Autistic tantrums - what do you do?

[sphil]

DS2 is 8 and has ASD with SLD. Having been the most placid, passive child, he has just started to get very angry when things don't go his way. I wanted to describe what happened today and ask how people on here would have dealt with it - before I tell you what I did.

Friends of ours got married today and we were invited to the reception afterwards, in a pub. DS2 wanted to take his tee-shirt off in the pub ( this has been a constant theme of the past few days, since the weather got hot. We have allowed him to go topless at home, but not when we go out.) When I told him he had to keep it on he became very angry - roaring loudly, grabbing me and pulling my face towards him. He then bit me on the face. I think he was quite surprised that he 'd done it as he pulled away and touched the place where he'd bitten ( it was a nip and didnt really hurt much).

what would you do in this situation? ( He has some speech but both receptive and expressive language are still quite basic)

have you tried doing clear picture 'schedules' of what's happening now and next? Yes he'll have been pissed off with you for telling him he couldn't have the t-shirt off, and it's probably overstimulating him to have it on, but if he know that pub, then home... and pub=top on, home=top off, would it help?

Yes, he responds well to picture schedules but the payoff has to be pretty immediate - he wanted that tee shirt off there and then and the promise that he could take it off in an hour wouldn't cut it.

Has he been getting a reaction to his new behaviours - not necessarily form you, but form ds1, or at school, or other relatives?

the pulling away and touching where he had bitten would, if it was dd1, be a sign she was wondering what my reaction would be (if I hadn't already reacted!)

dd1 does the public roaring too - she was at it today at lunchtime, in fact (pub lunch) - she didn't want the choice of food on offer (chicken and chps - she is fine with this meal), and kept shouting at me when I tried to run through her options (chicken, beef, or gammon - she has eaten all before, was likely to choose chicken).

we are working on a sticker system with ehr right now, to great effect - she earns stickers (this is a very new thing since Disneyworld - she is Disney Princess obsessed!), and if she earns eg 2 stickers by lunchtime, she can have raisins after lunch. so, haivng given her the chance to not shout at me, I hissed "if you carry on shouting when I talk, you won't get a sticker" and quickly turned it round with "remember ot earn a sticker, and get raisins, yuo need to talk nicely" and swiftly distracted with an activity book I had with me. thankfully it worked.

in your situation, I owuld have outlined a reward system for dd1 beofre we went (high stress activity - for me! - so dd1 woudl be bound to be acting up anyway...), and would have sternly reminded her what she stood to lose (raisins, ipad time, playing "what's the time Mr Wolf") - we ar supposed ot be working on making everythign positive, and giving he the chance to earn rewards, rather than using threats which leave us with nowhere to go, but sometmes (and this would be one of them), the urgency of the threat might work with dd1.

sphil, I'm thinking the wedding plus reception plus heat was just way too much for him. If he has sensory sensitivities/differences (and most of us do) then the noise, smells, social interactions, visual input and the feeling of heat/sweat combines to make it feel like a living hell for us after a while. Our brains are using wiring that is so totally not-built-for-the-job that it literally does overheat and cause us to go squirrelly.

It's interesting that he bit your face. Eye contact for us is wired straight into the "heck, scary monster about to eat me!" bit of the brain. Looks like that ancient bit of the brain pressed the emergency "bite it first to make it go away!" button.

Might be worth a different approach to similar situations where he's had a lot of input for several hours at a time and having some real quite 'downtime' built in at regular intervals e.g. I tend to do 30-75 mins of interaction and sensory eek, then half hour of letting my brain cool down, then repeat. Finding the right pattern for each person takes time, and varies with how tired we are and how much input there is. but it can help a lot.

Thanks Amberlight.

My brother gets married next year and I hadn't considered the sensory issues at all for him. I'll make sure I give this some extra though to build in the downtime.

The last wedding we went to with him was an absolute nightmare being in Italy, hot, outside at the top of a castle, lots of strangers etc..........cue massive meltdown. I didn't understand why my 3 year old was behaving so much worse than all of the other children (pre DX). I was so embarrassed.....

It would be so awful to ruin my brother's day if he were to kick off so is really really important for me to plan it around DS and how much he can cope with. Thanks again for your insight.

also do tons of preparation beforehand - social stories, piccies of the venues, plans what will happen when, etc. The more we know beforehand, the calmer we tend to be. Plus the emergency stuff e.g. "if something changes, I will let you know and we will find a quiet place for you to be for a while to think about it", so we don't panic like crazy if it turns out the service goes on 15 mins too long etc. A favourite toy or distraction is a good plan too (work for me!)

