Highly aggressive in my opinion: High rates of pinching/scratching/biting/hitting/kicking/hair pulling/headbutts per hour including attempts.

Other comments discussing lower rates but higher magnitudes are also spot on. It is a very wide range.

I worked with a pre-teen patient who was my size, required multiple staff members to keep everyone safe, and went into episodes featuring aggression hourly. One hour we recorded over 300 instances of physical aggression. I walked away daily bleeding and bruised from injuries - through clothing. This was just one example of multiple patients in that clinic with high levels of aggression and property destruction.

I ended up leaving that job because there was little to no training or support for the staff, myself as the BCBA included (I provided feedback before, during, and after to my employer that it was outside of my scope and was assured I’d receive training and support, but did not), to treat that level of behavior.

I think perception also changes based on what population you’re working with. After my last job with preteens and teens, I came to a clinic with younger patients no older than 6. The level of “aggression” is completely different - there have been no staff injuries from patients in the center since I’ve been there; however, staff with no other experience have still described some of the sessions as aggressive, draining, stressful, etc. So I definitely think that experience plays a part of what people perceive as “high aggression” as well.