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How to Manage Meltdowns in Kids on the Autism Spectrum

A meltdown is an intense emotional and behavioral response to “over-stimulation” (a form of distress for the child). Meltdowns are triggered by a fight-or-flight response, which releases adrenaline into the blood stream, creating heightened anxiety and causing the Asperger's (AS) or High-Functioning Autistic (HFA) child to switch to an instinctual survival mode.

Common Features of Meltdowns—
  • after the meltdown, there may be intense feelings of shame, remorse or humiliation, and a fear that relationships have been harmed beyond repair
  • children in the middle of a meltdown will likely become hyposensitive or hypersensitive to pain
  • cognitive dysfunction, perceptual distortion, and narrowing of sensory experience are associated with meltdowns
  • meltdowns are a reaction to severe stress, although the stress may not be readily apparent to an observer
  • meltdowns are caused by sensory or mental overload, sometime in conjunction with each other
  • meltdowns are due to overwhelming stimulation
  • meltdowns are time-limited
  • novel situations or sudden change can elicit a meltdown
  • transitions may trigger a meltdown (e.g., going from class to class, change in topic, change in teacher s, etc.)

Causes of Meltdown—
  • child does not receive understandable answers to questions
  • child does not understand the reason for sudden change
  • child has a sensory overload
  • child is given open-ended or vaguely defined tasks
  • child is given too many choices
  • child is taken by surprise

Warning Signs of Meltdowns—
  • becoming mute
  • experience difficulty answering questions (cognitive breakdown)
  • extreme resistance to disengaging from a ritual or routine
  • increasing self-stimulatory behaviors (e.g., flapping hands)
  • pacing back in forth or in circles
  • perseverating on one topic
  • repeating words or phrases over and over
  • stuttering or showing pressured speech

What Parents Can Do—

1. Don't reward the meltdown with a lot of attention. Obviously, you don't want your AS or HFA youngster to learn that this is a good way to impress you.

2. Give the youngster a warning before the end of an activity, which gives him a chance to readjust.

3. Give the youngster some control over small decisions so that he can feel he can make a choice (e.g., "Do you want us to read your book before you put your pajamas on or after?").

4. Give your youngster permission to have a major meltdown (e.g., "Joey, I know you usually have a meltdown when this happens, and I want you to know that it is ok for you to do that now."). This is a reverse-psychology approach.

5. If meltdowns are more frequent than about once a week and don't lessen as the youngster grows older, you may want to consider seeking professional advice.

6. Meltdowns are a sign of frustration that a youngster can't do something comfortably. Know what your youngster's tolerance level is and try not to push him beyond what he's capable of doing. Tolerance levels vary; he may be able to handle a situation one day and not the next. Try to identify the situations that trigger meltdowns and change them.

7. Prescribe the behaviors that your youngster usually does in this situation when agitated. You'll continue talking after telling your youngster it is o.k. to have a meltdown and list what the youngster normally does (e.g., “When you are feeling this way, you usually start swearing, kicking, screaming, and blowing snot so go ahead and get started.").

8. Remember to reward good behavior (e.g., "You were so good today when we had to stand in line at the post office.").

9. Think about whether your youngster may be acting up because he's not getting enough attention; even negative attention is better than none.

10. Scolding or shouting back simply won't work, although you may feel like having a meltdown yourself. Remember, moms and dads are models of appropriate behavior.

11. Stay cool. Acknowledge the youngster's emotions (e.g., frustrated, bored, tired) without a long discussion and say something like, "Tell me in your own words what's bothering you, and let's try to work it out" …or "I know you're frustrated and want to leave, but I would like for you to wait a few more minutes." It's important to let the youngster know you're willing to work this out reasonably, what your expectation is, and what you want him to do.

12. Always have some form of distraction available to get your child off the meltdown track.

The process of turning things around involves helping moms and dads to:
  • address the frustrations of the AS or HFA child’s siblings
  • create a more predictable and structured environment for the youngster
  • establish a belief that this problem can be solved but it will take persistence on their part
  • establish consequences to reinforce desired behavior and not reinforce undesirable behavior
  • focus on the game plan long enough for it to take effect
  • help the youngster to improve his social skills
  • learn what accommodations are needed to reflect the youngster’s weaknesses
  • learn what actions will promote the youngster’s growth in flexibility
  • re-establishing their role as authoritative parents
  • refocus on the youngster’s strengths
  • stop blaming each other and themselves
  • prioritize what is really important

The issue of prioritizing is particularly critical. Too often there are struggles about cleaning rooms, finishing meals, practicing piano or completing homework that are simply not worth the consequences. Some of those issues can be addressed when things are improved. Also, if some situations are just too difficult to manage right now (e.g., taking the youngster on a family activity), then arrange a sitter or a drop-off at a friend’s. In this way, you avoid ruining everyone’s experience. Explain to your youngster that you are working with him to fix the problem and eventually he’ll be able to come along. Again, this is about setting priorities and either targeting behaviors that can result in initial success or behaviors where safety/health is a concern.

