Monday, May 31, 2010

The Anatomy of a Meltdown Part I

You're in Wallie World and you see this. What is your first impression?
Spoiled brat!
He needs a good spanking.
What a terrible mother!
Can't she control her kid?
My angel would NEVER do that!

Pamela's last big public meltdown Pamela was at the Wallie World in St. Cloud, MN when she was fifteen years old. Meltdowns are bad enough, but the spectators make it worse. Even though we know we have more tools in our parenting tool bag, folks like me feel mortified, clueless, and inept. A friend of mine told me that people reacted much more kindly right after her autistic son had surgery. His scar smoothed things over with the general public until his hair grew back. People usually judge us because they don't understand why a kid that old is behaving like a toddler. It's simple! They have the social and emotional skills of an infant, are easily frustrated, and don't handle change very well.

Over the years, we have developed a thick skin. Pamela gets stares when she says something odd or laughs really loudly in her chortling way. Back in the day, when public meltdowns were like imagining I was in the Calgon take me away commercial. While I love creating autism awareness, trying to get Pamela calm trumped that goal when she was melting down. I blocked them out of my mind because they had no idea how to handle her. I ignored the ignorant for they didn't know how lucky they were.

These pictures depict children the world would judge as spoiled brats. The girl on the left is clearly referencing the person making their life miserable, trying to get her way with the "I hate you mom" scowl. Without footage, it is hard to know if the boy on is doing the same. If he cries and stops to peek at mom, well, he's no different than the girl. Crying and screaming without knowing who is watching, reacting, or judging is a typical autistic meltdown. A meltdown makes people feel like no one is in control.

A child with this level of distress doesn't consider the safety of himself or others. He has no clue about the social context and what is changing or staying the same. If he suddenly quiets when given a treat, it wasn't a true meltdown. Trying to stop a meltdown midstream is like trying to stop a stick of dynamite from exploding after the flame has hit the blasting cap.

Children with autism don't mean to meltdown. Because they have such difficulty with filtering in what is important and meaningful and filtering out what is not important, they have a hard time understanding what is going on and knowing what to expect. For example, suppose mother had promised to take the kids to the park after shopping. Baby brother sees the dark clouds before arriving in the store. Thunder starts to rattle and the rain begins to pour. While in the check-out line, he casually says, "I guess we won't be going to the park."

Big sister, who has autism, never anticipated that the dark clouds, thunder, and rain canceled the outing. She is already worn out from the fluorescent lighting and the noise of the store. She is too big to ride in the cart, which used to calm her down with its vestibular motion. She was already a bit freaked out about having to take a detour to get to the store because of a traffic accident. And, now, more unexpected surprises create the perfect storm.

Why should we be surprised that autistic children have more meltdowns than other children? Many deal with sensory issues, allergies, gut issues, neuro-chemical anomalies, inflexible thinking, difficulty connecting the dots, communication challenges, and problems with emotional regulation. Back in 1995, I attended a three-day workshop on Sensory Integration put on by Bonnie Hanschu (a wonderful woman who died in 2004, doing what she loved most). She gave us an inventory that helped me figure many things out about Pamela--this was before readable books existed on the topic of sensory integration (yeah, I feel old).

Anyway, Bonnie explained why meltdowns are such a problem for our kids. Suppose the green line represents the stress level of an NT, who doesn't even notice little things that affect an autistic person. Something happens and stress hormones flood the body of the NT. Once the situation ends, hormones that decrease stress help the body regulate and the NT recovers. Little things begin to upset an autistic person, and they gradually begin to build up as shown in the blue line. Their bodies are slow to release the anti-stress hormones and, without help, they quickly reach the threshold of meltdown (the red line) and you know the rest . . .

Our children face physical, mental, and emotional dysregulation. It requires a lot of detective work to figure out what creates stress. Physical issues include sensory over-registration (and under-registration because not knowing what is happening may lead to mental dysregulation); sensory overload; and being tired, hungry, sick or itchy. Sometimes, just having to behave like a good boy all day in school is enough to cause meltdowns at home. Mental stress is often caused by feeling confused or incompetent, not being able to understand what is happening, seeing the world in black and white, and finding only one response acceptable. Emotional dysregulation is caused by feelings of anger, sadness, frustrating, and fear, by having mood swings, or strong desires to win, control, possess, respond, etc. It takes many years to figure out what sets our children off.

But, what can be done about meltdowns? Stay tuned . . .


Prince Andrew and the Queen Mum said...

nice post. i have that same pic of the blond haired kid on one of my posts. the one that says.."what do you see?" there is one of various disabilities and then that pic.. which is of course..autism. or can be. looking forward to more on this subject. posting on my fB now :) have a good day.

walking said...

It does remind me of an autism meltdown!