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How to Manage Meltdowns in Kids on the Autism Spectrum

A meltdown is an intense emotional and behavioral response to “over-stimulation” (a form of distress for the child). Meltdowns are triggered by a fight-or-flight response, which releases adrenaline into the blood stream, creating heightened anxiety and causing the Asperger's (AS) or High-Functioning Autistic (HFA) child to switch to an instinctual survival mode.

Common Features of Meltdowns—
  • after the meltdown, there may be intense feelings of shame, remorse or humiliation, and a fear that relationships have been harmed beyond repair
  • children in the middle of a meltdown will likely become hyposensitive or hypersensitive to pain
  • cognitive dysfunction, perceptual distortion, and narrowing of sensory experience are associated with meltdowns
  • meltdowns are a reaction to severe stress, although the stress may not be readily apparent to an observer
  • meltdowns are caused by sensory or mental overload, sometime in conjunction with each other
  • meltdowns are due to overwhelming stimulation
  • meltdowns are time-limited
  • novel situations or sudden change can elicit a meltdown
  • transitions may trigger a meltdown (e.g., going from class to class, change in topic, change in teacher s, etc.)

Causes of Meltdown—
  • child does not receive understandable answers to questions
  • child does not understand the reason for sudden change
  • child has a sensory overload
  • child is given open-ended or vaguely defined tasks
  • child is given too many choices
  • child is taken by surprise

Warning Signs of Meltdowns—
  • becoming mute
  • experience difficulty answering questions (cognitive breakdown)
  • extreme resistance to disengaging from a ritual or routine
  • increasing self-stimulatory behaviors (e.g., flapping hands)
  • pacing back in forth or in circles
  • perseverating on one topic
  • repeating words or phrases over and over
  • stuttering or showing pressured speech

What Parents Can Do—

1. Don't reward the meltdown with a lot of attention. Obviously, you don't want your AS or HFA youngster to learn that this is a good way to impress you.

2. Give the youngster a warning before the end of an activity, which gives him a chance to readjust.

3. Give the youngster some control over small decisions so that he can feel he can make a choice (e.g., "Do you want us to read your book before you put your pajamas on or after?").

4. Give your youngster permission to have a major meltdown (e.g., "Joey, I know you usually have a meltdown when this happens, and I want you to know that it is ok for you to do that now."). This is a reverse-psychology approach.

5. If meltdowns are more frequent than about once a week and don't lessen as the youngster grows older, you may want to consider seeking professional advice.

6. Meltdowns are a sign of frustration that a youngster can't do something comfortably. Know what your youngster's tolerance level is and try not to push him beyond what he's capable of doing. Tolerance levels vary; he may be able to handle a situation one day and not the next. Try to identify the situations that trigger meltdowns and change them.

7. Prescribe the behaviors that your youngster usually does in this situation when agitated. You'll continue talking after telling your youngster it is o.k. to have a meltdown and list what the youngster normally does (e.g., “When you are feeling this way, you usually start swearing, kicking, screaming, and blowing snot so go ahead and get started.").

8. Remember to reward good behavior (e.g., "You were so good today when we had to stand in line at the post office.").

9. Think about whether your youngster may be acting up because he's not getting enough attention; even negative attention is better than none.

10. Scolding or shouting back simply won't work, although you may feel like having a meltdown yourself. Remember, moms and dads are models of appropriate behavior.

11. Stay cool. Acknowledge the youngster's emotions (e.g., frustrated, bored, tired) without a long discussion and say something like, "Tell me in your own words what's bothering you, and let's try to work it out" …or "I know you're frustrated and want to leave, but I would like for you to wait a few more minutes." It's important to let the youngster know you're willing to work this out reasonably, what your expectation is, and what you want him to do.

