9 - “Aggression” in young children on the autistic spectrum: the dysregulation–“aggression” hypothesis

Abstract

The central thesis of this paper is that aggression in young children on the autistic spectrum is in many cases not truly aggression because the behavior is without the intent to inflict harm, so central to the standard-definition, but rather misattributed and better explained as arising from dysregulation in multiple systems thus the dysregulation “aggression” hypothesis. The sources of dysregulation are proposed to be found in a complex interweaving of sensory-movement processing problems; flawed neuroception predicated on faulty appraisal of threat and the mobilization of fight/flight/freeze defenses, disturbed regulation of arousal and subsequent states of high anxiety. The hypothesis that dysregulation in multiple systems may be a robust source of aggressive-like behavior in young children on the spectrum, is not a big leap given what is known about sensory processing differences and the incidence of dysregulated states in young children on the spectrum. Atypical patterns of sensory processing are among the most pervasive of symptoms of the disorder, impacting up to 87% of individuals with autism spectrum disorder. An intervention paradigm derived from the dysregulation- “aggression” hypothesis that integrates sensory-movement and arousal regulation, the enabling of the social engagement system and the management of anxiety implemented in a relational context is proposed and discussed.