Hitting, Biting and Aggression in Young Autistic Children: What ABA Does

When a young child hits, bites, kicks, scratches or pulls hair, it is frightening and exhausting, especially when it is aimed at a baby sibling, a grandparent or you. It can also feel lonely, because few parents talk about it. Aggression is common in young autistic children, and it is almost always a form of communication: your child is trying to tell you something and does not yet have a safer way to do it. This guide explains why aggression happens, what to do in the moment, and how ABA works on it.

Why do autistic children hit or bite?

Behavior analysts ask what a behavior does for the child, not just what it looks like. Classic functional analysis research by Brian Iwata and colleagues showed that the same behavior can serve very different purposes in different children, and that the purpose points to the right treatment. Aggression usually serves one or more of these functions:

• Escape: getting out of something hard, boring, loud or uncomfortable. A child who bites when asked to brush teeth may be saying "stop."
• Access: getting something they want, such as a toy, food, a device or a favorite activity.
• Attention: getting a reaction from an adult or sibling. Even a scolding is attention.
• Sensory or automatic: the behavior itself feels good or relieves a feeling, for example biting to get strong input on the jaw.

Other factors make aggression more likely: limited ways to communicate, sensory overload, changes in routine, poor sleep, hunger and pain. The American Academy of Pediatrics' clinical report on autism says primary care providers should know the co-occurring conditions, such as sleep and feeding problems, gastrointestinal symptoms, anxiety and seizures, that affect a child's function and quality of life. A toddler with a painful ear or constipation cannot always tell you; they may show it by hitting.

What should I do the moment my child hits or bites?

In the moment, your only job is safety. Teaching comes later.

1. Protect the person being hurt. Calmly move the sibling or yourself out of reach. Turn your body sideways, keep your face and hair away, and step back.
2. Stay calm and quiet. Use a flat, low voice and few words: "Hands are for safe touching." A big reaction can make hitting more likely if attention is part of what drives it.
3. Remove hazards. Clear away things that can be thrown or used to hurt.
4. Do not restrain or hit back. Holding a child down or physically punishing them can injure them and you, increases fear, and does not teach a better skill. Hope Center uses no restraint.
5. Redirect when your child is calmer. Offer the communication you want them to use: "Say 'stop'" or "Show me 'break.'"
6. If anyone cannot be kept safe, call 911. Tell the dispatcher your child is autistic and what is happening.

If aggression happens often at home, take a few minutes to write a simple plan with your partner and older children. Our guide to a home safety plan for aggression walks you through it step by step.

What should I avoid?

• Giving in right after the hit. If hitting gets the iPad back or ends the bath, your child learns that hitting works. If you plan to say yes, try to say it before the behavior, or after your child has asked in a safer way.
• Long explanations in the moment. Your child cannot take them in when upset. Talk later, briefly, and practice.
• Biting back or "showing them how it feels." It teaches that hurting is acceptable when you are upset.
• Removing every demand forever. Avoiding all hard tasks can keep the peace short term but leaves your child without the skills they need. A behavior analyst can help you lower demands for now and rebuild them gradually.

How does an ABA assessment figure out the cause?

The core tool is a functional behavior assessment (FBA). A BCBA interviews you, watches your child in real settings and collects data on what happens right before and right after each episode. This is often called ABC data: antecedent, behavior, consequence. You can help by keeping a simple log:

In this made-up example, a BCBA would notice that aggression got the tablet back, got a lot of adult attention, and ended a loud bath. Each points to a different part of the plan.

What does an ABA plan for aggression include?

Once the function is clear, the BCBA writes a behavior intervention plan. A good plan usually has three parts:

• Prevention: changing what comes before. Examples are warnings before transitions, a visual timer, quieter bath time, a snack before homework, or giving a sibling a separate space for prized toys.
• Teaching a replacement: giving your child a safer way to get the same result. If aggression gets a break, your child learns to ask for a break with a word, sign, picture card or device. If it gets attention, they learn to tap your arm or say "play with me." This is often called functional communication training, and the new skill has to work faster and more reliably than hitting did.
• Changing what follows: making sure aggression no longer pays off while the new skill is rewarded right away. This is done kindly and consistently, never with pain, fear or restraint.

The plan also includes how data will be collected and how progress is reviewed, and it should be written so that parents, siblings, grandparents and teachers can follow it. That is why parent training matters as much as therapy sessions.

When should I call for help?

Ask for professional support when:

• aggression happens daily, or is getting more frequent or more intense;
• someone has been injured, including bites that break the skin;
• siblings are afraid at home, or a daycare or school is talking about sending your child home;
• the behavior began suddenly or changed suddenly. Call your child's doctor first, so pain or illness can be checked.

If your child also hurts themselves, read our guide on head-banging and self-injury.

How Hope Center can help

At Hope Center for Behavior Change, a BCBA assesses your child, writes a plan, and has it reviewed by our clinical director before it goes to insurance. RBTs deliver sessions under weekly BCBA supervision, and you get weekly parent training so the plan works at home. Our approach is trauma-informed and assent-based, uses the least intrusive and safest strategies such as brief response interruption and redirection, and never uses restraint. If a child in our care cannot be kept safe, families call 911 and then report to the behavior analyst, who returns the call within 24 hours.

We work with families in West Palm Beach, Temple Terrace (Tampa), Port Charlotte, Jacksonville and Sebring, and in homes, schools and daycares in other areas we serve. Request a free consultation or call 561-337-8865. We have no waitlist and offer a free benefits check.