Typically the parents have intuitively tried some very appropriate strategies to deal with the meltdowns, but have given up too quickly because they didn’t see change right away. When moms and dads begin to reassert their roles as being in charge and working with their youngster to improve his ability to be more flexible, the youngster will likely respond initially by getting worse. Even though he doesn’t really want the old system to remain in place, it is his natural instinct to try to hold on to what he knows rather that commit to uncharted waters. Moms and dads must believe in what they are doing and remain persistent, which is hard after having developed a sense of failure about trying to manage meltdowns up to this point.

Footnote:

I would like to point out the very rarely understood fact that basically this disorder is nothing but having little to no intuition. Kids on the autism spectrum do pretty much everything they do consciously, including facial expressions and body posture. That's why they tend to have fairly emotionless faces, awkward body postures and why they are horrible both are social interactions and organizing their daily lives. That's also why they have trouble with sensory overload or sensitivity to specific sensory impulses. It's also why their hobbies tend to be so extreme and specific as those are the only activities that stimulate their barely existing intuition to sufficiently feel a sense of satisfaction in their lives.

Because it does so many things consciously, the AS or HFA brain is much more engaged in reflective (conscious) processing of information than the "neurotypical" brain. Meltdowns are the consequence of AS and HFA kids suffering from cognitive overload. It's like a traffic jam in the brain. The brain tries to process more data than it can handle and the response to that is to create an emotional short circuit and cognitive standstill. To put it simply, nothing goes in, and intense emotions come out. The frequency and intensity of meltdowns is strongly related with how much data the child can process at the same time and thus also with his/her intelligence.

It's important to realize that the level of stress is directly correlated with the amount of data that needs to be processed, and the amount of data that needs to be processes is directly correlated to how much sensory data is picked up and the complexity of the child's personal planning. To relieve stress, it is important to adjust the amount of sensory data to a comfortable level and to adjust the child's planning in a way that is easily maintained. A logical and consistent structure often helps.

==> Preventing Meltdowns and Tantrums in Aspergers and HFA Children

23 comments:

Anonymous said...

Thank you-this is very helpful for me and the members of our support group Ocala Autism Support Network.

Caroline said...

Thank you for the excellent timing. My son has had a meltdown at school today (his first in secondary education - he is 13) and this was a useful reminder to keep plodding on! I would add that another cause of meltdown is extreme frustration during the school day (as was the case today when some kids "got on his case" for fun).

Anonymous said...

This is a really useful item. I would like to use it with my son's teachers and teaching assistants because they create situations which have been leading to meltdowns at school. They don't understand how AS children behave when these triggers occur. Could you do a newsletter on meltdowns aimed at teachers and teaching assistants and what they should be doing a) to prevent meltdowns if possible and b) what to do if one does happen - for the AS child and also the other children in the room. I would really like to give them something like that to improve their competence in supporting my son. Thanks for all your valuable advice. Chris. England.

Anonymous said...

This is an excellent article. One point I'd like to add to Common Features #1: meltdowns can be extremely scary for the child. It's terrifying to feel so out of control. After a meltdown I spend a lot of time talking my son through his feelings and his reactions and letting him know it's OK and he's safe.

Anonymous said...

Ben's meltdowns happen whenever he is really wanting something and cannot have it, he gets so obsessed, very inflexible. Also if he's bored, can go completely off the charts.

jonsaint said...

Thank you so much. I have now a clearer understanding of it all.

Anonymous said...

In agreement with Chris, England. A newsletter for teachers would be great, including the confusion and frustration caused by "teasing" language. Friendly and good natured banter works well for some, but for kids with aspergers it's just so confusing. They are left wondering if they have been praised/told off/insulted.
Zoe, England.

Anonymous said...

