Expert: Catherine Ridenour - 2/2/2006

Question
my nineteen yr old downs sydrome has i have just been told he has autism he recently started grabbing and hiting kicking me and teachers at school. he is on meds seroquel, lorazepam (ativan). it has helped but the problem is still there.. The dr says group home I say he can be broke of this... Is this a reg. thing with autism or not. and can it be broken and can you tell me how?  

Answer
Hi Marie,

I don't have much experience with the combination of autism and Down's.  I have experience with both of them, separately.

Any behavior can be trained and "untrained".  The trouble is finding a way to avoid rewarding the behavior.  It is not something that can be ignored as one would a tantrum in a 3 year old.  He is too big for this to be safe.  However, finding an effective "negative" consequence may be difficult.  Anything, even punishment, can reinforce a behavior if attention-getting was the goal all along.

It is worth some observation to figure out if there is a specific trigger for this behavior.  Sudden noise, too many people, hunger...?  It could be anything.

Puberty is often delayed in Down's syndrome individuals, I believe.  It may be that his aggression is due to surging hormones he has no understanding of how to handle.

Keeping a structured environment that is safe and predictable for him may help.  People he lashes out at should respond in as low-keyed a way as possible.  He may get a reward out of making people react.

I wish I had a better answer for you, but as with most things like this, only careful analysis and experimentation is likely to succeed.

Best wishes,
Catherine