If your son or daughter has autism, chances are you’re no stranger to the meltdown. Whether they explode out of nowhere or emerge from a tantrum as it gets further out of control, you’ll know it when you see it.
The threat of the meltdown hovers over a great deal of life with autism. They aren’t done manipulatively – in essence, they’re a loss of control – but knowing they can happen adds an extra level of pressure to every stressful situation.
What exactly is a ‘meltdown’?
‘Meltdown’ isn’t a technical term; you aren’t likely to find it in any official language. (‘Behaviour that challenges’ is more what you’re likely to hear, though that covers a lot of other behaviours as well.) It is, however, one of those terms that seems to have emerged spontaneously because almost everyone who’s seen a certain kind of behaviour applies the same word to it.
So, what is it? Basically, it’s a complete loss of behavioural control. A person having a meltdown tends to scream, attack people, hurt themselves, break things, and generally go all-out. Once you reach meltdown point, they’ve pretty much lost it – and the chances are fair that they won’t be able to get hold of themselves for quite some time.
Meltdowns vs tantrums
If you’re not familiar with autism, you might be wondering, ‘Isn’t that just another word for a tantrum?’ Actually, no. People with autism are perfectly capable of having tantrums, of course – pretty much anyone can have one – but a meltdown is somewhat different.
What's the difference?
A tantrum is basically a bid for attention or control. You’ll notice that a tantrumming child often sneaks the odd glance at their parent or caregiver to see if it’s working. A meltdown has no plan, and often seems as if the boy or girl can hardly tell what other people around them are thinking, never mind trying to manipulate them.
A child having a tantrum has some control over what they do. They may go all-out to convince you they don’t, and there’s probably genuine distress in amongst the histrionics, but they aren’t in psychological free-fall. A tantrumming child may also pick their location for maximum effect – making sure there’s a public audience, for example: they’re aware of their surroundings. With a meltdown, the child has completely lost control: they’re absolutely overwhelmed with distress and there’s nothing they can do about it.
A child having a tantrum still has some sense of where the limits are. They may hit someone else, but they probably won’t hurt themselves, or at least not on purpose.
With a child having a meltdown, the brakes are off completely. They’re too far gone to have any sense of what might or might not be dangerous, and people can get genuinely hurt.
A tantrum is generally aimed at getting something; if you give the tantrumming child what they want, they’ll generally stop in an instant. (It’s not the best way to deal with a tantrum, of course, but the fact that a child can stop if they get what they want shows they’re still basically in control of themselves.) Whether you give in or not, you do need to do something to resolve a lot of tantrums: they’re intended to influence people, and will carry on until it becomes clear whether or not that’s going to work.
With a meltdown, on the other hand, it can carry on even if you do give the child their way over whatever started the meltdown in the first place: their distress has started to feed on itself and can’t be ‘turned off’. However, the meltdown can gradually calm down at its own pace whether you give the child their way or not: it’s a storm that needs to blow itself out.
What sets a meltdown off?
Once it gets going a meltdown doesn’t need a reason to carry on, but they don’t happen for no reason in the first place. Exactly what causes them varies from individual to individual and meltdown to meltdown, but some common starting points are:
Many children with autism have hypersensitive hearing, touch etc, and if they get too much stimulation at once they can panic.
If a child has intellectual difficulties along with their autism – which isn’t universal, but it affects some kids – then getting too much complexity at once leads to desperate confusion. The ‘too much’ can sometimes be things that seem quite simple to a neurotypical adult, such as complex language or trying to manage several instructions at once, but if they aren’t simple for the child, then meltdown can result.
If someone has difficulties expressing themselves it can be hard for them to understand and manage their own feelings, and hard to ask for help dealing with them. As a result, if an emotion hits them suddenly, it can hit them hard, and down they go. This is one that can be quite a problem for hormonal teenagers; our feelings get more complex post-puberty and can be a lot to deal with, so, for instance, a girl struggling with PMS may have a meltdown because the emotions are too much to handle.
