WHAT TO DO WHEN YOUR CHILD
IS OUT OF CONTROL

Children and adults with autism can occasionally have behaviors that are simply beyond your (and their) control. If a child or adult is having a tantrum, the recommended intervention is ignoring the behavior by not looking at, talking to, or touching the person (except for safety). And this will usually help to reduce tantrums over time because the tantrum no longer is receiving attention nor is it getting the person any real benefit.

However, there are some things you cannot ignore. What about a tantrum that lasts all day and night and involves hitting others and breaking things? For little children, we may intervene physically and stop these things from happening. But every "child" reaches an age or size when that no longer is an option. Also an elderly parent or grandparent or foster parent may be no match for even a young but strong child. This article is about what can be done when things are out of control and something needs to be done.

At these times it does no good to be told: "I told you that you'd better get his behavior under control when he was three years old!" While that may be a true statement, it will not help - so - fuggetaboutit.

The behavior I am talking about here is not a tantrum. It is behavior that puts the person with autism and others at risk of harm. The behavior has moved to the point of being criminal. The person is trying to hurt others or is so out of control that hurting others and breaking the house up no longer matters to him or her. It is behavior that, if done by a stranger to your home, you would call the police.

Dealing with out of control behavior

Let's look at some steps (from least to most intrusive and serious) that you can take to defuse and/or deal with the situation.

Stop intervening

By this time you have probably tried talking calmly to the person, yelling at the person, restraining the person, etc. If these things have not worked up to this point - stop doing them. Do not talk to the person, stare at the person (watch them with your peripheral vision), or touch the person (except for safety). These steps may not calm the person down but they will take away some of the fuel to his out of control behavior. When a person is attacking you, you have the right to defend yourself. This is best achieved through defensive and blocking moves. If you have not attended a non-violent self-defense or crisis intervention program, I would highly recommend it (e.g., The Crisis Prevention Institute).

I do not recommend restraining the person for a few reasons: some people like restraints and will actually have tantrums in order to be restrained, a restraint is a temporary solution and teaches the person nothing about self-control, and it is too easy to harm another person when in restraint unless you are very well trained. If you must restrain for the safety of others, do so with only the force necessary and then release when the others are safely out of the way (e.g., other children). Remember, if you have been ignoring the person's behavior, the person may become more belligerent in demanding your attention. If that happens:

Walk away and get to a safe place

Sometimes the mere presence of another person sets off the person with autism. If you can safely leave the person where he is, do so. Make sure you have access to a phone so you can call for help if needed. Go to a bathroom or bedroom where you can lock the door but still hear what is going on. Bring a book about non-violent crisis intervention and read it. Listen for signs of calming. Do not come out immediately, but after five minutes of calm, step out and see what the situation is.

If all is well, go about your business as if nothing unusual had happened. This is not the time for talking about what happened, for setting consequences, for yelling at the person, or anything else but continued calming. When the person is truly calm (perhaps the next day even) you can discuss how the incident could have been avoided - but not now. It is very important for you to remain calm even if you are scared to death inside. There will be time for falling apart later.

Getting help

This step actually may precede steps one and two. If you know of a person who can usually calm the person with autism down, call him or her and ask this person to come over and help. If possible, it is always better to have the numeric advantage over a person who is out of control. Sometimes that in and of itself will defuse the situation. If the person comes - turn the situation over to him or her. You are the back-up at that point.

This is a short-term solution though. The person with autism needs to find a way to communicate frustration, anger, and other emotions without violence. So, when things are calm, talk to this helper and see what can be done to help the person calm down without outside intervention. Simple steps like teaching the person to tell someone when he is angry or upset, teaching a deep-breathing relaxation exercise to the person, or telling the person to count to ten can all be helpful. These things will have to be taught another day but they need to be done.

A social story that talks about dealing with anger can be helpful. In the social story you can also discuss the natural consequences for violent behavior, which may include involving the police, a stay in the hospital, etc. Talk to a behavior specialist or psychologist about a plan to help the person with autism deal with his or her anger in a peaceful manner. Then teach it regularly - don't wait for the next crisis.

Police, security staff or case managers

If things are not calming down and you have no back-up person to help, you may need to call the police or an on-call staff person (for those of you in a case management situation). Let's talk about calling the police. I am a big believer in natural consequences - I think natural consequences are the best teacher in most situations. The natural consequence for a person who is hurting you and tearing up your house is for the police to intervene. This is a drastic step for many parents. None of us want our kids to have a criminal record and none of us want outsiders dealing with our family issues. However, the person who gets violent changes all those wishes for privacy. Their behavior demands an intervention.

If you have a child or adult with autism who has even one episode of violence in their past, I would recommend calling the police when everything is cool and talking with them about your situation. Tell the police about your child, about autism, and about what you would want them to do if you called in a crisis. Explain what a typical crisis is and what steps from them would be helpful. Some people are so intimidated by the police that they immediately calm down (I know I do!). Their presence may be enough to defuse the situation. The police can "flag" your home on their system with the information you give them.

