From Anxiety to Anger to Meltdown: A Dilemma for Kids on the Autism Spectrum

“Can an autistic (high functioning) child’s anxiety play out as anger, and then morph to a meltdown?”

Good question. The answer is yes. There are many scenarios, but the most popular one I see goes like this:

The Aspergers or high-functioning autistic child begins to feel anxious ...his anxiety turns to anger ...his anger is misdirected toward the parent ...the parent becomes offended and pursues some form of punishment ...the child’s anxiety increases ...the conflict escalates (meltdown).

A meltdown is a state of neurological chaos where the Aspergers or HFA child's brain and nervous system overheat and stop working properly. A good analogy is a nuclear power plant where the fuel in the reactor core becomes so hot that it melts and releases energy.

Sometimes it gets so hot that it causes an explosion, and the energy is released outside of the core. It’s this explosive reaction that most parents and teachers refer to when they talk about meltdowns (although many confuse meltdowns with tantrums).

==> Here's how to stop meltdowns and tantrums...




 
COMMENTS:

•    Anonymous said... An even better question is "How do we get schools to recognize this so they don't punish"?
•    Anonymous said... Single parent here. Fully recognise that anxiety meltdown scenario! I find it a real struggle on the days I'm tired and have less patience than I need but mostly I think we all just do the best we can
•    Anonymous said... Exactly! My daughter's anxiety & frustrations will build to an inevitable meltdown if the wrong thing happens at the wrong time. We make sure she has an escape from known stressors so that she can calm herself when she is getting too upset. She is getting better about self regulating but we still have a ways to go.
•    Anonymous said... feel u frustration I have 3, my eldest has Aspergers, the younger children don't always understand. Also a single parent. It can sometimes feel like yr alone it does help to read others have similar problems, especially as others have no clue to yr child's uniqueness.
•    Anonymous said... How do u stop this anxiety manifesting in violent outburst when at school. My son has problems with fair play and gets very frustrated that people are cheating, he then gets angry and sometime violent. This then turns into deep remorse and guilt leading to feeling he's ruined his life due to these meltdowns.
•    Anonymous said... how do you manage to help them through a melt down or help them calm?
•    Anonymous said... I also took my son out of school and placing him in a special school that has services he needs.
•    Anonymous said... I feel your pain .
•    Anonymous said... I give my son updates on time we have to leave for dr appt ect. He says ok mom. Then when it is that time to leave he states "no" gets anxious then mad. Strikes out of me. Hates me ect. Total meltdown and I still have to get h in car. If I physically force him to car. I would get hurt. He is 10. Does anyone have suggestions? He had Aspergers
•    Anonymous said... I have 4 boys my oldest 12 was just diagnosed with aspergers we are having a lot of issues with anger and anxiety he is in counseling but feel we need to do something more. I am familiar with austim spectrum has my youngest is on it but they are totally different. Any tips or suggestions that could help us. Thanks
•    Anonymous said... I have one son diagnosed aspergers but my oldest,almost 15,has struggled in school since the start.he is diagnosed adhd and odd but he just can not have a single good day in school.he is in 9th grade now with an I.E.P. but i cant figure out why he has daily anxiety that leads to anger outbursts at school.i am at this point very desperate
•    Anonymous said... I now have my 12 yr old 6th grader home...public school doesn't work..next yr I will have a person from disability services come for iep
•    Anonymous said... I took my now 16 year old out of school her 8th grade year and did home school (i also worked full time as a sped teacher in the same district she was pulled out of- you can imagine how that went over!). She also did a lot of behavior therapy that year. It was very difficult, but she started her 9th grade beautifully and so much stronger emotionally. She still has struggles, but is making strides in a positive direction.
•    Anonymous said... I went round and round with the school. nothing was being done.So i took it in my own hands.
•    Anonymous said... It is the same for me , my 11yr is just like this anxious and meltdown and hart herself and me!!!
•    Anonymous said... It's expensive so I'm asking school district to pay. I know I have an uphill battle.
•    Anonymous said... Ive done deep breathing with my son to help him calm when he knows he's geting anxious and now he does this himself when he feels he's getting "frazzled" as he calls it. Helps he(and I) focus on what issue really is rather than explosion of temper. Not 100% of the time, but does help focus.
