"I read your article on preventing meltdowns, but what can be done when a child is already in a meltdown? My autistic son (high functioning) will experience meltdowns that can literally last for an hour or more."
There are a number of ways to handle a meltdown in a child with high-functioning autism once it has started.
Some simple strategies include the following:
1.You can positively distract the youngster by getting him focused on something else that is an acceptable activity. For example, you might remove the unsafe item and replace with an age-appropriate toy.
2.You can place the youngster in time away. Time away is a quiet place where she goes to calm down, think about what she needs to do, and, with your help, make a plan to change the behavior.
3.When possible, hold the youngster who is out of control and is going to hurt himself or someone else. Let the youngster know that you will let him go as soon as he calms down. Reassure the youngster that everything will be all right, and help him calm down. Parents may need to hug their youngster who is crying, and say they will always love him no matter what, but that the behavior has to change. This reassurance can be comforting for a youngster who may be afraid because he lost control.
4.Unlike a meltdown, you can ignore a tantrum if it is being thrown to get your attention. Once the youngster calms down, give the attention that is desired.
5.Try to intervene before the youngster is out of control. Get down at her eye level and say, “You are starting to get revved up, slow down.” Now you have several choices of intervention.
6.Think before you act. Count to 10 and then think about the source of the youngster’s frustration, his characteristic temperamental response to stress (e.g., hyperactivity, distractibility, moodiness), and the predictable steps in the escalation of the meltdown.
7.Talk with the youngster after she has calmed down. When she stops crying, talk about the frustration she has experienced. Try to help solve the problem if possible.
8.For the future, teach her new skills to help avoid meltdowns, such as how to ask for help. Teach her how to try a more successful way of interacting with a peer or sibling, how to express her feelings with words and recognize the feelings of others without hitting and screaming.
9.Remain calm and do not argue with the youngster. Before you manage him, you must manage your own behavior. Spanking or yelling at the youngster will make the meltdown worse.
10.If the youngster has escalated the meltdown to the point where you are not able to intervene in the ways described above, then you may need to direct him to time-away (not to punish, but to remove him from the current environment). If you are in a public place, carry your youngster outside or to the car. Tell him that you will go home unless he calms down. In school, teachers can warn the child up to three times that it is necessary to calm down and give a reminder of the rule. If the youngster refuses to comply, then place him in time-away for no more than 1 minute for each year of age (again, not to punish, but to remove him from the current environment).
Do not reward the youngster after a meltdown for calming down. Some kids will learn that a meltdown is a good way to get a treat later.
Explain to the youngster that there are better ways to get what he or she wants.
Never let meltdowns interfere with your otherwise positive relationship with the youngster.
Never, under any circumstances, give-in to a temper tantrum (which sometimes looks like a meltdown). That response will only increase the number and frequency of the tantrums. Also, when the youngster on the autism spectrum has become accustomed to successfully manipulating parents with tantrums in the past -- but then doesn't get his way with today's tantrum -- it can often escalate into a meltdown. Now the parent has two distinctly different problems (that may look the same) to address.
Teach the youngster that anger is a feeling that we all have and then teach her ways to express anger constructively.
More resources for parents of children and teens with High-Functioning Autism and Asperger's:
"Is it common for children on the autism spectrum to react strongly to one or two things (certain noises for example) - yet not react at all to other things that ordinary kids would react strongly to (such as a broken bone)?"
Many young people with High-functioning Autism (HFA) have a dysfunctional sensory system. Oftentimes, one or more senses are either over-reactive or under-reactive to stimulation. Such sensory issues may be the underlying reason for certain behaviors associated with autism spectrum disorders (e.g., rocking, spinning, hand-flapping, etc.). Although the receptors for the senses are located in the peripheral nervous system, the problem appears to stem from neurological dysfunction in the central nervous system.
Sensory integration refers to the accurate interpretation of sensory stimulation from the environment by the child’s brain. Conversely, sensory integrative dysfunction is a disorder in which sensory input is not organized appropriately in the brain, thus producing varying degrees of problems in development, information processing, and behavior.
