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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
 
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COMMENTS:

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!
 

Post your comment below…
 

What To Do When The School System Fails To Meet Your Child's Special Needs

"We've had a rough school year with our son (6 year old with high functioning autism). So glad it's coming to a close in a couple weeks! My husband and I are seriously considering some alternate form of education for him in the next school year. What have other parents done in a situation where the school is simply not meeting their child's special needs?"

All Aspergers and high-functioning autistic (HFA) children are different and will have unique characteristics and behavior. Various traits will be displayed differently in every one diagnosed with the disorder. This can make it difficult for schools to adjust their program or restructure the environment in the classroom to accommodate the "special needs" child. As a result, some parents discover that the traditional school setting is not the best scenario for their child.

If you are considering a different educational route for your youngster, then one of the following alternatives may prove to be a good option:

Home Schooling—

The number of home-schoolers in America continues to grow and now totals more than 1.4 million children. The typical home-schooled child is involved in 5.2 social activities outside the home each week. These activities include afternoon and weekend programs with conventionally schooled children, such as ballet classes, Little League teams, Scout troops, church groups and neighborhood play. They include midday field trips and cooperative learning programs organized by groups of homeschooling families. For example, some Washington, D.C., families run a home-school drama troupe that performs at a local dinner theater.

Increasingly, moms and dads of students with Aspergers and HFA are choosing to home-school their kids. This may be because they are dissatisfied with their youngster's school district, his curriculum, or issues related to his IEP. Some moms and dads may feel they know best how to meet their youngster's educational needs, or they wish to afford their youngster individualized educational opportunities that build on passions and interests and provide one-on-one attention. In the most disconcerting circumstances, kids with the disorder may be home-schooled because they have been taunted and bullied by other children, or because educators have misperceived them as “lazy” or devalued them as “underachievers.”

The superintendent of the school district in which the family resides has the responsibility for the supervision of a home-schooling program. When an initial decision is made to home school a child, a mother or father submits a notarized affidavit to the superintendent indicating the plan to home-school the child. The affidavit should be accompanied by a set of objectives that are to be worked on for that school year. This process may be done at any time in the initial school year; however, in subsequent school years August 1 is the deadline for submission.

The school district is required to provide books to the home-schooling family of the texts used by the children in the school who are in the same grade level as the home-schooled child. There is a wealth of curriculum offerings available to home-schooling families as most major educational publishing houses have come to recognize the home school market. Some families choose to invest in one curriculum and use it exclusively; other families pull resources from various places. The one substantial advantage to educating from a traditional homeschooling model is that the supervisor of the program has the flexibility to make decisions that she feels are best for the child and to use materials that are consistent with the needs and abilities of the child.

Throughout the school year the supervisor of the program should keep a record of the days of instruction and all the subjects logged by the child. Some use a plan book, some use a calendar or computerized log. The supervisor also should be consistently and regularly gathering examples of the work done by the child for the portfolio to be assembled for the end-of-the-school year evaluation.

In addition, tutors may be accessed for various areas that the home school supervisor doesn't feel qualified to teach. Private schools or educational institutions affiliated with religious denominations may offer a more individualized curriculum with one-on-one instruction, but the cost of enrolling your youngster may be prohibitive.

When deciding to home-school, parents should be aware of the advantages and disadvantages of homeschooling so they can prepare for any challenges they may encounter.

Waldorf School Model—

Waldorf schools offer a developmentally appropriate, balanced approach to education that integrates the arts and academics for kids from preschool through twelfth grade. It encourages the development of each youngster's sense of truth, beauty, and goodness, and provides an antidote to violence, alienation, and cynicism. The aim of the education is to inspire in each child a lifelong love of learning, and to enable them to fully develop their unique capacities.”

Though most Waldorf schools are autonomous institutions not required to follow a prescribed curriculum, there are widely-agreed guidelines for the Waldorf curriculum, supported by the schools' common principles. Government-funded schools may be required to incorporate aspects of state curricula.

The Waldorf curriculum has from its inception organically incorporated multiple intelligences. There are thus a few subjects largely unique to the Waldorf schools. Foremost among these is Eurythmy, a movement art usually accompanying spoken texts or music which includes elements of role play and dance and is designed to provide individuals and classes with a "sense of integration and harmony". The arts generally play a significant role throughout the pedagogy and Waldorf education's unique integration of the arts into traditional content has been cited as a model for other schools.

The school considers that each phase of childhood requires different perspectives. This translates into seven-year spans, starting at birth through age twenty-one. Throughout, the emphasis is about sequentially teaching what is good, truthful, and beautiful. By these standards, educators honor the work of all kids. The individual interpretations of each youngster are valued in balance with the contributions of others. Kids are shown with care how to be discriminating, thoughtful, and prudent.

