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Preventing Meltdowns in Students with ASD: Advice for Teachers

"Do you have any simple, 'cut-to-the-chase' advice I could share with my son's teacher (who seems to know very little about how to handle students on the autism spectrum who 'meltdown')? He is currently in the 6th grade and has a new teacher."

Sure. Here goes...


Students with ASD level 1, or High Functioning Autism (HFA), desperately need support from educators when they struggle with emotional and behavioral issues in school. Here are many helpful strategies that every teacher should know:

HFA can co-exist with other disorders (e.g., ADHD, depression, anxiety). But mostly, this disorder affects the ability to socialize. These youngsters have difficulty recognizing facial expressions, sarcasm, and teasing, and struggle to adapt to unexpected changes in routine. Their interests tend to be very narrow, and this can limit their capacity to relate to others.

Due to these struggles, kids on the autism spectrum oftentimes experience anger, fear, sadness, and frustration. There are several effective interventions that can be employed in the classroom to help improve the youngster’s learning experience. These can assist the student in feeling more comfortable and decrease anxiety, paving the way for academic achievement.
 

1. Make a Plan for Emotional Outbursts— Provide a quiet place for the student who has frequent meltdowns. This may be a trip to the bathroom with a classroom aide, or a visit to the school counselor. A written plan for coping in these periods of high stress is critical for an HFA student’s success.

2. Make Classroom Rules Clear— Students with HFA thrive on rules, but will often ignore them when they are vague or not meaningful. Educators should detail the most important classroom rules and why they exist. A written list prominently displayed, or a handout of the classroom rules can be very helpful.

3. Minimize Surprises in the Classroom— Youngsters on the autism spectrum need structured settings to succeed. They do not like surprises. Things like sudden seating changes or unexpected modifications to the routine could cause anxiety and even meltdowns. Educators should try to provide ample warnings if there is to be a change of plans (e.g., sending a note home to the parent if a seating change is imminent).

A back up plan can be presented to the class in anticipation of schedule changes (e.g., when the Friday schedule that usually includes watching an educational film in the afternoon changes if time is short, the teacher should inform the students ahead of time that they will work on free reading or journaling instead).

4. Promote Supportive Friendships— If it seems appropriate, educate the class about autism spectrum disorders. Develop empathy by making students aware of inappropriate words and bullying behaviors. Highlight the "special needs" youngster’s strengths in classroom lessons to enable him to find friends with common interests.

If the student on the spectrum seems to be struggling with friendships, group him during classroom activities with those that are more kind and empathetic. At recess or lunch, try assigning a “classroom buddy” who will be supportive and guide the youngster through those more chaotic times.

5. Provide Sensory Support— Many kids with HFA also experience sensory processing issues. Sensitivity to light, sound, touch, taste, and smells can irritate the youngster, making him more likely to act out or withdraw. Consult the mom or dad to determine what these sensitivities are. Minimizing classroom chaos, noise, and clutter will be a good start.

If possible, get help from an occupational therapist and try to work sensory breaks into the youngster’s school day. Chores such as returning a load of books to the library, or even doing a few jumping jacks in the hallway, can go a long way in helping the youngster realign and get back to learning.

Helping kids with HFA in the classroom is yet another challenge for today’s overburdened educators. However, with insightful monitoring, parental and professional guidance, and creative strategies, a love of school and learning can be fostered in these young people kids.
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Is it ASD, ADHD, or Both?

"My 6-year-old son was diagnosed with ADHD at age 5. But now we are seeing signs that he may have 'high functioning' autism. What percentage of ADHD children also have autism? Is a dual diagnosis common?"

Most kids with ASD level 1 (high functioning autism) don’t receive that diagnosis until after age 6. Usually, they are diagnosed with ADHD as toddlers. Part of the reason is that physicians routinely screen kids for ADHD but not for autism. 
 