Sensory integration focuses primarily on 3 basic senses: (1) proprioceptive, (2) vestibular, and (3) tactile. Their interconnections start forming before birth and continue to develop as the child matures and interacts with his environment. These 3 senses are also connected with other systems in the brain, and even though they are less familiar than other senses (i.e., taste, smell, sight, and hearing), they are critical to basic survival.
Dysfunction within these 3 senses manifests itself in many ways. For example, the child:
has an activity level that is either unusually high or unusually low
is in constant motion or fatigues easily
is over- or under-responsive to sensory input
becomes impulsive, easily distractible, or shows a general lack of planning
experiences gross and/or fine motor coordination problems
has difficulty adjusting to new situations and may react with frustration, aggression, or withdrawal
has speech and/or language delays
Let’s look at each of these 3 senses in greater detail...
Proprioceptive—
The proprioceptive system refers to components of muscles, joints, and tendons that (a) provide the child with a subconscious awareness of her body position, which is automatically adjusted in different situations (e.g., sitting properly in a chair, stepping off a curb smoothly, etc.), and (b) allow the child to manipulate objects using fine motor movements (e.g., writing with a pen, using a spoon, buttoning a shirt, tying shoe laces, etc.). In addition, proprioception involves motor planning, which is the ability to plan and execute different motor tasks.
Some common signs of proprioceptive dysfunction include the following:
tendency to fall
resistance to new motor movement activities
odd body posturing
minimal crawling when young
lack of awareness of body position in space
eating in a sloppy manner
difficulty manipulating small objects (e.g., buttons, snaps)
clumsiness
Therapy may include:
bouncing on a trampoline or a large ball
skipping or pushing heavy objects
wearing weighted belts
weighted blankets
weighted vests
Vestibular—
The vestibular system refers to structures within the inner ear that detect movement and changes in the position of the head (e.g., tells the child when his head is upright or tilted, even with the eyes closed).
Dysfunction within the vestibular system may manifest itself in two different ways:
Hyposensitivity: The HFA youngster may actively seek very intense sensory experiences (e.g., excessive body whirling, jumping, spinning, etc.). This type of youngster demonstrates signs of a hypo-reactive vestibular system (i.e., he is trying constantly to stimulate himself).
Hypersensitivity: The youngster may (a) be extremely susceptible to vestibular stimulation; (b) have fearful reactions to ordinary movement activities (e.g., swings, slides, inclines, ramps. etc.); (c) have trouble learning to climb or descend stairs or hills; (d) be apprehensive about walking or crawling on uneven or unstable surfaces; and (e) appear clumsy.
Therapy can include:
cartwheels
dancing
hanging upside down
rocking chairs
rolling
somersaulting
spinning
swings
All of these actions involve the head moving in different ways that stimulate the vestibular system. The therapist will observe the youngster carefully to be sure the movement is not over-stimulating. The most stimulating movement tends to be rotational (i.e., spinning) and should be used carefully by the therapist. Merry-go-rounds, being tossed on to cushions, or jumping on trampolines can be favorite activities with some HFA kids. Back and forth movement is typically less stimulating than side-to-side movement. A rocking motion will usually calm a youngster, while vigorous motions like spinning will be stimulating. Ideally, therapy will provide a variety of these movements.
The tactile system includes nerves under the skin's surface that send information to the brain (e.g., light touch, pain, pressure, temperature, etc.), which plays an important role in perceiving the environment – and protective reactions for survival.
Dysfunction in the tactile system can be seen in the following:
complaining about having one's hair or face washed
refusing to eat certain textured foods
refusing to wear certain types of clothing
using one's finger tips rather than whole hands to manipulate objects
walking with heels of the feet off the floor
withdrawing when being touched
A dysfunctional tactile system can lead to a misperception of touch and pain, and may lead to self-imposed isolation, general irritability, hyperactivity, and distractibility. Tactile defensiveness is a condition in which the child is extremely sensitive to touch, which can result in behavior problems, inability to concentrate, and negative emotional response to touch sensations.
