Intermittent Explosive Disorder (IED) is one of those diagnoses that can really make you feel like you’re a bad parent…but you’re not!
It’s a pretty common diagnosis for autistic kids, and one that isn’t always understood very well. It’s frequently diagnosed alongside Oppositional Defiant Disorder, or ODD. In fact, I don’t think I’ve ever seen a kiddo diagnosed with IED that didn’t also have an ODD diagnosis.
Either way, this is a challenging diagnosis for caregivers to manage, and can often leave everyone in the family struggling to deal with the chaos and upheaval of big emotions and even bigger meltdowns.
So let’s explore strategies and support ideas to help you navigate the challenges and bring calm to the stormy moments.
Understanding Intermittent Explosive Disorder (IED) in Autism
Intermittent Explosive Disorder is a condition characterized by recurrent, explosive outbursts of anger, aggression, and impulsive behavior. When IED occurs in the context of autism, it can present unique challenges due to overlapping symptoms and sensitivities.
These episodes can seem more severe and more challenging to deal with than “typical” autism-related meltdowns, and often leave both the caregiver and the autistic child exhausted, frustrated, and upset.
Is it Really IED, or is it Something Else?!
In a world where everything mental health related has to be categorized, codified, and organized so it can be diagnosed, IED is one of those diagnoses that comes about more as a label for what a diagnostician sees rather than an underlying or more pervasive condition.
While there are certain outward behaviors that qualify a child for an intermittent explosive disorder diagnosis, we still don’t know what the cause of it is.
That means, there may be many reasons for the outwardly observable behavior, and many paths to finding relief from the explosive episodes. It may be in your interest as a parent of a child with this diagnosis to dig a bit deeper to see what may be going on behind the scenes with your child.
Conditions such as PDA, or Pathological Demand Avoidance can spark a serious fight or flight response in your autistic child about seemingly trivial events. It’s an anxiety-based disorder that doesn’t respond well to most typical parenting advice. Adapting your parenting style to one which supports a PDA kiddo will most likely alleviate many, if not all, of the challenges associated with IED.
Also, explore how your child is feeling physically. Make sure they’ve seen a dentist and aren’t having any issues with their teeth. Look into possible testing for food allergies or consider doing a short-term elimination diet to see if things improve (under a doctor’s supervision).
Autistic kids frequently have mild to severe food intolerances that significantly impact their gut health and digestive system…no one feels good with an upset tummy! And it’s hard for a lot of autistic kids to understand the sensations coming from inside their body, a skill known as interoception, so they may not be able to tell you if or where they hurt.
Another possible reason behind IED is PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. It can cause a sudden onset of serious mental health issues in children. If your child had a strep infection prior to the sudden onset of IED symptoms, you should speak to your pediatrician about your concerns and ask for testing to rule out PANDAS.
Now that we know about a few things that may present as IED, let's talk about how you cope with the symptoms your child experiences…
Recognizing Triggers and Warning Signs
One of the first steps in managing IED in autistic children is to identify triggers and warning signs. These may vary from individual to individual, but common triggers can include:
- Sensory overload
- Changes in routine
- Difficulties with communication
By observing patterns and understanding these triggers, you can implement proactive strategies to minimize potential outbursts.
Create a Calm and Predictable Environment
Consistency and predictability are key for autistic children with IED. Create a calm and structured environment to help reduce anxiety and provide a sense of security. Establish visual schedules, clear expectations, and incorporate calming activities.
Following these steps can contribute to a more stable and peaceful atmosphere at home (and in other settings).
Teach Coping Mechanisms and Emotional Regulation
Equipping children with effective coping mechanisms and emotional regulation skills is crucial for managing IED.
This can include teaching deep breathing exercises, providing sensory tools for self-soothing, or introducing calming techniques like yoga or mindfulness. Play therapy has been the most effective strategy we’ve found for managing IED at our house, but the following resources may help your family as well…
Finding activities that resonate with the child's interests and strengths can make the learning process more engaging and enjoyable…and more likely to get done!
Communication and Social Skills Training
Enhancing communication and social skills can have a significant impact on reducing frustration and preventing explosive episodes. Utilize visual supports, social stories, and role-playing scenarios to help children better express their needs and understand social cues.
Building strong communication skills fosters healthier relationships and provides alternatives to aggression or outbursts. This is something a play therapist or a speech therapist can help you establish.
Build a Supportive Network
Remember, you don't have to, and shouldn’t, face these challenges alone! Building a supportive network of professionals, therapists, and other families facing similar situations can provide invaluable guidance, empathy, and understanding.
Support groups, online communities, and local organizations can offer a safe space to share experiences, exchange advice, and find solace in knowing you are not alone on your difficult parenting journey.
Also, if you haven’t heard of it before, the book, The Explosive Child by Dr. Ross Greene was a game changer for our family! His Collaborative Problem Solving approach can be a great tool to help you better understand your child and reduce their explosive outbursts.
Practice Parental Self-Care
If you’re parenting a child with IED and autism, I know how hard it can be.
I don’t want to add something else to your already overflowing plate, so please consider this a gentle reminder that taking care of your child also means taking care of you.
Try your best to get some time away from the responsibilities of caregiving, and seek easy ways you can add a few minutes of self-care into your day. Even just 5 or 10 minutes a day can have a serious impact on your outlook and the way you can handle, and bounce back from, your child’s more difficult meltdowns.
I created a guided meditation specifically for parental recovery after a meltdown, listen to it here. It’s quick, impactful, and will help you release your own built-up stress energy after you’ve helped your child get through an explosive episode.
But the most helpful thing I’ve done for myself as the parent of an autistic kiddo with IED is practice gratitude. It sounds hokey, I know, but following these steps has had a tremendous impact on how I see my kids, how we interact, and how well we’re all doing… I hope it will do the same for you and your family!
Conclusion
Managing Intermittent Explosive Disorder in autistic children requires patience, understanding, and a tailored approach.
By recognizing triggers, creating a calm environment, teaching coping mechanisms, and building a support network, we can navigate the storm and create a more harmonious and fulfilling life for ourselves and our children.
Each child is unique, especially when it comes to those diagnosed with Intermittent Explosive Disorder and Autism.
What works for one may not work for another. Experiment to see what helps your child, and don’t forget about the self-care you need along the way.
Disclaimer: This article provides general information and support. It's essential to consult with qualified healthcare professionals for personalized advice and guidance. This article is not medical advice, and should not be treated as such.
This article is part of our series on Autism and Co-Occurring Conditions…check back on August 2, 2023, to view the complete collection.
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