•    Anonymous said... I've had the same problem! Jared was hospitalized for attacking a teacher over that lack of fairness. He is now in a different school with a wonderful teacher. We've had 1 major meltdown in school that resulted in a suspension with her. And 1 when he had a sub. I laid it out for her at the start of school and in the IEP mtg. She has since been very fair (4 other kids, no mainstream ed) and tells him and I ahead of time when she will be gone.
•    Anonymous said... Just as it happens in our family!
•    Anonymous said... My son is 14 and i took him out of school.and Home School him .Took him in the 5th grade.He also had IEP.
•    Anonymous said... My son is 7 and having a tough time at school he's now refusing to go and when I get him there he won't work
•    Anonymous said... My son is ADHD, but I have noticed that "they" try to label the disability as simply a behavior. Then try to convince all that the behavior is a choice. Pointing the finger always back to the child in making a bad choice. I've always wanted someone to say a kind word to my son like, "Hey, I know this is difficult for you, . . ." Recognizing that EVERTHING is more difficult for him.
•    Anonymous said... Now my son DR. Has him on bipolar meds. Lithium and he still isn't at the level takes 900mg in the morning 1200mg at night and with another meds. and the behaviors are still the same maybe we have 2 or 3 days that i would call good. He has broken so many thing in my home a list a mile long .and 2 of my car windows WE done so much counseling i think i get more out of it then he does.
•    Anonymous said... OMGsh, yes! It took me forever to realize what was going on, but that is exactly what can happen. Through behavior therapy and practice, we are working toward avoiding triggers and then if triggers still happen , ways to self sooth so she doesn't get angry and or have a melt down. It is a process, but worth the effort.
•    Anonymous said... Same in mine.
•    Anonymous said... So true!
•    Anonymous said... Some times you feel like your alone and dont no what do.There days i could throw the towel in and give up. But that my and i love him he is on meds but they change all the time.Iam single mom i do have two other kids they are older and help me when they can. Well i just had to vent some time it helps.
•    Anonymous said... Thats how it goes with my daughter
•    Anonymous said... we are having a very ruff time , with our local catholic school , to the point they want her to leave ,,, but she Dosent want too , do I persist as its not children pushing her out its teachers ..... as she loves going to her high school angry .....
•    Anonymous said... We have recently developed a big deal, little deal hand sign. I use it as a reminder not to blow a minor annoyance into a major meltdown. It seems to help a lot. I also focus on remaining calm and try to offer face/scalp massage, or other reassuring touch, once he'll allow it. Yoga, with a focus on breathing is next.
•    Anonymous said... We too have the exact scenario as the original post (14yr old boy in our case). Tell me, there seems to be some very desperate parents crying out for help and support on this forum, is this just a place to vent or are there people monitoring these answers who can help? Genuine question not a criticism!
•    Anonymous said... when we learned about the Aspergers it made such a difference because we stopped getting offended and punishing and started working harder to prevent, redirect, help him center, change our process of expectations, and things improved dramatically
•    Anonymous said... Wow, spot on!
•    Anonymous said... Yes, just like that!
•    Anonymous said... Your formula is right on. It happen like that for my 9 yr old son in school today. Never ending cycle. It just takes one thing to throw him off.
•    Anonymous said... Yup, so frustrating! That's the pattern here, too.
*   OH MY GOODNESS! He explained that SO very brillantly! I'm 58 and STILL have meltdowns sometimes~makes me feel like a naughty little girl and that no one understands me AT ALL! I think my eldest son has Asperger's, but it just hit me that maybe I do, as well...I'm highly intelligent but didn't have as severe anxiety and depression as he did at as young an age...
 
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"Emotionally Fragile" Children with Asperger's & High-Functioning Autism

"Any tips for dealing with a very fragile and overly sensitive child on the autism spectrum ...he's a chronic worrier to say the least and will go back and forth between being extremely shy or very aggressive?"

As some parents may have discovered, many young people with Asperger’s (AS) and High Functioning Autism (HFA) are “emotionally fragile” (to coin a term). In other words, these individuals have great difficulty coping with day-to-day stressors, and exhibit unusually withdrawn or aggressive behaviors as a defense mechanism.

Emotional fragility is most prevalent in school-age AS and HFA kids. It can manifest itself in many ways, all of which are challenging for the youngster, parents, and teachers. These young people often exhibit a variety of symptoms that cause school psychologists to misdiagnose them with depression, bipolar disorder, or some other disorder. A wrong diagnosis can often lead to the youngster being placed in inappropriate special education classes, or even being treated with the wrong medication.

