I have a dear lady friend whose autistic son (he's in his early 20s) hits her. Not the father or sibling, just her.
That's why I asked if it's anger generally directed at one person. And, the son is a big guy, over 6ft.
Anyway...you should be having your surgery soon..Yay!
Take care.
If he's non-verbal or has a very limited vocabulary, he
may be hitting mom because he's just saying something, and it might not have anything to do with anger or aggression. It could actually be the opposite...could be appreciation, gratitude, or equivalent to "This is my Mom", "This woman is special" or "I like this person best"...something along those lines. And people with severe autism repeat things over and over, including sounds and movements, so he hits her multiple times. He's just repeating what he's "saying."
I'm just guessing, just saying what that
might be about, but I saw that behavior a lot during my short career, and similar ones. He might not know he's hurting mom, and most of them aren't capable of understanding if you explain it. They hear your words, but if they're in the severe category, they can't comprehend the meaning, especially when you string several words together.
I'm sad for the mom and the kid. If I was to suggest something, it would be to start music therapy with him. When he hits her, she shouldn't say a word about it, but after no more than 2 or 3 minutes, take him to a quiet place in the house, grab a pillow, and lie on the floor with him, if he's receptive to that, and listen to soothing music. If he isn't receptive to lying on the floor with her, he might lie down while she sits nearby or in a chair...somewhere in the room that he's comfortable with.
She could also massage him as well as
or instead of playing music. Hitting could mean he just wants physical contact with her, a literal connection, and massage could fulfill that need. I don't mean a deep, full massage; just gently, slowly,
repetitively run her hand, or even a finger or two, back and forth or in circles on his back, or shoulders, scalp, or forehead. Gently brushing his hair is a good one, too; whatever he can tolerate really well.
Those therapies might not stop the hitting, but can potentially limit it by quite a bit.
Oh...I just had a thought: if the kid is hitting himself, it's likely he's extremely frustrated about something. Could be something minor, like some chachki is sitting someplace he doesn't want it to be. But those therapies could still be very helpful.