Virtual Charter School—

The virtual charter school is like a “public school in a home environment,” but it is not the same as home schooling. Former U.S. Secretary of Education William Bennett and some others started a company called K12, headquartered in McLean, Virginia. K12 provides the curriculum and management services; the virtual charter school hires the educators and support staff. The head of the school, the controller, and a few others are employees of K12.

Why choose a Virtual Charter School?
  • Academic accountability
  • Co-curricular learning opportunities
  • Community involvement
  • Diamond Model Partnership - parent, teacher, family support coordinator and excellent K12 Inc. curriculum
  • Flexible learning opportunities
  • Safe and nurturing home-based learning environment that offers education at an appropriate pace
  • Socialization and outings
  • State-of-the-art technology

To attend a virtual charter school, the child's mother/father withdraws him from the local school district and enrolls him in the virtual charter school. The school district funding follows the child and encompasses books, materials for art and for science experiments, a computer, and other materials. The child also receives a regular education teacher, a special education teacher, and an IEP, just as in the local school district.

The educators become the educational supports working in partnership with the moms and dads (who have the lead) to educate the youngster and ensure he takes all the state-mandated standardized tests. The mother or father must log time daily on a website and track the child's progress, such as what lessons he has completed; lesson plans are also received via the website. Frequent field trips, all of an educational nature, are planned as a way for the kids, educators, and moms and dads to connect with one another.

Charter Schools—

Charter schools are nonsectarian public schools of choice that operate with freedom from many of the regulations that apply to traditional public schools. The "charter" establishing each such school is a performance contract detailing the school's mission, program, goals, students served, methods of assessment, and ways to measure success.

The length of time for which charters are granted varies, but most are granted for 3-5 years. At the end of the term, the entity granting the charter may renew the school's contract. Charter schools are accountable to their sponsor (usually a state or local school board) to produce positive academic results and adhere to the charter contract.

The basic concept of charter schools is that they exercise increased autonomy in return for this accountability. They are accountable for both academic results and fiscal practices to several groups: (1) the sponsor that grants them, (2) the parents who choose them, and (3) the public that funds them.

Most states have an educational option called charter schools, in which the school district has received a “charter” from the state. The charter provides rules, such as where it is located and the maximum number of children permitted to attend. With a charter, the school district receives the funding and allocations based on the number of children. The state department of education grants the school district funding to pay for teacher salaries, equipment, and materials to meet the individual needs of each child in a charter school.

Charter schools are considered “public schooling” and must abide by all state regulations. The charter school may have an emphasis on the arts or science with a smaller teacher-child ratio.

Delta Program—

DELTA is best described as a cooperative endeavor among students, parents, and teachers to develop personalized learning programs which best meet the needs and interests of individual students while providing a shared sense of community effort. An important goal is to help students become responsible, independent learners and contributing community members through experiential learning activities and community involvement.

Since its 1974 inception, the Delta program has become a national model for alternative, “nontraditional” educational programming for eligible kids from grades seven through twelve. Delta is founded on the belief that children are motivated to do their best when they are responsible for their own learning. Classes are not arranged by grade level, but by learning level, from introductory to mid-level to high level.

Delta is a partnership between the child, moms and dads, and staff through shared decision-making. Enrollment does not exceed 200 children at a time in order for educators, administrators, and support staff to provide quality, personalized interactions with children. Children are required to complete all state-mandated requirements for education the same as their peers. The program differs in that each child has an advising team (like an IEP team), and an open campus structure allows for flexibility, experiential learning, and community service projects.

Each semester, children in tandem with their advising team design personal educational schedules by choosing from courses offered in required subject areas. However, as a guide, each course has a difficulty level that ranges from introductory to mid-level to high. When planning child schedules, the set number of credits required in each subject area is taken into account along with the difficulty level. In advance of course enrollment, each Delta child is aware of the course content, learning objectives, and the manner in which his work will be evaluated — all of which serves to promote independence and personal responsibility in learning.

Benefits of Alternative Educational Programming—
  • Alternate educational placements may benefit the youngster with Aspergers or HFA through smaller teacher-child ratios, leading to more individualized attention and quality assurance in your youngster's learning comprehension.
  • Educational curricula in alternate settings may have greater flexibility and provide for enhanced opportunities to reinforce curricula in ways that may be tangible and concrete for the youngster on the autism spectrum, such as regular field trips to museums, businesses, landmarks, and other community attractions.
  • Greater individualized attention may mean that your youngster's personal passions can be used to underscore his learning in ways that might prove difficult or impossible in larger public school classes.
  • Smaller class size may afford instructors the luxury of time to focus attention on meeting the unique educational needs of each youngster.
  • There may be opportunity for creative programming in which the youngster may have myriad choices from which to select when planning class projects, presentations, or reports.

