During a Meltdown

A meltdown is scary and lonely. A change in routine can be enough to tip the scales in sensory input and cause what is titled a “meltdown” where a person with autism or asperger syndrome temporarily loses control due to emotional responses to environmental factors. They aren’t usually caused by one specific thing.

Triggers build up until the person becomes so overwhelmed that they can’t take in any more information. In previous blogs, we have addressed the complex topic of meltdowns. While the main message is to have a plan to PREVENT a meltdown, we must also be prepared if a meltdown does occur.

Portrait of unhappy screaming teen girl

I will start by outlining what NOT to do. I think this is best said coming from someone that has lived through a meltdown with neurological implications.  The following is an excerpt from a message from Mr. John Scott.

Meltdowns: What Not to Do

My meltdowns can be very frightening and confusing for those around me. I work very hard to appear as capable and composed as possible throughout each day, so when I finally lose it, people are shocked to see me act so “autistic.” I cry, scream, break things, flap my hands, and pound my fists against my head. I haven’t found the perfect remedy for my meltdowns, but I do know what makes them far worse… 

If I am having a meltdown… 
– DO NOT become angry with me or raise your voice. 

Autistic meltdowns may be frightening to observers, but at their most intense, they are nothing less than pure psychological torture for the person experiencing them. I feel as if I am caught in a war zone, terrified for my very life. My senses are on fire and I have very little control over myself. I may feel threatened by intense emotional displays. This is very dangerous. 

– DO NOT attempt to restrain me. 
I understand that my tantrums are scary, as I’m well over six feet tall, but you must remember that I am far more frightened than you are. I would never intentionally hurt anyone, but if you approach me in a hostile manner, or attempt to use any force without my permission, I may lose the last bit of self-control I have. 

– DO NOT ask me what is wrong. 
Trust me, when I’m banging my head into the wall I do not want to discuss my emotional triggers. 

– Most importantly, DO NOT tell me to “snap out of it.” 
Trust me, I would if I could. Don’t patronize or belittle me by acting as if I could control myself if I only tried harder. This is a good way to make the situation ten times worse.
You may know me from my column here on WrongPlanet. I’m also writing a book for AAPC. Visit my Facebook page for links to articles I’ve written for Autism Speaks and other websites.

CLICK HERE  for the entire posting.

I would like to add one more . . . this is not the time to say “Use your words.”  As the brain escalates in a meltdown, the ability to be rational and articulate diminishes.

So now for what TO DO?

  • During a meltdown a child most needs the opportunity to relax. Therefore, you should respond patiently and compassionately as you support this process. Offer choices of relaxing activities, perhaps through the use of a choice board. If the person is not able to make a choice, then simply present a pre-determined calming activity. Often, this might be an activity that incorporates a strong interest [e.g. video of SpongeBob or favorite song/music].
  • In some cases, it might be best to offer a way out of the situation through escaping the current stimulation of the environment. Again, a pre-determined location might be another room or other safe place [e.g. chill zone, motor lab, etc.].  However, it might be difficult for the individual to transition to another location if the meltdown is at its peak.
  • If there are others in close proximity, then it should be part of the plan to move them to a safe place.
  • Most importantly, do everything possible to keep the individual safe from him or herself. If they engage in head banging, protect their head by placing a pillow or bean bag between them and the floor or wall.

As you can see, there is little to really do during a meltdown. Again, all efforts should be made to PREVENT a meltdown.

by Lisa Rogers

Three Steps to Recovery After a Meltdown

Recovery may involve time to do nothing at all. For some students the recovery phase involves a process that takes him or her from a semi-agitated state to a fully calm state.

child in class

Consider the following steps:

  1. Allow the student to engage in the highly preferred/calming activity without setting the timer until he/she appears to have recovered as fully as possible.
  2. Once he/she is calm, then set the timer for 5-6 minutes. If he/she remains calm and is able to transition to the next activity, then do so and watch for early signs of repeated escalation.
  3. If he/she requests more time [by giving the timer to the adult], then honor the request and set the timer for 3 or 4 more minutes. Continue until he/she no longer requests more time or staff feel she is ready for a positive transition to the next activity.

