Behavior is communication when it comes to autism, especially with a non-speaking child like my 7-year-old son Liam. As much as I try to honor this truth in our interactions, however, Liam's behavior often seems confusing, and he's still learning to use the other communication tools (like his iPad picture apps and RPM) that he needs to tell us what he's thinking and feeling.
For example: Recently, he had some violent meltdowns. They lasted upwards of 30 minutes each, they were happening multiple times every day and in the middle of the night, and my husband and I couldn't discern the cause.
It was heart-wrenching to watch Liam go from peaceful to raging in a matter of minutes. He would approach my husband or I, drop to the ground, dig his fingers into the back of our knees, and pull us towards him. His hands would fly to my hair, and he'd pull my face towards his, trying to push my face against his cheeks. When I'd ask him: "What's wrong? How can I help?", he'd scream fiercely, pinching me, trying to bite, and hitting his head with his hands. Frequently, he'd be so full of adrenaline, all my husband and I could do was evade his hands and teeth or hold him close so he didn't hurt himself or someone else.
Desperate for answers and at our wit's end after having tried our many other meltdown-prevention techniques, my husband and I reached out for support. Suspecting anxiety and sensory overload, we talked to Liam's pediatrician about anti-anxiety medicine. We talked to other parents of autistic kids, our friends, our families, and Liam's former therapists for advice or suggestions. My mother-in-law, who worked for years with autistic children, offered practical solutions that she used in her school (wrapping kids in blankets, providing deep pressure). Other friends shared tips on what they did with their neurotypical kids during night terrors or tantrums. Although none of these suggestions really worked, it was good to tell other people what was going on and it helped us brainstorm new ways to help Liam. Finally, during a phone call with my parents, my dad asked the game-changing question: "What about his 7-year-old molars?"
Thunderstruck, I realized that this was what Liam was communicating with his surge of meltdowns. Always a late teether, he was finally getting those painful back molars. When I reflected on it, he had all the other symptoms of teething—fever, irritability, lack of appetite— but I hadn't put them together. By hitting his head, screaming in pain, pressing his cheek against mine, and grabbing the ice cream out of the freezer at mealtime, he had been trying to tell me his mouth hurt.
It was a revelation, and as soon as I got off the phone with my parents, I grabbed Liam's YES/NO board and asked him "Does your mouth hurt?" A look of relief passed over his face, and he hit "YES" several times.
Tears of relief running down my face, I hugged him, gave him some pain reliever, put numbing gel on the inside of his cheeks, and let him have a huge bowl of ice cream at dinner that night. I was thrilled we'd figured out what he was trying to tell us and that he'd no longer be in terrible pain.
Now, one week later, Liam's meltdowns have decreased markedly thanks both to us anticipating his teething pain and helping him alleviate it and also by starting some new medication to help with anxiety. Our house is more peaceful, and Liam is more focused and back to his affectionate, cheerful self.
I know that we'll have more challenging moments in the future, and I know that what works for my son won't work for all other autistic kids, but I think the takeaways here can help us all, no matter what the future holds or who our children are.
So, when you feel overwhelmed by an autistic child's behavior, reach out to the people in your life. Talk to friends, family, professionals, and seek out the writing or opinions of other autistic people. Most likely, you'll find support, suggestions for improving a situation, and perhaps even the answer to what your child is trying to communicate. Also, always remember that behavior is communication for an autistic child. There are reasons behind meltdowns, stimming, scripting, and other seeming quirks. Listening to this behavior can make everyone happier, healthier, and make life easier for us all.