Autism and Tantrums
Some children are more likely to have tantrums than other children. Causes that contribute to a child's tendency to
have tantrums include fatigue, the child's age and stage of development, temperament, stress in the child's
environment, and whether underlying behavioral, developmental, or health conditions are present such as ADHD or
autism. Also, a child may be more likely to have temper tantrums if parents react too strongly to difficult behavior
or give in to the child's demands. Tantrums are normal behavior for most children and there is no reason why
children with autism should refrain from this stage of development.

Tantrums are one of the most common problems in young children with autism. They may appear to go into a state
of rage, panic, anxiety or fear for no reason at all. This might involve screaming, crying, resisting contact with
others, or pushing others away. Unfortunately for individuals with autism and their families, ‘tantrums’ and
destructive behaviors are especially common, among children. The problem seems to be that it is more difficult for
parents to prevent ‘tantrums’ in children with autism, the child seems inconsolable during the ‘tantrum’, the
episode might last a long time, and consist of more aggressive behavior, such as hitting, biting, and pinching. Most
often the satisfaction that typically accompanies the end of the ‘tantrum’ rarely occurs. Similar episodes of panic,
anxiety, rage or even aggression might be seen all through childhood, adolescence and even adulthood.

Ignoring the tantrum behavior and helping a young child learn how to handle and express anger and frustration are
usually effective ways to deal with the behavior. Also, paying attention to what triggers tantrums can help you act
before a child's emotions escalate beyond the point where he or she can control them. This is supposed to identify
the cause of the behavior and prevent ‘blaming’ the individual. This is very important in autism, as it is doubtful that
any behavior which may cause difficulties for families is intended maliciously or menacing. There is almost always
some other, unidentified, trigger that brings on challenging behavior.

It is important to intervene as early as possible so that behaviors are not constant and so that other means of
expression and communication are open to children with autism.

Causes for challenging behaviors

What causes this? As with such behavior in all children there may be any number of causes. There might be
underlying reasons (such as feeling upset, anxious or angry) and immediate triggers (such as being told to do
something). In autism however there is also a specific pattern of behavior, social interaction and understanding the
tantrums are directed by frustration, can help explain some ‘challenging’ behaviors.

People with autism often rely on ritual and structure. Structure is a method that helps define the world in terms of
set rules and explanations in turn helps the person function most effectively. Most children with autism find their
own methods of imposing structure and maintaining consistency. They need this structure because the world is
confusing. Other people are complex and almost impossible to understand. The information they receive through
their senses might be overwhelming and hard to bring together into a strong whole, and there is likely to be an
additional learning disability that makes it hard to apply cognitive skills to all these areas at once.

When some form of structure or routine is disrupted the world becomes confusing and overwhelming again. It
might be like losing a comforting toy when feeling alone or homesick. This disruption of structure might be obvious
(having a collection of objects disturbed, being made to go a different way to school, getting up at an unusual hour)
or it might be hidden (subtle changes in the environment which the child is used to for example). Some of these
triggers might be out of the control of the individual or his or her family members. Some might be avoidable.  
Others might be necessary events, which can be slowly introduced so as to limit overt reactions.

Generally one of the most significant causes of ‘challenging behavior’ is a communicative need. For people with
profound difficulties in understanding others and in communicating with them it is hardly surprising for frustration,
anger and anxiety to build up. It is also quite likely that ‘challenging behaviors’ will directly serve as a form of
communication. Natural ‘tantrums’, for example in response to changes in routine or requests to do something the
individual does not want to do, may well become usual reactions to those involved.

Frequent Tantrums

If your child continues to have frequent tantrums after age 3, you may need to use time-outs. A time-out removes
the child from the situation, allows him or her time to calm down, and teaches the child that having a temper
tantrum is not acceptable behavior. Time-out works best for children who understand why it is being used.

Most children gradually learn healthy ways to handle the strong emotions that can lead to temper tantrums. They
also usually improve their ability to communicate, become increasingly independent, and recognize the benefits of
having these skills. Children who continue to have tantrums after the age of 4 usually need outside help learning to
deal with anger. Temper tantrums that continue or start during the school years may be a sign of other issues,
including problems with learning or getting along with other children.

Talk with a health professional if:

•        You have concerns about your child's temper tantrums.

•        Your child older than 4 years continues to have frequent temper tantrums.

•        Your child's temper tantrums escalate into violent behavior that endangers others or results in self-inflicted
injuries.

•        You have problems handling your child's behavior, especially if you are concerned that you might hurt your
child.

Difficult behavior that frequently lasts longer than 15 minutes, occurs more than 3 times a day, or is more
aggressive may indicate that a child has an underlying medical, emotional, or social problem that needs attention.
These are not considered typical temper tantrums. Difficult behaviors may include:

•        Kicking, hitting, biting, scratching, hair pulling, or pinching other people.

•        Throwing or breaking things.

•        Head-banging or inflicting self-injury.

•        The child's temper tantrums frequently last longer than 15 minutes or occur more than 3 times a day.

•        The child's behavior does not improve after 4 years of age.

•        The child hurts him/her self, other people, or objects during a temper tantrum.

•        You have problems handling your child's behavior, especially if you are concerned that you might hurt your
child.

•        You want help with learning to cope with your feelings during your child's temper tantrums.

Medical treatment for temper tantrums may be recommended for children who:

•        Have long-lasting and frequent temper tantrums.


•        Regularly have temper tantrums after 4 years of age.

•        Causing self-injury or becomes violent.

This is where support is needed both in the form of direct interventions related to the behaviors, and in advising and
helping parents manage episodes in ways which can be applied at home.

These difficulties can be improved slowly through education and other interventions, but particular differences
must be respected. Parents can help by making an effort to manage the environment so that the individual is more
comfortable (allowing some structure, avoiding distracting information when engaging in tasks, allowing personal
space where necessary). The second major area is where ‘challenging behavior’ serves a communicative conduct.
In this case the cause for the behavior must first be identified before teaching and developing other means of
communicating.
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