The 3 Interventions to Prevent Meltdowns in Kids on the Autism Spectrum

"Mark, You refer to 'meltdowns' quite frequently in your articles. Is it not similar to a tantrum... if not, what can be done to prevent them?"

A meltdown is not identical to a tantrum (although there is an overlap on occasion). From a biological standpoint, a meltdown is an emotional outburst wherein the higher brain functions are unable to stop the emotional expression of the lower (i.e., emotional and physical) brain functions. 
Kids who have neurological disorders are more prone to meltdowns than others (although anyone experiencing brain damage can suffer from meltdowns too).

From a psychological standpoint, there may be several goals to a meltdown, which may or may not be the "rewards" that are consciously desired by the youngster. To many parents and teachers, these goals may seem irrational, inappropriate, and sometimes criminal. 
To kids familiar with - or trained to recognize - the psychological causes of such behavior, however, there are clear emotional, cognitive, behavioral, and biochemical correlates to meltdowns.
==> How to Prevent Meltdowns and Tantrums in Children with Autism Spectrum Disorder

The three major interventions that are usually most effective in preventing a meltdown from manifesting in children with High-Functioning Autism (HFA) include (1) managing emotions, (2) a sensory diet to maintain optimal sensory regulation, and (3) visual supports.

1. Managing emotions:

Most often, the youngster's feelings are way too big for the situation. Managing felt emotions does not come automatically, but can be learned over time with systematic instruction. CBT is one example of an effective therapy for managing emotions.

2. Sensory diet:

Children with High-Functioning Autism usually do not have sensory systems that regulate automatically; rather, they must discover how to keep themselves regulated. This is most often accomplished by employing a sensory diet.

Just as a youngster needs food throughout the course of the day, he needs sensory input – and opportunities for getting away from stimulation – spread out over the whole day. A “sensory diet” is a carefully designed, personalized activity plan that provides the sensory input an autistic child needs to stay focused and organized throughout the day. In the same way that you may soak in a hot tub to relax, kids on the autism spectrum need to engage in stabilizing, focusing activities, too.

Each ASD youngster has a unique set of sensory needs. Generally, a youngster whose nervous system is causing him to be hyperactive needs more calming input, while the youngster who is more under-active or sluggish needs more arousing input.

The effects of a sensory diet are usually immediate and cumulative. Activities that perk up your youngster - or calm him down - are not only effective in the moment, but they actually help to restructure your youngster’s nervous system over time so that he is better able to:
(a) handle transitions with less stress,
(b) limit sensory seeking and sensory avoiding behaviors,
(c) regulate his alertness,
(d) increase his attention span, and
(e) tolerate sensations and situations he finds challenging.

3. Visual supports:

 “A picture is worth a thousand words” is the absolute truth. Although each child on the autism spectrum has a unique experience, processing written and spoken words is not considered to be her “first language.” Visual supports can be anything that shows rather than tells. Visual schedules are often used successfully with many ASD children. 
Having a clear way to show beginnings and endings to the activities shown on the visual schedule helps the child to have smooth transitions, thus keeping a meltdown from gathering momentum. For the best results, visual supports need to be in place proactively rather than waiting until the child's behavior unravels to pull them out.
Resources for parents of children and teens on the autism spectrum:

==> Videos for Parents of Children and Teens with ASD


Anonymous said… Meltdowns are not always "temper tantrums." I am a certified Aspie and my meltdowns usually have nothing to do with temper to anger. Meltdowns are the result of overstimulation in some area. It could be related to sensory issues such as a certain noise, or certain colored lights, or it could be a reaction to an emotionally charged situation (we don't understand emotions so when emotions are high it is unnerving and we can't handle it). I recently wrote about a meltdown on my own blog The Christian Aspie. It is a first hand account, through the eyes of an Aspie. It is horrible to experience. There is a lot of anxiety and stress, an out of control feeling. I have had milder meltdowns when people lie to me. I have also had rather serious meltdowns when I have just been overloaded in one way or another (usually sensory related). The thing to remember is that 1. We can't help it. Sometimes I have to stomp or flap my hands to release the pressure. 2. There is nothing you can do about it except to try to get the person into a sensory friendly (low sensory input - low lights, muted sound, isolated, etc) area.

Anonymous said… I think a lot of it is semantics. The closest term to describe a 'Meltdown', is a severe temper tantrum, altho a temper tantrum in a 'normal' child is generally caused by a child that is simply not getting his way and has learned that if he pitches a big enough fit, he will get his way. No Aspie or Aspie parent wants that perception to be used to describe an Aspie meltdown. I think there is also a big difference between a 'meltdown' and a 'shutdown', depending on how the aspie deals with the anxiety and often overwhelming experience of trying to navigate the 'normal' world. Some aspies INternalalize their feelings and emotions, and some EXternalize them. An internal 'meltdown' I would describe more as a 'shutdown'. They may be just as devastating to the child, but don't have the same outward effect on those around them, as a full-blown 'meltdown' can have. Especially if it happens in public. In my opinion, the term 'meltdown' has become way overused by some parents to describe anytime their child, aspie or not, cries or doesn't behave perfectly. I often want to tell these parents, "you apparently have never seen a real meltdown". In our experience, Mark Hutton described a meltdown perfectly, and I think the overuse, and misuse of the term minimizes what Aspies and their caregivers deal with daily. Thank you Mark for clarifying this. 

Anonymous said... A meltdown can be very subtle. Essentially they are overwhelmed with emotion or sensory input. Early on this can be expressed as irritability (early in the meltdown). It can go into a tantrum/screaming fit or just as easily into what I call a shutdown (retreating somewhere "safe" and trying to block the world out).

Anonymous said... A meltdown is NOT the same as a tantrum. A meltdown is involuntary, it is not under the child's control, and it is usually due to sensory overload, something important getting changed unexpectedly, or some kind of "straw that broke the camel's back," when somebody's been under chronic stress and there's a final incident that they just can't take anymore. Good ways to avoid one are to tell a child in advance if something in their plans or schedule is getting changed--not waiting until the last minute. Figure out what kind of environmental/sensory stresses cause them sensory overload, and avoid those, or make sure they have a way to escape if they need to.

Anonymous said... I found my meltdowns used to occur mostly in social situations that were noisy -- too much noise, too many people talking, too much input. I have learned to handle them by staying to the side of a room, so it is not all around me and occasionally having a time out (from the noise) where I would go outside or to the bathroom & just breath and calm down. But them I am over 50 and have had many years to figure out what works. It is not a tantrum which, as I understand it, comes from anger and not having ones own way; it seems to be a sensory overload which explodes.

Anonymous said... Tantrums are typically from not getting their own way. Meltdowns or at least with my son are usually because he got overwhelmed with something and doesn't know how to properly express it to me. Kudos for finding something that works for you!

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