One of the most common questions that I am asked is about meltdowns. It is understandably one of the biggest issues a person on the spectrum can face, and it can really make loved ones feel helpless. I always feel a little bit hesitant on giving much general advice. I find that there are about as many different types of meltdowns, as well as ways to help as there are autistic people. What works for one may not work for another, and vice versa. So, I thought that I could offer some general tips and ideas based off of what I have seen in my life. Some of these won't apply to you, or the autistic people you might know, but hopefully a few will be able to at least provide a little insight.
So, what is a meltdown?
This questions jumps right to the center of what this entry is about. It's also one that is really hard to answer. I don't know how to describe something that has no physical form. It's almost like trying describe what an emotion is. I just can't quite find the right words to convey the depth of a meltdown, and it's many, many facets.
I think a common misconception is that there is only one kind of meltdown. This is what makes it seem so elusive to onlookers who want desperately to problem solve when their autistic child/loved one is in the throes of what they think is a meltdown. What worked last time might not work this time, and a trigger that seemed to be mild last Thursday might be too much today. There's different types of meltdowns, as well as different combinations of things that tend to set one off at different times, and believe it or not is even unpredictable to many of us adults who are very self aware.
I can list a few different general types, and triggers so that you might be able to gather some info from here to possibly compare to your own situation. One thing that I heard once from a behavior specialist is that a meltdown is like a seizure in that you cannot stop one once it's started. You can make one worse, and you can prolong it's effects, but once the brain has reached that tipping point it is over. You can't unspill the overload, which is is to me what a meltdown is. It is an acute reaction to too much happening all at once, in which the brain has no way to cope, or contain. The excess must go somewhere. From what I can gather there are three main categories of meltdowns. Sensory, Executive functioning mishaps, and Emotional.
The different types of meltdowns:
Sensory: This is probably the most common. A meltdown caused by too much sensory input can be sudden, and out of no where, or look like a pot slowly about to boil over. A noise that barely bothered the person last week suddenly seems to push them over the edge this week leaving everyone confused, at best, and accusatory (as in viewing the autistic person as if their reaction is geared towards manipulation) at worst.
There's so many factors that play into this type of overload that it is hard to even catch it all here in this paragraph. There are some noises, and sensations that always overload some of us, and there are some that we can tolerate if we are having a good day. There are some that we can tolerate for awhile on a good day, and some we can tolerate alone, but not mixed in combination of other sensations. Sleep, hunger levels, and something as simple as one tiny routine change, or confusing social encounter that day may all lead up to usually tolerable sensory experience being intolerable.
What does this type of meltdown look like?
As I said earlier, this can be hard to describe when there are so many factors.The person might be covering their ears, or nose trying to block out stimuli. Stimming may increase, which includes rocking, and pacing in an effort to regulate the body. Agitation is pretty common across the board. We often come across as if we're just being grumpy, because suddenly everything is bothering us, and we are not mixing words about it. I get downright mean, and insulting when I am overcome with too much sensory input. My brain feels like it's pulsating, and tender. I have to protect my fragile self at that moment, and I can't do that if I am worrying about everyone else's feelings. I have to take care of this emergency, because whether others see it as an emergency or not, it is.
My older, verbal son is quite a bit like me in how he expresses sensory overwhelm. He typically is quite a bit harsher than me, and that often leads people to believe he is just rude, or needs to learn manners, but what they are actually seeing is someone who is doing their best with the neurology he has. Better ways of coping will come as he matures, but for now too much stimuli causes him to complain about everything that is happening around him. He might say things about his brother making noise, or how much he hates his life. He really sounds negative at these moments as if he's just got a really poor outlook. This is mistaken as a poor attitude by others, and often instead of getting the support he needs to feel better, and get back on track he is treated like he is purposely misbehaving, or trying to make trouble.