Another reason is that an ASD child's social impairment becomes more evident once he starts school. Finally, physicians are reluctant to label a youngster "autistic." It is okay - and even a badge of honor - to have a hyperactive youngster, but it is another thing entirely to have an autistic youngster.

Physicians make their diagnoses based on the youngster’s behaviors. Since kids with ADHD and ASD share similar behaviors, the two can appear to overlap. However, there is a fundamental difference between the two. For example:
  • An autistic child can appear unfocused, forgetful and disorganized like a youngster with ADHD, but there is a difference. The ADD youngster is easily distracted. The ASD child has no "filter."
  • Autistic children don’t understand that relationships are two-sided. If an ASD child talks on and on in an unmodulated voice about his particular interest, he simply does not understand that he is boring his friend and showing disinterest in his friend's side of the conversation. On the other hand, the youngster with ADHD can’t control himself from dominating the conversation.
  • Autistic children lack what physicians call "social reciprocity" or Theory of Mind. Theory of Mind is "the capacity to understand that other people have thoughts, feelings, motivations and desires that are different from our own." Kids with ADHD have a Theory of Mind and understand other people's motives and expectations. They make appropriate eye contact and understand social cues, body language and hidden agendas in social interactions. ASD children can’t.
  • Autistic children tend to get anxious and stuck about small things and can’t see the "big picture." Kids with ADHD are not detailed-oriented.
  • Both have social difficulties, but for different reasons.
  • Both kinds of kids can tantrum, talk too loud and too much and have problems modulating their behaviors and making friends.
  • If the unfocused autistic child is "nowhere," the obsessive-compulsive and "fantasy" autistic  child is somewhere else. "Fantasy children" retreat into a world of their own making - a world where everything goes the way they want it to. They play video games for hours or retreat into books and music. Their daydreaming and fantasizing resembles the behaviors of non-hyperactive kids with ADHD.
  • Kids with ADHD respond to behavioral modification. With ASD, the disorder is the behavior.
  • Obsessive-compulsive ASD children live a world they create from rules and rituals. Like ADHD kids, they appear preoccupied and distracted, but for different reasons. They appear distracted because they are always thinking about their "rules” (e.g., Did I tie my shoelaces right? Did I brush my teeth for 120 seconds?).
  • The ADHD youngster understands the rules but lacks the self-control to follow them. The autistic child does not understand the rules.
  • The autistic child views everything in her environment as equally important. Her teacher's dangling earring is as important as what she writes on the blackboard. The ASD child does not understand that she does not have to memorize the entire textbook for the next test. She does not "get" such rules.
  • The youngster with ADHD knows what to do, but forgets to do it. ASD children don’t know what to do.

Some researchers estimate that 60% to 70% of ASD-Level 1 children also have ADHD, which they consider a common comorbidity of ASD. Other researchers say that the two can’t exist together. Still others insist physicians have it all wrong and that the two disorders are the same.

The real problem is that there is no hard science. No one knows exactly how slight imperfections in brain structure and chemistry cause such problems. For this reason, getting the right diagnosis for a youngster who exhibits behavior problems may take years of trial and error. Diagnosis is based on observation of behaviors that are similar for a myriad of disorders. 

The tragedy is that the youngster often does not receive the correct medications, educational strategies, and behavioral modification techniques that could help him function on a higher level. He falls farther behind his peer group and loses ground when he could be getting appropriate treatments.


