Abstract  

 
Children with autism spectrum disorder (ASD) present with a variety of concerns prior to
diagnosis, including delayed or limited communication and language skills, repetitive behaviors,
and lack of eye contact. One common symptom that is observed in children with ASD, but has
been under-researched, is challenging behavior (e.g., tantrums, aggression). The purpose of this
study was to gather information on the extent to which early challenging behavior is a feature of
autism. Specifically, we conducted a scoping review to explore the causes of challenging
behavior and if those causes differ between autistic children and neurotypical children. We also
investigated whether the severity of children’s challenging behavior is related to the severity of
their ASD symptoms. PsycInfo and PubMed were used to locate studies that identified risk
factors and characteristics of early challenging behavior in autism. Nineteen studies published
between 2005-2019, fit study criteria. Participants' ages ranged from 1-18 years old. However,
the primary focus of this review was on toddlerhood and early childhood. A few of the studies
(31.5%) investigated why autistic children have challenging behaviors, while the majority of the
studies (68.5%) explored tantrum intensity and how it may relate to clinical conditions, such as
ASD. Most tantrums were thought to occur due to language and communication deficits, or an
unknown reason. Although more research is needed, there was a higher occurrence of
challenging behavior in older children than younger children. Children with co-occurring
diagnoses, usually ADHD, had higher rates of challenging behaviors than children with ASD
alone. While there is a lack of empirical research on this topic, existing research suggests that
challenging behavior and tantrums are related to autism. Future research is necessary to
understand challenging behavior in early toddlerhood and how it relates to ASD.