The Meltdown Battlefield: Problem Solving Meltdowns in Autistic Children
By Jennifer Imig Huffman, PhD, ABPdN
Severe temper tantrums, explosive behaviors, or “meltdowns” are a common cause of concern and referral for behavioral treatment of autistic children. Managing these meltdowns is often a challenging task for parents and teachers; however, there are recommended techniques and strategies to reducing the occurrence and severity of the meltdowns.
The first step in managing meltdowns is to identify the precursors, or the factors that are impacting the child prior to the meltdown. These factors may be internal (tired, hungry, scared, illness, mood), external (sensory overstimulation, academic demands not meeting cognitive ability, peer issues or bullying, relationship with parent/teacher, etc.), or a combination of the two.
Meltdowns have been described as having three stages: the ”rumbling stage,” the “rage stage,” and the “recovery stage.” (For more information, see Albert 1989; Myles 1999; Lipsky & Richards, 2009.) Prevention of the meltdown from occurring is the best intervention, as once your child enters the earliest meltdown stage (rumbling stage), they are typically unable to reason with you or learn strategies to avoid further escalation. Talking and reasoning with your child directly about meltdown behaviors can only occur when they are fully out of the three meltdown stages.
Rumbling Stage: Subtle emotional and behavioral cues (often difficult to identify) may suggest that your child is in a pre-meltdown state. You may see crying, pacing, increased frustration, avoidance of tasks, and greater distractibility. When you see these symptoms, your child is in the rumbling stage of the meltdown, and steps to intervene may be somewhat successful at this point if you use redirection, distraction, or calming strategies to attempt to avoid further progression into the next meltdown stage. Engaging directly with the child to talk or rationalize about the meltdown behaviors is not recommended at this point.
Rage Stage: Behaviors at this stage include increased anxiety, impulsivity, agitation, elopement, and/or aggressive behaviors. Talking with or attempting to reason with your child at this stage typically only escalates the situation. Safety of the child and those around them is the goal at this point. Having a predetermined safe, calm, and sensory appropriate place for the child to de-escalate during this time is suggested.
Recovery: Behaviors at this stage often include crying, fatigue, anger, and/or remorse. Your child is still vulnerable to further escalation into meltdown at this point, so gentle re-engaging the child in rewarding behaviors, redirection, and calming strategies are recommended.
When meltdowns begin to occur for a child in a setting (for example, home or school), it will be particularly important to identify the precursors and the rumbling stage as soon as possible and attempt to “break” the meltdown cycle or pattern. Once a pattern of meltdowns is established in a certain setting, it becomes particularly difficult to reduce the risk of a meltdown. In fact, after a meltdown occurs in the same location or setting several times, the location itself may become a trigger.
If you need additional assistance, or if your child is in danger of hurting you or themself, please contact your child’s doctor. Sometimes it is hard to identify the patterns resulting in a meltdown and outside help may be needed through the community or school. This is especially important if the meltdowns increase in frequency, severity, or aggressive behaviors.
Originally published by Dr. Huffman in Healthy Cells Magazine, April 2, 2014