managing head banging

[deb251]

4 year old autistic boy,  no speech some communication through compics and pecs . last  2 months has started banging head with fists causing bruising whenever he is frustrated or requested to do somthing,  example toilet.table activity also can also happen for unknown reason when everything seemed to be going ok. Ignoring not an option as banging is servere.  managing at moment by holding close until slightly calmer then sitting with him untill calm and slowly introducing activites he likes. any other suggestions.

[Angela77]

Consult a Board Certified Behavior Analyst.  They will be able to guide you through this process without trying tricks or things that may not work.  Once you identify the function of the behavior (attention, escape demand, gain access to a tangible item or activity or sensory-internal function), they will be able to develop a plan to help decrease it.  For example, if your son is engaging in this behavior for attention, giving him deep pressure after he engages in the head banging will actually increase the likelihood of the headbanging to occurr, something you don't want to have happen.  

[MJIthewriter]

Another thing: About the setting the clock ahead, I wouldn't recomend anyone other than the autistic individual to try it because, I'm pretty sure the person will get angry if they can't have the REAL time once they realize the time is false. If that happened to me, I may feel a bit like I was lied to, which is a very bad feeling...  It may be good to have two clocks handy. One set 5-10 min ahead and one that as the REAL time.

Also with meal times: If I start to feel hungry and it's time (Right now) then I know I better start to wrap up whatever I am doing and eat...so this will be my last post before I eat dinner... I have to resist the urge to look anywhere else on my computer and not check messages until I get that dinner eaten...

[MJIthewriter]

The neurologist sounds right about that. It seems to be negative emotions that I notice the most... But then again I guess who's going to complain if they feel overwhelmingly happy?  I know I wouldn't if that were me.

I wonder if the same thing occurs with people diagnosed with depression?  Some people with depression replied to my journal that they observe something like that with themselves... Interesting. I think there's a lot of crossover with mental conditions.

I think I manage my emotions most of the time. It's just once the tears come on, then I have to weather out the storm... I find it interesting that no matter how much rational thinking I do during that time will stop the crying.

I think that may be where the connection error occurs in autism. Perhaps most people can rationalize themselves out of an emotion. If you're autistic, then no amount of rationalization will stop the feeling... It just has to run its course.  I've learned some coping mechanisms helps: Ideally get the problem resolved ASAP in the way I'd like to see it resolved. If that doesn't occur then I need to find other strategies:

- talking to someone. That seems to diffuse it through the act of talking out. If I can trust the person, just be honest... I can't stop the crying feeling even though I know the logical reason...and maybe even the solution if it's one I don't like.
- getting distracted... This is tough, but it seems to help in some cases.
- take a nap if I can and if I'm not too riled up
- writing down my feelings and copying the trigger thoughts on paper and leave it out for the person I am angry at or feel hurt me. Maybe they didn't intend to hurt my feelings, but if I write out what is going on in my mind they can learn to avoid making the same thing again. I do this if whatever it is is preventing me from sleeping... That also works with things I am mentally trying to remember like - feed the cats, go out and get x at x location, and misc "to do" things.

I do that with medical anxieties... getting new glasses, having foot pain looked at, etc...

- and if all else fails jut tell myself I'm crying because I am crying... there doesn't need to be a logical reason. It's okay to feel the way I feel... (I don't know if it really is) but it seems to help if I just let myself go ahead and believe it is okay to feel mad at someone even if I know they didn't do anything intentionally to anger me.

It's a bit different than the "neuro-typical" approach, I am sure...  I suspect neuro-typical feelings are in line with their thoughts and what they believe is true vs. false.

With an autistic individual feelings and thoughts can be tied together, but not with what they know to be true and false.  Therefore I can be fully ware my feelings are based off a false assumption, but still feel as if I did not know...plus the added frustration that I am fully aware that my feelings are not in line with my beliefs.

But if I tell myself my feelings are okay regardless of what I know to be true, then I'm less prone to try to stop or control them by committing aggressive acts to myself or others...
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We've done the warning system with me, but determined enough I will blow off the warnings, even thought I am fully aware of the time I need to get off...  What did work was having a rather negative unpleasant consequence for ignoring the warning...  Unpleasant enough I would stop immediately, but too unpleasant, not only would I stop immediately, but I could pitch a really nasty hissy fit and get somewhat aggressive if I felt the consequence was too harsh...  If you try the consequence method make sure it's something unplesent enough to get the job done (interrupt the child) but not too unpleasent that the child will feel threatened and hostile.