My younger nonverbal son will just begin to freak out at what looks to others as out of thin air. His main reaction is to start punching as soon as he even predicts that a loud noise is going to assault his ears. This often happens in the bathroom where the acoustics are louder, and people might be close to him in proximity. Loud noises hurt his ears so much that for him it is extremely painful for even a slightly raised voice to be close to his ears. Others will be like 'Then he just punched me out of nowhere!' No, it was not 'nowhere', and furthermore if they were watching his body language they would have known that he was already overwhelmed, and not to speak to him as indicated by the fact his hands were over his ears, and he was making sounds that indicated that he was feeling agitated. I often see type of thing happen where the onlooker sees the autistic person hit out, or self injure, and then assume it was out of nowhere, and punish the person. They might tell them to have 'nice hands', and even put the kid in a timeout. I find this response ridiculous given the fact that the onlooker probably has no idea what elicited the violent behavior to begin with. It would be the equivalent of me coming up to them with a megaphone, and yelling in their ears however long, or loud as I want, then telling them to calm down when they desperately tried to push me away, even punishing them for acting out citing that they MUST learn to control themselves better. When trying to protect the body from excruciating pain one does tend to get pretty testy. Just because an antecedent can't be identified at that moment from the person not experiencing the 'acting' out' behavior does not mean that there wasn't one. There always, always, always is one, and it rarely is because the person just wants to bully, hurt, abuse, or manipulate others. When a child is punished for trying to protect their sensory system what I see happen more often than not is that not only do they predict the sensory assault to happen again when in the same, or similar circumstance, but they also fear their reaction, because of the consequence they had to face last time it happened. They go straight from thinking of the sensory assault to behaving like it already happened, which does look like it came out of nowhere to the onlooker.
People might say, "But, Matriarch... if I let them get away with hitting then they will think they can use that tool as a means of getting their way."
That is a common thought, but here you are confusing a tantrum with a meltdown, and the two are miles apart. That subject is too involved to add to this entry, but the only 'way' they're trying to get is for the sensory climate to change. It's a matter of self preservation, which is not the same as a child throwing a fit for a candy bar at Kmart. Allow the person their human right of being overwhelmed, and expressing that. The more you learn what induces meltdowns the better you can help the person who is having them avoid situations that they will likely occur, and the more you respect the person having one the more safe they will feel sharing with you what they need. The autistic person needs to trust that you will keep them safe, and that includes their sensory system.
Executive Functioning Issues:
A brief explanation of what executive functioning issues can entail can be found HERE.
So, now that we have the basic definition out of the way we can discuss some the triggers.
Routine change: This is a big one many on the spectrum struggle with. It is hard for us to find ourselves having to make sudden adjustments to our routine. The same with the sensory type of meltdown, there is so much else that can weaken our ability to tolerate routine changes that our reaction may vary. The main issue is something changing, and then we are literally stuck, because we have such a difficult time seeing the bigger picture. We can't just switch gears, and think of another way to get through this situation like others do. What I recommend doing is changing up small things as tolerated with your child when they are young. For example, Bubby had a specific plate he liked to eat off of every meal when he was really young. He used to get really upset if he could not have that plate. As long as he wasn't already having a terrible day I began not to hand wash it for him. It would have to wait to be washed with the other dishes in the dishwasher, and he would have to pick out another at mealtimes if it weren't available. It would be available when it was clean. I had to walk him through the process of handling this routine change. I didn't just tell him he couldn't have his beloved plate, and to deal. I would tell him it was dirty, but he could choose the blue, or green plate instead. This left it up to him, but still limited his choices, because unlimited options, and choices is what scares us the most when we have a sudden routine change. That was a small, but effective building tool for feeling successful in dealing with unpredictability. He is 12 now, and is pretty good at dealing with surprises, and typically is more flexible than I am at handling routine changes.I must note, I was brought up in a chaotic environment where no consideration to my need for sameness was ever given. Any upset that I may have expressed over wanting something to be the same, and planned out was viewed by my parents as manipulation, and they would purposely withhold whatever it was I was requesting to show me I 'wasn't the boss'. I cannot explain how much damage this did to me anxiety wise. Please, don't do this.
