How many times have you taken your neurotypical child to the store and, after being told for what seems like the millionth time no to the toy de jour, you watch your beautiful little angel red-faced, crying, and well on their way to convincing everyone in the store that you are the worst parent alive? Now, how many times have you walked by a child in a store and you see this? Have you assumed this is just another brat whose parents have laid out no boundaries for them? If your a parent of a child with Autism you have been at the receiving end of this and, for lack of a classier word, it’s really crappy. The sideways glances or slide under the breath comments from the meaner viewers are enough to make you want to start screaming at your child. But there is a huge difference between a tantrum and a meltdown and the more educated people get about it the easier we can make it on other parents. To do this let’s start by breaking down what a sensory meltdown is vs. what a tantrum is and understand that the two are not interchangeable.
Sensory Meltdown: In this type of situation a child with Autism in having an adverse reaction to something that is outside their control and in their environment. Whatever is affecting the child is putting them in a state of being overwhelmed and, in many cases, is having a reaction that is physically hurting them. Think about it like this, how many times have you gone into big stores like Costco and been exhausted by the time you leave? You have had to make use of so many of your senses in such a short amount of time that you are overwhelmed and it leads to you being tired. This can go for the mall, social functions, you name it. Where ever there is a dense amount of people (and people translate into energy) there is the possibility of being overwhelmed. Now, this is fine for most people because we have the skills to front-load ourselves with what to expect, put a time frame on the amount of time we will spend there, and then leave when we want. Now imagine not being able to utilize any of those skills and being put into situations and not being able to navigate them. There is so much sensory input coming at people with Autism, and they are working so hard to make sense of it all, it’s not wonder they go into overload! During a meltdown, there is not a quick resolution that will speed up the process. In a meltdown, the child is not having an outburst for attention and can be self-injurious. It’s important to know that self-injurious behavior is a way to self-soothe or make sense of what is going on. For lack of a better explanation, it is a way to relay a message without using their words, “I am confused, scared, and in pain and I need it to stop now!” Many times removing the child from the situation to a quieter area is very helpful, even an area that has dim to no artificial light.
Tantrum: Before a tantrum begins there is usually a clear predecessor to it. Let’s use this scenario; you have to go to Toys R Us to get a gift for a friends child (really, do you need any other explanation for me to go on? So many of us have been in this situation!) and your child decides that they want a toy as well. You say no, they persist….and now we are off to the races! It’s a battle of wills and you remind yourself you WILL NOT give in! You're bigger, your older, and damn it you have the money! In these cases we clearly see what is preceding the tantrum (wanting the toy) and the outburst will stop if the child's goal (getting the toy) is achieved, and the duration of the tantrum will depend on how strong the child's will is to obtain the goal and how strong the parents will is to follow through. The child is clearly doing it for attention (yours or others) and is very careful not to hurt themselves.
Now that we have discussed the differences I wanted to touch on what we can do to be proactive in a situation where there is a possibility of a meltdown. There are so many ways to help a child with Autism and I’d love to share a few that I’ve used and found to work great.
Visual Schedule: It takes about two minutes to do this and it can save you hours of meltdown time, no brainer. Before you and your child go into a possible “meltdown trigger” situation write down what the child can expect. It can look as simple as this: 1.) Get into the car 2.) Drive to the store 3.) Pick up Moana doll (I tend to be as specific as possible, I’ve found this sets the child up for success) 4.) Get back into the car 5.) Drive home
You will know how many steps your child can handle without getting frustrated. If it’s a new place then the simpler the better, if it’s a place that has been introduced into their routine then they are likely more flexible. Think of it this way, do you yourself use a planner or a To Do list? Why? Because you want to remember what to do and what to expect. Do you like to be thrown a curve ball and have to rearrange your schedule for something unexpected. Well people with Autism are very literal and having them know what to expect ahead of time can only help
Token Board: This is seen as a “Special Education tool” but I highly disagree. Like HIGHLY. The way I explain it to parents is why do you have a job? To earn a paycheck. So your paycheck is your reinforcer to have a job (and to, you know to survive and all that fun adult stuff). We all have our own reinforcers and all children (not just children with Autism!) are no different. Until a certain age, there has to be a payoff (ok, some people go beyond childhood with this but humor me) for them to follow through with what parents are asking. I usually have a piece of paper or small dry erase board and make 4-8 squares on it, then I discuss with the child what they would like to “work” for (i.e. iPad time, deep pressure massage, a favorite toy, swimming, etc). I take about four opportunities to go over how many stars (4-8, you decide) they will need to obtain for their reinforcement. And the stars aren’t guaranteed either (oh yes, I play hardball!) and can be erased if they exhibit a negative behavior that they know it’s appropriate. Soon the child will see that the payoff for their good behavior is getting what they want and it’s a win/win!
Picture Schedule: I’ve used this with some of my very young learners to get them used to a written visual schedule. It’s the same concept of the above visual schedule but uses pictures of the situation they will be going into. This is extremely helpful because they are seeing real life pictures of the environment and it seems to make them more comfortable and confident.
Regardless of what system you use, setting a child up for success is the most important outcome. The more successful a child feels, the more confidence you will see. I have seen the flushed glow of accomplishment on my student's faces when they have achieved something that seemed out of reach. Seeing a child happy and confident is a blessing and an inspiration for all of us to keep working towards the great good for our children. And I would love to hear from all of you, what types of systems do you use? I would love to include some on my blog to share with one another.