Jace was 18 months old when his pediatrician first diagnosed him with autism spectrum disorder. His parents had immediately enrolled him in applied behavioral analysis therapy, the gold standard for autism therapy, and Jace had done very well. He was now in the second grade with a robust individual education plan in place. For the past few months before we met, Jace had been struggling with increasingly aggressive behaviors towards his younger brother, mother and father and even towards his aid in school. His aggressions were usually hitting, biting or kicking and more than once his father had feared he would kick the car window out while they were driving in the car. Sometimes Jace seemed upset when he became aggressive but other times, he was smiling and laughing and the aggressions seemed very unexpected. His parents were understandably distressed about this new behavior and were particularly worried he would seriously hurt a classmate or his brother.

Aggressive behaviors are common in children with autism spectrum disorders, especially as hormones begin to change. Often times these behaviors are difficult to control with behavior modification strategies alone and this is when medication to help with impulse control and emotional regulation can be very beneficial. In Jace’s case, we started him on a small dose of a medication to decrease his impulsivity and within weeks, his aggressions had significantly reduced in both frequency and intensity. His behavioral therapist told his parents that Jace was “back on track in therapy” and his school aid reported a significant improvement in his attention at school.