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Public Tantrums in ASD Children

Question

I need some practical advice on how to deal with public tantrums and meltdowns and shrieking. It seems like sometimes when I try to stop the shrieking in public, it increases. I want to do what is right by my son, but I feel ignorant as he has just been diagnosed with ASD... Please help!

Answer

The tantrums and meltdowns caused by Autism Spectrum Disorders (ASD) can be very different than what most people would consider a 'temper tantrum'. They are caused by the same sort of things, but they may happen more easily, or for a much more unusual stimulus. In addition, it may not be that the youngster particularly wants something, so much as that the world has become too much, and he is simply lashing out against it.
 

The most important part about dealing with tantrums and meltdowns is finding out what is causing them. While a lot of what is causing them can't be avoided, there will be some that can, and you can work on keeping him away from them or removing him from the stimulus if it starts. If it can't be removed or dealt with, asking your specialist about various coping methods would be a good idea. I'm not sure how old your son is or how severe his ASD is, so I can't give more detailed suggestions on the 'coping mechanisms'. 
 
For instance, if your youngster has a meltdown in a very crowded location, then maybe you can work on finding ways to avoid bringing him into very crowded areas and work your way up. Maybe it's strong scents, and you can keep them away from the perfume aisles. Of course, it may just be the usual emotional frustrations, which come even with the most neurotypical kids.

Now, for actually dealing with them when they happen, the first thing you can do is to try and remember that the meltdown isn't something that needs to be punished. Most moms and dads might see it as a temper tantrum, but they are much different than that. It can help if you get in the frame of mind of "how can I help my son through this" rather than "how can I make my son stop this."  
 
 
Lashing out at the youngster will just make it harder, since he will be more terrified of losing control, seeing it as a bad thing. Instead, detach the youngster from the uncomfortable situation and work on some coping skills. Move it up a little at a time, if you can. He may never be able to handle everything, but he should at least be able to control himself well enough to say, "Mom, I need to go," rather than fall down and start screaming. Make sure that he feels you are a safe place in this, and that he can trust you to help him through it.

Now, if these 'meltdowns' genuinely are a temper tantrum rather than an overload, it's possible that you'll need to start discipline to work on them. In that case, focus on treating them the way that most tantrums are to be treated (e.g., primarily ignore them; don't punish; don't reward, etc.). It's not easy, but it's probably the best way to handle a tantrum. Now, I'm not saying the youngster is having tantrums rather than meltdowns, but being unable to hear the details of what's happening, I'd rather cover all bases.


Resources for parents of children and teens on the autism spectrum:
 
 


COMMENTS:

•    Anonymous said… hi my name is amanda and my autistic son no matter how bad it got i always kept a calm voice and low tone i just repeated his name over and over till i got through to him he always calmed down with low tone talking if you get angry of course he will respond with anger if you raise your voice he /she will do that too i found they respond to your tone .he once threw fit in store i kept my calm voice and he calmed down even though people were looking at us i kept my voice calm and he was done in 5 min . thanks for reading .
•    Anonymous said… My behavioralist (my son is 5 with ASD and SPD) says to ignore them. Make sure they are safe, offer other alternatives, try to distract, but if none of that works, ignore it.
•    Anonymous said… My son is HFA....diagnosed at age 15. When he was younger and had a tantrum. ....we removed him from the place. BEFORE we went anywhere, we talked about behavior. My neuro - typical daughter raised her hand to me me ONCE at age 16. She never did it again. Don't sell your ASD kids short, they "know" how to push buttons. We never coddled our son, before or "after" the diagnosis.
•    Anonymous said… One thing might be to begin to recognise when your child is already overloaded. When our son is overwhelmed we just can't go out. If we do it has to be very short. Maybe also see if there are sensory issues in some spaces like strong smells/sounds in some places and avoid them. Pubs with kids play areas for example. We use headphones so our son can listen to music to block stimulation.
•    Anonymous said… Same as you do with any kid. Pick him up and take him to the car.
•    Anonymous said… Take the child out of situation ( to car or otherwise) - as you would for any child. Aspergers doesn't mean they can't learn to know how to behave it's just they take s lot longer to learn... Explain calmly that screaming and shouting in public ( for whatever reason ) is not acceptable. Eventually they get it!
•    Anonymous said… To this mother,I would suggest trying two things. One we call "Red Balloon"-My daughter would hold her hands as if she was holding a ballon between them and slowly breathe out,letting the "bad/angry air" out. She would do as many "balloons" as required,until she felt calmer. Another thing to try is whispering. While they're shouting and screaming,whisper calming words. Your child will want to understand what you're saying,and will adjust their volume so they can hear you,possibly whispering themselves.
•    Anonymous said… What if,like me,you don't drive for medical reasons-so no car. And any attempts to move the child take superhuman strength because the "child" (my daughter is 16) is bigger than you and has become physically abusive when attempts are made. Then what?

