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Possible ASD meltdowns - tips for handling

(24 Posts)
IsItMeOr Mon 18-Aug-14 23:44:03

5yo DS is waiting for an assessment for possible social communication disorder, and we've been advised to operate on the assumption that he has ASD in the meantime.

His issues present as behavioural problems - not listening and hurting others. It's unclear quite what his difficulties are, as he's bright, and it looks as if he may have been able to compensate partially for them, masking the underlying issues.

This has the unfortunate side-effect of making it really hard to know what is triggering him.

We are really unsure how to cope when he goes into a violent rage. He will hit/scratch/bite us, run away, throw anything he can get his hands on.

We were away on holiday for the last two weeks, and seriously considered coming home several times, as it was so bad. Not sure what was behind it, as DS has always been fine on holidays before.

We are doing time outs for misbehaviour, and sometimes that is fine, but if DS is worked up, it just escalates. I tried a glitter jar, but that became another missile.

Please are there any survival tips on how to avoid things getting so wild?

Could you try identifying one behaviour at a time you want to improve and start by filling out a functional analysis chart/form?

IsItMeOr Tue 19-Aug-14 00:04:39

Hi Starlight, I was mostly wondering if there are any survival tips once you're past the point of no return. I don't know enough yet to know whether this is a daft question!

Survival tips IME experience are understanding the cause and either preventing it from happening again, or gentle desensitisation to the trigger with the teaching of a better response.

When it does happen though I would treat if much as I would an epileptic fit, keep the child safe, keep others around them safe and keep myself safe until it has run it's course, offering a chill out when it is over for everyone involved. I tend not to engage, or engage minimally/reassuringly in a hope that my calm behaviour helps move that way for all.

IsItMeOr Tue 19-Aug-14 00:22:00

That sounds sensible. Part of the problem is that a major trigger for DS is interacting with his peers. He loves to do it, and can sometimes be fine. But other times he will struggle, and then he will attack other children. This means that I am on tenterhooks as soon as I see that DS is getting into any kind of conflict. But trying to get him to move away from a situation and calm down hasn't been at all successful so far.

Our current, time out, based approach is more controlling than you're describing. But we do need to make sure the other kids are safe...

Can you allow interaction in 5 min slots with breaks?

Teach him to ask for breaks or take them himself?

Reward every 5 minute 'session' with no incidents?

Reward self-breaks?

The problem is if he alienates his peers he will reduce his socialisation practice opportunities, and their reactions will increase his anxiety levels and become aversive to him.

IsItMeOr Tue 19-Aug-14 08:06:09

Thanks again Starlight - will have a think about how to incentivise DS to comply with that. It's actually similar to what they have been trying at school. But it stopped working when they started practising for sports day...

DS seems to get anxious at two levels - the immediate triggers e.g. of a child not doing what DS wants, and then more persistent triggers (like practising for sports day, maybe being on holiday) which seem to make it much harder for DS to handle the immediate triggers.

OneInEight Tue 19-Aug-14 09:02:47

Once ds1 & ds2 are past the point of no return any consequences just escalate the situation so we don't implement & have found this a better approach for our family.

We do find the best strategy is prevention and early intervention. For both ds's reduction of overall anxiety levels reduces a lot of the meltdowns. So lots of reassurance and warning of changes. For ds2 giving an element of choice and an escape route if he is not coping also helps.

If the anxiety-provoking situation is unavoidable e.g. ds1 is getting angsty because he is starting at a new school in September then we try and reduce demands (and to a certain extent expectations). So we will be doing lots of individual stuff with him rather than forcing him into large social situations.

We have also got better at reading the signs that they are getting stressed. For ds1 it is getting upset at minor things & low tolerance of his brother. For ds2 one of the initial signs is increasing level of violence in his talk targeted either at himself or others and increased demand-avoidance. In these circumstances we would choose quieter activities or limit time at busier places so reducing rather than totally eliminating demands.