12. Always have some form of distraction available to get your child off the meltdown track.

The process of turning things around involves helping moms and dads to:
  • address the frustrations of the AS or HFA child’s siblings
  • create a more predictable and structured environment for the youngster
  • establish a belief that this problem can be solved but it will take persistence on their part
  • establish consequences to reinforce desired behavior and not reinforce undesirable behavior
  • focus on the game plan long enough for it to take effect
  • help the youngster to improve his social skills
  • learn what accommodations are needed to reflect the youngster’s weaknesses
  • learn what actions will promote the youngster’s growth in flexibility
  • re-establishing their role as authoritative parents
  • refocus on the youngster’s strengths
  • stop blaming each other and themselves
  • prioritize what is really important

The issue of prioritizing is particularly critical. Too often there are struggles about cleaning rooms, finishing meals, practicing piano or completing homework that are simply not worth the consequences. Some of those issues can be addressed when things are improved. Also, if some situations are just too difficult to manage right now (e.g., taking the youngster on a family activity), then arrange a sitter or a drop-off at a friend’s. In this way, you avoid ruining everyone’s experience. Explain to your youngster that you are working with him to fix the problem and eventually he’ll be able to come along. Again, this is about setting priorities and either targeting behaviors that can result in initial success or behaviors where safety/health is a concern.

Typically the parents have intuitively tried some very appropriate strategies to deal with the meltdowns, but have given up too quickly because they didn’t see change right away. When moms and dads begin to reassert their roles as being in charge and working with their youngster to improve his ability to be more flexible, the youngster will likely respond initially by getting worse. Even though he doesn’t really want the old system to remain in place, it is his natural instinct to try to hold on to what he knows rather that commit to uncharted waters. Moms and dads must believe in what they are doing and remain persistent, which is hard after having developed a sense of failure about trying to manage meltdowns up to this point.

Footnote:

I would like to point out the very rarely understood fact that basically this disorder is nothing but having little to no intuition. Kids on the autism spectrum do pretty much everything they do consciously, including facial expressions and body posture. That's why they tend to have fairly emotionless faces, awkward body postures and why they are horrible both are social interactions and organizing their daily lives. That's also why they have trouble with sensory overload or sensitivity to specific sensory impulses. It's also why their hobbies tend to be so extreme and specific as those are the only activities that stimulate their barely existing intuition to sufficiently feel a sense of satisfaction in their lives.

Because it does so many things consciously, the AS or HFA brain is much more engaged in reflective (conscious) processing of information than the "neurotypical" brain. Meltdowns are the consequence of AS and HFA kids suffering from cognitive overload. It's like a traffic jam in the brain. The brain tries to process more data than it can handle and the response to that is to create an emotional short circuit and cognitive standstill. To put it simply, nothing goes in, and intense emotions come out. The frequency and intensity of meltdowns is strongly related with how much data the child can process at the same time and thus also with his/her intelligence.

It's important to realize that the level of stress is directly correlated with the amount of data that needs to be processed, and the amount of data that needs to be processes is directly correlated to how much sensory data is picked up and the complexity of the child's personal planning. To relieve stress, it is important to adjust the amount of sensory data to a comfortable level and to adjust the child's planning in a way that is easily maintained. A logical and consistent structure often helps.

==> Preventing Meltdowns and Tantrums in Aspergers and HFA Children

Will my Aspergers child’s symptoms get worse over time?

Question

Will my Aspergers child’s symptoms get worse over time?

Answer

It doesn't actually worsen, but when a child with Aspergers (high functioning autism) reaches puberty, he/she can come under tremendous pressure and stress. So even though there is no actual cure for Aspergers, it can be made less noticeable if the Aspie is taught the correct ways to behave. This can mean going to occupational therapists, speech therapists, or the like. The more positive work you put towards helping your child, the less noticeable his/her Aspergers traits will be.

Click here for more...

Interventions for Children and Adults with Aspergers

Interventions for Children with Aspergers (High-Functioning Autism) —

All people in the Aspergers youngster’s life need to accept the diagnosis of Aspergers and understand its impact. Interventions are driven by each youngster’s age and individual needs and will vary, however, listed below are commonly needed interventions for kids in all environments:

1. Advocate for your youngster to have the school program that they need.

2. Be patient with your youngster and yourself and prioritize what to focus on first. Just focusing on today builds a better tomorrow.

3. Be prepared with your response to a difficult behavior or cycle that will calm the situation so you can react from your plan and not from your emotions.