Traits of Emotional Fragility —

1. An emotionally fragile AS or HFA youngster may become socially anxious and withdrawn in public. When faced with risks or decisions, however trivial, he may become tense and fearful. He may have extremely poor self-esteem, and may seem to have a distorted sense of reality, usually preferring to live in his own fantasy world. These kids will often internalize their feelings and emotions, and have difficulty talking about them when asked. Occasionally they may act out and hurt others out of fear and a desire to be left alone.

2. Emotional fragility often causes AS and HFA kids to regress developmentally. They may behave as though they were much younger, even to the point of seeming overly dependent on others. As these kids become older, they may be at risk for substance abuse, although due to their lack of social skills, they may be less likely to use drugs in a peer-group context.

3. An AS or HFA child with emotional fragility usually has some degree of difficulty at school. A “typical” child will be able to follow a teacher's instructions independently, and will have no problem asking for help if needed. The emotionally fragile youngster will have difficulty carrying out these same age-appropriate instructions, and may be fearful of asking for help. This can create an inability to learn on the same level as other peers of the same age, which causes the youngster to view school as a source of misery and confusion. This often leads to poor grades and excessive absences.

4. Emotional fragility can have detrimental effects on a youngster's ability to make friends and interact with others. A “typical” youngster will be able to approach a group of his peers, converse, and join in their activities. The emotionally fragile youngster will be consistently rejected or ignored by these peers due to a lack of appropriate social skills, and may even be taunted or called names. This youngster may be viewed as immature or "weird" by his peer group.

Warning Signs—

Some of the most common warning signs of emotional fragility are a loss of interest in school, depression, social withdrawal, hyperactivity, sleep problems or fatigue. However, these are just a few of the most common warning signs. It is also important to keep in mind that just because a youngster has some of these behaviors doesn't necessarily mean that she is emotionally fragile. All kids experience these things at different points in their lives. Parents should only be concerned if their youngster is displaying any of the associated behaviors over a prolonged period of time.

The most difficult part of determining eligibility for special education services is deciding if the child is emotionally fragile, or has a behavior disorder (one can often look like the other).

Let’s draw a distinction between the two along the following domains:

1. Affective Reactions— Emotional Fragility: disproportionate reactions, but not under child’s control. Behavior Disorder: intentional with features of anger and rage; explosive.
2. Aggression— Emotional Fragility: hurts self and others as an end. Behavior Disorder: hurts others as a means to an end.
3. Anxiety— Emotional Fragility: tense; fearful. Behavior Disorder: appears relaxed; cool.
4. Attitude toward School— Emotional Fragility: school is a source of confusion or angst; does much better with structure. Behavior Disorder: dislikes school, except as a social outlet; rebels against rules and structure.
5. Conscience— Emotional Fragility: remorseful; self-critical; overly serious. Behavior Disorder: little remorse; blaming; non-empathetic.
6. Developmental Appropriateness— Emotional Fragility: immature; regressive. Behavior Disorder: age appropriate or above.
7. Educational Performance— Emotional Fragility: uneven achievement; impaired by anxiety, depression, or emotions. Behavior Disorder: achievement influenced by truancy, negative attitude toward school, avoidance.
8. Interpersonal Dynamics— Emotional Fragility: poor self-concept; overly dependent; anxious; fearful; mood swings; distorts reality. Behavior Disorder: inflated self-concept; independent; underdeveloped conscience; blames others; excessive bravado.
9. Interpersonal Relations— Emotional Fragility: inability to establish or maintain relationships; withdrawn; social anxiety. Behavior Disorder: many relations within select peer group; manipulative; lack of honesty in relationships.
10. Locus of Disorder— Emotional Fragility: affective disorder; internalizing. Behavior Disorder: conduct disorder, externalizing.
11. Peer Relations and Friendships— Emotional Fragility: difficulty making friends; ignored or rejected. Behavior Disorder: accepted by a same delinquent or socio-cultural subgroup.
12. Perceptions of Peers— Emotional Fragility: perceived as bizarre or odd; often ridiculed. Behavior Disorder: perceived as cool, tough, charismatic.
13. Risk Taking— Emotional Fragility: avoids risks; resists making choices. Behavior Disorder: risk-taker; daredevil.
14. School Attendance— Emotional Fragility: misses school due to emotional or psychosomatic issues. Behavior Disorder: misses school due to choice.
15. School Behavior— Emotional Fragility: unable to comply with teacher requests; needy or has difficulty asking for help. Behavior Disorder: unwilling to comply with teacher requests; truancy; rejects help.
16. Sense of Reality— Emotional Fragility: fantasy; naïve; gullible; thought disorders. Behavior Disorder: street-wise; manipulates facts and rules for own benefit.
17. Social Skills— Emotional Fragility: poorly developed; immature; difficulty reading social cues; difficulty entering groups. Behavior Disorder: well developed; well attuned to social cues.
18. Substance Abuse— Emotional Fragility: less likely; may use individually. Behavior Disorder: more likely; peer involvement.