There is a book called "The Red Beast" which might be good for a child your son's age which helps describe how your body feels when you get angry and what you can do about it. I also recommend the NAS course on anger management if you could get a place on one of these.

IsItMeOr Tue 19-Aug-14 10:19:05

Thanks OneinEight. Lots to think about and discuss with DH there.

I have ordered the Red Beast and also the one on disappointment (DS basically can't cope with competition and starts getting worked up if he isn't picked straight away for stuff). Should arrive tomorrow as I forgot to cancel the Amazon Prime subscription before it stopped being free...

Ineedmorepatience Tue 19-Aug-14 10:33:31

Great advice from one and star I just wanted to add that seeing the meltdowns as panic attacks really helped us.

When another child does something unpredicatble it is throwing uour Ds into a blind panic! He doesnt have the skills to negotiate or accept that he might win or go first next time so he lashes out.

Have you ever tried firm holding instead of timeout? Obviously you have to be mindful of your safety but if you can get in quickly and hold him he may be able to calm quicker without escalating into a full scale "meltdown"

When children are in that panic mode they are genuinly scared and out of control and a firm hold can sometimes just be enough to bring them back down.

Obviously if he hates being touched or held this would not work.

Just a thought.

Ineedmorepatience Tue 19-Aug-14 10:37:00

I would also suggest staying close to him in parks etc so that you can help him to negotiate if need be. Dont be afraid to be "that parent" he needs your support if he is to stand any chance of playing alongside his peers.

IsItMeOr Tue 19-Aug-14 10:41:36

Thanks Ineed - yes, we are definitely towards that end of the parenting spectrum ;)

I have seen that curve about opportunities for intervention/teaching, and it occurred to me that, for whatever reason, DS was already quite a long way up the curve just because we were on holiday. I did suggest to DH that we should therefore do as you suggested. We didn't actually test it though, as we came home soon after I'd had that lightbulb moment.

It does get a bit wearing being the only parent entertaining multiple people's DCs mind...

IsItMeOr Tue 19-Aug-14 10:43:21

Thanks so much star, one and Ineed for taking the time to explain. This is incredibly helpful.

Ineedmorepatience Tue 19-Aug-14 10:49:05

When we are on holiday we try to build in downtime, so after a busy day we have a quiet day. We go out early somedays or late and in the middle of the day Dd3 watches a DVD or something to give her chance to process all the new stuff going on.

We still dont always get it right though and made a massive cock up trying to do Legoland and a tour of London the next day which was a disaster.

Be kind to yourself and make sure you get some breathing space too smile

sammythemummy Tue 19-Aug-14 11:07:46

I can totally relate with wanting to be first or being picked first.

My dd(4) is very very competitive, if she loses at anything cue lots of crying and "I want to be no.1" We've had success with lots of distraction and redirecting to another activity. Could you try that?

I agree that it's very exhausting constantly being the helicopter parent. I hate play dates for this reason, but as star has said, this gives them a better chance at practicing their social skills.

I have found that short, sharp bursts are good for peer interactions. DS is wary enough to 'be on his best behaviour' and the other children are tolerant and see Ds as a bit of a novelty. DS enjoys getting positive reactions and social rewards for his efforts.

However, after a whilst Ds tires or gets a bit stimmy or repetitive the other children's patience runs thin and their responses are less positive and the whole thing disintegrates.

Difficult as this often can be I think the interactions need to be ended whilst they are still going well for everyone and all have been successful in both their effort not to alienate and their tolerance levels of each other.

It's easy to stare in amazement when something is going well, and it is understandable to close your eyes and thank god for a few minute respite too, but this kind of this is what you put on the DLA form. The child needs 'constant' supervision.

IsItMeOr Tue 19-Aug-14 11:57:17

I had forgotten about playdates. Yes, I always have a number of back-up activities in case they need distracting/focusing (they are all, after all, still only 5).

The last playdate actually went really well, apart from a bit of difficulty in the two boys negotiating what they were going to play at one point, which we managed to navigate.

But DS kicked off when the other boy went home, so I got hit and shouted at for my troubles sad.

