When Supporting Autistic Students Gets Physical: What Your Injuries Are Really Telling You About the System
You've been there. Maybe it was a scratch that left a mark, a bite that broke skin, or a shove that knocked you off balance. Or maybe, like me, it was a concussion that forced you to finally stop and ask:
Why does supporting autistic students sometimes feel dangerous?
But whose fault is it when we get hurt? If you've ever gone home with a bruise, written yet another incident report, or felt your stomach drop when you saw a certain student's name on your schedule, this post is for you. Because we need to talk about the injuries we sustain in this work, not to place blame on the children we serve, but to shine a light on the systems that are failing all of us. Let's be clear from the start, when a child injures us, it's not a reflection of their character it's a reflection of dysregulation, unmet needs, and a system that was never designed to support regulation in the first place.
The Incident No One Talks About (But We've All Experienced)
I'll never forget the day I got a concussion at work. I had been feeling burnt out for months. The school I worked in was understaffed, under-resourced, and running on a culture of compliance over connection. The administration didn't know how to support us, and we were all running ourselves into the ground.
That day, I walked into a classroom to see a student for speech therapy. He was behind a divider, a physical barrier the staff used to "keep everyone safe" when a child was dysregulated. My stomach dropped. I knew immediately this wasn't going to go well.
But I'm the kind of person who walks toward the fire, not away from it. So I removed the divider, tried to offer a calm presence, and within minutes, I was on the floor with a head injury.
The response from the crisis team? "You called us for him? This little guy?" As if the size of the child negated the severity of the moment. As if I had somehow overreacted. That was the day I realized that I wasn't going to be protected here and neither were the kids.
Why We Need to Stop Blaming Children for Our Injuries
When a child injures someone, it is not a reflection of their character. It's a reflection of dysregulation. It's a reflection of sensory overload, fight-or-flight activation, unmet needs, trauma, fear, and systems that push children past their capacity every single day. When we as professionals get injured, it's not because we failed to control the situation. It's because the situation was never designed to support regulation in the first place.
Think about it. How many of these factors were present the last time you or a colleague got hurt?
- The child had been isolated or put in time-out
- Demands were placed without checking for regulation first
- The environment was loud, bright, or sensorily overwhelming
- The child's communication attempts were ignored or dismissed
- Staff were burnt out, under-supported, and stretched too thin
When we start connecting the dots, a pattern emerges. It's not about the child. It's about the system.
The Problem With "Safety Trainings" That Only Teach Restraint
Most of us have sat through trainings like Safety Care or CPI. While they teach some useful de-escalation skills, let's be honest, they're designed to respond to crisis, not prevent it. These trainings mainly focus on how to block, restrain, and document. They don't teach us how to read the micro-cues of stress in a child's body language, how to regulate our own nervous systems in the moment, or how to advocate for environments that make these moments less likely in the first place.
When these systems fail to prevent harm, the blame still falls on individuals. The teacher didn't intervene fast enough. The therapist didn't use the right strategy. The parent didn't follow through. But why are we working in systems where both kids and adults are being pushed past their capacity every single day?
What "Getting Injured at Work" Really Means: A Call for Trauma-Informed, Neuroaffirming Systems
Let's reframe this. Every injury I've sustained at work could have been prevented. I don't say that with guilt or shame, I say it with clarity. Those moments weren't just "a child being aggressive." They were a child who had been systematically dismissed, pushed beyond their window of tolerance, backed into a corner (literally and metaphorically), and operating in fight-or-flight mode with no access to co-regulation.
This is what happens when we operate in reactive systems instead of proactive ones.
What Needs to Change: Moving from Reactive to Proactive Support
If we want to create environments where both children and staff are safe, we need to shift from asking "What do we do when a child is aggressive?" to asking "What can we do to prevent dysregulation from escalating to this point?".
Here's what that looks like in practice:
1. Prioritize Co-Regulation Over Control
When a child is dysregulated, they're not thinking logically. They're in survival mode. Trying to control them with demands or consequences will only escalate the situation. Instead, offer a calm, grounded presence, lower your voice, remove demands, and offer sensory support by dimming lights, reducing noise, or offering movement.
2. Read the Signs of Dysregulation Early
Most meltdowns don't come out of nowhere. There are always signs such as changes in body language, tone, eye contact, breathing, or engagement. Ask yourself, was the child regulated before this interaction? What happened earlier today that might have been stressful? Are there sensory or relational factors at play?
3. Create Sensory-Informed Environments
Dysregulation often stems from sensory overload. Consider things like the lighting, is it fluorescent and harsh? Consider noise levels, is the environment consistently loud? Also think about the Demands we’re placing. Are we asking too much without offering breaks? It’s also important to consider access to movement and sensory tools.
4. Advocate for Staffing Ratios and Support
You cannot pour from an empty cup. You cannot co-regulate a child when you're dysregulated yourself. Push for adequate staffing and time for breaks and self-care. Reflective supervision and emotional processing after hard moments is key, as well as trauma-informed training for all staff.
5. Hold Debriefs That Actually Matter
Post-incident meetings should not just be about filling out forms. They should be spaces for reflection. Meetings should be a time to actually talk and reflect on what was happening in the environment. They should be a time to talk about how the child was feeling leading up to this, what supports would have helped staff feel safer or more regulated, what patterns we’re seeing, and what we can learn moving forward.
Why This Matters for Speech Therapy Goals and Neuroaffirming IEPs
If you're a speech therapist or educator working with autistic students, you know that communication doesn't happen in a vacuum. A child who's in fight-or-flight mode cannot access higher-level thinking. They can't process language. They can't regulate enough to communicate. This is why neuroaffirming speech therapy and trauma-informed communication support must start with regulation.
Before we can write communication goals, we need to ask ourselves some questions. Is this child safe? Is this child regulated? Do they trust me? If the answer is no, we're wasting everyone's time and potentially putting ourselves and the child at risk.
So friends, if you take anything away from this blog post, I hope it’s the following things. When a child injures someone, it's not a character flaw, it's dysregulation. Our injuries are a reflection of systems failures, not individual mistakes. Compliance-based methods increase the risk of harm to everyone. Co-regulation, sensory support, and trauma-informed care prevent escalation. Advocate for reflective debriefs, adequate staffing, and neuroaffirming practices. And lastly, your safety and the child's safety are interconnected; we can't have one without the other.
You're Not Alone
If you've been carrying the weight of a difficult moment physically, emotionally, or both, I want you to know: You are not alone. You didn't do anything wrong and you deserve systems that protect you and the children you serve.
The work we do matters and the way we do it matters even more. Let's keep advocating for environments where connection, regulation, and respect come before compliance. Environments where both children and adults feel safe and where injuries aren't just "part of the job."
Because they shouldn't be.
