13 year old extreme tantrums when asked to do anything

[Advice126]

DD is 13, is on the waiting list for an ASD assessment, but has always had extreme meltdowns when she gets overwhelmed.
We arranged some CBT therapy sessions at different stages to work through ways for her to regulate emotions but they didn't seem to help.

We're at a point now where every-day things such as asking her to shower or saying no to anything minor is causing extreme meltdowns, her kicking things, throwing things, following us around shouting at us for an hour or more.

We try to talk things through when she's calm, but the next time she gets frustrated it's the same reaction.
We're not overly strict but are consistent, I often cook her a separate meal as she refuses to eat most healthy foods and thats another source of meltdowns, I try ways for her to feel more in control such as setting an alarm on her phone for the days she needs to shower rather than me telling her to, but it's still the same reaction.

Days out are often disrupted too as one of us regularly has to stay home with her as she refuses to leave the house, but then has a meltdown about not going.
It will often play out that she will be refusing to put her shoes on, we will wait, talk through options, eventually one of us will leave with DS, then she will have a meltdown about wanting to go once it's too late to.

She is often like a younger child in her interests, she still likes to play with toys alone, and wants to play at the park with DS for example, but can have an intelligent conversation when she's calm, and does seem to genuinely be sorry after each time.
Consequences like losing her phone after a warning don't do anything.

Any advice at all would be appreciated.

What are your transition strategies like? Do you do verbal transition prep or use a visual system?

We do verbal preparation, always a few times leading up to anything. Quite often she seems fine with it, or to even be looking forward to something, until it gets to the actual point of needing to do the thing.

We haven't tried visual preparations. Do you think it could help? She definitely understands everything verbally, her language skills are average for her age when she's calm.

It sounds like she's in a time of constant near-overwhelm which must be very tiring for her and for you.

What does she think about her own neurodivergence?

I would be looking into low demand parenting. Days out might not be what she needs for a while.

She's telling you with her behaviour that she struggles with eg. showers - can she verbalise why? Baths might be better - less sensory input with noise and sensation. Maybe run her a bath and show it to her without speaking. That would work for my asd ds but tbf he is younger.

My DD was/is the same (she is autistic). She understands verbal cues but needs visual aids because she needs to see things laid out in front of her. We had a whiteboard in her bedroom and every sunday we wrote down what she needs to do for the next week in the mornings before school, and the evenings after school. The whiteboard was divided in half and the top read: 'In the mornings before school I need to:' and then has things like 'brush teeth', 'brush hair', 'get dressed', 'eat breakfast', 'put plate into dishwasher'. She would tick things off as she did them. Same after school. Then each night we'd wipe the ticks off and she would start again.
You can also get downloadable ones and then laminate to save you writing it all down. But it means you can simply go 'have you ticked off all your tasks?' and she knows in advance what she has to do and what order to do it in, so it takes away any uncertainty and provides very clear instruction well in advance. It also sets a clear routine that is repeated day by day which is important. Free Printable Visual Schedules and Daily Routine Charts for Children - Free Social Work Tools and Resources: SocialWorkersToolbox.com

it's worth a try. A visual plan of the day might be worth a shot.
it can often be that visual cues are better processed than verbal ones. It depends on the individual. Both my sons have always struggled with verbal prompts and done much better with pictures and text.
I communicate mostly through text and email with my younger son even now (he's in his 20s)

Sounds a lot like my son who is PDA when in burn out. Low demand parenting is the only thing that works for us.

Look up PDA strategies, hopefully some might help her and you manage the overwhelm and ways to reduce extreme meltdowns.

Are there any triggers that you notice? I find with DS it’s like layers of an onion. It’s not one thing that triggered the meltdown but a series of triggers and demands throughout the day that build up and then leads to an explosion at a simple statement such as ‘dinner is ready’ (she will see this as a demand too many). DS has to be in control of what he eats, when he eats and how much for example. We gave up the food battle 18mths and he is much calmer. Today he chose to eat noodles and veg which is unheard off but he saw his sister preparing some and said he wanted to eat it too. No pressure and we didn’t make a song and dance of it, just acted normal.

How is she at school? Could it be that demands at school are ever increasing and overwhelming and she masks there and explodes at home because it’s her safe zone?