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Managing Autism Meltdowns

Some individuals with autism experience emotional and physical “meltdowns” in response to feeling overwhelmed by sensory or mental stimulation. During a meltdown, a person may scream, cry, and become physically aggressive toward themselves or those around them. Meltdowns are most common in children and younger people with autism. However, experts note that “the state of panic and acute anxiety that drives meltdown behavior can still cause profound difficulty for adults.”

 

To address meltdowns, parents and caregivers must understand their root causes, how they differ from tantrums, and how to act within the moment to help their child. Parents should prepare their children for unfamiliar environments and demands as best they can. This involves working together to create unique behavioral plans and strategies. Having a plan can help parents calm the child should they become overwhelmed, and give the child and other loved ones ways to adapt and cope in the moment.
 

Tantrums vs. Meltdowns

 

It is important to distinguish between tantrums and meltdowns. Tantrums can be viewed as outbursts related to a lack of emotional control on the part of children. Tantrums are often strategic. Children throwing tantrums may do so because they know it will get a reaction or a perceived result. For example, a child may throw a tantrum because their parent refuses to buy them ice cream, in hopes that the parent will give in and get them what they want. This is not the case with meltdowns.

 

Meltdowns are comparable to panic attacks. They are not calculated, and the individual experiencing a meltdown cannot control their behavior in the moment. They usually occur because an individual with autism is scared, surprised, or otherwise overwhelmed by their situation or surroundings. According to researchers, meltdowns are “more intense, protracted and potentially physically and emotionally dangerous to both the child and parents” when compared to tantrums. For parents, it is disturbing and draining to witness one’s child in distress and can be frustrating and embarrassing if it occurs in public. Although parents may become upset and excitable, and try to control the situation immediately, meltdowns require a unique approach.
 

Sensory or Cognitive Overload

 

In her work “From Anxiety to Meltdown,” author Deborah Lipsky, M. Ed., identifies the causes of meltdowns as “sensory or cognitive overload” due to “novel situations or sudden changes.” These can include unexpected demands, shifts in routine, loud or visually excitable locations, or surprises – even those meant to be positive. Since it is impossible to avoid change, it is best to instead focus on preparing those with autism for these new situations. Parents must also be able to recognize the signs of a meltdown, and know how to behave in the moment to help their children feel safe and protected.

 

Meltdowns may be preceded by repetitive behaviors, an abrupt break in communication, or a sudden inability to focus. If these occur, it is advisable to minimize sources of stimulation in the environment, such as noises or lights, and to divert the individual with a favorite calming activity. When a meltdown has started, however, removing the individual from the source of over-stimulation is even more important. This can involve the removal of physical stimuli, or the removal of other forms of pressure such as social demands.
 

Scolding and Controlling Will Not Work

 

Attempts to control the behavior, or restrain the individual physically, are generally not the right responses. Even in situations of self-injurious behavior, experts recommend placing physical barriers, such as pillows, to prevent harm rather than attempting to restrain the individual. Light physical redirection may be necessary in extreme cases where the individual is likely to harm themselves. However, this approach can easily worsen the situation and place caregivers at risk, so it should be used as a last resort.

 

Instead of trying to restrain or scold, parents should stay calm as they address the child by name, acknowledge their fear, and indicate their support and safety – saying something like, “it’s okay, [name]” until they begin to calm down. The worst thing one can do is become agitated, raise one’s voice, and respond to a person’s overstimulation with more highly stimulating behavior. Don’t try to explain, ask questions, lecture, or shame, as these behaviors can further overwhelm the individual experiencing the meltdown. Instead, safe routines that an individual may use to calm down, like pacing, should be encouraged. Try to offer short, firm, comforting assurance to calm and support the individual having the meltdown. It is advisable to stay with the person having the meltdown until they have calmed down.
 

Time, Distance, and Recognizing Meltdown Triggers

 

Given some time and distance, it is best to create a plan that makes the child feel more comfortable in the future. This starts with identifying what triggers these meltdowns and which responses minimize them and help the individual cope. Strategies can involve rethinking how one communicates with the child, perhaps by avoiding open-ended questions or certain tones of voice. Knowing when to remove the child from an uncomfortable situation, or how to remove triggering stimuli from the environment, can also be helpful. Try coming up with routines that comfort during new or difficult situations, like having a favorite game to play. Finally, it is crucial to develop a detailed plan for assisting during a meltdown using strategies that the person with autism finds helpful. These are specific to the individual, so listening to them, monitoring their reactions, and noting what works in the moment is key.
 

Conclusion

 

While some children with autism may not experience meltdowns once they get older, meltdowns may remain a part of life for some. In such cases, meltdowns can still be reduced in frequency and severity. Parents, friends, and loved ones can learn to tailor their responses to these situations. Recognizing triggering situations and stimuli, knowing how to adapt and listen, and understanding how to intervene and comfort the person with autism go a long way. With these tools, meltdowns can be managed so that those with autism feel safe and supported, and families and loved ones can have the confidence that a detailed plan for healthy intervention provides.


i. http://www.researchautism.net/autism-issues/challenging-and-disruptive-behaviours/meltdowns-and-tantrums
ii. https://journals.sagepub.com/doi/full/10.1177/1359104517730114
iii. https://books.google.com/books/about/From_Anxiety_to_Meltdown.html?id=7A6DvDthpqYC
iv. https://www.autism.org.uk/about/behaviour/meltdowns.aspx
v. https://www.autism.org.uk/about/behaviour/challenging-behaviour/self-injury.aspx
vi. https://books.google.com/books/about/Managing_Meltdowns.html?id=D8fKIrvLVFsC