Disadvantages of Alternative Educational Programming—
  • A disadvantage to alternative educational programming and placement may be the cost.
  • Social opportunities may be more limited with smaller or one-child classes unless efforts are made to compensate for this.
  • If a newly designed program is considered, planning, implementation, and start-up time are all factors that may be deterrents for some.

Your local school district or state department of education should be able to provide you with details about a range of education program options, as well as funding options and obligations in order for you to make an informed decision about where your youngster receives his or her education.


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

Remarkable Traits That Your Child on the Autism Spectrum Has That “Typical” Kids May Not Have

In the social world, there is not a huge benefit to a precise eye for detail; however, in the worlds of cataloguing, computing, engineering, linguistics, math, music, and science, such an eye for detail is crucial.

The genes for ASD Level 1 [High-Functioning Autism] include a combination of abilities that have operated throughout recent human evolution and have made remarkable contributions to human history.

Here are just a few of the “abilities” associated with ASD (i.e., a low central coherence cognitive style):

1.    Visual, three-dimensional thinking – most people on the autism spectrum are very visual in their thought processes, which lends itself to countless useful and creative applications.

2.    Logic over emotion – although people with ASD are very emotional at times, they spend so much time ‘computing’ in our minds that they get quite good at it, and they can be very logical in their approach to problem-solving.

3.    Internal motivation – they are motivated internally, as opposed to being motivated by praise, money, bills or acceptance - which ensures a job done with conscience and with personal pride.

4.    Independent, unique thinking – people on the spectrum tend to spend a lot of time alone and will likely have developed their own unique thoughts as opposed to a ‘herd’ mentality.

5.    Honesty – the value of being able to say “the emperor isn’t wearing any clothes.”

6.    Higher IQ – some experts say that those with ASD often have a higher than average general IQ.

7.    Higher fluid intelligence – scientists have discovered that ASD kids have a higher “fluid intelligence” than neurotypical kids, which is the ability to (a) find meaning in confusion and solve new problems, and (b) draw inferences and understand the relationships of various concepts, independent of acquired knowledge.

8.    Focus and diligence – the autistic person’s ability to focus on tasks for a long period of time without needing supervision or incentive.

9.    Attention to detail – sometimes with painstaking perfection!

Kids on the spectrum are a varied group of people who are mostly bright, funny, articulate, caring, logical, honest, and persistent – and who just happen to think and behave a bit differently.
 
 


 

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

==> Videos for Parents of Children and Teens with ASD
 
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Your Child on the Autism Spectrum: What the Future Holds

*** Prognosis ***

There is some evidence that kids with High-Functioning Autism (HFA) may see a lessening of symptoms as they mature. Up to 20% of kids may no longer meet the diagnostic criteria as grown-ups, although social and communication difficulties may persist.

People with HFA appear to have normal life expectancy, but have an increased prevalence of comorbid psychiatric conditions (e.g., major depressive disorder, anxiety disorder) that may significantly affect prognosis.

Although social impairment is life-long, the outcome is generally more positive than for people with lower functioning autism spectrum disorders. For example, autism spectrum disorders (ASD) symptoms are more likely to diminish with time in kids on the high functioning end of autism. 
 
Although most students with the disorder have average mathematical ability and test slightly worse in mathematics than in general intelligence, some are gifted in mathematics. HFA has not prevented some grown-ups from major accomplishments such as winning the Nobel Prize.

Kids on the spectrum may require special education services because of their social and behavioral difficulties, although many attend regular education classes. Teens with the disorder may exhibit ongoing difficulty with self care, organization and disturbances in social and romantic relationships. Despite high cognitive potential, most young adults with HFA remain at home, although some do marry and work independently.

Anxiety may stem from (a) preoccupation over possible violations of routines and rituals, (b) being placed in a situation without a clear schedule or expectations, or (c) concern with failing in social encounters. The resulting stress may manifest as inattention, withdrawal, reliance on obsessions, hyperactivity, or aggressive or oppositional behavior.

Depression is often the result of (a) chronic frustration from repeated failure to engage others socially, and (b) mood disorders requiring treatment may develop. Clinical experience suggests the rate of suicide may be higher among teens on the autism spectrum, but this has not been confirmed by systematic empirical studies.

Education of families is critical in developing strategies for understanding strengths and weaknesses. Helping the family to cope improves outcomes in these young people. Prognosis may be improved by diagnosis at a younger age that allows for early interventions, while interventions in adulthood are valuable, but less beneficial.

As one parent stated, "I keep telling my 7 year old that things may be more difficult for him than other kids but he is smarter than his brain (the best way i can describe it at his age) and that he can train his brain to over come most any obstacle. i truly believe that this is possible with a lot of hard work."
 
 


 
More resources for parents of children and teens on the autism spectrum:
 

Understanding the Role of Risperidone and Aripiprazole in Treating Symptoms of ASD

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