Behavioral Meltdowns

In my previous post, https://autismhippie.wordpress.com/2014/03/12/meltdowns/, I described my approach to sensory meltdowns.  Basically, a sensory meltdown occurs when the individual is overwhelmed and unable to process their surroundings.

Then there are behavioral meltdowns. These are more like temper tantrums – at a significantly higher level. The individual typically wants or doesn’t want something. For an individual with communication challenges, these can be extremely frustrating. There is a sense of urgency that they’re not being understood. The behaviors tend to escalate because the need is not being met. Oftentimes, a behavioral meltdown escalates into a sensory meltdown.

When Mike was little, he did a great job using meltdowns to get his way. There is power in meltdowns and it’s an easy tool.  He barely had language, so I was constantly reinforcing his requests. When I tried to deny them, he would protest, oftentimes leading to behavioral meltdowns.

While a behavioral meltdown can be challenging, there is only one way to reduce their occurrences. The child must be taught to understand “NO”.

Sounds easy enough – LOL! Trust me, I have bought the toy to avoid the meltdown. I have conceded the fight on many occasions. It’s embarrassing for parents and with therapy appointments to get to; it’s often easier to give in.  Then it occurred to me – Mike is smarter than that.  He can learn to deal with ‘NO’. Actually, he HAD to learn to deal with ‘no’.

I also had to come to terms with my own guilt.  I had moments where I felt so badly for Mike’s struggles that I would have bought him an elephant, if it had made him happy. I tried to compensate for his challenges with things.

At some point, I finally recognized that I couldn’t afford to fulfill his every demand.  Furthermore, I was harming him by doing so.  Eventually, someone is going to tell him “no”.  Did I want that to occur when he was 60 or 200-pounds?

I have always been conscious of the fact the Mike was going to be a large man. I knew that I had to be very consistent and follow through with consequences.  I had to maintain control and leadership over Mike to keep him safe.

So, I started out on my quest. Since most meltdowns seemed to occur when I was rushing and/or carrying my then, toddler daughter, I planned opportunities to practice teaching this skill. I brought him to stores during the morning hours when the crowds were minimal and my daughter was at preschool.  I selected stores that sold desired items.  In essence, I set him up to have a behavioral meltdown.  At first, I allowed him to select one small item, which would be given to him when he calmed down. Since I planned these life-lessons, I was able to remain calm.  I was prepared to block-out the stares and ugly looks from random strangers.  I was prepared to spend as much time as we needed to ride out the meltdown. Since leaving the store without the desired item was a challenge, I was prepared to carry him to the car and soothe him there. I lived in Washington at the time, so dog days of summer were not an issue.

My focus was on remaining calm and comforting my child while he learned that life was not going to always give him EVERYTHING he desires. I utilized the same calming techniques described in my posting, Meltdowns.

Since these outings were educational – I maintained a random pattern. I didn’t want Mike to get anxious every time I took him to a store without his sister. As we progressed, I included my daughter during the outings.  Since she was used to receiving ‘guilty-mom’ items too, it was a learning experience for her, as well. At times, I would allow desired items.  At other times, I did not. Which I might add, is life!

Today, Mike rarely has meltdowns with me.  He understands that I follow through with consequences and I’m not scared of him. I am able to refuse certain inappropriate video games or movies he requests. He has the opportunity to earn desired items and/or wait for the next gift-giving holiday.  Which, I might add, is life!

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Meltdowns

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I recently had a very insightful exchange with an autistic friend of mine about meltdowns. She explained to me that during a meltdown, she is fully aware of her surroundings and the people’s reactions to her; but unable to control her body. The meltdown is very much in control, until she is able to calm her mind and body to recover.

This exchange gave me so much insight and reinforced my thoughts/approach to Mike’s meltdowns.

My approach to meltdowns developed first from an acknowledgment that my son has a disability; he isn’t engaging in these behaviors to ruin my day. He is unable to fully control his behaviors. When you view a meltdown with the same compassion, urgency and concern as you would a person having a seizure; you tend to recognize that your role is to remain calm and have a plan.

With this understanding, I developed an approach Mike’s meltdowns to help him learn to self-soothe, with the intent to help him avoid or decrease the frequency and/or severity of his meltdowns.

My approach, in essence, was to utilize calming techniques I learned in yoga.  In addition, I wanted to act as a guide for him. I kept my behaviors very ritualistic in nature. I saw significant benefit in providing a framework of consistency for my own behavior. He soon knew what to expect and it removed his fear of an unknown reaction from me. It also allowed him to slowly regulate his behavior to mine.

As soon as the meltdown began, I would move Mike to a safe surface, either carpet or a bed. I would remain silent, extremely calm and model deep breathing. Over time, he joined in the deep breathing with me. I placed NO DEMANDS on him. I simply remained physically connected. By ‘physical’ I’m not implying that I’m restraining him. I would gently place a hand on his arm, back, or leg.  On occasion, I would apply mild rhythmic strokes. I used a deeper pressure to provide sensory input, but I gauged my pressure on his reaction. At times, a simple touch was all that he tolerated. I followed his lead and never forced the connection. If he retreated, I followed him to remain physically present and connected.

If the meltdown intensified, I became more sedated. If he looked at me, I provided a compassionate smile, but no notable reactions. The only language I ever used was a simple chant, “You’re a Big Boy – You Can Do It.” I would alternate modeling the deep breathing and quietly repeat the chant to him.

Over time, Mike joined me in the breathing and chanting. My behavioral framework provided him the structure to recover from the meltdown. He could focus on and join my ritualistic behavior to regulate and calm his body and mind.

Eventually, the breathing and chanting became a tool for him to utilize to self-soothe. He would engage in them when he was under stress. I believe that he eventually began to sense his body melting down and used the breathing and chanting to regulate himself.

He continues to utilize these tools today and recently offered the strategy to his sister.

My daughter is a new driver and was navigating a drive-thru window for the first time. She wanted to switch seats with me to avoid the drive-thru. From the backseat we quietly heard, “You’re a Big Girl – You Can Do It.”

 

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