Too many demands
Or demands too complex to cope with. Autism makes it harder to process information: if you’re being required to do something and you don’t understand or don’t know how, being prompted too many times can lead to meltdown.
Too much unpredictability
Autism causes difficulties with flexible thinking; if things go as expected then it’s manageable, but if something happens that they weren’t prepared for, an autistic boy and girl can have a meltdown because they feel unsafe. These changes don’t have to be big; they can be as simple as a jacket zip getting stuck: normally it works, this time it doesn’t, and it’s just too much.
What starts as a tantrum can spiral out of control. Kids with autism often have difficulty regulating their own emotions. They can also be pretty rigid in wanting their own way, and it’s neither realistic nor reasonable to say ‘yes’ to everything. As a result, tantrums can be a regular part of life for many families – but if the frustration of an ordinary tantrum passes a certain tipping point, it turns into a meltdown and gets out of control.
Heading it off before it happens
The best thing for everyone is if you can stop the meltdown before it really gets going. Of course, this is easier said than done – some kids with autism have a harder time managing their feelings than others, and some give more warning of impeding meltdown than others – but there are some signs to watch out for:
Asking to leave the area or take a break.
Physical signs of tension and anxieties such as increased fidgeting or stimming. ‘Stimming’ is short for self-stimulatory behaviour, and includes things like rocking, pacing or flapping. People with autism often use stimming to manage their anxiety levels or sensory input, so if your son or daughter is doing more of it, that’s sometimes a sign that those levels are rising.
Bolting or running away. Some kids with autism just like to run for fun and don’t think about the consequences, but sometimes a dash can be an attempt to get away from a situation or environment that’s overloading them.
These are just examples; your son or daughter’s signs will be particular to him or her. A good way to get the measure of them is to use what’s known as an ‘ABC chart’, the ‘ABC’ standing for ‘Antecedent, Behaviour, Consequence’.
You write down what happened just before the meltdown (or other problem), what your son or daughter did, and what happened as a result. As you fill in more and more charts, you may start to see patterns emerging, which can point you towards what’s causing the meltdowns. You can read more about ABC charts and find some examples on the Special Connections website.
Assuming you do become a meltdown early-warning expert, what do you do about it? The key thing is to calm your son or daughter down.
You can use verbal reassurance, visual reminders to help them understand things, distract them or redirect them to another activity, remove the thing that’s upsetting them or else remove them from the environment. If you know what’s building up the tension, do what you can to put some kind of buffer between that and your child; hopefully that’ll break the escalation before it reaches meltdown point.
If a meltdown starts
Even with the best parenting, you may not always be able to head off every meltdown: the world is a stressful place for many kids with autism and you can’t control every corner of it. If worst comes to worst and a meltdown gets underway, what do you do?
The first point is safety. If your child is small enough, you might physically hold them to make sure they don’t run under a car or fall down a flight of steps, but if you’re dealing with a strong young adult, that may just not be possible.
In that situation, you’re probably well advised to equip yourself in advance – a crash mat to use in the house, for instance (either for them to lie on or to block them if they run at a wall), plus keeping the rooms they frequent as free of breakables as possible.
If meltdowns are a regular feature of life and your son or daughter is too big for you to manage, then it’s time to call in help: there’s a limit to what you can physically do and you shouldn’t endanger either them or yourself.
Meltdowns can happen anywhere, and this includes in public. Again, if your son or daughter is too strong for you to handle safely, you need to start talking to social services about getting more intensive support.
Meltdowns are an awful experience; for your son or daughter and for you. Seeing your child suffer so badly can be heart-wrenching, and keeping them safe while it’s happening can be back-breaking. The positive thing to remember about meltdowns is that they do tend to burn themselves out. If you’re able to reassure or distract your son or daughter then that can help the process along – though it’s very hard to get through to a child in the middle of a meltdown – but they pass eventually.
Who can talk to if I need help?
Great Ormond Street Hospital has produced a useful booklet on understanding behaviour (PDF) which gives details on dealing with behaviours that challenge and who to seek help from.