether it be a want, need, concern, emotion, or discomfort.
Secondly, I can assure you that if your child or student is struggling with aggression now, it often does not last. Studies show that youth age predicts rates of behavior. They find that as autistic children get older, aggressive behavior lessons as they strengthen their communication skills and coping strategies. You know the common phrase “it’s just a phase”? Well, most times aggression is a phase of autistic childhood. But, there are exceptions, and sometimes it lasts longer. Or, some autistics will enter into another aggressive phase later in life. This is due to a multitude of individualized factors. Remember, each autistic child is very, very different from the next! If your child or student has been struggling with aggression for prolonged or recurrent periods, consider an anxiety medication or impulse control medication. It can be hard to take this step towards medicating, so I encourage you to try therapies, talk to professionals, and have assessments first. From experience, I know that for some, these types of interventions do not work or are not enough. I can comfortably tell you that medications help so, so much, especially anxiety medications. It doesn’t seem like anxiety would curb aggression, but remember autistics experience 10x stronger anxiety than the rest of the population. As we are not inside their minds, we often cannot understand just how potent their anxiety is. I can say for certain that my anxiety medication changed my life in more ways than I can count. I will also share that we resisted medicating for several years (I know what you are feeling!).
Finally, what can you do in the face of aggression? First, give them space, be quiet, and limit any sensory stimuli. If they come after you, move away. If they follow, you can block a hit or kick with your arm (or leg). Simply hold out your arm with your elbow bent, so that the outside of your forearm absorbs the force. At times, you may just have to let them fizzle out. But, as usual, there are exceptions to this. If they are seriously hurting themselves, you, or others, or if their aggression is prolonged, you have to take the next step and shut down their aggression completely for safety reasons. I am not going to discuss next-level interventions here, but if that is relevant in your situation, speak to medical professionals like a psychiatrist and board-certified behavioral analysts.
So, in the face of aggression, stop and remember:
1) communication
2) sleep
3) emotional regulation
4) anxiety
5) precipitating factors
6) impulse control
Bibliography
Brown, C. E., Quetsch, L. B., Aloia, L. S., & Kanne, S. M. (2024). Predictors of Aggression, Disruptive Behavior, and Anger Dysregulation in Youths with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 54(4), 1264-1280. doi:10.1007/S10803-022-05876-6
Buckley, A. W., Rodriguez, A. J., Jennison, K., Buckley, J., Thurm, A., Sato, S., & Swedo, S. (2010). Rapid eye movement sleep percentage in children with autism compared with children with developmental delay and typical development. Archives of pediatrics & adolescent medicine, 164(11), 1032–1037. https://doi.org/10.1001/archpediatrics.2010.202
Columbian University Mailman School of Public Health. (2017). Individuals with Autism at Substantially Heightened Risk for Injury Death. American Journal of Public Health.
Kaeser, Kloey. (2024) An Autistics Guide to Autism. (2nd ed.)
Yenen, A. S., & Çak, H. T. (2020). Melatonin and Circadian Rhythm in Autism Spectrum Disorders. Otizm Spektrum Bozukluklarında Melatonin ve Sirkadiyen Ritim. Turkish Journal of Psychiatry, 31(3), 201–211. https://doi.org/10.5080/u25160
February 13, 2025
