What is an Autistic Meltdown and How to Help Someone Experiencing one.
Autism affects each person differently and so each individual will have many unique difficulties as well as gifts and talents. Autism is often presented and perceived as a disorder or dysfunction but in fact it is a neurological difference that causes people to see and understand the world in a different way.
This difference can allow those with autism to excel in some areas and to become highly skilled but also causes limitations in what they are able to cope with in day to day life. To someone with autism the world can appear to be a chaotic mess of sights, sounds, smells and people which can lead to feelings of fear and anxiety in situations that may seem simple to others. At these times, what is often called a meltdown can occur. To everyone else a meltdown can look like a temper tantrum even though they are in fact different and caused for different reasons. As autism awareness is increasing more people are becoming aware of this difference which is a great step forward but many still are unaware of or how to best manage meltdowns and help to avoid them in future.
What is Your Connection to Autism?
Individuals who live with autism spectrum disorders (often abbreviated to ASD) can struggle to integrate sensory information when it is coming from more than one source at a time. For someone who has autism having lots of different items to look at; such as in the supermarket, or being able to hear lots of different sounds at once can be massively over whelming. Each item or sound is experienced individually, rather than as a whole and each is competing for the persons attention all at once. This can cause the sense or senses to feel overloaded and the person may become afraid and feel that they are unable to cope if they cannot get away or stop the information coming in somehow. On top of this people who have autism spectrum disorders can be hypersensitive to sensory stimulation meaning that even normal amounts of sensory input can feel overwhelming to them.
Sensory overload can cause different reactions in different people. A common reaction is to freeze; almost like an animal caught in car headlights and then not being able to respond if someone speaks to them or be able to remove themselves from the situation. This freezing can be physical but can also be cognitive and effect thinking and the ability to order thoughts and feelings or work out what to do next. Individuals with autism may display self-stimulating behaviours such as hand-flapping, rocking, twitching, rocking or fiddling with clothes, hair or other objects. These behaviours help to make them feel safe and to rebalance their emotional state.
As well as sensory overload, meltdowns can be triggered but a range of other causes including:
- Sudden changes
- Being taken by surprise or caught off guard
- Not understanding why something has happened/is happening
- Other people failing to explain adequately what is or will happen in a given situation
- Having too many tasks to complete at once
- Feeling rushed
- Feeling overwhelmed by too many questions or people
- Use of non-concrete language such as ‘maybe’ ‘I will see’ or ‘If you have been good’
- Transitions, for example moving between classes, leaving home, school holidays or moving between activities at home such as mealtimes or bedtimes.
- Being given too many choices
- Being given vague or too open ended instructions
Meltdowns are an extreme reaction to stress or over-stimulation. The persons fight or flight response is triggered and releases adrenaline into the body in preparation for either having to run or fight. It is an instinctual and protective survival response but the heightened anxiety and over-stimulation can be very unpleasant for someone with autism.
Meltdowns are experienced differently and can happen with or without warning. Just as autism and meltdown are unique to each person, any warning signs of a meltdown will be too. Behaviours that may been seen building up to a meltdown can include; pacing, self-stimulatory behaviours, visible frustration, echolalia, difficulty answering questions, stuttering, inability to respond verbally and a resistance to leaving the task or situation causing the difficulty. Although they may appear the same meltdowns and temper tantrums are not the same thing. Meltdowns are uncontrolled reactions of overwhelming stress whereas a temper tantrum is a goal directed behaviour that are generally intended to change someone’s mind or manipulate them into doing something. During a tantrum a child may make eye contact, scream or kick out harder if they feel their behaviour is not having the desired effect or even move themselves to follow another person if they walk away. A child having a meltdown will not have the cognitive processing or control available to do so. A child having a meltdown will also not be able to communicate what they want or need and will likely not respond to anything that is said to them. During a tantrum children may repeat their request or respond to being told no or any other communications for others. Not all meltdowns are as noticeable and some people may have what are often called shut down meltdowns. During these the individual may disengage, shut off, become mute or have difficulty talking. They may also wish to be left alone and want to spend time alone for a while, until the over-stimulation has passed and they feel able to function well again.
When a person has a meltdown how others around them react and behave can make a big difference. What may seem like a reasonable question or comment to others can cause even more upset, frustration and confusion to someone with autism, especially when in meltdown state. During a meltdown it is unlikely that the individual will be able to respond to questions well, if at all and be at risk of injuring themselves or others. During a meltdown pain responses may lessen so that the person is unaware that they have hurt themselves until afterwards.
Useful strategies that can be employed during a meltdown include:
- Do not restrain or move an individual unless it is completely unavoidable. Due to hypo-sensitive pain responses it can be easy to hurt someone during a meltdown without them realising and be able to react to it. This can lead to more serious injuries because the other person is unaware that their restraining is causing pain. During a meltdown the person is not thinking logically and may hit out, kick or bite in an attempt to escape the restrain which they are likely to perceive as further threat, however well meant it is. This can lead to injury to the other party.
- Do not ask open ended questions such as ‘Are you ok?’. These are likely to add to the overload the person is feeling as it creates another thing for them to think about and cope with.
- Do not be forceful. This will heighten any fear the person with autism is already feeling. They are behaving in this way due to fear not out of aggression.
- Reduce all sensory stimulation in any way possible. Turn out lights, turn off music, televisions etc. and ask other people to leave the room.
- Remain calm yourself as this will create a feeling of safety and security for the person experiencing a meltdown and so reduce their feelings of fear and anxiety.
- Talk directly to the person in a gentle tone and using phrases that are reassuring and calming. Let them know you are there to help them and ensure they are safe.
- Any intervention should be performed by one person only. Lots of people being present, talking and making suggestions will be too stimulating and not provide the sense of solidity and calm that is needed.
- Do not tell the person that they need to calm down. They are unable to do so.
- Do not ask lots of questions or try to reason with the person in the hope of bringing them out of the meltdown. The more the person has to think about, the more they will become overstimulated.
- Ignore any behaviour that may normally be deemed ‘bad’ such as swearing or shouting. During a meltdown a person is not thinking clearing or at their normal level and are full of fear. They may say things they do not mean or behave in a way uncharacteristic for them.
- Make supportive statements and show compassion. Statements such as ‘I will stay with you until you feel safe’ will provide reassurance and reduce fear.
- Do not trivialise the meltdown or the experience or situation that led to it. This will only serve to hurt the person’s feelings and make them feel worse. Meltdowns can be very scary for those experiencing them and cannot be controlled.
For older children and adults it can be useful for them to carry medical id in the form of a card or piece of jewellery so other people can be altered to the fact that they have autism. There are many styles of bracelets or necklaces available that can be engraved or otherwise filled out with the medical details of your choice. A metal dog tag type pendant could be engraved with ‘ I have autism. Please remain calm and contact …….. in case of emergency’. Wrist bands and other items can also be purchased that may be suitable for younger children. Where possible an individual can also carry further information about how they experience autism and what will help them, particularly in the case of a meltdown. Someone who is not familiar with autism may mistake a meltdown for a tantrum or in older children, teenagers and adults for aggressive and dangerous behaviours. The inappropriate intervention that this can then led too is very likely to worsen the meltdown and cause further problems for the individual. Carrying basic information about autism and meltdowns can help avoid this and enable others to understand what the person needs. Contact details of the person’s parents, support workers or friends could also be included. Mobile phone contacts can be marked with ‘Contact in case of emergency’ or similar and support workers, social workers and other professionals details could be listed with their job title as well as name.
© 2013 Claire