An enormous gap exists between the traditional view of anger for Neurotypicals and that for the ASD population. From the expelled ASD second grader that tells his therapist, “I DID feel like I wanted to kill him, that’s why I said it”, to the misunderstood ASD teen that spent 6 months in detention for stopping a recreation of the Columbine shooting, preconceived notions of emotional control do not apply. Another of many related questions raised by the increasing violence is, when does a violent video game provide catharsis for anger and frustration and when does it feed a growing pathology?
Given the multifaceted nature of the ASD condition, a thorough functional assessment of the specific aggressive behavior is required along with a biopsychosocial assessment of the individual. Undiagnosed learning disabilities can also have a profound effect upon an individual’s ability to maintain emotional equilibrium when self-esteem is constantly challenged.
The general conceptualization of the frustration-aggression hypothesis (Dollard, et. al,1939) appears particularly applicable to the ASD population. This model indicates that when the individual’s source of the frustration cannot be changed, overcome or adequately resolved, the aggression gets displaced onto an “innocent target”. Using the stair step analogy, the individual’s unique set of noxious stimuli surpassing the individual’s frustration tolerance resulting in the aggressive act. Not all individuals externalize their aggression. With those on the spectrum, the increase may result in symptoms such as withdrawal, increased obsessions, compulsions or self-mutilation. Social learning, or lack of, may direct these symptoms or reduce their severity for a period of time.
Areas that factor into this equation would include:
Learning Issues-These are the situations and factors that negatively influence academic performance and behavior in the school setting. Difficulties with attention, anxiety and school related self-concept issues are of concern. In addition, specific learning styles, learning disabilities, written language deficits, difficulties with storage and retrieval of information all play a part. Are appropriate educational services and/or modifications provided.
Health/Diet-Areas of assessment regarding health and diet include food and environmental allergies and sensitivities. If indicators of difficulties in this area are suspected, extensive testing is sometimes necessary. Parents report that the evaluation of environmental and food sensitivities is important to consider beyond traditional allergy testing.
Behavior Analysis- Analysis of current behavior management techniques, use of reinforcers, etc. provide light to areas of possible intervention
Anxiety Reduction-At the core of the symptoms manifested by those with ASD is significant anxiety, arousal or dysregulation.
Speech-Language (Pragmatic)-Language/ Pragmatic language deficits are a defining features of ASD and continuously have some effect on the functioning of the individual.
Sensory Issues (OT)-Usually the environment surrounding those with ASD contributes significantly to the anxiety, arousal or dysregulation level. Visual, auditory, tactile, smell and taste can be areas of hypersensitivity.
Peer Relations- Aggression is frequently directed toward peers and this area is another defining area.
Physical Activity-Finding physical activities that are of interest to those with ASD can be challenging. If there is a regular routine there is frequently reduce aggression.
Family Variables-Those suffering from Asperger's syndrome/HFA are highly sensitive to emotional factors that may be affecting other family members. Frequent moves, health problems of family members, conflicts, divorce and emotional problems of family members can have a great influence on the amount of behavioral difficulties of the individual. Siblings can develop their own behavioral or emotional problems due to the stress that is placed upon the family, thus compounding the problems
Medication/Neurobiology-What are the interventions in this area and what have been tried in the past?
Advocacy
Addressing the needs of violent, or potentially violent children suffering from an ASD is often a role fulfilled by those with expertise in School Psychology. Typically, assistance is needed in addressing comorbid learning disabilities, ADHD or a significant emotional disturbance. This ideal situation is not always the case, however. For example, as a result of a lengthy court process, a girl with Asperger's Syndrome from a York County Maine school district was found eligible for special education services despite having average grades. The schools fought providing her services since her grades were C’s. Therapists with expertise in this area can have an enormous effect for such children in obtaining appropriate services.
Fitness for duty evaluations can sometimes result in the “violent” worker being identified for the first time as being on the spectrum. Once identified, the Americans with Disabilities Act (1991) requires appropriate workplace accommodations for those with disabilities. Therapists with an understanding of ASD and vocational issues can assist in determining whether reasonable accommodations would result in workplace success for a given individual.
There are a multitude of cases that highlight the need for police and legal professionals to understand the characteristics of ASD. The authorities sometimes escalate a minor incident into a highly violent situation.
Special consideration has been given in regards to the issue of sanity at the time of the offense for those on the autistic spectrum. Use of the PTSD, irresistible impulse or similar defense method may be appropriate in some situations when violence has occurred.
Whether a defendant is competent to stand trial is often a question posed to forensic experts. The answer to this question for those on the autistic spectrum can be affected by developmental issues, cognitive ability and emotional state. It is important to consider factors beyond cognitive or developmental levels such as the anxiety/arousal level of the individual and subsequent cognitive decline as a result the stressors that may be present in the courtroom setting. One of the questions posed to forensic evaluator's is whether the individual can assist the defense attorney in their own defense..
Parents are sometimes the recipients of criminal justice efforts gone wrong. Abuse and neglect charges are sometimes brought up against parents of children on the autistic spectrum and are accused of violence for stopping their child’s violence. Sometimes children or adults on the autistic spectrum engage may run away from home or engage in self-injurious behaviors leaving scars. Neglect or abuse charges have been filed against parents as a result of such occurrences.
There is a growing need is for therapists with a variety of different specialties to assist those on the autistic spectrum in order for these individuals to obtain equal and/or appropriate treatment and to ensure that their “violence” is put in the proper context no matter what the setting. With this understanding, horrendous incidents could surely be averted. In addition, those with knowledge of this special population should be encouraged to share their understanding to ensure that the outside world is provided a glimpse into the life of these unique individuals and that their positive characteristics are emphasized.
Actual cases of the author’s will be discussed.
(Author’s note- I just found out about this deadline yesterday)
C. Rick Ellis, Ed.D
Licensed Clinical and Forensic Psychologist
Spectrum Psychological and Forensic Services
Dr. C. Rick Ellis has over 20 years' experience working with ASD as a School, Clinical and Forensic Psychologist. He is a sought-after speaker, media expert, therapist, author, advocate and forensic specialist on ASD/LD/ADHD, etc. He serves on the Board of the Elizabeth Birt Center for Autism Law and Advocacy.