When it gets to that stage, there is not much else you can do.
However - there are strategies you can begin to put in place, to prevent.
One a rage escalates to this point, there is not much you can do except duck and cover, until it passes.
Whether to take a child to the ER - we do things a little differently here in Australia, we don't call the police as often, we don't take an out of control child to the ER as often. We actually have never taken a kid to the ER for out of control behaviour.
But we nearly did. Perhaps we should have. The incident which had us wondering - difficult child 3 had been on Strattera for three days, a new psychiatrist thought it would be better than stimulant medications for a kid with anxiety issues. But difficult child 3 got physically violent with me, he was out of control. We were at a friend's place, thankfully in a separate room because I'd already sent difficult child 3 out of the room for inappropriate behaviour. Poor kid - there was so much anger in him, not for any valid reason but purely a medication reaction. It was after midnight when we left the place, difficult child 3 was talking non-stop, aggressively, not making a lot of sense. We should have taken him to the ER but chose instead to get some sleep. it worked out for us - next morning we had a calmer, contrite and non-Strattera'd kid.
We chose to not take him to the ER, and we lucked out. With hindsight, we should have taken him if only to be sure he was OK - the Strattera was the culprit.
Another time - difficult child 3 was at school, a new school for him (which meant staff didn't know how to handle him, only his class teacher and aide understood). Class teacher gave difficult child 3 his Communication Book and said, "Put it on my desk." Then left. At that point another teacher took charge of the class and said, "We are now going to the school hall to watch a movie."
Two problems right away - strange teacher. Going to watch a movie - always a problem for difficult child 3. On top of this, we had the conflicting instruction. difficult child 3 said to the new teacher, "Class teacher said I have to put this book on his desk."
Teacher said, "Do it later."
BIG problem. difficult child 3 took an instruction from class teacher as more important and as now being prevented form doing what he had been told to do. As they got closer to the school hall and further away from the classroom desk, difficult child 3's agitation and distress grew, until by the time they got to the hall he became violent and began throwing chairs. They kept all the other kids out of the hall and summoned the class teacher. difficult child 3 as calmed down enough to be escorted out, he missed the film and I was told about it later. No ambulance called, no police called. The class teacher was able to work out what triggered it, and with triggers removed, difficult child 3 calmed down.
With Asperger's, if you can work out the trigger and de-fuse it, that can often be a more effective outcome. But that's a big IF. Also, there need to be consequences if the behaviour really is uncontrollable and you can't find that trigger, or can't defuse things for one reason or another. Really, what you're dealing with is no different to the tantrum a toddler will throw when their ice cream is knocked to the ground. We forgive a lot in toddlers because they don't know any better or don't have the social understanding. The thing is - Aspies, especially younger ones, are working at the toddler level, in some social respects. They have a shorter fuse, they have less capability to deflect themselves. But they are capable of learning these skills. They just can't learn them the way other people do. These kids need help, not punishment.
I want to be clear here - I am not blaming you in any way. You are trying to be the best parent you can be. But FOR THIS CHILD, chances are you are doing it wrong. Not your fault - it's just that what is right for these children, is sometimes the opposite of what you would expect.
So when others accuse you of being the problem - in a way you are, but because you are trying to be a GOOD parent.
When a kid misbehaves, the tendency is for us to clamp down on them and control them more firmly. The trouble with this in Asperger's, is it makes them a lot worse. You also may notice that they have a different attitude to cause and effect. We found that if difficult child 3 got to full-blown rage, he just could not get, even later when he calmed down, that he was wrong. Once he was angry, he felt justified in his anger. However, if we could deflect before it got that bad, he often would come and apologise of his own volition, once he calmed down.
Read "The Explosive Child" by Ross Greene. It should help you better understand what I'm trying to say. It also helps give you alternative techniques for managing such a child. I find these methods more painless and a lot more effective. Also a lot easier for me.
When a child rages to the level of violence against others, transport to the ER is the way to go, because we don't know why this is happening and if there is an underlying serious condition, this needs to be assessed and treated. However, in Asperger's, that alone is enough to explain such a rage. You don't need to worry they're having a psychotic break, for example. You do need to be sure you are safe and the child is safe. Other than that, it's a waiting game. If the child cannot regain self-control even when left alone, or if the child is posing an imminent danger to self and others, then again - transport to ER. But they will send the child home once he is calm.
The best way to go, is to learn what triggers a rage, and work to head them off. Even if you feel like you're giving way. So you need to plan ahead. First, avoid triggers. If you know your child hates mashed potato, don't feed the child mashed potato. if you do put some on his plate and he yells at you for it, DO NOT make him eat it as punishment for his rudeness. Deal with the rudensss entirely separately - YOU made the mistake, apologise for it. It teaches the child how to admit a mistake and apologise. These kids learn to behave, by following your example. So if you are a strict disciplinarian focussed on punishing bad behaviour, you are producing a child who will be trying to punish YOU for what they perceive to be your own "bad behaviour".
The rudeness angle - you do not have to become a doormat, but you have to accept that your child does not know how to behave and you cannot punish it into her. Instead, keep your tone quiet and calm, but say, "That was not the way to handle that. I made a mistake putting mashed potato on your plate. I am sorry, accidents happen. I apologised - you need to now accept my apology gracefully, and work with me to find a solution. Now, what is it you want out of this? Let's discuss it."
Every interaction is a teaching opportunity. People will look at you like you have two heads, when you let some really rude behaviour apparently pass without "Go to your room!" But you have to do what WORKS. And punishment for hat a kid can barely control, does not work. Instead you use modelling, encouragement, support and praise. It is amazing how fast it can bring improvement on so many levels.
I think your family picked up on your trying to maintain some firm control in the face of apparent chaos, and could see that this was aggravating things. But they can't see what else you could do, that would work. But they still felt the ER as not warranted. In a way they are right, but only in a way. Overall, looking at the whole problem AFTER thins got to tat point - you did the right thing. But if you had realised or had the chance, there was a much better right thing you probably could have done. But I bet you, they will be even more critical of you to begin with. The payoff for you - these methods work, and also any family members NOT on board with these methods, will find themselves the focus of her remaining hostility! Poetic justice!
So in summary - as far as possible, learn how to prevent such rages. It can be done, it's in the book. But if ever things get this bad - do what you did.
Stick around, let us know how you get on. Pick brains. I was talking to a new friend yesterday, I mentioned my autistic son. Then I mentioned that his older brother has a different set of problems, and their sister is different again. I saw the look of shock on her face and came out with my line, "Aspergers and autism doesn't just run in our family, it gallops."
I'm not the only one here with a strong 'feel' for Asperger's. Not many of us have a daughter with it too - girls are very different in how it manifests. easy child 2/difficult child 2 doesn't actually have a diagnosis, although that may change soon. Girls are very difficult to diagnose because they are often so atypical. In a way this can be to her advantage - she has more potential to be able to learn how to adapt and "pretend to be normal" as difficult child 3 calls it.
Marg