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… fabulous info! thank you....
•    Anonymous said… Great article, thanks!
•    Anonymous said… My son haznt got any speech delays but shows every sympton of aspie but they wont diagnose him they wana diagnose him wid adhd an attachment disorder cus he waz poorly when a babie im still thinkin aspergers thow
•    Anonymous said… My son is 11 and still officially 'undiagnosed'!!!
•    Anonymous said… my son was diagnosed smack bang on the age of 6 ... no speech delay for this man . cant shut him up since the age of one !!! but other things make sense now . hes nearly seven :)
•    Anonymous said… My son was diagnosed with autism at 3. He is now 11 and presents as a child with Aspergers but at 3 there was speech delay.
•    Anonymous said… My son was just diagnosed at 7... at three he was diagnosed with speech delay anxeity disorder and ocd....
•    Anonymous said… the doctor that diagnosed my daughter said the only difference between asperger's and high functioning autism is the speech delays in the early years 
•    Anonymous said... Adhd n add will never be on the spectrum. Add n adhd are commonly diagnosed with Aspergers because some of the "symptoms" are in both. Sensory issues are in almost every child with an ASD.
•    Anonymous said... I have 2 with adhd and one with asd. While a few of the symptoms are the same, and a child can have both, I could not imagine add or adhd being on the spectrum in any way ever.
•    Anonymous said... My son has asbergers adhd ocd and generalized anxiety disorder
•    Anonymous said... They are talking about putting ADD and ADHD on the spectrum, so your question is yes. Going to share your page.
•    Anonymous said... yes my son was diagnosed with adhd when he started school but he always had the aspergers tendencies. he has been re diagnosed as adhd-asd-aspergers syndrome.
•    Anonymous said… I agree. My 15 year old son was diagnosed with ADHD at 5 but wasn't given a formal diagnosis of Aspergers till he was 9. One of the reasons for the delay was other cases where the disability was evident took precedent. Unfortunately, in cases such as Autism or FASD where the disability is "invisible" or intangible, individuals are more often than not last priority in psychological assessments in school.
•    Anonymous said… I've had a lot of anger towards the specialists who were a part of diagnosing my son with ADHD when he was 5. I always knew it wasn't the answer, and sought help from different sources (pediatrician, school special education team, therapists...) only to feel like I was going crazy because I was the only one who didn't want to medicate him for ADD. Four (long and tough) years later, we're in the process of an autism assessment. The more I read about the spectrum, the more I feel that it's so blatantly obvious that autism symptoms are what have been ailing him and causing his issues at school for so long; and it has made me angry that those specialists (who should be familiar enough with those symptoms) didn't see it or suggest it 4 years ago. This article helped me come to peace with that a little bit. I still find it strange that doctors routinely screen for ADHD over autism, and I think it's because there is medication for ADHD, a quick fix, where ASD takes a lot more time/resources/intervention.
•    Anonymous said… Very common to have both diagnosis. Actually, having only Aspergers is more rare. Aspies usually have a second diagnosis of ADHD, depression, or OCD according to what I have read and seen. My son was diagnosed ADHD at 3 1/2. At that time he was also tested for ASD, but not diagnosed. Within 2 years, he had changed quite a bit, and it then became evident that he also had Aspergers.
•    Anonymous said… Yes, there can be a dual diagnoses. I have a triple one. In our case, it is all evident and true. Asperger's and ADHD. The third one is a attachment/ bonding disorder. All are clearly right on point 100%. Some do not like to diagnose so quick. It is a process that may require a couple of opinions.

 Please post your comment below... 
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Dealing with Difficult ASD-related Behavior: Critical Tips for Parents

"I need some advice on how to handle behavior problems in my child with ASD, such as how to use the right discipline, dealing with his obsessions, sibling issues, sleep problems, school-related problems, and acting-out behavior in public. Thanks!"

Disciplining kids displaying ASD-related behavior will often require an approach which is somewhat unique to that of "typical" kids. Finding the balance between understanding the needs of a youngster with ASD - and discipline which is age appropriate and situationally necessary - is achievable when applying some simple, yet effective strategies. These strategies can be implemented both at home and in more public settings.

General Behavior Problems—

Traditional discipline may fail to produce the desired results for kids with ASD level 1 ("high-functioning autism"), primarily because they are unable to appreciate the consequences of their actions. Consequently, punitive measures are apt to exacerbate the type of behavior the punishment is intended to reduce, while at the same time giving rise to distress in both the youngster and the mom or dad.

