Violent behavior in autism spectrum disorders: Who's at risk?

Autism spectrum disorders (ASD) are a range of complex neurodevelopmental disorders characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. Over the last decade, there has been increased media attention focused on the relationship between ASD and violent behavior due to a number of school shootings and high-profile criminal cases involving offenders with alleged ASD diagnoses. This coverage and these incidents have given rise to public concern and led to the perception that people with ASD are predisposed to violent behavior. In this manuscript, we provide a comprehensive review of the literature bearing on the relationship between ASD and violent behavior, and in doing so, characterize which people with ASD are most likely to be violent and under what circumstances. We conclude that, on the whole, while research findings are mixed, they lend support to the assertion that ASD does not cause violence, and indicate that when violent behavior occurs in people with ASD, it is the result of third variables including poor parental control, family environment, criminality, bullying, or psychiatric comorbidity (e.g., psychosis), that go undetected or untreated. The conclusions of this review have implications for families, clinicians, and policy makers, as a greater understanding of ASD-related violence risk is needed to combat misconceptions about people with ASD and the stigma associated with these conditions.