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Meltdown describes the situation where the individual – autistic or otherwise, as it is not only a term used for neurodiversity – is no longer able to cope. Their skillsets aren’t sufficiently honed to deal with the situation at that time, and the individual lets off steam one way or another, in order to recalibrate. (Skillsets may include social and language skills, as well as executive functioning skills, as examples).

Autistic meltdowns differ from person to person, and some autistic individuals, especially adults, say that they rarely have meltdowns. (They will undoubtedly experience challenges and periods of ‘overwhelm’, but perhaps they head straight to shutdown, or some kind of low mood, or withdrawal).

Read more on autistic shutdown here.

Meltdowns – panic attacks and neural high jacking

rl in black and white to illustrate autism article on black and white thinkingMeltdowns can sometimes be defined as panic attacks; they may look like tantrums; sometimes they can just be bursts of anger or frustration, and they can manifest as tears or extreme sadness. They may be over extremely quickly once the individual has let off steam, or they may last for a much longer duration.

On some occasions, a meltdown is extremely serious, as the individual or people in close proximity may be at risk, e.g. from violent or erratic behaviour.

Some experts describe meltdowns as ‘neural high jacking’, when coherent, rational thought is absent, and what is left is a debilitated state of incoherence.

According to psychologist Dr. Daniel Goleman, what the child does and says during meltdown is simply ‘mental debris’.

Bring on the autistic meltdown!

Sometimes (as an outsider), one can see a meltdown coming, in an autist; and in fact a teacher or carer may even want to want the meltdown to occur, simply so the child can recalibrate, and get the outpouring over and done with in a safe and supportive space.

The teacher may for example spot signs in the classroom, such as the child being easily upset, ‘spoiling for a fight’ or picking an argument, having a lot of nervous energy, or generally becoming withdrawn. There could be specific rituals or behaviours that the child is doing ahead of the meltdown. Maybe for example an anxiety-related stim like clenching and releasing the teeth, or clicking their fingers, or the child may have the self-awareness to realise a meltdown is imminent, and recognise triggers. (As do many adults).

Triggers for autistic meltdown

girl ball pool - illustrating autism article on spectra.blogThe meltdown triggers themselves are many and varied; they obviously vary depending on the individual and are usually multifactorial. Elements like sensory overload from sources like lights and noise may play a part (clinicians may describe this as ‘sensory integration dysfunction’); as well as excessive demands (or things that are perceived to be demands by the autistic individual). Excessive socialisation, known stressful situations, and anything that triggers the autist’s quirks or ‘peccadillos’ (e.g. maybe a favourite food has run out, or a play date has been cancelled), can contribute to meltdowns.

Masking

It is often said that masking is a factor too; masking or trying to appear ‘typical’ can be very energy depleting. Whether it is trying to fit in at school, attempting to follow social conversations in a group, or blending in with neurotypical colleagues in the workplace, the act of masking one’s autism drains emotional energy, or conceptual ‘mental bandwidth’. A build up of masking, combined with general tiredness and a specific trigger, however minor it is perceived to be, can easily trigger autistic meltdowns.

Therefore, some or all of the triggers described above (as well as others not listed, but relative to the individual) can initiate meltdown. Other everyday factors like tiredness and hunger, as well as hormones, can also play a part. Often, the concept of ‘the straw that broke the camel’s back’ can take place, e.g. something that seems innocuous and not worthy of such a level of upset can tip one over the emotional edge – the proverbial last straw.

Melting down at home, not school

female child - for autism article on spectra.blogIt is not uncommon for autistic children at school to meltdown at home, after a day of blending in, and masking at school – invariably, they are melting down in their safe place, even though the anxiety was building all day. This can lead parents’ concerns about the possibility of an autism diagnosis for their child to be questioned, as those who do not understand the challenges presented by autism may assume the cause of the meltdown is occurring ‘at home’. In such instances, viewpoints like: ‘Well, she seems fine at school’, or ‘Maybe he’s picking up on the parents’ anxiety at home,’ are rarely helpful.