4. Determine what a tolerable social and physical environment is for the youngster and provide it.

5. Don’t forget to nurture your spiritual side.

6. Educate yourself about Aspergers.

7. Learn how and when to talk to others for help, both professionals and other moms and dads or friends.

8. Learn what your youngster needs—become an expert of your youngster.

9. Model and teach your youngster how to do tasks or how to understand social and physical cues in the home environment.

10. Moms and dads must remember to nurture themselves and seek a balance between helping their Aspergers youngster and remembering the needs of the rest of the family.

11. Provide and teach the youngster to use visual organizational supports for all weak areas.

12. Provide direct instruction for all areas of need, especially social behavior and communication skills.

13. Provide your youngster with more support (often visual charts, photos, examples) to help the youngster learn to do organizational tasks (e.g., clean room, pack backpack, get ready to leave the house).

14. Pull together a team of professional supports (therapist, psychopharmacologist, OT, S&L, sensory specialist or others) as needed.

15. Remember that the key is pacing yourself, prioritizing the most penalizing behaviors currently impacting your youngster, and starting with them. Over time and with the right team, the initial concerns will become less, and your attention can shift to other areas to capitalize on or to minimize.

16. Set up structures and supports so home can be predictable and comfortable. Then teach a procedure for tolerating a change in the day.

17. Talk less, slower, calmer and in clear language that the youngster can understand.

18. Teach emotional regulation with visual systems and feedback to the youngster and provide breaks from social situations as needed.

19. Teach new concepts by using their special interests.

20. Teach the youngster to know what they need and the language to ask for it.

21. Teach them to understand themselves and appreciate who they are.

22. Use “thinking out loud” as your method of teaching your youngster to problem solve.

23. Use kindness and humor for mistakes and enjoy the youngster’s strengths.

24. Use routines, minimize change and prepare for all types of transitions.

25. Use visuals to teach the youngster a problem-solving method for when they are stuck.


Interventions for Adults with Aspergers (High-Functioning Autism) —

Everyone with Aspergers is unique, so interventions need to be individualized. Grown-ups come to this awareness at different ages and stages of their lives, which can influence the approaches they choose. Be creative in the combination of interventions you use. Simplify your life. Here are some general ideas regarding interventions for grown-ups with Aspergers:

1. A Cognitive-Behavioral approach to therapy is strongly indicated.

2. A therapist with an awareness of Aspergers or interest in learning about it with you is essential.

3. A variety of therapies can be helpful to grown-ups with Aspergers, depending on the person.

4. Advocate for environmental changes at work or home; if you are more comfortable, the people around you will be as well.

5. Attend a group where social skills are explicitly taught (often by a speech language pathologist).

6. Build on your strengths.

7. Contact the vocational rehabilitation agency in your state; with an official diagnosis of Aspergers, you are entitled to service.

8. Decrease “isolation-time” (i.e., do not stay home - all day - by yourself everyday).

9. Disclose strategically – only share the information that is required for that time and place. Consult with a trusted person to determine what to disclose if unsure.

10. Downtime is required. Sensory and social demands of daily life make more downtime essential for grown-ups with Aspergers. Communicate with those around you about your need for this, but do not use it as an excuse to avoid participation in family or other activities.

11. Educating others in your family, workplaces and communities about Aspergers.

12. Heightened sensory sensitivities may make particular environments unpleasant or intolerable. Thus, change lighting, decrease noise, wear comfortable clothing, etc.

13. Hire people to do the things you’re not good at (e.g., money management, housework, organization and bookkeeping).

14. Join a group where you can meet other adults with Aspergers.

15. Know that a slower-paced environment will likely be more tolerable and allow for a greater sense of comfort and competence.

16. Know what Aspergers is in general and how it affects you specifically.

17. Know your areas of difficulty.

18. Know your strengths.

19. Listen to trusted family or friends.

20. Medication can be helpful in decreasing symptoms of depression and anxiety that often accompany Aspergers.

21. People with Aspergers tend to connect most comfortably around shared interests.

22. Physical and emotional comfort is essential to adults with Aspergers.

23. Psychodynamic psychotherapy is generally less helpful.

24. Read about Aspergers from a variety of perspectives.

25. Stop the blame. Blaming yourself or others is common and not helpful.

26. Strategic disclosure can provide relief for an adult with Aspergers and promote greater understanding.

27. Strengthen your areas of difficulty or minimize their presence.

28. Treat yourself like you would a trusted/valued friend!

29. Utilize career one-stop centers (i.e., federally funded centers designed to help people learn new, marketable skills, identify jobs and prepare for interviewing).