Sorry this was no real help there...  As an adult I have to be fully aware of the clock and keep it right in front of me... I'm glad I got a program to synchronize my computer clock with the actual time so I can see what time it REALLY is...  It also takes a matter of will too. I have to willingly decide, yes I will get off and go to work regardless of how messy I feel I left the task... (By messy I mean the feelings/thoughts/ whatever I was thinking about doing, not just  the physical mess...For instance if I am writing a conversation with my characters... I have to just let go and let the conversation continue in my head, even though I can't write it...)

Another trick I may do from time to time is "cheat" myself by setting the clock ahead so I'm momentarily tricked into thinking it is time to leave when it isn't.  If I do it too long and give too much time, I'll eventually get "wise" to it and just compensate by thinking oh yeah this clock is ahead, so I've got plenty of time...

I've also learned to break up tasks. For instance if I'm repotting plants right before dinner, I'll finish the plant I am holding, and maybe do the next one, but stop once I'm satisfied. I may still be late for dinner, but at least I'm not putting off dinner to finish all 20 some plants at once...

[Sally44]

Yes, the counting down strategy kind of works with my son.
We also have a timer clock so we can set it to show when we have to leave the house for example.
Lots of verbal warnings.
We are going to start using a traffic light system for a number of situations eg. green is okay to continue, amber is the warning and red means he has to stop what he is doing.
Your difficulty is going to be trying to interpret how much of these systems he is understanding.  Don't assume that because he is non-verbal that he doesn't understand language and speech etc because unless proven otherwise, there is a good chance that he does.

[NewMom13]

Hi there,

   I work in the field of autism and the one thing I can suggest is that you give him a warniing before your terminate an activity or begin another.  For example, you are about to end something that he really like to do, let him know he has one more minute and then when the minute is up, give him a 3-2-1 and then end the actiivity.  More prepared he is for the end of an activity the less stressful it will be for him.  Lots of reinforcement for appropriate behaviour, and let him know he is sitting nicely etc.  Hope that gives you some help.

[Sally44]

At a seminar we were given an answer (by a neurologist) to these overwhelming feelings that people on the spectrum get.  The analogy he gave (and apparently it is scientific fact) was that when NT people experience an emotion it is like when someone takes a shower using a shower curtain ie. the water (emotion) is contained.  For those on the spectrum it is like taking a power shower without a curtain or screen.  Ie. the water (emotions) gets everywhere.  And apparently there is something different in the brain structure whereby those on the spectrum are flooded with sensation/emotion and because it goes everywhere and there is alot of it, it takes alot longer to get it under control.  So, the person is not being immature, or silly, or mardy.  They are simply reacting to the level of emotion they are experiencing, which is different to the level we would experience.  Does that sound true from your experience?

[MJIthewriter]

I'm thinking the chasm between conscious thought and emotion may have a biological factor to it. It does give me comfort to think that even though I came up with this without any scientific basis, that it could be partially if not true. I guess it comes with the being "differently wired" package, lol.

That way I’m not beating myself over the head mentally wondering why can’t I control this feeling… If I think about it being a biological thing, then I can move one step ahead and say. Yes I may think this way and I may feel something else. That’s okay… It’s okay to feel that way no matter what the trigger is.  The trigger may not bother anyone else, but the important thing is it bothered me at one time enough to make me feel it is important.

Letting go helps a lot… Being able to realize this takes maturity unfortunately, as a child your son won’t realize this right away. He will have to learn it and probably the hard way.

[MJIthewriter]

I like Salley's counting analogy.  Funny I was thinking about the lack of emotional control.

I've been wondering with myself if it is something that all people deal with or an autism thing. There's a good example for my "friends" to view in my journal about a crying spell I went through today because I felt ignored.  Nothing could shake me of that feeling until I made up with the person... I could try to tell myself that person is not ignoring me, that I'm focusing too much on myself, I'm not the center of the universe, etc... All that means NOTHING to me. I guess apparently it helps people not autistic; otherwise they wouldn't be trying to give me advice that doesn't work...

If I try to take people's advice and "rationalize" my feeling then I find myself feeling worse, because not only am I upset about the original trigger, but I'm upset with myself because I can't change the emotion by just a thought...  My mood crashes because not only would I still be upset over the trigger, and upset about the thoughts not working, but the fact I have absolutely _NO_ control....

