Based on the clinical literature and my clinical experience, it is clear to me that 'rage attacks' or problems with anger and aggression are one of the most socially disabling aspects for many individuals. While some adults have learned to cope with the problem, their ongoing struggle sends a clear message to those who will listen: do not assume that the problems you see in the child will miraculously remit or just go away. We need to take the time and make the effort to help the child or teen learn to manage this problem via proactive and constructive means, including cognitive skills and social skills training, if indicated. And although I always recommend to parents who email me about their children that they find a qualified psychologist or therapist in their area who understands these disorders and how they contribute to rage outbursts, I know that in many places, parents and schools do not have local mental health professionals with expertise in these disorders. If you have a student who is having rage attacks in school, you will need to work closely with the parents, other members of your school team, and any prescribing physician to figure out how to help the student learn to self-manage. It may be difficult, but consider this:
If the parent can't or doesn't stop destructive rages that hurt others or others' property, and if the school can't or doesn't stop it, then it will be stopped in the courts. But it will be stopped, because no matter what the reason, assaulting others or their property is unacceptable in most societies.
That said, there is a difference between holding the child responsible for their behavior and saying that the child voluntarily chose to exhibit the behavior. So.... is a child responsible for such behavior? In my opinion: unless the "behavior" is known to be an involuntary tic that the child has no warning is coming, then yes, I do think the child is 'responsible' for their behavior. And we do not do children a favor when we don't help them understand that they are responsible for their behavior or if we teach them to excuse everything because they have a "diagnosis." Even if a child or teen is not "responsible for" their tics, they still have a responsibility as members of society and communities to do what they can do to insure that their symptoms or problems don't create problems for other people. Even if their "storms" or "rage attacks" are neurochemical events, they have some responsibility for attempting to learn what they need to do to avoid triggers or to avoid taking their outbursts out on others. Are they entitled to understanding, support, and reasonable accommodations? Absolutely, in my opinion. But that doesn't mean that having a diagnosis is license to destroy or harm or threaten others. And it doesn't mean that we should necessarily suspend or expel a student who has a 'rage attack' in school, even if we could.
What do we do, then, if a 'rage attack' destroys property? What do we do if our student is threatening others or shouting obscenities at them? While we work with the student to help them avoid such unhappy or unfortunate situations, and while we educate the peers to help them understand the student's problems, we had better instill in the student a sense that they need to make restitution or reparations. If they punch a hole in the wall, then they should either repair it themselves or help the building maintenance team repair it. If they create a major disturbance in class, do they just pretend that nothing happened or do they acknowledge the impact of their symptoms/behavior on their classmates and teacher and offer some apology? If a student has rage attacks and does not say anything or do anything to restore and repair their relationships with their peers, they will suffer socially. If a student has rage attacks, they can protect their relationships with their peers by taking steps to protect their peers from their loss of control, by letting their peers know that they are trying to take steps to deal with the problem, and by making reparations afterwards if they do lose control.
We may not be able to prevent all symptoms at all times, but we can teach children what it means to be members of a community.