1. Self-control techniques have been used in the treatment of both aggressive and anxious adults on the spectrum, and given the difficulty that some have controlling these emotions, it may be advisable to make this deficit a key target of interventions for these individuals.
These individuals develop better self-control over their emotions by learning to recognize the physical signs of anxiety or anger (e.g., heart pounding, muscle tension, etc.), by practicing positive self-talk (e.g., “I’m upset right now, but I need to stop and think before I open my mouth”), and the utilization of relaxation techniques (e.g., muscle relaxation, deep breathing, etc.) to reduce emotional arousal and delay an immediate response to a stressful situation. This will permit careful reflection (e.g., problem solving, cognitive restructuring, etc.) prior to taking action.
2. Problem-solving skills are common to cognitive-behavioral treatment targeting behavioral or emotional problems. Adults with ASD are helped to think of several possible solutions to a given problem, and to reflect on the positive and negative consequences of each in order to choose the strategy that will maximize positive consequences in both the short and long term. These individuals who get frustrated easily rely too heavily on aggressive solutions, whereas depressed adults often default to avoiding their difficulties.
Problem-solving skills can be used in either case to broaden the repertoire of constructive coping strategies and enhance decision-making. Decreasing depression and anxiety related to low-frustration tolerance would be beneficial in itself for the adult with ASD, but it may have the added benefit of reducing negative moods that render the individual vulnerable to engaging in explosive, emotional and reactive aggression.
3. Reframing techniques have been used to deal with aggression, anxiety, and depression. The central feature of reframing is to identify thoughts that increase anger, anxiety or sadness, challenge their accuracy, and replace them with interpretations that are more realistic and less harmful.
To reinforce this perspective, the adult might use some encouraging self-talk (e.g., “It’s alright to make mistakes from time to time …that’s how I learn to avoid making the same mistakes in the future”). Applied to address emotional difficulties, reframing techniques are often used to emphasize that there is more than one way to explain the actions of other people.
Autistic adults who are easily frustrated over things both big and small face a complicated array of social and emotional challenges, and it is imperative that they recognize the full extent of their difficulties and tailor interventions to match their complex needs. More research is urgently needed to create and evaluate treatment strategies that integrate cognitive-behavioral strategies for the therapeutic intervention of both behavioral and emotional problems.
In the meantime, therapists who work with these adults may broaden the focus of existing clinic-based interventions by flexibly applying techniques such as cognitive restructuring, problem-solving skills training and self-control skills, along the lines described above.
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