 ==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

Accommodations for Emotionally Fragile AS and HFA Children: Tips for Parents and Teachers—

1. AS and HFA kids with emotional fragility are often achieving academically below their “typical” peers in reading, writing, and arithmetic. Accommodation: early detection and intervention is the best strategy; set up personalized goals and strategies so that the youngster can find success.

2. Kids with emotional fragility may appear easily distracted, less attentive, and have poor concentration. Accommodation: by setting up an environment and materials that are stimulating, these kids can stay more engaged and interested; set clear rules and expectations with visual stimulating material.

3. Some young people with emotional fragility may be blame others, manipulate situations, and even bully others. Accommodation: use behavior contracts; use a highly structured environment; stay consistent in expectations; set limits and boundaries; develop a cue word for the youngster to note inappropriate behavior; clearly post rules.

4. AS and HFA kids who are emotionally fragile often have skewed views of their long term possibilities and desires. Accommodation: include these children in the planning process and IEP so they can visualize and voice their goals; it can also be helpful for them to note the goals it will take to get there.

5. Youngsters with emotional fragility may present extra challenges to parents in the form of outbursts and disobedience. Accommodation: parents should not give into this as it only validates the youngster’s behavior; instead parents need to challenge their child to keep him learning new skills.

6. Children with emotional fragility may have difficulty establishing a variety of relationships. Accommodation: use seating arrangement to encourage social interaction; use role-playing situations; set up goals aimed at social interactions.

7. Children with emotional fragility often have low self-esteem, high stress points, and may engage in self-injurious behaviors. Accommodation: be aware of your speech and non-verbal cues when talking to the child; establish a quiet cool off area; provide time for relaxation techniques; teach and put in place self-monitoring and self-control techniques; teach self-talk to relieve stress and anxiety.

8. AS and HFA children with emotional fragility are often truant from school and disruptive when present. Accommodation: communicate with moms and dads so similar strategies and expectations are used at home.

Additional Strategies to Assist Emotionally Fragile AS and HFA Children—

1. Create a new behavior to replace the behavior you want to change. If the AS/HFA youngster is aggressive toward others while working in a group, you may want him to take turns or talk in a quiet tone of voice while in a group. Remember to create an alternative behavior that is directly observable.

2. Establish rewards and/or consequences for behaviors. Overall, it's more effective to reward the positive behavior that you are trying to increase than to punish the behavior you are trying to decrease. If the behavior does not pose an immediate threat to you, the AS/HFA youngster or other kids, or does not disrupt the entire group lesson, try to ignore the disruptive behavior while rewarding the positive behavior.

3. Identify the behavior you want to change. Keep a written record of the behaviors the AS/HFA youngster exhibits during social and independent play and academic activity (e.g., "I want Julie to play without pushing other kids …or to remain quiet during a test …or to stay seated during a lesson"). Once you describe the youngster's behavior in terms of observable actions, you will be able to monitor and mediate the behavior.

4. Provide plenty of opportunities to practice new behaviors. AS and HFA children with emotional fragility usually have difficulty working with others whether they are aggressive or withdrawn. You will want to set up social situations where the youngster can practice taking turns in a group or with a partner, and sharing and talking appropriately.

5. Role-play and hold conflict-resolution meetings so the AS/HFA youngster can practice and discuss alternative responses to social situations.

6. Teach the youngster to monitor progress independently. Have charts in folders, in a locker, or at home where she can document progress in achieving a particular behavioral goal. Have her write or verbally explain why a certain behavior is unacceptable and what behavior she can do to change it.