Ineed - you are spot on with the need for downtime. I think part of the issue was that we are all desperate for some relaxation and rest, and it just didn't happen.

IsItMeOr Tue 19-Aug-14 12:13:35

Starlight, that makes sense. I've definitely had that thought myself before now. It feels like trying to pick the least worst of multiple unappealing options...all a bit daunting just now, but I guess we just need to press on with it.

DS doesn't give us many clues that something is going wrong for him. I don't think he stims - he does bite his nails (hands and feet) and the skin around his nails. But that seems to be almost constant.

He also seems to have next to no instinct to withdraw from a situation he is finding difficult - it's fight all the way.

I don't think you can withdraw when things are about to go wrong. I think you have to do it in the middle of things going well. Like in night clubs. They play the low dance so those who want to pull have their chance and then they announce end but chuck in one last fast 'good time' dance to that people leave with a bit of disappointment that it is over.

It feels mean and I think we are all desperate to get the maximum for our child and ourselves and stopping something that is good and going well and also often a rarity is hard.

PolterGoose Tue 19-Aug-14 19:52:17

My ds was violent towards other children starting at around 3yo and then increasing hugely in frequency in reception when there were incidents almost every day. He's 11 now and things are a lot better but he still has an instinctive fight response to what he perceives to be an attack/threat or general overwhelm.

None of the 'behavioural' methods worked, they just made things worse.

Any attempt at reward just raised anxiety and made him worse. He knew he shouldn't hit/bite/punch/push but he had no control. It is very hard to overcome an instinctive fear driven response, imagine trying not to put your hands out to protect yourself as you fall, it's like that. You need to work in reducing the anxiety/fear before you can change the response.

What Star says about removing before it goes wrong is really important, it's far better he has a short good experience than a long one that is happy for the first 90% of time then falls apart for last 10%. As he builds up a memory bank of good social experiences his anxiety will reduce and he will be less likely to get overwhelmed.

Our biggest breakthrough in understanding was learning that ds is very sensory defensive. So by understanding, preparing and reducing sensory 'assault' we reduced the rages. Sensory OT strategies have worked brilliantly here. As has the collaborative problem solving approach of Ross Greene who wrote 'The Explosive Child'.

IsItMeOr Tue 19-Aug-14 23:17:49

That's very interesting Polter. Your DS sounds very like ours in terms of it starting at around 3yo and increasing dramatically in reception.

Somewhat similar on the rewards too. I found it very traumatic doing a reward chart linked to his behaviour at school, so it was a huge relief when the behaviour team said to keep home and school entirely separate.

We started a reward chart at home about 4 weeks ago, and that seems much more helpful. It's focused on flash points we noticed during the day, and it does seem to be making some of the nightmare points gradually a bit easier (teeth brushing had become hideous, but is now merely awful. Meal times are definitely less stressful now we have some written reminders for DS to follow). It doesn't reflect everything in the day, but just key points (with a few easy to achieve ones thrown in, e.g. dirty clothes in the laundry basket).

DH doesn't want to move away from the behaviour management approach unless/until DS has a diagnosis, so we won't be able to try all your suggestions just yet.

Meanwhile, I will have another look at The Explosive Child - I know I bought a copy on MN recommendation earlier this year, but not sure where it has got to...!

Star - "It's easy to stare in amazement when something is going well, and it is understandable to close your eyes and thank god for a few minute respite too"

So true!

PolterGoose Wed 20-Aug-14 08:16:22

I understand where you're coming from. Ds didn't get his dx until he was 6, so we had reception and half of Y1 without diagnosis. Getting his diagnosis was like a ticket to do things differently and that's when things started to improve steadily.

It is very very hard being the parent of a child who is violent, good luck flowers

IsItMeOr Thu 21-Aug-14 13:36:32

Thanks PolterGoose. Hopefully we will get wiser, and things will start to improve for us too.

I tried the Dragon of Disappointment book with DS this morning, and it seems to have wound him up sadconfused.

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