We've worked for years to reduce my son's aggression and we've had fair success. He has a complex behavior around this behavior. Generally the reasons for aggression vary and its hard to give a generic answer on how to resolve this problem because the reason is different.

Basically you need to identify all the triggers that set him off. You've identified two. Denied requests and frustration. We've worked on both of those. I just posted the program for working on frustration tolerance about 3 questions up from yours. If you want to know specifically on how to do it for a certain trigger, let me know.

As far as denied requests, change those into "delayed requests". So let's say he wants a donut. Instead of saying no, you would say "not now, you can have one in 5 minutes if you stay calm". Don't give him the donut if he does not stay calm. Then over time, you increase the wait time. When he's handling longer times, then you can start saying No.... but reinforce him with something else.

Now of course theres some things that you can't do this for. Say he asks to go to school and its Saturday. Instead of saying now, you go get a calendar and explain it and mark the day when he next goes to school. Say he wants to start a fire on the dining room table, again try to explain it. Keep your language short as possible.

Now if your child has no language or limited language, then it gets more complicated. You need to build more visual supports to help him understand. If you can identify some examples then we can address each of those in a systematic way.

I understand the lack of providers. We also few skilled providers in our area and my son was not learning when we were using one of them.

Here's what I did. I hired a consultant outside of the state to come in and train the in-home supports and respite workers that I had from the Medicaid waiver. Now I had to go into debt a bit to pay for the consultant. But eventually I was able to apply for grants and other things to help pay for it. In some states, insurance will pay for the consultant. You have to research your funding options and think outside the box. Maybe you have already did this. But I wanted to mention this things in case you haven't.

Another option is to find an RDI consultant to work with you and your family. Generally this is much cheaper and it helps give you skills to interact and make connections with your child.

I'm going to suggest a few unorthodox things that can't hurt but I'd love to know if you try them and if they help.

1. Remove food coloring from his diet, especially Red 40 which can have a steroidal effect on children (unofficially). My son gets PUMPED UP on Red 40, no BS. Totally strike it from your food supply for a couple weeks and see if it doesn't help a teeny bit (if you haven't already.)

2. I see commercials for "The Total Transformation System" and it's free to try for 30 days or money back. I'm ordering it also... maybe you should try too?

3. Next- Anger, Frustration etc... all "Fight" response part of the sympathetic nervous system (fear: fight/flight) usually stemming from disappointment (in himself, you, etc.) and lack of control and defensive outlook. Learn to modify YOUR reactions to be "de-escalating" so lean back, palms open and facing him, be calm, speak steady, etc. be WARM and OPEN. Hug therapy. For my son, sometimes he's "out of control" I sort of TAI-CHI his movements to keep him from hurting himself/others/stuff and in the process talk and love and love and love and hug and squeeze gently, and stuff until he sort of just flops over exhausted. Once relaxed I give him marbles and explain.Its not often a tantrum as you say yours are but follow me here. THE OPPOSITE OF FEAR IS LOVE. The OPPOSITE of SYMPATHETIC is PARASYMPATHETIC. You want to trigger oxytocin in his body with gentle non-offensive touch (like hugs) calming environment, non-threatening, etc. Trigger the parasympathetic. My son and I are at a point where if I see him start to get worked up, I hand the marble and he sits down quietly.

If NOT VALIDATING is making it worse, then try VALIDATING. I mean, wouldn't YOU want someone in your life that VALIDATES your feeling upset? You don't want anyone dismissing your feelings or saying they're wrong. (I know you're just following the experts). Try being ON HIS TEAM not his enemy, even when he's seemingly wrong. If he starts to outburst, try grabbing a pillow and saying "You must be so angry! Me too! Let's pillow fight!" And it can eventually turn into hugs and giggles (maybe) This also works for my son. When he raises his hand I grab a stuffed animal and by the end we're a giggly mess... and I tell him no need to be angry mommy take care of him.

Shots in the dark.

I use a calendar to teach my son the passing of days and to show him when things are happening.

Lots of people assume that every negative behavior is "for attention". I disagree. Most of my son's aggressive behavior is frustration.

The behavior plan is different for frustration than it is for attention. If the specialists recommended withholding attention without evaluating what was the cause of the behavior, then they are not very good. And in that case, you should look for a new specialist that has experience with kids on the spectrum. Preferably experience with ABA and behavioral treatment.

My son has a very innocent charachter but still gets frustrated really badly, especially since he cut his eye. I often ask questions in WE format. "Are we bored? Is Joey bored?" Or "Are we tired?" And I'll go through a dozen things before he gestures or says yes to something. When my son gets frustrated it's often because he can't say or do something. I try not to deny him things unless I have to. And when I deny, if I have a chance to say YES in another way instead of no, it helps. Like instead of NO, you can't play trains. It will be Yes, (in a nice excited voice of enthusiasm) you can play trains after dinner, ok? Or Yes, you can have that toy but we have to wait until your bday. Or Yes, you can go out but tomorrow, after school, because today "WE" have to ____... key words are WE and things that make us seem like a UNIT or the SAME. When he didn't like his eyepatch, I wore one too and made it no big deal. Same with glasses. Or with waiting, pointing out all the people waiting for a week (on the bus, in lines, etc... making waiting look not out of the ordinary.) Helping the child realize verbally or by showing that his impulses are unusual but accepted, helps them to not feel bad about them but still try to restrain them somewhat (I've found.) I've also found it helps to say it's not fair. Like, "hey buddy sit down, look at everyone sitting, it's not fair to everyone if you stand up, we want everyone fair to you we have to be fair to them." And also maybe look for a preferred method of calming. For my son, it's marbles.