You know your child or adult with autism better than anyone. You know what their reaction may be to the police coming. If the person will look at this as a positive thing, it may not be a good idea for the police to come if all they will do is visit. This actually may reinforce the crisis behavior. If that is the case but the police are still needed - make sure you talk to them about how to handle the situation.

Perhaps you need them to transport your person with autism to a medical facility for an evaluation or to a crisis intervention program (if your community is so fortunate). This will be a different outcome from what he or she expects. Many police will have a hard time being "typical police" with a person with a disability. When you call, explain what you want - if you do not want them babying your person with autism, tell them that (of course, they do not need to use excessive force but tell them you just don't want them to be nice). The key to a police visit is that it is such an outrageous and negative experience for the person that they do not wish for it to be repeated, ever.

Do not warn or threaten the person with the police. Prior to this incident, you have already told him or her that violent behavior could lead to the police coming to the home. When you are alone in your "safe" room, call the police, explain the situation, and what you would like for them to do. They will tell you what they can and can't do - that is beyond your control - so do not worry about it. Wait for the police to arrive and then come out of your room to let them in. Let the police deal with your child or adult with autism from that point on. Do not intervene and ask them to be nicer, etc. (unless they are clearly using excessive force). The police may be able to calm the situation enough so they can leave and all will be well.

The fact that you did not warn your person with autism that the police were coming may be a great deterrent for future violent behavior - he or she will never know when they may show up. Normally, the police will not treat a person with disabilities as a criminal. Typically, they will not take him to jail. However, if they witness an assault or other crime, they may very well take the person to jail. If that should happen, demand - do not ask - that your child or adult with autism be kept separate from the jail population. If they will not guarantee that, call a lawyer or do whatever you can to prevent them from that action. Again, this is not a normal occurrence - I have never once seen a person with a disability under my care taken to jail (but it could happen).

If charges will be brought against your child or adult with autism, it will not be the end of the world. If the person is habitually violent - then it may actually be a good thing to have his behavior on record. The disposition of the case may include additional services to help curb his aggression or hospitalization. More often than not, rather than to jail, the police will be transporting the person to a hospital emergency room for an evaluation by a psychiatrist. Most often if things have calmed down, the psychiatrist will release the person to your custody and schedule a follow-up visit with his physician or a mental health facility.

Sometimes, especially if the person is still violent or if you demand it, the person will be sent to a secure hospital for an evaluation. Frequently all that occurs is the person is observed and sometimes medicated or the medications are adjusted. Don't expect a miraculous clinical breakthrough in this short stay. This is most often just another unpleasant experience for your person with autism - but it is one he or she caused. The end result will be that you have taught your child or adult with autism this important lesson: "I will not be hit and this is how I will handle it every time you hit me (or tear up the house, etc.)."

Transporting your child or adult with autism to the hospital yourself

Sometimes the police will not cooperate, or you have determined that you do not wish to involve the police for some other reason. Transporting a child or adult with autism who is in a crisis is not a task for the feint of heart and it should not be done alone. An out-of-control person in a car is a recipe for disaster - please do not attempt this alone. You may be able to call an ambulance or even a cab to transport. At least in those situations you will be free to restrain the person if necessary.

If you must transport the person to a hospital or other program, you will need help. Prior to this step you should identify someone in your family or circle of friends who is fearless, physically large and fit, and will agree to come with you and supervise your child or adult with autism in this situation. Call this person and tell him or her to come over immediately for the transport. Depending upon the size and/or strength of your child or adult with autism, you may need to arrange two people for this task. Do not tell your child or adult with autism what you are up to. When the person arrives, let him take over with your child or adult with autism as you go to prepare the car. Tell the person to come when you honk the horn.

You prepare the car by opening the rear passenger door behind the driver, getting behind the wheel, locking all the other doors, start the car, and honk the horn. The person(s) who is helping you will bring your child or adult with autism out to the car. If there are two people have the first slide into the car and sit on the far side of the backseat away from the driver. If you have child safety locks, set them to locked. The second person places the person with autism into the car and slides in right after him or her and shuts the door. I have no problem with lying to the person with autism at this point. If you have to say, "Come on, let's go get an ice cream cone." Do it - if it will gain cooperation - at some point in the future (when he is calm) you can, indeed, get ice cream - so it won't be a complete lie. We are talking about safety here and that trumps a "white lie" - sorry.

Go directly to the hospital or other facility. The person who is helping you can restrain if necessary and most of all protect you so you can drive safely. Call ahead so the hospital or facility knows you are coming and may even have someone meet you at the car. When you arrive, take the child or adult with autism into the facility and the hospitalization information in step five should be followed.

by Gary J. Heffner, creator of The Autism Home Page at MSN Groups.

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Visit http://groups.msn.com/TheAutismHomePage/environmental.msnw which is the autism home page of Gary Heffner, the author of this article. This fact sheet remains under his copyright and is used with his permission. You are encouraged to visit his site as it is one of the few autism websites offering free comprehensive information.