Expert: Melanie R Jones, PT MTC - 12/6/2011

Question
Hi, I have a 4 year old autistic son who in non-verbal. He was diagnosed in 2009 with autism/lead poisoning. One of the youngest ever in our state that still has mobility. He has progressed into an aggressive development stage of his life; headbutting, and high pitched screaming dang near to the point of ear bleeding. We took him to his specialist and was told it may be time to put him on antipsychotic medication.His doctor tells me that it is because he is "afraid", just because of what little he saw of his behavior in the doctor office.(Due to the fact that since diagnosis he has had multiple blood draws and has a definite fear of doctor offices already.) I did not agree and asked for a second opinion, because I believe what causes these outbursts is frustration with not being able to express himself in a way others can understand. He is in great physical shape, and acts as if he has no fear. (Except for the sounds of a vaccum, blender, and hair clippers, scares the crap out of him.) He attends sessions at the Achieve Center to help with his ability to express himself. His last appiontment we tried out a touchscreen device that aids in the ability to communicate and he did great. He made his own choices of what he wanted to do and was so excited after pushing the picture and then playing on the picture of the toy he chose. Now I have heard many stories and rumors of the use of medical marijuana on autitic individuals to help them cope with symptoms without zombifying them with neuralogical manmade medications.  I would love to hear your opinions on this subject, I hope I have given enough info. to paint a small picture of our life for now. Thanks for taking the time to help.   I could use all the help we can get.

Answer
Hello Anthony,

    It sounds as though you're going through a very traumatic time.  Acquired autism is often less pervasive than congenital autism, and may also have features that are NOT like an autistic who has inherited the condition such as I and my children have.  Please remember that and take anything I say with a "grain of salt", so to speak.  I hope I can help nonetheless.


"He has progressed into an aggressive development stage of his life; head-butting, and high pitched screaming dang near to the point of ear bleeding."  

Try to define "triggers" which bring on these behaviors.  Keep in mind that it may be something that you would not normally notice.  For example, sunlight on a specific spot of a carpet, several people talking at once, certain fabrics or clothing styles, certain colors or foods, certain times of day or degrees of fatigue. As an example, some autistics are so sensitive to auditory noise that even the noise generated by some electrical appliances (even unheard by others) can be painful to them.  If there is a specific trigger you can locate, the solution is to minimize or limit the occurrence of triggering influences.

Most of the aggressive behaviors are triggered by some combination of fatigue, pain, frustration and overstimulation.  Some of these behaviors "flood" the senses of the autistic in such a way as to soothe him or her.  This can be compared to the use of "white noise" or rubbing a bumped spot, or even putting a bleeding finger to the mouth and biting it gently that neurotypical people often do.  With autistics, though, the sensory information is different than with neurotypicals, so it may not be as clear a comparison as these examples.  

Frustration is a huge problem either from a sensory overload, or attempts to communicate, or even inconsistencies the autistic picks up in the behavior of others.  An autistic does not have the inborn "social interpreter" that others have, and will often see others as quite arbitrary or inconsistent in their behavior.  They also are more likely than others (especially because of the communication issues) to feel rejected and criticized by others.

Occasionally there is another psychological reason, such as trying to hurt himself before someone else does (and thus make it no longer "necessary" for the other to hurt him) which becomes more likely as the autistic becomes older and more used to poor treatment by others, or as an attempt to gain attention of others for some reason.  Despite what the general opinion may be, the latter is less common in autistics than in the general population.  This is because autistics are so often confused or rejected by others as well as subject to gawking or ridicule that they tend to prefer the attention not always be focused upon them.
  
"His doctor tells me that it is because he is "afraid", just because of what little he saw of his behavior in the doctor office. (Due to the fact that since diagnosis he has had multiple blood draws and has a definite fear of doctor offices already.)"

Poor thing.  Doctors don't have a lot of reliable information about the "whys" of autistic behavior, largely because most of the information is written by non-autistics and observers. But many people expect them to know, so some will often try to say something (even clueless or superficial like that).

I did not agree and asked for a second opinion, because I believe what causes these outbursts is frustration with not being able to express himself in a way others can understand.

You are probably right.  Frustration or pain are the primary causes.  Confusion and chaos are others. By studying your child you will become the expert.

He is in great physical shape, and acts as if he has no fear. (Except for the sounds of a vaccum, blender, and hair clippers, scares the crap out of him.)  

Sometimes you can minimize his reaction to sounds such as these by allowing him to either play with the tools in a calm and supportive setting when he is well rested and aware of what is happening (supervised, of course) or giving him sufficient warning that the sound is about to occur EVERY time you plan to use them.

Now I have heard many stories and rumors of the use of medical marijuana on autitic individuals to help them cope with symptoms without zombifying them with neurological man-made medications.

I recommend against the use of marijuana for several reasons.  First, because it is not a generalizable coping method, has very long-term side effects, and doesn't actually address the specific difficulties an autistic experiences.  Second, the marijuana leaf has hundreds of biologically active compounds, any one of which could be problematic for your child.  Even if you have medically prepared THC which has been isolated out (which defeats the purpose of your argument) it tends to be stored in the fat cells throughout the body and is difficult to eliminate completely.  Third, you said your child has lead poisoning, which adds a consideration not well studied in combination with the effects of marijuana.  And Fourth, your child will have enough to deal with in his life without having to deal with various stereotypes which the use of marijuana can stimulate in others.