At all times, the emotional and physical well-being of your youngster should take priority. Often this will necessitate removing your youngster from a potentially distressing situation as soon as possible. Consider maintaining a diary of your youngster's behavior with a view to ascertaining patterns or triggers. Recurring behavior may be indicative of a youngster taking some satisfaction in receiving a desired response from peers, moms and dads, or teachers. 
 
 
For example, the youngster may come to understand that hurting another classmate will result in his being removed from class, notwithstanding the associated consequence to his peer. The solution may not be most effectively rooted in punishing the youngster for the behavior, or even attempting to explain the situation from the perspective of their injured peer, but by treating the root cause behind the motivation for the misbehavior (e.g., maybe the ASD youngster can be made more comfortable in class so that he will not want to leave).

One of the means to achieve this may be to focus on the positive. Praise for good behavior, and reinforcement by way of something like a Reward Book, can assist. The use of encouraging verbal cues delivered in a calm tone are likely to elicit more beneficial responses than the harsher verbal warnings that might be effective with "typical" kids. If necessary, when giving directions to stop a type of misbehavior, these should be framed as positives rather than negatives (e.g., rather than telling a youngster to stop hitting his brother with the ruler, the youngster should be directed to put the ruler down).

Obsessive or Fixated Behavior—

Almost all kids go through periods of development where they become engrossed in one subject matter or another, but kids with ASD often display obsessive and repetitive characteristics, which can have significant implications for behavior. For example, if an ASD youngster becomes fixated on reading a particular story each night, she may become distressed if this regime is not adhered to, or if the story is interrupted. Again, the use of a behavior diary can assist in identifying fixations for your youngster. 
 
 
Once a fixation is identified, it is important to set appropriate boundaries for your youngster. Providing a structure within which your youngster can explore the obsession can assist in then keeping the obsession within reasonable limits, without the associated angst which might otherwise arise through such limitations (e.g., tell your youngster that she may watch her favorite cartoon for half an hour after dinner, and make time for that in her routine).

It is appropriate to utilize the obsession to motivate and reward your youngster for good behavior. Always ensure any reward associated with positive behavior is granted immediately to assist the youngster recognizing the nexus between the two.

A particularly useful technique to try to develop social reciprocity is to have your youngster talk for five minutes about a particularly favored topic after he has listened to you talk about an unrelated topic. This serves to help your youngster understand that not everyone shares his enthusiasm for his subject matter.

Bridging the Gap between ASD and Discipline and Other Siblings—

For siblings without autism, the differential - and what at times no doubt appears to be preferential - treatment received by an ASD sibling can give rise to feelings of confusion and frustration. Often, they will fail to understand why their brother or sister apparently seems free to behave as they please without the normal constraints placed on them.

It is important to explain to siblings of ASD kids and encourage open discussion about the disorder itself. Encouragement should extend to the things siblings can do to assist the ASD youngster, and this should be positively reinforced through acknowledgement when it occurs.

Sleep Difficulties—

ASD kids are known for experiencing sleep problems. Kids with the disorder may have lesser sleep requirements, and as such are more likely to become anxious about sleeping, or may find they become anxious when waking during the night or early in the morning.

Combat your youngster's anxiety by making her bedroom a place of safety and comfort. Remove or store items which might be prone to injure your youngster if she decides to wander at night. Include in the behavioral diary a record of your youngster's sleep patterns. It may assist your youngster if you keep a list of her routine (e.g., dinner, bath time, story and bed time) in order to provide structure. Include an image or symbol of her waking in the morning to provide assurance as to what will happen. Social stories have proven to be a particularly successful tactic in decreasing a youngster's anxiety by providing clear instructions on how part of her day is likely to play out.

At School—

Another autistic characteristic is that kids will often experience difficulty during parts of the school day which lack structure. If left to their own devices their difficulties with social interaction and self-management can result in anxiety. The use of a buddy system can assist in providing direction, as can the creation of a timetable for recess and lunch times. These should be raised with teachers and implemented with their assistance.