Post your comment below…

Six-Step Plan for Teachers of Aspergers Students

Following the six-step plan, detailed below, will help prepare you for the entrance of a youngster with Aspergers (high functioning autism) in your classroom, as well as foster inclusion throughout the school. The steps are as follows: (1) educate yourself; (2) reach out to the moms and dads; (3) prepare the classroom; (4) educate peers and promote social goals; (5) collaborate on the implementation of an educational program; and (6) manage behavioral challenges.

Step 1: Educate Yourself—

As the person responsible for the education and behavior management of all your children, including a youngster with Aspergers, you must have a working understanding of Aspergers and its associated behaviors. Different behaviors are very much a part of Aspergers. When kids with Aspergers do not respond to the use of language or act out in class, it is typically not because they are ignoring you, trying to clown around, or waste class time. These behaviors may be more related to their Aspergers, and they may be having difficulty interpreting language and expressing their needs in socially acceptable ways. It is important to find ways to create a comfortable environment for your children with Aspergers so that they can participate meaningfully in the classroom.

Learning about Aspergers in general and about the specific characteristics of your child will help you effectively manage this behavior and teach your class. You have already started your education by reading this guide. Below are some helpful hints that can guide everyday school life for young people with Aspergers. They can be applied to individuals with Aspergers across the school years and are applicable to almost all environments.

Operate on “Asperger time.” “Asperger time” means, “Twice as much time, half as much done.” Children with Aspergers often need additional time to complete assignments, to gather materials, and to orient themselves during transitions. Provide this time or modify requirements so they can fit in the time allotted and match the child’s pace. Avoid rushing a youngster with Aspergers, as this typically results in the youngster shutting down. When time constraints are added to an already stressful day, the child can become overwhelmed and immobilized.

Manage the environment. Any changes―unexpected changes, in particular―can increase anxiety in a child with Aspergers; even changes considered to be minor can cause significant stress. Whenever possible, provide consistency in the schedule and avoid sudden changes. Prepare the youngster for changes by discussing them in advance, over-viewing a social narrative on the change, or showing a picture of the change. The environment can also be managed by incorporating child preferences that may serve to decrease his or her stress. For example, when going on a field trip, the child might be assigned to sit with a group of preferred peers. Or if the field trip is going to include lunch, the child has access to the menu the day before so he or she can plan what to eat.

Create a balanced agenda. Make a visual schedule that includes daily activities for children with Aspergers. It is essential that the demands of the daily schedule or certain classes or activities be monitored and restructured, as needed. For example, “free time,” which is considered fun for typically developing youth, may be challenging for children with Aspergers because of noise levels, unpredictability of events, and social skills problems.

For a youngster with Aspergers, free time may have to be structured with prescribed activities to reduce stress and anxiety. A good scheduling strategy is to alternate between preferred and non-preferred activities with periods in the schedule for downtime. It is important to distinguish free time from downtime. Free time refers to periods during the school day when children are engaged in unstructured activities that have marked social demands and limited teacher supervision. Lunch time, passing time between classes, and time at school before classes actually begin all meet the criteria for free time. These activities are stressful for many children with Aspergers. Downtime, on the other hand, provides an opportunity for the youngster or youth with Aspergers to relax or de-stress. Children’ downtime may include using sensory items, drawing, or listening to music to relieve stress. During downtime, excessive demands are not made on the children.

