How can we help autistic nephew when our visits stress him out?

Q: My nephew is almost 8 and has autism. He is very bright, has a great sense of humor and can get really involved in things he’s interested in. However, he is not good with change and lives pretty far away, so when my family visits with him, we are always resetting the clock. The first few days of the visit are rough. He will bite, hit or pinch whoever is nearby if he is not getting what he wants or if someone is not paying attention to him. After a few days, the attacks end as he becomes more comfortable with us.

Do you have any suggestions for how to handle these behaviors? My children want to avoid these visits (we don’t stay over, just in the area), and I can hardly blame them, because the older he gets, the more his physical attacks hurt. He is really a great kid, and we enjoy him, but we don’t like those first few days. We have tried ending the visit as soon as it happens, sharply saying no and ignoring his behavior, but only giving it time seems to work.

A: Thanks for writing; this is an interesting challenge. At the risk of sounding callous, I don’t think this problem has a lot to do with your nephew having autism. Is it a major consideration? Of course! Any person who struggles with accepting change and regulating emotions should be supported and worked with, but there is a glaring omission in your letter: his parents or caretakers.

Reading the letter at face value, you would think your young nephew lives on his own. He obviously doesn’t, so we need to start there. I want to clarify that, to solve this problem, we must recognize that autism is not the focus here; the violence is the focus. Ignoring the violence, not creating boundaries around it and shrugging it off as a result of autism is not only unfair to your own family but is also quite hurtful to your nephew.

You have taken many precautions, but, unfortunately, many of your solutions are geared toward a neurotypical 8-year-old. Staying somewhere else? Check. Ending the visit when the violence begins? Check. Sharply saying no and ignoring his behavior? Check and check. These techniques haven’t worked, because they aren’t solving the correct challenge.

Trying to trigger his alarm (sharply saying no) will not override his circuitry; trying to extinguish his behavior (ignoring him) will not have an effect; and trying to shame or teach him a lesson (leaving after the first hit) will not work. So, is your nephew’s autism the problem? No. The problem is the violence caused by dysregulation. I don’t blame you for trying these solutions; they are common disciplinary techniques for neurotypical children, and they often work. But you are using the wrong tool for the project, so no matter how good the tool is, it isn’t going to work.

To be sure, you cannot allow your children to be physically hurt, regardless of whether someone has autism. There are only a couple of boundaries that must be held, and physical safety is one of them. It is a disservice to everyone to allow your nephew to hurt people, so start there. Call a meeting with your in-laws or siblings, and let them know that this violence must be addressed for both of your families. It is unfair to continue to subject your nephew to situations that make him feel unsafe and dysregulated, so what else can be done? Typical triggers for many autistic children are sensory, so can your nephew wear headphones the first couple of days he is with you? Can he be in the house, but in another room (if he chooses)? Can you eliminate loud noises, strange smells or new objects? Is there access to exercise, a trampoline, a swing or another form of movement that could calm your nephew?

Another typical trigger for autistic children is a break in routine, so how can your nephew keep his routine while your family is around? This could involve play, technology, items, places, you name it. In either case, your nephew isn’t suffering from shyness, and he isn’t slow to warm up; his nervous system feels as if he’s under attack.

Unfortunately, this work is ultimately the domain of his parents, not you.

Though it may be a sensitive topic, please talk to his parents so your families can stay connected and your nephew won’t be ostracized. Prevention is the answer here. When it comes to helping you and your family understand your nephew more, I recommend the Thinking Person’s Guide to Autism website (thinkingautismguide.com/p/ resources.html). Good luck.