If you are with an autistic person when their routine suddenly changes be calm. Don't try to explain to us how we're being unreasonable if we begin to get upset. Calmly, and kindly let us know what our options are. How can we proceed? We need to know that, and sometimes need a minute to process it all. Try to warn us of any changes way ahead of time. Respect that it is hard for us to process change at last minute.
Also, please be as consistent as you can. I know that I can be guilty of giving in at times that I shouldn't which results in Beans deciding that the thing I gave in about gets to happen all the time. An example of this is a couple months ago we were walking to his speech therapy. As we passed the park he decided to run toward it. We often go there after speech is over, and he does usually try to run for it on the way to speech, but every time I tell him no, Speech first, then park. On this day I thought it would be okay. He was almost all the way to the swings before I caught him anyway. I called the speech therapist to cancel and we played the morning away at the park.
Then, came the next time we were on our way to the speech. You probably can guess what he went to do. I told him no, "Speech first, then park." He wasn't having it, and on an epic meltdown ensued out in public on a sidewalk. I just held onto his shirt, and wouldn't let him run. He had his meltdown, and we went to speech therapy where he was really too wiped out to actually do much. The next time we went to speech he looked at the park, and I told him no. He didn't run. I was 110% responsible for causing that meltdown by being inconsistent. I set the rule as it being okay to go to the park instead of speech when he felt like it when I allowed him to have that choice last time we went. Rules are not implied to us. Either it is okay all the time, or none of the time. Of course, this doesn't apply when the person is having a meltdown, and needs a break. I know that can at times be about as clear as mud to try to understand which is which.
Information overload: This is another type of meltdown, and is pretty self explanatory. Sometimes, too much talking, or other types of communications are coming at us at a pace our brains cannot process it. It feels like a fuse pops in my brain, and I just can't manage to take in another single detail. For me, this typically results in a shut down more than a meltdown. My brain slows down, and one by one my senses begin to shut off. Hearing first, then sight, then feeling, ect... This shutdown type of meltdown is common for me in all the other situations, too. It may look like a good thing, but it is not, at all. In my opinion, it us a result of a type of PTSD behavior that I learned to use as a child to avoid being punished for melting down outwardly. It is much harder on my brain, and body to internalize this much emotion, and can lead to a complete nervous breakdown if an autistic person uses this coping mechanism too often.
Emotional Meltdown: Now we come to the last, but not least type of meltdown. It is the most confusing for me to try to explain, and I wonder if it is perhaps even more common than the sensory induced type I explained first for some of us on the spectrum. It's just not as identifiable as the sensory type of overload.
There are three main triggers for this type of meltdown that I can think of at this moment. Being bullied, taken advantage of, or otherwise abused, any social situation that left us confused, and or embarrassed, and too much of any emotion, primarily frustration.
Occasionally we will react right away to any of these triggers, but more often than not they just kind of sit inside festering for minutes, days, sometimes years, then come out at the various times.
Let's start with the first type. Let's just call it someone (or a group) being mean to us. That covers the gamut. This happens when we are made the butt of a joke, or harmed on purpose by others for their gain. On occasion when this has happened to me as a child, or teen I would react right away by having a small meltdown that would look to my peers as a huge overreaction to a small slight. More often than not, what would happen is that I would go home, and either explode at someone there that might look at me the wrong way, or just cry when alone. Maybe, even not cry when alone, because I have had the misfortune of hurt feelings somehow catching up to me in public places, (like while grocery shopping) and just completely be unable to stop the tears from coming, and my brain from turning to mush as I mired my way through whatever task I was attempting to do. Leftover pain strikes us often when we are not suspecting it.
This type of meltdown looks mostly sad. It's defensive in nature, and often has no words. I will feel often feel very frustrated, and be a bit short, but the main symptom is just total sadness that seems to encapsulate me from head to toe in a way that zaps my brain into barely functioning.