Share the agenda. Children with Aspergers have difficulty distinguishing between essential and nonessential information. In addition, they often do not remember information that many of us have learned from past experiences or that to others come as common sense. Thus, it is important to state the obvious. One way to do this is to “live out loud.” Naming what you are doing helps the youngster with Aspergers accurately put together what you are doing with the why and the how. In addition, “living out loud” helps the child to stay on task and anticipate what will happen next.

Simplify language. Keep your language concise and simple, and speak at a slow deliberate pace. Do not expect a child with Aspergers to “read between the lines,” understand abstract concepts like sarcasm, or know what you mean by using facial expression only. Be specific when providing instructions. Ensure that the youngster with Aspergers knows what to do, how to do it, and when to do it. Be clear, and clarify as needed.

Manage change of plans. When planning activities, make sure the child with Aspergers is aware that the activities are planned, not guaranteed. Children with Aspergers need to understand that activities can be changed, canceled, or rescheduled. In addition, create backup plans and share them with the youngster with Aspergers. When an unavoidable situation occurs, be flexible and recognize that change is stressful for people with Aspergers; adapt expectations and your language accordingly.

For example, a teacher could state, “Our class is scheduled to go to the park tomorrow. If it rains, you can read your favorite book on dinosaurs.” Prepare children for change whenever possible; tell them about assemblies, fire drills, guest speakers, and testing schedules. In addition to changes within the school day, recurring transitions, such as vacations and the beginning and end of the school year, may cause a youngster with Aspergers to be anxious about the change. Children with Aspergers may require additional time to adjust to the new schedule and/or environment.

Provide reassurance. Because children with Aspergers cannot predict upcoming events, they are often unsure about what they are to do. Provide information and reassurance frequently so that the child knows he is moving in the right direction or completing the correct task. Use frequent check-ins to monitor child progress and stress.

Be generous with praise. Find opportunities throughout the day to tell young people with Aspergers what they did right. Compliment attempts as well as successes. Be specific to ensure that the child with Aspergers knows why the teacher is providing praise.

Step 2: Reach Out to the Parents—

It is vitally important to develop a working partnership with the moms and dads of your child with Aspergers. They are your first and best source of information about their youngster and Aspergers as it manifests itself in that youngster’s behavior and daily activities. Ideally, this partnership will begin with meetings before the school year. After that, it is critical to establish mutually agreed-upon modes and patterns of communication with the family throughout the school year. Your first conversations with the family should focus on the individual characteristics of the child, identifying strengths and areas of challenge. The family may have suggestions for practical accommodations that can be made in the classroom to help the youngster function at his or her highest potential. In these conversations, it is critical to establish a tone of mutual respect while maintaining realistic expectations for the course of the year.

Building trust with the moms and dads is very important. Communication with families about the progress of the child should be ongoing. If possible, schedule a monthly meeting to discuss the youngster’s progress and any problems he or she may be having. If regular telephone calls or meetings are hard to schedule, you can exchange journals, e-mails, or audiotapes with families. While the information you exchange may often focus on current classroom challenges, strategies employed, and ideas for alternative solutions, do not forget to include positive feedback on accomplishments and milestones reached. Families could respond with their perspective on the problem and their suggestions for solutions. Families can also support you from home in your social and behavioral goals for your child with Aspergers.

Open, ongoing communication with families of children with Aspergers creates a powerful alliance. Be aware that some families may have had negative experiences with other schools or educators in the past. You will have to help them work through that. If you make the effort to communicate with the family about the progress of their youngster and listen to their advice and suggestions, they will accept you as their youngster’s advocate and thus be more likely to give you their complete support.

Step 3: Prepare the Classroom—

Having learned about the individual sensitivities and characteristics of your child with Aspergers, you now have the information you need to organize your classroom appropriately. There are ways that you can manipulate the physical aspects of your classroom and ways you can place kids with Aspergers within the classroom to make them more comfortable without sacrificing your plans for the class in general. Use the search bar at the top of this page for more information about specific approaches for structuring the academic and physical environment to address the particular behaviors, sensitivities, and characteristics of your individual child with Aspergers.

Step 4: Educate Peers and Promote Social Goals—

Perhaps the most common myth about kids with Aspergers is that they do not have the ability, motivation, or desire to establish and maintain meaningful relationships with others, including friendships with peers. This, for the most part, is not true. There is no doubt that kids with Aspergers have social deficits that make it more difficult for them to establish friendships than typically developing kids. However, with appropriate assistance, kids with Aspergers can engage with peers and establish mutually enjoyable and lasting relationships. It is critical that educators of kids with Aspergers believe this to be true and expect children with Aspergers to make and maintain meaningful relationships with the adults and other kids in the classroom.

