Characteristics of aggression among persons with autism spectrum disorders

Highlights

• Aggression is a common problem among persons with autism spectrum disorder (ASD).

• Escaping tasks and gaining tangible items are common causes of aggression in ASD.

• Males on average had more severe aggression than females.

• Most of the available research is on children.

Abstract

Autism spectrum disorder (ASD) is a commonly occurring life long developmental disorder with core symptoms of communication and social skills deficits. Stereotyped and repetitive behaviors are also present. Along with these core symptoms, a number of co-occurring problems such as aggression are present. The present study reviewed papers that describe various characteristics of aggressive behaviors among persons with ASD. The preponderance of studies involved children who were male. Aggression was more severe in males. Where the maintaining variables were studied, tangible and escape, and some core aspects of ASD such as cognitive rigidity and poor social and communication skills, were associated with aggression. The implication of these data and other characteristics of this challenging behavior are discussed.

Introduction

Autism spectrum disorders (ASD) have become a highly studied topic. This development is certainly justified given the serious nature and life long course of the problem (Matson and Boisjoli, 2008, Matson et al., 2009d, Matson and LoVullo, 2009, Osada et al., 2012, Smith et al., 2012). Prevalence studies have continued to show greater and greater rates of ASD. Thus, once considered rare, the disorder is now viewed as one of the most common and debilitating of the childhood disorders (Matson et al., 2010a, Matson et al., 2009a, Matson, Dempsey, & Fodstad, 2009b). Similarly, feeding issues are common and can lead to behavior problems (Matson et al., 2005). Additionally, there is no cure. Thus, developmental course and other age-related factors and characteristics need to be taken into account (Horovitz and Matson, 2010, Matson et al., 1997, Matson and Rivet, 2008). Treatments, therefore, must be adjusted based not only on the heterogeneity of core symptoms but also on various age-related factors (Matson, Gonzalez, et al., 2009d).

Core features of the disorder include social, communication, rituals and stereotypies (Matson et al., 2010a, Steiner et al., 2012). The heterogeneity of ASD within core symptoms is well known, as are the presence of other debilitating problems. Thus, a variety of comorbid features are also present, some at very high rates. Among these issues are a variety of mental health and adaptive behaviors (Matson et al., 2009b, Matson et al., 2010b, Matson et al., 2009e, Smith and Matson, 2010a, Smith and Matson, 2010b, Smith and Matson, 2010c). Challenging behaviors also occur at very high rates (Healy et al., 2013, Rispoli et al., 2013, Symons, 2011). Feeding disorders, noncompliance, and self-injurious behavior (SIB) are also among the most common and serious behaviors (Kuhn and Matson, 2002, Matson and Kuhn, 2001, Miles and Wilder, 2009).

Aggression is another of these serious, comorbid challenging behaviors, that approximately half of individuals with ASD exhibit (Kanne and Mazurek, 2011, Mazurek et al., 2013). To date, however, this problem is not routinely screened for among persons with ASD (Matson & Nebel-Schwalm, 2007). Routine screening is necessary, however. If not, the identification and treatment of the problem is likely to be hit or miss. Additionally, these evaluations are essential in efforts to assess frequency and severity of these problems.

Given these issues, it is critical to establish a better idea about the characteristics of aggression as it applies to persons with ASD. The purpose of the current paper was to review studies on aggressive behavior and who and how they are expressed. These data have important implications for assessment and treatment, as well as for a better understanding of the causes of aggression.