Think about something that made you feel stupid and embarrassed... dwell on the feeling. I guess it's a form of self embarrassment... There's no audience, except for my mind... Somehow I have to break myself from that feeling of shame...  If I were a bit less mature, then I'd lash out and bite myself or bang my head.  If it hurts enough, that may disrupt the whole process...

Being a bit more mature, I don't hurt myself...I let go and let myself cry it out. I may know consciously the tigger was minor, but it does no good to think about the trigger at all... Instead I realize I'm sad and that it will pass. In the mean time I must find something to focus on to occupy my mind in the mean time... When I felt upset, I decided to go on another website and talk about my African violet hobby. While I was composing my reply about African violets, I was not thinking much about the original trigger and the feeling.
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Since I almost always get a blank look when I try to explain this (and my advice for getting around it) to non autistic people, I'm thinking what I am describing must be purely an autistic thing, unless someone non autistic is willing to chime in and let me know any different.

[Sally44]

All I can do is tell you things that upset my son and why I think that is, and maybe some of it will be relevant.
Firstly, he has alot of attention and focus for his interests and the things he likes.  If I try to stop him doing any of that type of stuff for something else he will get upset.  I've found it really helpful that anything he 'has' to do, to try to use his interests to motivate him.  For example maths homework.  If I just talk about numbers he's already in tears and may have a tantrum.  If I talk about him having 15 starwars ships and can he show me how many that is on the abacus etc, then he's all for it!
Stopping and starting activities in general can be a problem.  If he is engrossed in doing something getting him to leave it unfinished will upset him.  If communication is better you can get to a stage where you break down any activitiy into smaller units and can then communicate to the child that when they have finished that piece they will have finished for today.  But, for example, if I were playing a game of war with my son using toy soldiers and we had to stop for tea, he has to leave all the soldiers out (and this particular time they were on the dining table!), and they cannot be moved so that we can resume the game after tea.
I also know that my son tends to function mainly through one sense at a time.  So if he were engrossed in doing something he would appear deaf.  If he is watching TV I could tickle his feet or pinch his ears and he would feel nothing.  The reason alot of autistic people do this is so that they don't get overwhelmed by all the incoming sensory information, so they shut down a couple of channels and concentrate their attention through just one of them.  That means they can be completely unaware of other people close to them or what is happening in their enviroment.  If my son is engrossed in doing something and I talk to him I force him to change sensory channel to listen to me.  That will upset him because I have broken his focus of attention and he may find it hard to go back to the place he was and he may need to start all over again.  I suppose it is the same idea as if you were trying to count something and someone else kept trying to engage you in conversation, you would forget what number you had got up to and would have to start again.  That is very frustrating isn't it.
When my son gets very upset he says he can't control it.  And afterwards he will say he doesn't know why he got so upset.  And when they do get upset it appears to be totally out of proportion to the incident that caused it.  But if they do get flooded by emotions that they cannot control, then their reaction is understandable.  He can eventually get it under control, but it can take a long time.
Do you suspect that your son has any sensory issues.  
I know you say your using picture exchange communication at the moment.  Do you think you'll be able to teach some basic signing some time in the future?
Not being able to communicate must be very frustrating.

[MJIthewriter]

It sounds what you're doing is helping. I'm not sure about the holding down, but if it is calming your child down, then the better.  Does he like being squeezed or given a firm hug?

Gradually introducing enjoyable activities is a good idea.  As far as triggeres. I find with myself I could get self abusive if I had a negative emotion I couldn't cope with.  Ovcer the years I learned how to cope with most of those negative emotions, but sometimes I still can get very angry and frustrated and feel tempted.  When that happens, the best thing to do, is to be able to take a break.  If it's triggered by an argument, then I'm best off walking away and leaving that situation until I can think better.

I believe inside the mind of many people, especially autistic people, there's a lot of active thought processing going on. Sometimes things trigger us to remember or relive things that may be pleasent or not.  For instance, if you broke up with a friend and it was upsetting, you may or may not react right away.  Other things may come up and trigger those emotions.

Thing is, especially a nonverbal autistic person they can't express those emotions they feel. Think of it being like 3:am, you're greatly upset about something, crying, and have no one to talk to. You may feel lost and alone. Only in this case your son _really_ is alone and having to cope with his emotions on his own.

It sounds pretty sad and that's why I hope that some day if there are any "treatment"s out there for autism, would be to enable all autistic people to be able to communicate their thoughts and feelings.  I honestly believe that would settle over 95% of the aggressive meltdowns.

You can also feel free to look at my med health article on self injurous behavior. Some time I need to add onto it to include the stuff I mentioned here.