impulsive child : teaching patience, wait, later and ask properly concepts

IMPULSIVENESS it may be just begining of ADHD ,OR JUST A TANTRUM OR STUBBORNNESS USUALLY, or a controlling behaviour.

here are some tips Dr Kondekar tried to help with

repeatedly demanding different things, insisting that the parent comply, and then hitting when the demand is refused—is not simply a “therapy problem.” 

I would treat it as a specific learned communication/behaviour pattern that needs a fresh functional assessment rather than simply adding more therapies.

The important question is:

“What does the child obtain by asking repeatedly and hitting?”

In autism, aggression can function as communication. It may obtain an object/activity, adult attention, escape from a demand, or control over what happens next. If hitting reliably produces the desired outcome, the child can learn that “hitting works.”

What I would do at home

Do not try to stop every request. Instead, separate requesting from controlling.

For example:

Child: “Mobile! Mobile! Mobile!”

Parent: “Ask once.”

Then teach one replacement response—spoken words, gesture, picture, AAC, or another reliable communication method:

“Mobile please.”

If the answer is yes, give it after the appropriate request.

If the answer is no, use one consistent response:

“No mobile. Later.”

Then do not enter a prolonged negotiation.

The critical part is what happens after hitting. If the child hits and the parent immediately gives the requested object, changes the rule, or repeatedly argues, the child may learn:

Request → refusal → hitting → parent gives in → success.

You want to gradually establish:

Request → response → waiting/accepting → appropriate outcome.

AAP guidance similarly emphasizes teaching an alternative response and using functional behavioural assessment to determine what maintains the challenging behaviour.

Don't make “no” the main lesson

A common mistake is to create a battle every time the child asks.

Instead, deliberately create many opportunities where appropriate requesting does work.

For example:

“Water?”

Child requests appropriately → water.

“Ball?”

Child requests appropriately → ball.

Then occasionally:

“Tablet?”

“Not now. Later.”

This teaches an important cognitive distinction:

“I can ask, but asking does not mean that I control the other person.”

That is a major developmental target.

When he hits

Keep your response brief and boring.

Protect yourself and other people. Increase physical distance if necessary. Remove dangerous objects and prevent injury. Avoid shouting, lengthy explanations, threats, or physical punishment.

Once he is safe and calmer, prompt the replacement communication:

“Say/point: help.”
“Say/point: later.”
“Say/point: finished.”
“Say/point: I want ___.”

Do not make a long lecture immediately after the aggression. During the episode, the brain is usually not in an optimal learning state.

I would also investigate why this has persisted

Because this has continued for two years despite therapy, I would not simply continue the same program.

Make a 7–14 day ABC record:

Before	Behaviour	What happened immediately afterward?
Parent says no	Screams/hits	Parent gives object
Asked to stop mobile	Hits	Mobile returned
Parent busy talking	Repeated demands	Parent attends to child
Asked to do task	Hits	Task stopped

Look particularly for the consequence.

If the pattern repeatedly shows:

child demands → parent refuses → aggression → parent changes the situation,

then the behaviour may have become an effective strategy for obtaining control.

A formal Functional Behaviour Assessment (FBA) is appropriate when this is persistent or severe. The AAP specifically recommends identifying antecedents and consequences and developing an individualized behaviour plan rather than treating aggression in isolation.

One additional point is particularly important

Before assuming that this is purely behavioural, reassess possible contributors to irritability or aggression—sleep disturbance, pain, constipation/GI problems, seizures, medication effects, anxiety, ADHD/impulsivity, communication difficulty, or other medical problems. AAP recommends considering medical contributors, particularly when behaviour changes or becomes more severe.

Given your emphasis on reassessing stagnant intervention, two years without meaningful change is a strong reason to redesign the intervention rather than simply continue more of the same. Your 100-day reassessment principle is relevant here: measurable functional outcomes should determine whether an intervention is actually changing the child's real-world behaviour.

The goal should therefore not be simply “stop hitting.”

It should be:

INPUT → AWARENESS → COMMUNICATION → REQUEST → WAIT → ACCEPT “YES/NO” → FLEXIBILITY → SELF-CONTROL

In practical terms, I would make “I can ask, but I cannot force another person” one of the child's explicit developmental goals.

Author Prof. Dr Santosh Kondekar MBBS, MD (Pediatrics), DNB (Pediatrics), FAIMER Fellowship in Pediatric Neurology & Epilepsy Postgraduate Diploma in Developmental Neurology Professor of Pediatrics Developmental Neuro Pediatrician TN Medical College & BYL Nair Hospital, Mumbai Director — AAKAAR Clinic Child Development Center Mumbai, India 📞 9869405747 🌐 www.autismdoctor.in for all post links click https://speechandsenses.blogspot.com/p/httpsspeechandsenses.html for autism ADHD speech delay behaviour disorders epilepsy learning disability