I really need help for my daughter, Courtney she is 6 years old and has mild aspergers and SID. She was diagnosed by a child psychologist Dr. Diane Mobly, at the age of four. Her meltdowns are horrible. She has been in counseling for a year, but its not working. Iam a single mom and struggling with how to discipline Courtney and how to handle her when she does have a meltdown. She will hurt herself and me, she screams, destroys her room and is starting to hurt our dog. I do not know what to do. She has been having nightmares that her dad is going to kill her and stab her with a knife. Her father has only seen her once and has spoken to her on the phone several times. Her dad and I are divorced due to his drug abuse and violence to me. I left him when Courtney was 6 months old. When Courtney was 5 years old her father and I tried to reconcile and recently he left and moved to Indiana without telling me or Courtney. He was clean and sober for two years went through rehab, became a christian and that’s why I decided to try and make things work with him. Courtney is having a very difficult time with the fact that her Dad is gone and that’s when her nightmares started.

Dee said...

My daughter is 9, but you're daughter sounds so much like mine, along with our situation. Many of my extended family members have experienced these scenarios as well. There's much we should compare and there's good news. e-mail me at deliazoey@gmail.com

Zoey said...

My daughter will obsess on things or obsess over her ability to carry on a ritual and this will start a horrible meltdown but boredom for her almost creates paranioa like terror which then turns into a meltdown.

Anonymous said...

Our 17 year old son was diagnosed about a year ago with Asperger’s. We have been doing as much as we can to educate ourselves and him. He is very angry and has violent meltdowns every 2-3 weeks. We have been working with psychiatrists, family therapists, dieticians, and school staff to try to help him control his anger. Nothing seems to help. Right now he is living in a shelter until his court date as a result of his last violent outburst. He has been in the shelter for about a week and has continued to have meltdowns there. What can we do for him? I am afraid for him to start down this negative path with the law that he really does not understand and I do not think will help him. We just do not know what else to do.

Anonymous said...

My son Matthew is 7. In mid July, his father and I took him to two different dr.s. Both say he may have aspergers. We are in the process of trying to find out for sure. It has been an upward spiral with him since he was at the age of 3. I come from a town that doesn't offer to much help on this subject. Glad to find other parents in the same circumstance.

Anonymous said...

Carol Harding
I'm in the same boat. My son is 9 and was formally diagnosed with Aspergers last May. He had to wait for 2 years on a waiting list to see the appropriate doctors to get the diagnosis. Now, because we live rurally, it's very hard to find support. We are still trying to find a behavioural interventionist who is willing to drive out to our place once or twice a week. The community school here showed no understanding of my son's needs, gave him no support, and allowed the bullies to feed on him like a pack of wolves to a lamb. Now, I home school him. This support group provides a lot of information and is a place of comfort on those days when I feel like I'm all alone.

Anonymous said...

Stephanie Carson Maxie When my son was in pre-school they made him a picture schedule. It really helped. He is in first grade now and they still use one. He didn't like not knowing what was going to happen next. They change it everymorning and he can look at it and know what is in store for the day.
2 hours ago · Like
Claire Donovan I really sympathise with you as this is exactly how my 5 year old was when he started school last September, stay strong and keep your head held high cos it does get better. Alex now has 1 to 1 to help him at school socially and despite the way he is the other children love him. Big hugs to you cos i know how i was feeling this time last year! X
2 hours ago · Like
Stephanie Muggli Menefee
My son had a very rough start to the school year last year (he is in kindergarten this year), and most of the issues were halted immediately by having a written schedule that we went over each night and then again in the morning for the upcoming day. That way he knew what to expect, in what order, the next day. I put each activity on a card and put the cards on a ring in the order that they would happen. As soon as I get the daily schedule from his teacher this year, we will be doing the same thing. Truely, it worked overnight for my son. I'm not saying that this will necessarily take care of all of the issues your son is having, but it certainly can't hurt!
2 hours ago · Like
Adrianne Elmer-Melby We kept my son home until this year when he started 3rd grade. We felt that he was finally able to show some SELF-control.

Anonymous said...

