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