Clearly stated social skills, behaviors, and objectives should be part of the IEP and assessed regularly for progress. While teasing may be a common occurrence in the everyday school experience for young people, kids with Aspergers often cannot discriminate between playful versus mean-spirited teasing. Educators and moms and dads can help kids with Aspergers recognize the difference and respond appropriately. A more serious form of teasing is bullying. It is important for educators and school staff to know that children with Aspergers are potentially prime targets of bullying or excessive teasing and to be vigilant for the signs of such activities to protect the youngster’s safety and self-esteem.

One strategy for educators could be to assign a “buddy” or safe child in the classroom. In this way, the child with Aspergers would have a friend to listen to them and to report any potential conflicts with other children. Also, educators should routinely check in with the child with Aspergers and/or the moms and dads to ensure the comfort of the child in the classroom. In addition to the “buddy” strategy described above, it may also be important to educate typically developing children about the common traits and behaviors of kids with Aspergers.

The characteristics of Aspergers can cause peers to perceive a youngster with the disorder as odd or different, which can lead to situations that involve teasing or bullying. Research shows that typically developing peers have more positive attitudes, increased understanding, and greater acceptance of kids with Aspergers when provided with clear, accurate, and straightforward information about the disorder. When educated about Aspergers and specific strategies for how to effectively interact with kids with Aspergers, more frequent and positive social interactions are likely to result.

Many of the social interactions occur outside the classroom in the cafeteria and on the playground. Without prior planning and extra help, children with Aspergers may end up sitting by themselves during these unstructured times. To ensure this does not happen, you may consider a rotating assignment of playground peer buddies for the child with Aspergers. The child will then have a chance to observe and model appropriate social behavior of different classmates throughout the year. This “circle of friends” can also be encouraged outside of school. The academic and social success of young people with Aspergers can be greatly enhanced when the classroom environment supports their unique challenges. Peer education interventions, such as those listed in the Resources section of this guide, can be used with little training and have been shown to improve outcomes for both typically developing peers and young people with developmental disorders, such as autism and Aspergers.

Step 5: Collaborate on the Educational Program Development—

The next key step in your preparations will be to participate in the development and implementation of an educational program for your child with Aspergers. It is critical to develop this plan based on the assessment of the youngster’s current academic skills and his or her educational goals, as defined in the IEP.

A Brief Legislative History…

Congress passed the Education of All Handicapped Kids Act in 1975 and reauthorized it in 1990 as IDEA. This legislation guarantees that all children with disabilities will be provided a free and appropriate public education (FAPE). It also states that children with disabilities should be placed in the least restrictive environment (LRE), where they can make progress toward achieving their IEP goals, meaning that as much as possible, kids with disabilities should be educated with kids who are not disabled. Finally, it states that children with disabilities must have an IEP, which describes the child’s current level of functioning, his or her goals for the year, and how these goals will be supported through special services.

IEPs are an important focus of the six-step plan, and they are discussed in greater detail below. Because the challenges associated with Aspergers affect many key aspects of development, the impact of the disorder on education and learning is profound. Therefore, kids with Aspergers are considered disabled under the IDEA guidelines and are legally entitled to an IEP plan and appropriate accommodations from the school to help them achieve their developmental and academic goals.

Individualized Education Program…

IEPs are created by a multidisciplinary team of education professionals, along with the youngster’s moms and dads, and are tailored to the needs of the individual child. The IEP is a blueprint for everything that will happen to a youngster in school for the next year. Special and general education educators, speech and language therapists, occupational therapists, school psychologists, and families form the IEP team and meet intermittently to discuss child progress on IEP goals.

Before the IEP team meets, an assessment team gathers information together about the child to make an evaluation and recommendation. The school psychologist, social worker, classroom teacher, and/or speech pathologist are examples of educational professionals who conduct educational assessments. A neurologist may conduct a medical evaluation, and an audiologist may complete hearing tests. The classroom teacher also gives input about the academic progress and classroom behavior of the child. Moms and dads give input to each specialist throughout the process. Then, one person on the evaluation team coordinates all the information, and the team meets to make recommendations to the IEP team. The IEP team, which consists of the school personnel who work with the child and families, then meets to write the IEP based on the evaluation and team member suggestions.