His tantrums are usually very sudden - I think my usual reaction is to stay calm, and from talking to his TAs, they do this too. DS1 gets a bit more het up and sometimes shouts 'No DS2' - but he wasn't involved this time. What I did this time was talk to him quietly but I was holding his wrists, which may have precipitated the bite I suppose. Also I kept saying quietly " You have to keep your tee shirt on in the pub ". After he bit me I took him outside the door of the pub ( mainly because a group of children were goggle eyed at him) and spoke to him again. I told him that if he kept his tee shirt on he could have a bag of crisps. This sort of immediate reward is the only thing that works for him - he doesn't understand token systems or deferred rewards at all. He was very well behaved for the rest of the time and also extremely affectionate to me - lots of stroking, face rubbing etc.
I'm sure the sensory environment had a lot to do with it - but this happened as soon as we arrived and we hadn't been to the wedding itself beforehand. We were sitting on a table away from the main melee and no-one had tried to talk to him. I do think, though, that we need to do more preparation for outings now - and I was also thinking of a simple photo story about when and where we have to wear clothes!

The only toy/distraction he really likes is his portable DVD or the iPad - and although both of these would have been possible in the pub ( it was a very relaxed affair ) I am wary of letting him think it's OK to have these things in public places where the noise might be anti-social.

As an update - we've just had Sunday lunch in the pub in my dads village and he was absolutely fine - just a bit agitated at first by my roaring nephew...but that's another story!

Sorry - keep thinking of things I've forgotten to say! Amber-very interesting what you say about choosing the face to bite. My instinct is that's it's a pure anger response - he always goes rigid, grabs my head and pulls my face towards his, then presses his whole face very hard against mine. Very occasionally he uses my arm. Usually I can feel his teeth against my skin but they're clenched, so he doesn't bite. Because of this I tend to go with it, rather than pulling away. It's rather like the equivalent of me going ' aaaarrrgghh' or kicking the wall when something has gone wrong (except I do it in private!) Yesterday was the first time he has actually used his teeth, and I have to say it's made me much more wary.

hmm - dd1 shouts first thing on going to stuff like this too. I sometimes wonder if she is trying to work out her boundaries, or get somethign out of ehr system before settling down and enjoying it. kind of like trying to guage ow the day is going to go - she shouts a lot, if I react badly (and I mean not consistently, rather than shouting or similar) then she gets even more unsettled, and the whole day goes down the pan. if I keep calm, and lay out her usual options, then she (usually) calms right down again, and we all have a good day - kind of testing the waters to see whether it will all be ok, I think.

what apps does he like with the ipad? I have sometimes given dd1 her ipad at stuff like this (we were at a Christmas do which sounds similar - lots of people, sort of sit-down llunch, but very relaxed - and dd1 got ehr ipad after the meal was over, which kept her (mostly) sitting at the table for another 90 minutes while we finished... now that he is into the ipad, is an itouch an option - a bit smaller, more portable?

iPod touch has been a bit of a lifesaver for us in public situations, like waiting rooms etc. Has advantage of earphones or headphones if noise is a problem for them (or others!)

the problem with the iPad is that he mainly likes it for YouTube -so need Wi-Fi. At home we use YouTube as a reinforcer for doing the educational apps, so he gets fed up very quickly if YouTube doesn't work. He does like the Thomas Misty Island Rescue app and the talking cat one, but they wouldn't keep him occupied for long. Won't wear headphones!

I do agree though SF, that if we behave consistently he usually calms right down. I suppose it's the aggression that I'm unsure about - tantrums I can deal with!

Public wifi is too slow for you tube. Or so DS2 tells us!

what sort of mobile phone do you have? I can use mine as a wifi hotspot (and have a contract with T mobile, which is unlimited internet), so can, if needed get dd1 internet access when out and about. might be worth a look?

thankfully dd1 is currently obsessed with number/letter tracing apps, so no internet issue.

sympathise with the no earphones - dd1 is the same (how surprising! ). we can usually turn the sound down a bit htough - I try to get it to the same level as a conversation (ie, if the ipad was another person, what level woudl they be talking to your ds? - I use htis kind of gauge when on an aeroplane too - other people may still look and htink it is antisocail to be playing a dvd player without headphones, but if the overall noise is the same as it would be if she nd I were talking, then I tend to view it as the other person's problem!)

DH has an iPhone but it's too small for Ds2 to manage properly. I agree about the sound levels - I suppose I am a bit hmm about Ds2 watching clips etc when we're out and about because he does it SO much at home - it's what he does all the time when we're doing stuff round the house.