4 Ways to Help a Family Member with Autism Through COVID-19 Quarantine

The novel coronavirus (COVID-19) has disrupted society on a global level, with countless families sheltering at home in hopes of staying safe and slowing the spread of the virus. Even as the United States begins to gradually reopen, it is clear that this virus will continue to have massive economic, social, and emotional impact on U.S. citizens. These disruptions affect everyone, but not equally. Individuals with autism and their families face additional challenges in this time of crisis. With the abrupt shifting of therapeutic services, school, and work to at-home settings, and the pressure that families are feeling to stay safe and keep food on the table, COVID-19 has made it much more difficult for families with children or other loved ones with autism to maintain a sense of normalcy and safety.

 

Many families have experienced severe disruptions in therapies and services for their children with autism, with families of children under the age of five reporting the greatest level of disruption. A large proportion of surveyed adults with autism report moderate to severe disruptions to their social lives, home lives, and employment status. Further, many independent adults with autism also responded that their mental health had been moderately to severely impacted by COVID-19. These effects appear to be felt most by adult women with autism. A survey of 377 respondents found that as many as 27% reported severe mental health struggles related to COVID-19, as related to 14% of male respondents.[i] Given these discouraging trends, it is clear that individuals with autism are likely to need a great deal of support from their families throughout this crisis. Here are 4 ways to support your family member in quarantine:

 

1. Establish a Care and Support Network


For families of children with autism, there are numerous ways to help children adjust to this unfamiliar new reality. First, establishing a network of care and support is crucial. This can include educators, therapists, and family members and friends outside the household. Having a “team” who looks after and supports your family is critical for morale and therapeutic help. Regularly communicating with this group, and finding ways to incorporate it into one’s life, can provide an individual with autism a feeling of support, safety, and care. It is also vital to have such trustworthy contacts given the possibility of a parent or care provider contracting COVID-19. The greater the support network a family has, the better the chances that they can reestablish a sense of normalcy and comfort for their children.

 

2. Reestablish Therapeutic Services


Reestablishing a child’s therapeutic services in a socially distanced or remote setting is of key importance. Many therapists and care providers are recognizing the need to transfer to a remote care model for the time being, with telehealth services and remote therapy options becoming more widespread. Taking advantage of these services requires a great deal of patience and flexibility on the part of both children with autism and their families. Regular communication with care providers and educators is essential for distance learning, remote therapy, or care sessions to be successful. This can require a dialogue between educators, therapists, and parents to understand the successes and challenges a child is experiencing. Families and care providers must be willing to adapt to what works, what doesn’t work, and how to modify a child’s environment to suit their unique needs. Helpful strategies can include teaching via a child’s preferred activities, utilizing online educational resources, being willing to take breaks when a child is overwhelmed, establishing a unique physical learning space in the house, encouraging a child with positive reinforcement, and finding out what type and duration of educational sessions works best for your child. Writing for the Doug Flutie Jr. Foundation for Autism, Ellen Fitzpatrick, M.Ed. expands on these ideas and offers more in a helpful post on Distance Learning.[ii]

 

3. Create a Sense of Structure


A common stressor for individuals with autism during COVID-19 is the upheaval of a familiar, comfortable structure to daily life. Creating a new sense of structure can be a first step towards getting back on track. One of the best ways to do this is via the creation of a schedule. Even a loose schedule outlining when school sessions or therapy appointments occur can be a useful tool. Schedules can also be more detailed, depending on the needs of the child. This could include a more structured day where meals, chores, or appointments all have their place. It is important, however, to allow for play and for breaks, since an overly rigid schedule may induce more unwanted stress. Scheduling social activities with the family, such as a cooking session, a group walk, or a fun game night together can break up the day for children and parents, help children adjust to their new schedule, and give them something to look forward to throughout the day.

 

4. Prioritize Socialization


For teenagers and adults with autism, prioritizing socialization and care are crucial. Independent adult family members with autism may be struggling with employment or their social lives, so directing them to helpful resources such as the U.S. Department of Labor’s Resources for People on the Autism Spectrum is advisable. Beyond that, setting up regular remote or socially distanced visits to catch up, or to watch a favorite movie together, can be helpful. Simply checking in regularly on how a family member is coping can also reassure individuals that they are being thought of and supported. Encouraging or participating in activities like exercise, meditation, or cooking healthy meals together, along with passing along valuable mental health resources, can help independent adults with autism address the emotional issues that have arisen from this crisis and help them to reduce stress, anxiety, and health issues. Above all else, making yourself available and making it clear that you are open to supporting and talking with your family member when they need you throughout this crisis is invaluable.

 

Supporting your family member with autism throughout the quarantine period is profoundly important. In a time where virtually everyone is feeling a sense of anxiety, upheaval, and fear, taking the time and energy to reach out to, comfort, and connect with a struggling family member is one of the most worthwhile things we can do. For more resources on how to cope with and keep family and loved ones safe throughout the COVID-19 crisis, please see the Autism Society of America’s COVID-19 toolkit.

 

 

[i] https://www.spectrumnews.org/news/quarantine-may-hit-autistic-women-and-children-hardest/

[ii] https://www.flutiefoundation.org/blog/spectrum-ideas-autism-home#virtual