Understanding Aggression in SATB2-Associated Syndrome: A Mixed-Methods Study Exploring Caregiver Perspectives.

Abstract

Background: SATB2-associated syndrome (SAS) is a neurodevelopmental condition characterised by developmental delay, speech impairment, and craniofacial anomalies. High rates of aggression are reported in SAS, yet the profile and contributing factors remain poorly understood. This study explored caregiver perspectives on aggression in SAS.

Methods: Caregivers of 37 individuals with SAS (M age = 11.42 years) completed questionnaires on adaptive ability, aggression and behavioural function. Semi-structured interviews with 34 caregivers explored contextual factors such as triggers, co-occurring emotions, and management strategies.

Results: Aggression was reported in 87% of individuals, with frequent forms including pulling/grabbing (84%) and hitting with a body part (69%) or object (53%). Aggression was often linked to frustration, anxiety, and triggers relating to demands, routines, repetitive behaviour, and tangibles. Caregivers described varied management strategies and background factors influencing aggression.

Conclusion: Findings provide the first detailed description of aggression in SAS, highlighting vulnerabilities to guide tailored behavioural assessment and interventions.