Meltdowns 411: Prevention, Reaction, and Recovery
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 for all involved. 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. It is critical to learn to recognize when the meltdown is imminent in hopes of preventing this complete emotional episode. In today's blog post, guest contributor Lisa Rogers, MA of Asperger's 101 shares advice for what to do before, during, and after a meltdown.
Following this post, you will find more evidence-based therapy resources from The Speech Link podcast and SpeechTherapyPD.com.
Links to "The Behavior-Communication Connection" and podcasts are below this article. Enjoy this week's post from Lisa!
Preventing A Meltdown Before It Starts
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. That 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.
Here is a link to 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.
Also, listen to Lisa's one-hour podcast called "The Behavior-Communication Connection" for FREE.
During a Meltdown
While the main message is to have a plan to PREVENT a meltdown, we must also be prepared if a meltdown does occur.
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. For the entire posting, click HERE.
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.
-DO NOT say "Use your words."
As the brain escalates in a meltdown, the ability to be rational and articulate diminishes. - 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.
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 of the meltdown is at its peak.
If there are others in close proximity, then it should be part of the plan to remove 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.
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. Consider the following steps:
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.
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.
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.
About the Author: Lisa received her M.A. in Special Education with an endorsement in the area of individuals with severe disabilities. Mrs. Rogers maintains The Education (K-12) Blogs as well as the Special Ed Q & A on the Asperger's 101 website. She has also created products that have been used throughout the state of Texas for training purposes. Through the Association for Texas Professional Educators [ATPE], Ms. Rogers has produced an online course that targets the importance of visual strategies for student with autism spectrum disorders and just released her highly anticipated book titled: Visual Supports for Visual Thinkers.
Looking for even more therapy resources?
The Speech Link hosted by Char Boshart, MA, CCC-SLP is chock-full of school-based strategies, and features weekly interviews with expert guests such as Lisa Rogers, MA. You can listen to Lisa and Char's episode "The Behavior-Communication Connection" for FREE on iTunes by clicking HERE.
This episode is registered with ASHA for .1 CEU by completing the accompanying podcourse. Access live, interactive episodes and unlimited CEUs for as little as $89/year at SpeechTherapyPD.com Click HERE to learn more.