Claire Donovan You could also explain to the parents that he has aspergers and cant help it, some parents will always be hostile whatever but you will find some more supportive once they know the situation. My sons school also did a story time about aspergers with the class so some of it could filter back to the shall we say less understanding parents!
2 hours ago · Like
Jessica Ford
Stephanie Carson Maxie, my son has things like that to tell him what's going to happen throughout the day and he's going on 11. It really helps at school and home related stuff I give him plenty of notice. He's only recently been diagnosed and its such a relief as similar to what the parent is describing here my son went through a slight lashing out phase but that was more at teachers physically trying to move him when they thought he just being "bloody minded"!? But now they realise he isn't being 'naughty' they have ways of allowing him to express himself, his needs and worries etc and he doesn't feel so frustrated that nobody understands him. I'd say communicate with the school and try and come up with things to try and involve a sen teacher, I have been to sooo many meetings but for now, its been worth it.. Until he starts secondary school.. Not looking forward to that :L good luck
2 hours ago · Like · 1 person
Erin Farley
Good advice, it is also imperative to inform and educate the teacher. Let teacher know your child is a literal thinker (teachers like to say things like "listen with your eyes" which completely confuses our boy). Teasing is intolerable for him, so teachers need to keep an eye out (even things like "got your nose"). The flourescent lights are killers, so natural light whenever possible...a warning prior to fire alarms...the list goes on and on. Most importantly for our little guy is that he needs breaks - time to regroup and relax - because he is overwhelmed by trying so hard to fit in... our little ones hae to work so much harder, and they need breaks.
2 hours ago · Like

Anonymous said...

Kylie Bathman- Ahumada
hi I have 2 aspergers kids , now 11 and 14 my advice to you is go up to the school and I would ask , if I could stick around maybe volunteering to help at the school so to your child is a bit more calmer knowing your there to help resolve some of the things the child is doing and to teach them when they are doing the wrong thing that "you " can take them to a thinking room Wich is what we have instead of time out and also not crowd him in his new environment don't be in the actual class be a helper from a far , and help advice the teachers on what could help , this is what iv done in some cases and it has worked , but you have to rember to start to diminish your time at the school slowly so start to stop going every day so in the end your only there very short times antil your nit there at all .... Hope this helps and if you have a good school they should be open to do this .. :)))
about an hour ago · Like
Jackie Wall Fields
Our 6 year old just started kindergarten. My advice is keep him out of the main stream daycares until Kindergarten. If you can get him in a Therapy based daycare/preschool he will get the therapy he needs plus the regular classroom teachers are trained to help these kids and normally have a therapist right around the corner that can help during meltdowns. They are also more structured which will prevent the meltdowns. When you get ready for Kindergarten you will work on an IEP with a transition team. Now that my 6 year old is in Kindergarten he is in a mainstream class but goes to the SpecialEd teacher for 30 minutes a day to do things like working on his picture schedule. She is also there for him if needed for meltdowns. Public educators are going to be more prepared to work with the child. My experience was that mainstream daycares were not and created more problems for the child. Good luck!
about an hour ago · Like
Jennifer Reed
Back to "pinpoint the cause" my son has Asperger's and had behavior issues in school. After years of struggle I finally found out that he also has CAPD (Central Auditory Processing Disorder.) His biggest problem was the teacher mostly using verbal instruction when he has trouble learning information from auditory sources. In order to start figuring out what is causing this behavior I suggest getting your son assessed. I would ask the school, in writing, for a Functional Behavior Analysis (FBA). I don't know where you live but they should be able to do one at that age in a public school. I wish the best for you and your son. :)
55 minutes ago · Like

Anonymous said...

Kathy Foster Been there and it is tough for all... including your son. :/ Our son is now 12.. but at that age... exact same - he spent 4 years in therapeutic schools - challenges with that, too... On year two Homeschooling and it has been a blessing for both. But your sons age is tricky, too... self control is such a process... You are not alone and I wish you peace!
49 minutes ago · Like
Shanna Dawson-Ferguson
I would ask the school what supports they are using in the classroom. Try to uncover what might be causing the behavior. I would say a picture schedule and visual timer would help your son. My son is 6 and in the first grade. He is still having meltdowns but the school and myself are working together to develop a plan that will work. The only way to get the school to cooperate is to tell them what you want or expect and then follow up on it often. I hope this helps.
42 minutes ago · Like

Anonymous said...

Keturah Broadwood
We went through the same thing with our son. We put a name place card on his desk and chair so that he always new where to sit. Even on the carpet for mat time. We had picture cards on the door so he knew what to take into class at the begining of the day and found that having a picture schedule for the morining to help getting ready really helped. We had a friend roster so that he played with and did activities with the same person all week and for a transition day on monday he had the friend from last week and the friend from this week. A huge impact was made by getting him to school 20 mins early while there was many kids there and leaving him there. This gave him the opportunity to ease into the amount of kids in the school and to play first. This way when the music (we use music instead of a bell) went he was relaxed and excited to go to class.
Yesterday at 2:20am · Like
Tammy Watson Tomaszewski went through years of this and the schools not following IEP's ....Happy and Homebound..with Sad side effects'' Good Luck !!
Yesterday at 1:31pm · Like
Carol Bird Lagana
My son is now 13, in 8th grade in mainstream classes (and they are Advanced, to boot). When he was in Kindergarten, he had wicked meltdowns and hit and scratched other classmates. That is how we found out he had Asperger's. Once we got the diagnosis, we were able to get his IEP and the school has actually supported him...giving him a place to chill out when he was overstimulated. I think your child definitely has a Sensory Integration issue. My son went through 2 years of Sensory Integration Therapy and hasn't had any meltdowns. He has learned how to work through his frustrations and he gives himself time out if he feels it coming on. I also think the older kids get, the more they figure out how to deal with things. STill, I would look into Sensory Integration Therapy in your area.
11 minutes ago · Like

Anonymous said...