My son will often start crying at school, and go on and on about how so and so said this, and now he hates his life, or they need to apologize when this sort of thing triggers him. Usually, the thing he is going on about either makes no sense, or is completely out of proportion to the emotion he is displaying. I will know that either the person was very mean to him in a way that he can't explain, or something else happened that he can't process enough to get out, but he is still being affected by it. He might be overly sensitive, and be melting down over every tiny thing when someone is being mean to him at school. The thing is, he may not be able to read a lot of expressions, or body language, but he knows when he is not being treated well, even if he has no way to explain it to someone. This is how, even in good schools where bullying is not tolerated bullying happens to kids with poor social skills. The child gets picked on, but can't process it enough to reach out for help in a way that actually looks like they need help. Instead, they tend to act out, looking like they are the behavior problem, and are punished. They can't find the words to reach out, so they don't, and the vicious cycle continues. Once a kid (or let's face it, adult, because this happens in workplaces, too) is on the downside of a power shift it is so hard to get back up to a place where others will listen, and support them.
The second type is not so different than the first. It is usually borne out of a social situation in which we feel like we may have done the wrong thing socially. I think shame would adequately describe how I feel before, and during one of these meltdowns, but I am not sure that I feel comfortable pinning that emotion everyone who has this type of meltdown happen. Anxiety tends to happen first, where I will obsess over some situation that either I knew went wrong, or thought that did, and now I can't let go, Maybe, I embarrassed myself, or feel that I can't ever see those people again because I did, or said something out of place. Most of the time after a lot of time has passed I will realize that the situation I let get all wound up inside of my head about was not that big of a deal to begin with. At the time, though... if I let the situation loop in my head it will cause a meltdown.
The third type: Emotion overload. All these types ( in my opinion) are about emotion overload, but having too much of any emotion at one time can cause an immediate meltdown. Frustration is the main trigger with this type. This is the type Beans has all the time. Developmentally, he is just not able to tolerate very much frustration. Not being able to get what he wants when he usually does, or being told no can cause too much frustration for him, and lead to a meltdown. Say, he wants to go out to play, but I tell him he can't right now. He might begin to hit himself, or others, and cry. He simply cannot process that much upset at once.
Odd as it sounds, too much happy can also cause meltdown, too. It is an emotion after all, and too much of it at once can be too overwhelming for us at to process. I find this kind of positive overload to trigger a meltdown that occurs after the event that made the autistic person so elated, happy, or joyful.
So, in summary,
We are all individual, so meltdowns can vary wildly from one person to the next, even in the same person from one day to the next.
Meltdowns can be similar to seizures in that one cannot be stopped after it's been set in motion.
There are different types of meltdowns, as well as different ways to prevent, and recover.
I personally, am of the belief that the less hands on the better. Unless the person needs massage, deep pressure, ect.. you should not attempt to hold down, or restrain the person having a meltdown. This only intensifies fear, and will lead to more violent behavior in the future. There are safety exceptions to this rule, but not many.
Meltdowns should never be punished. Ever. This includes taking privileges away via behavior charts like color cards, ect. Children typically do the best with the skills they have. If they're hitting others, and such behaviors that typically means they need to learn a better coping skill, or need support in their current environment that they currently don't have access to. I see this a lot, and it really, really upsets me when parents punish their child for basically being autistic. Usually, I hear the parents tell them they 'need to make better choices'.When this happens they miss an opportunity to teach them how to advocate for themselves, and learn important coping skills. The child learns their well being doesn't matter, and that they can't win.
Finally, meltdowns happen. In my opinion, it's part of being on the spectrum. Learning how to deal with them when they happen can mean the difference between having a small hiccup in our day, and having an all out total chaotic mess that leaves everyone totally exhausted.
You cannot reason a person out of a meltdown, so please don't try. We know we are out of control, and not making sense. There is nothing we can do about it while in the middle of a meltdown.
Thanks for reading this novel of a blog entry! Please, feel free to add your own meltdown experiences in the comments section.