Once the person is fully recovered, then it might be possible to debrief and make a plan to prevent future escalation. Pictures and words can help to paint a clear picture and develop a workable plan.   

By Lisa Rogers

Preventing Meltdowns: Part two

There is nothing amusing about “the meltdown”. It is reflective of a complete loss of control of the person with an autism spectrum disorder. It is often loud, risky at times, frustrating, and exhausting.

Here is a video that explains meltdowns from the perspective of someone living with autism.  Feel free to share with others, as it is available through youtube.

 Ask an Autistic: What is a meltdown?

One might say that the loss of control overtakes the child. They need their teacher or parent to recognize this and help them to regain control, as they are unable to do so on their own. A child with autism in the middle of the meltdown desperately needs help to regain composure.

Moreover, it becomes critical to learn to recognize when the meltdown is imminent.

In this way, you can both work to prevent a meltdown. The individual with an autism spectrum disorder needs to learn how to recognize the feelings of escalation and then actualize strategies to de-escalate before the crisis ensues.

LRfeelingschartThat is why a “feelings chart” or “emotion rating scale” can be such an important strategy.

Notice the left column of this particular feelings chart. It should be reviewed when calm to help identify the internal and external indicators that emotions are changing. The right hand column is just as, if not more important, in that it helps to identify calming strategies for that particular individual.

It is best to intervene early in the escalation process to increase the likelihood of a successful solution to the situation.

We are not “giving in to” or “reinforcing” negative behavior when providing one of these calming strategies, but rather throwing a lifeline to someone that is unraveling neurologically for many possible reasons.

by Lisa Rogers

Middle School, High School, and College Through the Eyes of a Young Autistic

Middle school. The darkest and most hideous, oppressive years a human can fathom. When the hormones are just ripe enough to make you want to take on the whole world, but maturity has not yet developed enough to realize there are things such as consequences. But me, I did not get into any real trouble, instead I became profoundly confused and unhappy. These are years that are difficult to handle under even the best of circumstances. On top of this, my family moved from the Northeast to the Southwest just as I was about to start middle school. To take a young child from one environment and to suddenly thrust them into new ones is very distressing and painful.

ChristopherS2

For the Autistic it can be hell. Somehow I managed to survive it all, and to escape being beat up by the other kids. One thing I didn’t escape? Humiliation. I had a tendency to laugh uncontrollably at the things I thought were funny at the time. I had always been led to believe that laughing at someone’s joke was the best genuine way to prove that you understood it, and that you admired their sense of wit. But somehow, laughing at everyone’s joke meant I was weird. Wanting to learn was weird. Humming music that I liked was weird. Reading books that I wasn’t required to because of a class was weird. My hair was weird.

Seriously. Other than my hair, someone explain to me what’s weird about any of that.

How to Help ASD Students Express Their Feelings and De-Escalate a Meltdown

Feelings Chart

If a student can express their inner feelings, then adults could help them prevent further escalation. This can be done by engaging the student in conversation about the problem, or beginning a calming activity. Often however, the student has difficulty expressing those feelings until it is too late. A feelings chart may be an effective visual support to help students express how they are feeling with or without using any words.

Feelings Chart in Class

In order for the feelings chart to be an effective strategy, students must understand the meaning of different feelings represented at each level. What does it mean to feel great versus having a problem?  Connecting meaning for each feeling may require direct instruction. Lessons to build this understanding can be done in a variety of ways, including the use of props or pictures of self or others.

AuTalkz: Meltdowns

A common mistake some people make is comparing an autistic meltdown to a temper tantrum in younger children.  Often when someone is younger, they don’t know how to properly express or work out frustration which occurs during the meltdown, so there could be screaming, crying, and even thrashing.

016_Meltdowns

It might look like a temper tantrum, but it’s not being done for attention or to get something like a temper tantrum is done for.  It’s done because the child is overwhelmed and-or frustrated, and don’t know any other way to express it.