#Autism: How I manage a meltdown and self-injurious behavior

The Lost and Tired family is once again struggling with daily meltdowns and ever increasing self-injurious behaviors. This is one of my very least favorite things to deal with because there is no clear cut right or wrong answer. As my son gets older and stronger, the severity of these meltdowns and self-injurious behaviors becomes greater and greater. We have been coping with severe meltdowns and self-injury for many, many years.

What makes this particularly challenging for me is the fact that more traditional methods or interventions don’t work with Gavin.

As with many Autistic children, everyone is unique in their own right and so it would stand to reason that behavioral interventions would vary as well. In Gavin’s case, we have had to employ a more aggressive approach. It’s not fun for me or my wife but it does have a proven track record of success. I’ll be real honest with you, when you’re dealing with meltdowns of this caliber, it becomes more about  bringing it to an end, than taking a softer approach.

When these occur, the entire family is thrown into upheaval. The younger siblings are terrified and there is the constant fear or someone getting hurt, not mention that one of my neighbors are going to call the police.

The priorities are to immediately ensure everyone’s safety. That often times means evacuating the the rest of the family to an upstairs bedroom, while I deal with the meltdown. When self-injury becomes a problem, I have to find a way to restrict his movement without making physical contact, at least as much as humanly possible. If he is being unsafe with his hands, I require him to sit on them, until they are once again under control and not a threat to anyone or anything.

Likewise, when his feet and legs become dangerous, he is instructed to sit like a pretzel. This, at least in theory, limits his movement and ability to kick anyone or anything.

When these events occur, it’s not about making Gavin comfortable, it’s about literally surviving the meltdown and limiting the risk of injury.

As Gavin gets older and struggles more and more with self-injury, it becomes so important that I document as much as possible because there needs to be a clear record of what happened and why he’s injured. It’s sad, but we have to protect ourselves in the event that any of Gavin’s injuries are ever called into question. If you asked me 11 years ago if I ever thought I would have to be taking these measures, I wouldn’t even be able to imagine why that would ever be necessary.

Time changes many things and sometimes, those changes are not for the better.

 

In this video, this is meltdown number 2 for that day. I’m out of patience and it was really hard to remain as calm as I did. I have to use a very gruff voice and be very direct with him. I can’t play into anything that he says because a large portion of what he says if for the sole purpose of manipulating me by attempting to make me feel bad. There is a long documented history of this type of manipulation. I’m not being cruel, this is simply the only way we can survive these meltdowns and minimize the fallout. 

[youtube width=”720″ height=”480″]http://www.youtube.com/watch?v=GdSdHlXghnE[/youtube]

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Karl Nordling

I just came across your blog
and this video. You have probably heard enough advice to last you a life time
but in case it is of any help I am pasting an excerpt from a book by the
autistic Iris Johansson called A different childhood. This excerpt is about
meltdowns from her chapter with Q and A about autism.
But if you don’t know what causes the tantrum? What do
you do then?
It is important that you
don’t start controlling the child. Don’t do anything, just stop and observe the
child. See first if there is any danger involved because then, of course, you
have to intervene immediately. But if there is no danger you have plenty of
time to think about what intuitive impulses you are getting. Often when the
child has an outburst there is some information of what the child needs right
then and it is up to you as a parent to read it.
If you stay calm and just
observe the child you will get ideas about what the need is. Maybe just for you
to be present. Maybe you just need to put your hand on the child’s hand. Or
that you need to speak calmly about everyday things or about the coming day. Or
that you describe for the child what you think happened: “Sometimes we have
anger inside us and it wants to come out”, or “Sometime we get very unhappy
about something.” When you say those things you need to allow your own
consciousness and your own body to feel how it is to be sad or angry or glad,
so that your own emotion in some way emerges from yourself and comes out in the
atmosphere, hopefully something of the feeling the child has which it can
capture.
Then the outburst often
changes. It subsides and the child ends up in her feeling instead of in the
outburst. The autistic child is to a certain degree like an infant. It cries
when something feels wrong, but it doesn’t know what’s wrong. By talking about
what feeling it might be that is in the child which has caused the outburst you
can help the child find that feeling, and then the outburst stops and the child
ends up in the feeling instead, and thereby in communication.

lostandtired

Karl Nordling thanks. However, as time has gone by, we learned that these were reactive attachment disorder related tantrums…

Ken Brzezinski

I work with violent children who get very physical. Restraining them is not my favorite pastime but if it is necessary I do it. The key to this is figuring out why they are acting out. If it is possible to prevent the outburst because it is sensory, then either you prepare the child for the sensory problem or you remove it. If the outburst is due to required work in school, then the first thing that they do after the child cleans up the mess he made is that the child has to do the required work. Every time they have a meltdown we review the reasons for it and try to prevent it from happening again. The worst thing is to give in to the outburst. That is rewarding bad behavior and almost guarentees that it will happen again. The surest way to reduce outbursts is to make sure that they are not rewarded. It takes time and a lot of observation to determine the cause and to decide on the correct course of action.

lianemarkus

Thanks for the tip and for this very meaningful story of yours. It ws very nice reading your blog and I find it very interesting and attention grabbing.
My recent post Glock Sights

jodi

i have to say working in a class with children with autism for the past 6 years and working in a group home with adults with dual diagnosis (behaviours and developmental disability)
I've done my share of behaviour therapy, modification and more and have dealt with my share of meltdowns, aggressions and various behaviorus.
I actually find it great that the method you use works for him, at this time. he for the most part stays sitting on the floor and for the most part listens to you.

jodi

In these situations you need to use a firm directive voice, that is the response you use in that situation when the person has lost control, they are in a situation where they cannot make choices themselves and at that point need to be directed until they regain control and you can talk to them in a more therapeutic way.
I have seen and had to do much more intrusive methods for a persons safety as well as staff and others in house.

if he bangs the floor alot with legs and feet, have you tried using a mat (similar to gym mat) under him so he is less likely to injure or bruise)
do you have a basement in your house where you can make a 'venting room' for him so he can go there for his meltdowns (or a place on main floor" that way the other children can be away from him. If he was in a room, you can have a half door so you can close it but still observe him,
that way the other children can be seperated with him without worry about being injured as he would be away from them until he has regained self control.
basement may be better for sound and the neighbors,

jodi

i work in a behaviour group home as i said before, we have guys that yell obsenties to us and out the window the neighbours can here often i know.
I do find though that your method seems to work for him, he does for the most part stay where he is and sit on his feet or hands (or holds the lego,) as instructed,
we just always wish we had ways to de – escalate before they get to that situation.

Clydeine Adamchick

I am so sorry! And yes I agree with you. This day and age, protect your butt while protecting your children. Wsih I could help you guys but I am praying for you and your family!

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