30. Work with a Life Coach. He or she will work with you on multiple levels (e.g., concrete skills-building and goal direction, independent living skills, employment related skills, social skills, understanding your traits and symptoms, etc.).


The Aspergers Comprehensive Handbook

Intestinal Dysbiosis and Autistic Spectrum Disorders (ASD)

Intestinal dysbiosis is common to many kids with an Autism Spectrum Disorder. Living in our intestinal tract are trillions of cells of microbial organisms such as bacteria, yeast and viruses (called "flora"). There are friendly flora that are an asset to gut function and there are unfriendly flora that are harmful to the gut. Under normal conditions all these organisms live in competitive balance and synergy. Problems occur when something happens to upset the normal balance between friendly and unfriendly flora (e.g., antibiotics).

Antibiotics kill friendly bacteria in the gut but do not kill “unfriendly” bacteria such as yeast. With the friendly bacteria compromised, the yeast flourishes. Thus we have dysbiosis. Dysbiosis leads to leaky gut wherein undigested food, toxins, microbes and all kinds of things we really don't care to know about are leaked into the blood stream. Leaky gut is involved in numerous health conditions. We are most interested in food allergies, common to kids on the autism spectrum.

History and symptoms questionnaires give good clues into the possible presence of dysbiosis. The following is a yeast questionnaire. Complete the questionnaire. The scoring is at the end.

Yeast Questionnaire—

Write down the score number of each question to which your answer is "yes":

1. Are your youngster's symptoms worse on damp days or in damp or moldy places? 20

2. Do you feel that your youngster isn't well, yet diagnostic tests and studies haven't revealed the cause? 10

3. Does exposure to perfume, insecticides, gas or other chemicals provoke moderate to severe symptoms? 30

4. Does tobacco smoke really bother your youngster? 20

5. Does your youngster crave sweets? 10

6. Does your youngster have a short attention span? 10

7. During infancy, was your youngster bothered by colic and irritability lasting over three months? If "yes" circle mild 10 or severe 20.

8. During the two years before your youngster was born, were you bothered by recurrent vaginitis, menstrual irregularities, premenstrual tension, fatigue, headache, depression, digestive disorders or "feeling bad all over"? 30

9. Has he/she been bothered by persistent nasal congestion, cough and/or wheezing? 10

10. Has used youngster received:
  • 4 or more courses of antibiotic drugs during the past year? Or has he/she received continuous prophylactic courses of antibiotic drugs? 80
  • 8 or more courses of broad-spectrum antibiotics such as amoxocillin, Keflex, Septra, Bactrim, or Ceclor during the past three years? 50

11. Has your youngster been bothered by persistent or recurring digestive problems, including constipation, diarrhea, bloating or excessive gas? mild 10, moderate 20 or severe 30

12. Has your youngster been bothered by recurrent headaches, abdominal pain, or muscle aches? mild 10 severe 20

13. Has your youngster been bothered by recurrent hives, eczema or other skin problems? 10

14. Has your youngster been bothered by recurrent or persistent athletes foot or chronic fungus infections of the skin or nails? 30

15. Has your youngster been labeled hyperactive? If "yes" circle mild 10, moderate 20 or severe 30.

16. Has your youngster experienced recurring ear problems? 10

17. Has your youngster had tubes inserted in his/her ears? 10

18. Is your youngster bothered by learning problems even though his/her early development history was normal? 10

19. Is your youngster persistently irritable, unhappy and hard to please? 10

20. Is your youngster unusually tired or unhappy or depressed? mild 10 severe 20

21. Was your youngster bothered by frequent diaper rashes in infancy? If "yes", circle Mild 10 or severe 20.

22. Was your youngster bothered by thrush? If "yes" circle mild 10 or severe 20.

Scoring Your Questionnaire—
  • 60 to 99 - low (child may not have intestinal dysbiosis)
  • 100 to 139 - moderate (child may have intestinal dysbiosis)
  • 140 and above - high (child probably has intestinal dysbiosis)

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

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

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