IEPs always include annual goals, short-term objectives, and special education services required by the child, as well as a yearly evaluation to see if the goals were met. Annual goals must explain measurable behaviors so that it is clear what progress should have been made by the end of the year. The short-term objectives should contain incremental and sequential steps toward meeting each annual goal. Annual goals and short-term objectives can be about developing social and communication skills, or reducing problem behavior. Appendix E (page 61) provides more information on IEP and transition planning for children with Aspergers, including writing objectives and developing measurable IEP goals for learners with Aspergers.

As a general education teacher, you will be responsible for reporting back to the IEP team on the child’s progress toward meeting specific academic, social, and behavioral goals and objectives as outlined in the IEP. You also will be asked for input about developing new goals for the child in subsequent and review IEP meetings. This resource can decrease the time spent documenting the child’s performance in a comprehensive manner.

Step 6: Manage Behavioral Challenges—

Many children with Aspergers view school as a stressful environment. Commonplace academic and social situations can present several stressors to these children that are ongoing and of great magnitude. Examples of these stressors include:
  • Anticipating changes, such as classroom lighting, sounds/noises, odors, etc.
  • Difficulty predicting events because of changing schedules
  • Interacting with peers
  • Tuning into and understanding teacher’s directions

Children with Aspergers rarely indicate in any overt way that they are under stress or are experiencing difficulty coping. In fact, they may not always know that they are near a stage of crisis. However, meltdowns do not occur without warning. There is a pattern of behavior, which is sometimes subtle, that can indicate a forthcoming behavioral outburst for a young person with Aspergers. For example, a child who is not blinking may well be so neurologically overloaded that they have “tuned out.” They may appear to be listening to a lesson when, in fact, they are taking nothing in. Tantrums, rage, and meltdowns (terms that are used interchangeably) typically occur in three stages that can be of variable length. These stages and associated interventions are described below. The best intervention for these behavioral outbursts is to prevent them through the use of appropriate academic, environmental, social, and sensory supports and modification to environment and expectations.

The Cycle of Tantrums, Rage, and Meltdowns and Related Interventions…

Rumbling-

During the initial stage, young people with Aspergers exhibit specific behavioral changes that may appear to be minor, such as nail biting, tensing muscles, or otherwise indicating discomfort. During this stage, it is imperative that an adult intervene without becoming part of a struggle.

Intervention-

Effective interventions during this stage include: antiseptic bouncing, proximity control, support from routine and home base. All of these strategies can be effective in stopping the cycle of tantrums, rage, and meltdowns and can help the youngster regain control with minimal adult support.

Rage-

If behavior is not diffused during the rumbling stage, the young person may move to the rage stage. At this point, the youngster is disinhibited and acts impulsively, emotionally, and sometimes explosively. These behaviors may be externalized (i.e., screaming, biting, hitting, kicking, destroying property, or self-injury) or internalized (i.e., withdrawal). Meltdowns are not purposeful, and once the rage stage begins, it most often must run its course.

Intervention-

Emphasis should be placed on youngster, peer, and adult safety, as well as protection of school, home, or personal property. Of importance here is helping the individual with Aspergers regain control and preserve dignity. Adults should have developed plans for (a) obtaining assistance from educators, such as a crisis teacher or principal; (b) removing the child from the area [removing the upset child from the peer group is far less memorable for the peers than is moving the entire peer group away from the upset child]; or (c) providing therapeutic restraint, if necessary. Especially in elementary and middle school, every effort should be made to prevent allowing a child to have a meltdown in view of peers as this behavior tends to “define” the child in the peers’ minds in years ahead.

Recovery-

Following a meltdown, the youngster with Aspergers often cannot fully remember what occurred during the rage stage. Some may become sullen, withdraw, or deny that inappropriate behavior occurred. Other individuals are so physically exhausted that they need to sleep.