Services—

Children with emotional fragility often have an early diagnosis among school districts. This is because educators initiate the referral process among concerns over behavior in class. Often, the DSM is used by a school psychologist, whom may conduct interviews and distribute surveys as part of the social-emotional evaluation.

When it is determined that the child is emotionally fragile, he should receive an Individualized Education Plan (IEP). Children can also receive specific behavioral plans such as a 504 in the state of California. This often includes goals towards appropriate behavior, productive coping strategies and academic skills. Effective services should focus on these, and can mandate an educational assistant for support in regular education classes, access to a resource room for individualized instruction, medication management provided by a mental health professional, as well as individual counseling.

Emotionally fragile children are often considered at-risk for dropping out of school, suicide, criminal activity, as well as being diagnosed with a learning disability. Nonetheless, with the appropriate supports in place, these young people have been shown to have enormous potential to succeed.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

How Will My Son [high functioning autistic] Do As An Adult?

“I have a 19 y.o. son with high functioning autism. I am curious how he will do out in the world as an adult. How well do people with the condition truly 'function' when they actually have to fend for themselves?”

One of the most interesting and useful sources of data on outcome derives indirectly from observing those parents of kids with High-Functioning Autism (HFA) and Asperger’s (AS) who themselves appear to be somewhere on the autism spectrum.

From these observations, it is clear that HFA does not preclude the potential for a more "typical" adult life. These grown-ups will often gravitate to a job or profession that relates to their own areas of special interest, sometimes becoming very proficient.

Many young people with HFA and AS are able to successfully complete college – and even graduate school. However, in most cases, they will continue to demonstrate (at least to some extent) subtle differences compared to “typical” adults. For example:

• Many find their way to psychiatrists and other mental health providers where the true, developmental nature of their problems may go unrecognized or misdiagnosed.
• Their rigidity of style and idiosyncratic perspective on the world can make interactions difficult, both in and out of the family.
• There is a risk for mood problems (e.g., depression, anxiety).
• They can be challenged by the social and emotional demands of marriage, although many do marry.
• They may exhibit significant differences in social interactions.

It is estimated that 30-50% of all grown-ups with HFA or AS are never evaluated or correctly diagnosed. These individuals are simply viewed by others as "different" or “odd.” I’ve counseled many young adults that I believe fall into this category, yet I’m frequently amazed by how many of them have been able to capitalize on their strengths (usually with support from family) to achieve a high level of functioning, both personally and professionally.

In fact, some of these high-functioning men and women represent a unique resource for society in general, having the single-mindedness and consuming interest to advance our knowledge in various areas of engineering and science (just to name a couple).

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

Does My Preschool Daughter Have High-Functioning Autism?

"How can a parent tell whether or not her preschool daughter has high functioning autism? I’m beginning to have my suspicions!"

There is no single, uniform presenting picture of High-Functioning Autism (HFA) in the first 3-4 years of life. The early picture may be difficult to distinguish from typical autism, suggesting that when evaluating any young girl with autism with apparently normal intelligence, the possibility should be entertained that she may eventually have a picture more compatible with an HFA diagnosis.

Other girls may have early language delays with rapid "catch-up" between the ages of 3 and 5 years. Some of these young people (especially the brightest ones) may have no evidence of early developmental delay (with the possible exception of motor clumsiness).

In most cases, if you look closely at the girl between the age of about 3 and 5, clues to the disorder can be found, and in most cases a comprehensive evaluation at that age can at least point to a diagnosis somewhere along the spectrum.



Although these young people may seem to relate quite normally within the family setting, problems are often seen when they enter a preschool setting. For example:

• appearing to be "in one's own little world"
• difficulty regulating social/emotional responses with anger, aggression, or excessive anxiety
• difficulty with transitions
• having a preference for a set routine
• having odd verbal responses
• hyperactivity
• problems sustaining simple conversations
• tendency to avoid spontaneous social interactions
• tendency to be perseverative or repetitive when conversing
• tendency to over-focus on particular objects or subjects
• tendency to show very weak skills in interactions

In reality, this list is much like the early symptoms of autism. But, compared to the autistic child, a girl with HFA is more likely to show some social interest in others, will have less abnormal language and conversational speech, and may not be as obviously "different" from her peers. Also, areas of particularly strong skills may be present (e.g., letter or number recognition, rote memorization of various facts, etc.).

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism