Autism Meltdowns

Everything you need to know about meltdowns

The diverse team of neurologists, behavior therapists, occupational therapists and speech therapists at KidsLink Neurobehavioral Center provide simple explanations on everything related to behavior issues (also referred to as autistic meltdowns or tantrums) in children with autism.

What is a meltdown?

People often use the term “meltdown” to refer to disruptive or tantrum behaviors.  It is often used to describe a moment of intense emotional responding and can include behaviors such as yelling, crying, falling to the floor, aggression, or self-injury.  Sometimes, behaviors can last several minutes and can be described as an “episode”.  This episode can look different for every person and across circumstances. 
Jaclyn Crissinger, Behavior Therapy, KidsLink

What triggers autistic meltdowns?

People engage in behaviors for different reasons.  Everyone has different “triggers”.  Some children with autism are sensitive to environmental events that may “trigger” behaviors.  Common examples may include: disrupting a routine, changes in an expected schedule, interrupting a repetitive behavior, when an environment is too overstimulating, being told “no” to something that a person wants, being asked to transition from something that is highly preferred, and being asked to do something that is unpreferred.  Triggers to meltdowns are different for every person and can be different from day to day.  It is important to take notes and identify common triggers as this helps to determine how best to respond to a meltdown or how to change the environment to prevent it in the future.
Jaclyn Crissinger, Behavior Therapy, KidsLink

What causes meltdowns?

Behaviors occur for 4 primary reasons:  1-to get or obtain something (like attention, a preferred object, access to a preferred person); 2 – to escape or avoid something (like a task, assignment, a person, an event); 3-to obtain an internal experience (like a feeling of pleasure or self-soothing); 4- to escape an internal experience (like pain).  The longer a behavior has a “learning history” the longer it will be to “undo” the behavior.  If a behavior causes difficulty with learning, interacting with others, and/or self-injury, we recommend developing a behavior plan as soon as possible. 
Dr. Michelle De Polo, Psychology, Behavior Therapy, Co-founder, KidsLink

Can medical issues like food sensitivity cause meltdowns?

Food sensitivities and allergies can often play a role in behaviors. Food sensitivities can cause gas, bloating and stomach discomfort. Anytime a child is experiencing physical discomfort, such as nausea or pain, coping mechanisms become more difficult to access. Certain food allergies (such as to gluten in celiac disease) can cause behavioral differences, including meltdowns, due to the impact of the immune response on the brain.
Dr. Nevada Reed, Pediatric Neurologist, Co-founder, KidsLink

Can hearing issues cause meltdowns?

If a child is having difficulty with receptive and/or expressive communication due to hearing concerns, this could lead to meltdowns as a result of frustration.
Dr. Nevada Reed, Pediatric Neurologist, Co-founder, KidsLink

Can communication issues cause meltdowns?

One of the primary diagnostic criteria for autism is communication difficulties.  As such, a person with autism that has expressive communication difficulties and cannot effectively share their needs, wants and thoughts can engage in behavior.  At times this can create tremendous frustration and lead to “meltdowns”
Dr. Jocelyn Geib, Speech Therapy, Co-founder, KidsLink

Why do emotional regulation issues cause meltdowns and behavior issues in children?

When a child has difficulty regulating their emotions, they often resort to outward behavior to alleviate this dysregulation. Sometimes children don’t have the expressive language to communicate their feelings and emotions. Other times they lack the regulatory strategies to combat impulses or immediate reactions to a situation. It’s important to remember that along with training on ways to regulate emotions, opportunities to practice, particularly outside of stressful situations are critical to success.
Dr. Amy Ciardi, Psychology, KidsLink

Executive functioning refers to a set of mental skills that include a person’s ability to engage in flexible thinking, control their emotions and behaviors, and use working memory to solve problems or complete tasks. Many children with autism have challenges with executive function. This can make it harder for them to pay attention, stay organized, follow directions, start and finish tasks, and cope with transitions or difficult emotions. This can result in increased anxiety, frustration, and meltdowns when dealing with change or when faced with challenging tasks.  
Rachel Kallin, Behavior Therapy, KidsLink

How to handle meltdowns?

When handling a meltdown, it is important to stay calm.  Use a limited amount of verbal language.  Prompting communication or offering choices are helpful in the moment.  Ultimately, Identifying the function of the behavior (why is the meltdown happening) will help to determine how to respond to the meltdown in the future.
Caroline Turnbull, Behavior Therapy, KidsLink

Can a speech therapist help with meltdowns?

Speech therapy that focuses on understanding the underlying causes of behavior and then provides intervention to support communication to address language difficulties that lead to frustration and meltdown can be a very powerful tool to reduce any unwanted behavior and give the person with autism a form of  effective communication.
Dr. Jocelyn Geib, Speech Therapy, Co-founder, KidsLink

How to select a speech therapist?

When selecting a speech therapist, it is important to pick someone who has specific experience with students who have autism or more significant communication difficulties. You can specifically ask the SLP about their experience with functional communication.
Jordon Gleim, Speech and Language Pathologist, KidsLink

How to do speech therapy at home?

Your SLP should be able to provide you with some ideas for practicing specific skills at home. Overall, 2 good things to focus on is getting your child to request and modeling language for them.
Jordon Gleim, Speech and Language Pathologist, KidsLink

Can PECS (Picture Exchange Communication) help with autistic meltdowns?

PECS is a form of functional communication and can absolutely help with meltdowns. Pick a communicative message that is equivalent to the message the meltdown is attempting to convey is key. And often, when your child is in crisis, communication is even more challenging. PECS is a great way to encourage communication in those moments.
Jordon Gleim, Speech and Language Pathologist, KidsLink

How does occupational therapy help with meltdowns?

Occupational therapists have a knowledge and understanding of self regulation techniques as well as sensory processing.  Depending on the individual, autistic meltdowns may have a sensory component to them in which occupational therapists are able to identify and provide techniques to help the child engage in the activities and improve self regulation. 
Kristen Hopkins, Occupational Therapy, KidsLink

Can pediatric Occupational therapy help with autistic meltdowns?

Pediatric occupational therapy can help with autistic meltdowns in a variety of ways.  Occupational therapists have expertise in self regulation which can help individuals utilize coping strategies in autistic meltdowns.  They can also provide proactive sensory strategies that allow individuals to receive the input needed to help regulate throughout the day.
Kristen Hopkins, Occupational Therapy, KidsLink

How does behavior therapy help with autistic meltdowns?

There are many strategies used in behavior therapy that can help to reduce meltdowns, but it is important to remember that meltdowns occur for different reasons for each individual. For some, structuring time and using schedules may be successful as the unpredictability of the day can be stressful. For others, strategies such as shared control in choice making, behavior momentum, or temporarily lessening demands may help to reduce meltdowns. In conjunction with any of these strategies, however, should be a reinforcement system in which to teach the desirable behavior. Our center offers a unique program called KidsLink Connect centered around applied behavior analysis (ABA).
Samantha Chesney, Behavior Therapy, KidsLink Connect

Can autism meltdowns improve with age?

Yes and no, as children with autism learn skills  to replace the maladaptive behaviors the meltdowns appear to improve.  Teaching children to communicate, replacement behavior and coping skills will help with maintaining lower rates of meltdowns.  Without these skills the meltdowns can persist into adulthood.
Caroline Turnbull, Behavior Therapy, KidsLink

Can autism meltdowns get worse in puberty?

Yes, just like for typically developing teenagers, people with autism who are in puberty can have more difficulty with anxiety and mood regulation due to hormonal changes. This can lead to more frequent meltdowns.
Dr. Nevada Reed, Pediatric Neurologist, Co-founder, KidsLink

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