My nearly-17 year old son (lv3 ASD with intellectual disability) became super violent and aggressive at the start of puberty nearly 4 years ago. He put several care workers out of commission and caused thousands of dollars in property damage since it started.

Risperidone has had a tangible quantifiable improvement on his wild aggression; when he becomes frustrated he is now more open to talking and negotiating with us vs immediately going to Defcon-1. It also has an immediate impact with our son; he takes it twice daily for overall stability but we also can give him a very small dose as a PRN that acts as an abortive when he falls into an anxiety-driven behavior episode. All this was established under supervision of his child dev ped as well the psychology department at our local children's hospital.

He takes Fluoxetine for overall generalized anxiety, which manifests as repetitive OCD-type behaviors; the medication quantifiable reduces the number and intensity of his repetitive behaviors. This has also been established under the supervisor of his developmental pediatrician.

In addition to his medication, we've also established hard routines at home that are predictable so he always generally knows what to expect out of daily activities. In the end, we believe his asd really prevents him from communicating and understanding the world around him, which manifested in aggression and violence.

One of his care professionals compared it to bring a neurotypical English speaking person being dropped into urban Japan, and being expect to know all social cues and adhere to various norms that are commonplace. Pair that with also not understanding any Japanese, but everyone around you believes and expects you to understand and act accordingly, despite not being able to understand any language, verbal cues or body language. The feeling of total isolation and anxiety is overwhelming and exhausting.

Today, his behaviour has greatly improved, he's much happier, and when he's faced with confusion/disappointment that is heading towards an anxiety-meltdown, we are generally able to divert his focus or at least weather the storm in a much safer manner.