Ask A Therapist: Special Needs & Medical Diagnoses

 

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Therapist Questions & Answers - Special Needs & Medical Diagnoses

I have a 9 year old son who has pdd. I also have a 1 year old daughter who is his 1/2 sister and he is great with her. He plays with her, and attends to her, makes her laugh. On 2 separate occasions he got aggressive with her. The first time he pushed her head and said it was because she kept dropping her bottle after he kept giving it to her, and the second time he kicked her and said it was an accident. My question is, how can I differentiate if he is telling what happened or how or should I hold him accountable for his actions? 

Let me preface this reply by telling you that I am not an expert in PDD, and my expertise in working with children on the autistic spectrum is centered on the 0-3 population. I have read on various parenting forums for families of older children with PDD or autistic spectrum disorders that male children sometimes become more aggressive around the age of 9 as they near puberty and are producing more testosterone.

Some families have addressed concerns with aggression and    outbursts with the child's teachers and have asked for more behavioral therapy to work on specific issues, or visited a    psychologist to assess whether any other disorders are contributing to their child's aggression (ADD/ADHD, Conduct Disorder, Oppositional Defiant Disorder). Some families have chosen to try medication to control aggression and have found success. I would definitely address these concerns first and foremost with your son's teaching team at school and see if perhaps goals can be built into his IEP to address these issues, then if that is not successful you may want to move onto one of the other above mentioned steps. You asked about his    accountability, and I do not believe a child's diagnosis or disability excuses him from his actions, so his aggression with his younger sibling should be addressed in a manor that is suitable to his intellectual level.

This is the only way he will begin to  learn that his actions were not appropriate in that situation. If he is  hurting his sister it cannot be ignored and must be dealt with in the  moment when it happens, but you would deal with it based on his  cognitive level, whether it be a time out, loss of privilege or a  demonstration of how he could have acted differently and more  appropriately. It sounds like your son may need to be in close  supervision with an adult when he is around your younger child, and  should not be left alone with her. Many parents do acknowledge that  their children with PDD can be extremely loving, caring and sweet, but  that often little things may set them off...and your son can probably  not yet understand that the behaviors of a one year old (dropping her  bottle is a game to her, but to him it was just plain annoying or  distracting) are not intentional and intended to annoy him and so he  may deal with her as if another 9 year old were to continuously throw  or drop a toy.

Children with PDD also often have language and social interaction difficulties, so instead of your son being able to say "Knock it off sis" or "Mom, she is bothering me", or being able to understand the social cues of a baby, he acted out toward his sister to stop her actions from bothering him. You may be able to do some role modeling and positive reinforcement with your son at home to work on specific situations which may occur with his little sister...for example, when she is dropping her bottle from the high chair, you keep picking it up and making it a fun game, demonstrating to your son a positive way to interact to this situation and rewarding him for his appropriate play with your daughter. Lastly, you might want to look into sensory issues with your son, if this isn't being addressed, for example an oversensitivity to sounds (the sound of the bottle hitting the floor), could be enough to cause an outburst. An occupational therapist at your son's school should be able to explain sensory therapy. I have also found a link that describes aggression associated with PDD.

 

Therapist Questions & Answers - Special Needs & Medical Diagnoses

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