Although Aspergers has not been diagnosed yet, it does appear that my 9 year old son C___ is suffering with some of the symptoms that point to this with meltdowns being the main factor. The main triggers seem to be going to bed and going to school and it is these meltdowns that we are 'desperate' for help with.

C___ has suffered anxiety and bullying at school for a number of years and after numerous complaints to the school it never seemed to improve, In September we decided to change his school ( C___ was happy about this) however trying to get him ready and into school is becoming impossible. Some mornings he wakes up has breakfast and will go to school absolutely fine however other mornings whilst walking to the car or at the school gate he will just stop, run off, and then what we believe to be a meltdown begins. We have tried to remain calm and let these pass and then take him into school but this can sometimes mean he only attends school for 2 hours a day.We have also tried physically restraining him and carrying him into school ( this is what the school have told us to do)kicking, punching, biting, pinching, head butting, screaming, throwing anything he can get hold of and scraming that he hates us and wishes we were dead etc etc. Once in school he is taken into the Head!
Mistresses office where within ten minutes he is usually back in class normally as if nothing has happened, he has told us he likes the school and prefers it to his old one, when asked in the evenings why he has done what he did he says he is scared of school! but he has also confirmed there is nothing bad about the school and as yet has had no meltdowns whilst 'in' school.

C___'s meltdowns have recently become more frequent and although the bedtime ones are just as bad its the ones before school that we really need some advice on. Do we continue to let them pass and allow him to miss so much school? or do we put him through the added stress when forcing him into school? C___ often would want to be left alone and would curl up and act silly when told to do something he didn't want to do occasionally running off and it is only the last 4 weeks that this has turned into raging, aggressive uncontrollable attacks. They are sudden and we see no sign of them beginning which makes it difficult to take any preventative action though in honesty we have no idea what preventative action to take and we would be grateful for some advice on this also.

The current situation with medical help is C___ has had his 1st assessment and we are awaiting results, on ringing the Health Service yesterday for advice on a particularly aggressive outburst we were told that they were not a 24 hr helpline and to ring the police!!! ( This was in office hours)

Any advice you can give us would help C___ and this desperate family that are floundering in the dark at the moment and it is affecting everyone concerned with C___, he has 1 sibling aged 5.

Anonymous said...

I have an 11 year old boy with AS …we just got the news 2-3 weeks ago after many years …oh it’s this oh maybe this …so now were at Asperser’s syndrome. We are at our breaking point with him and have been talking about residential care. So here goes.

He doesn’t fall asleep until 11 or 12 and I have to stay up with him to monitor him. He likes to go through stuff and make messes (like putting food in glass of water). We have found lots of other family member’s stuff in his room (money, lock boxes, stuff of his dads).

He is very defiant and out of control …he cusses a lot and does inappropriate things …like tonight he peed in a soda can and said his brother did it. When I cleaned his bathroom, he had written ‘fuck you’ on the wall. He has no respect for anything or anyone. He follows NO rules and we can’t get him to do anything. I don’t know what to do or where to go to get help! Where do we even start?

Anonymous said...

After my son has an anger meltdown, how long should I wait before talking things over with him?

Anonymous said...

Devin is10 and has just recently started getting "angry" enough at things to act in this matter. I guess I'll let it ride and see how long it lasts. At first I thought if I ignored it he would stop, but that hasn't happened.

Anonymous said...

Ignoring it didn't work for me either. I think part of Ward's problem with this is how frustrated he gets with himself. When he throws things he feels better at first, but often feels worse later (especially when he throws things at ME!!) Maybe you could talk to Devin in calm times about how to release his frustrations in other ways. I've heard several suggestions: hitting the pillow or punching bag, sitting in the dark, a metronome set at a very slow pace, exercise, blow up balloons & let them go & try to catch them, etc. These things didn't work for my son, but to each his own and I will keep looking & studying other techniques for mine.
12 hours ago · Like

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