Explain the concept of free time to your youngster, or consider providing a separate purpose or goal for your youngster during such time (e.g., reading a book, helping to set up paint and brushes for the afternoon tasks, etc.).

In Public—

Kids on the spectrum can become overwhelmed to the point of distress by even a short visit in public. The result is that many moms and dads with ASD kids simply seek to avoid (as much as possible) situations where their youngster is exposed to the public. While expedient, it may not offer the best long-term solution to your youngster, and there are strategies to assist with outings.

Consider providing your youngster with an iPod, or have the radio on in the car to block out other sounds and stimuli. Prepare a social story or list explaining to the youngster a trip to the shops, doctor, etc. Be sure to include on the list your return home. Consider giving your youngster a task to complete during the trip, or having him assist you. At all times, maintaining consistency is a key concern. It pays to ensure that others involved in your youngster's care are familiar with your strategies and techniques and are able to apply them.

Lastly, don't hesitate to seek support networks for parents with ASD kids, and take advantage of the wealth of knowledge those who have dealt with the disorder before you have developed. The assistance you can gain from these and other resources can assist you in developing important strategies to deal with problems in a manner most beneficial to your youngster.
 

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"Do children with ASD Level 1 have speech problems, or is this purely an issue in ASD Level 3?"

"Do children with ASD Level 1 have speech or language problems, or is this purely an issue in ASD Level 3?"

Although kids with ASD level 1, or High-Functioning Autism (HFA), acquire language skills without significant general delay - and their speech typically lacks significant abnormalities - language acquisition and use is often atypical. Abnormalities include:
  • abrupt transitions
  • auditory perception deficits
  • literal interpretations
  • miscomprehension of nuance
  • oddities in loudness, pitch, intonation, prosody, and rhythm 
  • unusually pedantic, formal or idiosyncratic speech
  • use of metaphor meaningful only to the speaker
  • verbosity

Three aspects of communication patterns are of clinical interest:
  • marked verbosity
  • poor prosody
  • tangential and circumstantial speech

Although inflection and intonation may be less rigid or monotonic than in ASD level 3, young people with HFA often have a limited range of intonation (e.g., speech may be unusually fast, jerky or loud). Speech may convey a sense of incoherence, and the conversational style often includes monologues about topics that bore the listener, fails to provide context for comments, or fails to suppress internal thoughts.

Young people with HFA may fail to monitor whether the listener is interested or engaged in the conversation. The child’s conclusion or point may never be made, and attempts by the listener to elaborate on the speech's content or logic, or to shift to related topics, are often unsuccessful.

Kids with HFA may have an unusually sophisticated vocabulary at a very young age and have been colloquially called "little professors," but have difficulty understanding figurative language and tend to use language literally. These kids also appear to have particular weaknesses in areas of non-literal language that include humor, irony, and teasing.

Although young people with HFA usually understand the cognitive basis of humor, they seem to lack understanding of the intent of humor to share enjoyment with others. Despite strong evidence of impaired humor appreciation, anecdotal reports of humor in kids with HFA seem to challenge some psychological theories of both ASD level 1 and level 3.
 
 




 
COMMENTS:

•    Anonymous said… Article is very accurate.
•    Anonymous said… I might have helpful info. My 7 yr old has Aspergers and my 3 yr old is deaf. Signing has really helped my family. My Aspie can sign to me anytime, anything and not interrupt anybody or say something that might be rude. I can do the same if I need a behavior to stop but don't want to publicly point it out.
•    Anonymous said… my son has aspergers but didn't talk till he was 3 and a half. his speech is still behind his age group.
•    Anonymous said… My son is 7 and has Aspergers. Hes never had trouble with talking, but having a conversation and understanding and following instructions, he really gets lost. We have to slow everything down and do everything in little steps for him.
•    Anonymous said… The only problems with speech my son (hfa) had was due to tongue tie. His language skills are way above average, he has always had a wide vocabulary.
•    Anonymous said… usually just the idioms and pragmatic stuff... my kids vocab are awesome...

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