Therapy may include the following:
For HFA kids who enjoy the feel of sticky textures, the therapist may use certain materials (e.g., glue, stickers, play dough, rubber toys, sticky tape, water, beans, rice, and sand). On the other hand, kids who are very sensitive to touch may go through a brushing program that attempts to desensitize them to touch by systematically brushing their body at regular intervals throughout the day.
Some HFA kids enjoy a sense of firm overall pressure. This can be provided by weighted blankets, weighted belts, being squeezed by pillows, and firm hugs. Also, making tunnels or tents from blankets over furniture can be soothing to these “special needs” children.
Other therapeutic approaches for HFA children with dysfunctional sensory systems may include the following:
Difficulty with using both sides of the body simultaneously can occur in some of these young people. The therapist may encourage the youngster with hopscotch, crawling, skipping, playing musical instruments, playing catch, or bouncing balls with both hands to help with bilateral integration.
Hand and eye coordination can be improved with activities such as popping bubbles, hitting a ball with a bat, beanbags and balloons, and throwing/catching balls.
Skills such as riding a bike or tying shoe laces can be difficult for some HFA children, because they involve sequences of movements. Therapy to help in this area may include obstacle courses, swimming, mazes, constructional toys, and building blocks.
Evaluation and treatment of sensory integrative dysfunction is performed by an occupational and/or physical therapist. The therapist's general goals are to:
assist the youngster in inhibiting and/or modulating sensory information
assist the youngster in processing a more organized response to sensory stimuli
provide the youngster with sensory information which helps organize the central nervous system
Sensory processing functions on a continuum. Everyone has difficulty processing certain sensory stimuli (e.g., a certain touch, taste, smell, sound, movement etc.) – and everyone has sensory preferences. Processing difficulties only become a Sensory Processing Disorder when an individual is on extreme ends of the continuum or experiences disruptive, unpredictable fluctuations which significantly impact developmental skills and everyday functioning.
If you believe your HFA child may be experiencing some form of sensory integration dysfunction, ask your child’s doctor for a referral to an occupational and/or physical therapist for treatment.
Resources for parents of children and teens on the autism spectrum:
More articles for parents of children and teens on the autism spectrum:
Social rejection has devastating effects in many areas of functioning.
Because the ASD child tends to internalize how others treat him,
rejection damages self-esteem and often causes anxiety and depression.
As the child feels worse about himself and becomes more anxious and
depressed – he performs worse, socially and intellectually.
Meltdowns are not a pretty sight. They are somewhat like overblown
temper tantrums, but unlike tantrums, meltdowns can last anywhere from
ten minutes to over an hour. When it starts, the Asperger's or HFA child
is totally out-of-control. When it ends, both you and your child are
totally exhausted. But... don’t breathe a sigh of relief yet. At the
least provocation, for the remainder of that day -- and sometimes into
the next - the meltdown can return in full force.
Although Aspergers [high-functioning autism] is at the milder end of the
autism spectrum, the challenges parents face when disciplining a
teenager on the spectrum are more difficult than they would be with an
average teen. Complicated by defiant behavior, the teen is at risk for
even greater difficulties on multiple levels – unless the parents’
disciplinary techniques are tailored to their child's special needs.
Your older teenager or young “adult child” isn’t sure what to do, and
he is asking you for money every few days. How do you cut the purse
strings and teach him to be independent? Parents of teens with ASD face
many problems that other parents do not. Time is running out for
teaching their adolescent how to become an independent adult. As one
mother put it, "There's so little time, yet so much left to do." Click here to read the full article…
Two traits often found in kids with High-Functioning Autism are
“mind-blindness” (i.e., the inability to predict the beliefs and
intentions of others) and “alexithymia” (i.e., the inability to
identify and interpret emotional signals in others). These two traits
reduce the youngster’s ability to empathize with peers. As a result, he
or she may be perceived by adults and other children as selfish,
insensitive and uncaring. Click here to read the full article...
Become an expert in helping your child cope with his or her
“out-of-control” emotions, inability to make and keep friends, stress,
anger, thinking errors, and resistance to change.
A child with High-Functioning Autism (HFA) can have
difficulty in school because, since he fits in so well, many adults
may miss the fact that he has a diagnosis. When these children display
symptoms of their disorder, they may be seen as defiant or disruptive.
