Wednesday, April 29, 2009

Meltdowns vs. Tantrums

In my opinion, comparing an autistic/sensory meltdown with a typical tantrum is much like comparing an F5 tornado with a windy day. The differences lie in the intensity, duration, and motivation (or as Barbara more eloquently put it, it's a matter of degree). The motivation is important, because knowing what motivates a behavior is critical to knowing how to respond appropriately.

I'll be the first to admit I'm no expert on raising NT children, so I may be off base here, but based on the well-meaning-but-not-particularly-helpful advice I’ve received over the years, my understanding is that "typical" tantrums are most often motivated by (1) the child’s desire to somehow manipulate the parent into doing something they want, (2) anger over not getting their way, or (3) being tired and cranky. The appropriate parental response (according to conventional "wisdom") includes (1) ignore the tantrum and it will stop, (2) don’t give in to what the child wants, you’ll only encourage this kind of behavior, (3) use "the look" or "the tone" to let them know you mean business and they will stop, (4) punish them for misbehaving.

Those responses may make sense if that is the reason your child is having a tantrum, but all of those responses will likely make things worse if that isn’t the reason. I know, because I’ve tried them all and then some. In contrast, children with autism are not interested in manipulating others – they won’t be watching mom and dad to see how they respond to the meltdown. They don't understand nonverbal cues so the "look" and the "tone" are meaningless. They are not choosing to have a meltdown so punishing them makes no sense.

Quite often, meltdowns are triggered by sensory overload. The sights, sounds, smells, and textures that most of us routinely tune out and aren’t even aware of, bombard them to the point of being painful. I have looked into my sons eyes during a meltdown, trying desperately to figure out how to "make it better" and what I see is anguish, fear, and pain. Another common reason for meltdowns is a transition between activities or a change in the routine. Sure, most kids need a certain amount of structure and routine, and many have difficulty with transitions. But most can be consoled and/or redirected when these things come up. Not necessarily a child with autism. Not only that, these are children who notice the little details, and those details are important to them. The term "routine" takes on a whole new meaning and gets much more granular for children with autism.

It may seem unreasonable that a child insists on parking in a particular place when you go to the store or on doing things in a particular order, but it is because they have attached meaning to those things and it gives them a sense of stability and order. To someone unfamiliar with them, their actions may appear to be manipulative, but that isn't their intent. It's not about making people do what they want. It's about trying to create a little order to help them feel at ease in a world that to them is often an uncomfortable and unpredictable place.

Even the slightest changes to them can feel like their world has been turned upside down. Imagine if you came home one day and your house wasn’t where it should be, if instead there was just an empty lot. You might start to freak out just a little. Well, that is what even small changes feel like to our kids.

So, you might see parents doing some unconventional things to calm their kids. Instead of ignoring the tantrum, they may try to gently hold their kicking, screaming child and softly rock them to help soothe them. Or sometimes any intervention or attempt to help can make things worse, so you may see them just sit down next to their child and wait it out until their child is able to calm down, their only intervention being to clear the area of things that their child could hurt himself on, or moving him to a safe place. You may see them start counting random things because maybe numbers are soothing for their child. You may see them hugging their child tightly (deep pressure) or covering their ears to help them with sensory overload. Or you may see them realize that sensory overload is just too much, so they ditch a cart full of groceries and carry their child outside.

If the parents are able to figure out what triggered the meltdown, they might be in a position to give the child what they want (ok, I didn’t realize you wanted to count the squares on the floor and I wasn’t giving you time to do that, I’ll slow down). This isn’t about reinforcing or not reinforcing a meltdown, it’s about recognizing what is important to your child and trying to accommodate that when possible. Children with autism typically have difficulty communicating effectively, so the meltdown could very well be out of frustration over not being able to let the parents know what they want. Sometimes the meltdown itself is a last resort at communication. In this case, giving them what they want is not going to reinforce "bad" behavior, but rather it will show them that you understand what they wanted, which over time will reinforce their efforts to communicate (hopefully in more effective ways as time goes on).

I'm sharing this because I think the one thing I've wanted most for people to be aware of was to have a better understanding of why my kids react to things the way they do. Why they may run from a room screaming while the other kids are having fun. Why they may drop to the floor in the middle of the grocery store and start rolling around shrieking. Why, in attempt to stay in control and avoid dropping to the floor in a full-blown meltdown, they run up and down the aisles like it's a hundred-yard dash. Why we let them run (b/c it's their coping mechanism and if we didn't things could get much worse in a hurry), although we warn them not to bump into people. Why we take them out in the first place. Aside from the fact they have as much right to be out and about as anyone, it just makes sense that they're never going to learn how to cope with daily life out in the world unless they are exposed to it. That means taking them out.

Of course we try to do everything we can to make sure the stars are properly aligned before setting out. Well-rested... check. In a decent mood... check. Drinks and snacks... check. Toys, books, etc. to keep them occupied... check. Let them know where we're going, any stops along the way, and how long it will take... check. Make sure not to take unfamiliar turns or make unplanned stops... check. Scope the place out ahead of time (when possible) to assess likelihood of sensory overload (and potential escape routes)... check. All the planning in the world doesn't guarantee that everything will go well, but it does increase your odds :). And it takes time. Teaching our kids to cope with sensory overload, teaching them appropriate behavior in public, it's a process. It requires lots of patience, and of course, opportunities to practice (which is why, tempting though it may be sometimes, we can't just stay home all the time).

There was a time when I didn't know if the meltdowns would ever improve. But slowly, over time they have, at least for Cuddlebug and Bearhug. By that time, Little Bitty had started having meltdowns. Nice, huh? But now that we've experienced the light at the end of the tunnel once (well, technically twice), at least now when Bitty's having a rough day I can tell myself we've surved this before and it did eventually get better :).

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K on April 29, 2009 at 10:48 PM said...

great post and soo true - the part about the soothing rituals with the counting etc soo spoke to me

Maddy on April 30, 2009 at 12:21 AM said...

We are also experiencing far less of what you describe in far less intensity.......but it's definitely the understanding behind it that makes all the difference in the world.

Anonymous said...

Thank you for this. I guess I never really thought about the difference between meltdowns and tantrums...although we have definitely experienced and dealt with both. And I good to know there is light at the end of the tunnel. I see it. =)

Anonymous said...

From one mother to another, THANK-YOU!!! ((hugs))

Your post was beautifully done and is much needed for children like ours. I hope many people find your site so they can learn the difference between the two. I was searching on google and was a bit frusterated and down hearted about how many of the links led to judgemental based posts.

I will be sharing yours with my readers as a resource to help them understand. Thank-you so much. : )


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I'm a mom of three boys on the autism spectrum, 11-yr-old identical twins and a 7-yr-old. My husband is a SAHD.


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