Intervention-

During the recovery stage, kids are often not ready to learn. Thus, it is important that adults work with them to help them to once again become a part of the routine. This is often best accomplished by directing the youth to a highly motivating task that can be easily accomplished, such as an activity related to a special interest. If appropriate, when the child has calmed sufficiently, “process” the incident with the child. Staff should analyze the incident to identify whether or not the environment, expectations, or staff behavior played a role in precipitating the incident.

Pulling It All Together—

The six-step plan presents a constructive framework for how to approach the inclusion of a youngster with Aspergers in your classroom. Specific strategies for developing and providing academic, environmental, and social supports are given in the Appendices of this guide. Your classroom is already a diverse place, including many children with varying backgrounds, talents, difficulties, and interests. With the increasing inclusion of children with Aspergers, the challenges associated with managing a diverse classroom into today’s educational environment will grow. Just as every youngster with Aspergers is different, so is every school environment. It is quite likely that there will be constraints -- environmental, interpersonal, financial, and administrative -- on the ways that you can implement the approaches suggested in the Guide.

Despite the challenges, your hard work makes a difference in the lives of all the kids in the classroom. It is clear, though, that kids with Aspergers may need more help and support than some of your typically developing children.

As you learn more about kids with differences and how to support their inclusion in the classroom, you will become a mentor to other educators who may be facing this challenge for the first time. Many of the skills that make you a powerful educator will help you succeed in the tasks ahead of you. Your curiosity will fuel your education about Aspergers and other disorders on the autism spectrum; your communication skills will help you create a meaningful alliance with the moms and dads of the youngster with Aspergers in your class.

Most of all, your collaboration skills will help you work as a key part of the team that will support the youngster with Aspergers throughout the course of the school year. The reward for your patience, kindness, and professionalism will be the unique sense of satisfaction that comes with knowing that you have helped a youngster with a special need and will have made a difference in that young person’s life! 

Struggling with an Aspergers student? Click here for highly effective teaching strategies -- specific to the Aspergers condition.

Stephen's Story: Parents Share Their "Aspergers" Experience

While we are a bit sad about our son Stephen's diagnosis of Aspergers, we are also actually somewhat happy to find out. Finally, we have direction and some understanding!

Just like you read about kids with Aspergers or PDD-NOS (Pervasive Developmental Disorder - Not Otherwise Specified), Stephen has a lot of idiosyncracies, practices, attitudes, etc. that get him in trouble and teased and ridiculed.

He's also very sad at times, very depressed to the point of talking about suicide at least every other day.

We had problems with him being attacked at school, over and over again, and after much screaming and threats of lawsuit over the lack of safety contributing to Stephen being repeatedly assaulted we were finally granted a meeting with the Director of Pupil Services, the District Psychologist and the Principal and Vice Principal of the school.

After reciting Stephen's history to the District Psychologist she then asked us if anyone had ever mentioned Aspergers in regards to Stephen's difficulties.

As soon as that meeting was over and we got home I started researching Aspergers online and it wasn't long before I was convinced that this is what Stephen has been dealing with all this time.

I downloaded information from online, highlighted sections and made notes that were specific to Stephen's issues and scheduled a couple appointments, one with a psychiatrist (med doctor) and one with a particular psychologist whom Stephen is familiar with and connects with.

Our suspicions were confirmed and Stephen was officially diagnosed with Aspergers in November 2005.

After his diagnosis, his depression subsided quite substantially. I think it's because of a few reasons...

1. I think our son somewhat realizes that we understand him better and sees that we are fighting for him to make life in school smoother for him.

2. The psychiatrist that he has started seeing (he was seeing just a behavioral doctor for behavioral issues) has changed his medication, he eliminated the Risperdal and put him on Prozac.

3. We are able to understand him better and we now realize that he's not necessarily purposely breaking rules, not necessarily purposely hurting feelings and not necessarily purposely 'bugging' people and because of this new-found understanding we are working with him differently now.

4. Mark Hutten’s eBook entitled My Aspergers Child has given us the tools to deal with Stephen’s meltdowns. We had no idea what to do about these intense temper tantrums before. But the information in the eBook and videos has made a tremendous difference in how we react to our son, which in turn has made a big difference in how our son reacts to us – his parents. There is much less tension in our home now, which gives everyone more energy to focus on the really important things.

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