The main challenges presented by autism – difficulties communicating and socialising, sensory challenges (e.g. to noise and light, for example), and specific thinking styles or rigid thought processes that aren’t supported by the learning style at the school – can all cause great anxiety to a child. It’s no wonder that after a day of using up all of their ‘spoons‘, many autistic kids come home and feel comfortable enough to let their frustrations and emotions out. (NB – the reference to spoons relates to the spoon theory, a kind of disability metaphor developed by Christine Miserandino, who has lupus, and uses ‘spoons’ to explain how to ration one’s energy. Read more about the spoon theory here.)

What happens during meltdown, or ‘cognitive debilitation’?

Different individuals react differently – some may meltdown in the more obvious sense, e.g. excessive stimming, tears, anger, arguments and even out-of-control aggression, while others may consciously try to make their meltdown more low key, and private. (The latter is a big concern, as self-harming could be an issue).

For the loved one, educator or carer of an autist, the key to coping with meltdowns is often to get a handle on what triggers that individual, to help reduce factors that are likely to trigger the meltdown. Once it has started, it really needs to run its course – it is, after all, a release, a situation of overwhelm, or a kind of panic attack.

Naturally, it is best not to judge or be cross about the meltdown. Sometimes the individual may appreciate someone being close to them (e.g. in the room, or outside the door); other times, they may need or prefer to be left alone, to work through the process.

When can we chat?

Once the autist has calmed down (and when they’re ready, which may even be the next day), the family member, carer or educator may find the opportunity to talk about what happened, what triggered the episode, and how everyone handled it. Generally, autists in meltdown mode are unable to discuss anything properly at the time, as their emotional bandwidth is busy trying to recalibrate, and manage their ‘fight or flight’ response. Directly afterwards, they may feel too exhausted to talk. (NB – some families do have to cope with very aggressive and even dangerous meltdowns, and at these times, keeping all individuals safe is the priority. See ‘Interventions for meltdowns’, below.)

The Explosive Child

Dr. Ross Greene has studied and written extensively about what he describes as the ‘inflexible-explosive child’, and has written a book titled: The Explosive Child (HarperCollins), full of fascinating facts and tips.

Rebecca Law, American advocate for autistic children and their families, states in her paper (based on Dr. Green’s concepts): ‘Thoughtful response to agitation, escalation and meltdowns In children with autism spectrum disorders’:

Children playing - for autism article on spectra.blog‘Inflexible and explosive children have difficulty managing and controlling emotions associated with frustration. They also have difficulty thinking through ways of resolving frustrating situations. In these children, frustration (usually caused by a demand to ‘shift gears’) often leads to a state of ‘cognitive debilitation’.’

Her paper, based on Dr. Ross Greene’s work, details useful de-escalation techniques, including the tip to offer words that describe the mounting feelings. (E.g. “I know you are really mad that it is time to go! It is hard to stop playing with that toy. I understand.”) Green and Law also advocate framing requests (e.g. from the parent or educator to the child) as either A, B or C requests, with A being vital and non-negotiable (e.g. taking crucial medication), and C being not terribly important (e.g wearing a warm hat).

Law also includes this invaluable gem, which is aimed at the person who is addressing the autistic child who is in meltdown: ‘You need to stop talking, unless your words have a soothing effect [on the autistic individual].’.

Marvellous movement

Many families of autistic individuals, and autists themselves, say that using movement often helps disperse feelings associated with meltdown. Therefore, having a trampoline to ‘bounce out’ feelings can help, as can activities linked to pressure (e.g. pressing one’s hands against a wall, lying heavily over a Swiss ball, or lying under a weighted blanket, as examples.)

Interventions for meltdowns

A word on interventions for meltdowns – it may be useful, in more relaxed situations, to discuss with the autist their preferences for how their families or their educators ‘deal’ with future meltdowns. Sometimes physical interventions may be required to retain safety, e.g. if more modest de-escalation techniques haven’t worked – these interventions would be classed as restricting an individual’s movement, liberty or freedom to act independently. The National Autistic Society (NAS) states that almost everyone who is autistic has the ability to express a view on how they’d like to be treated, so consent for potential restraining actions should ideally be sought.

(NICE, the National Institute for Health & Care Excellence, advises – ‘Restrictive interventions should only be used if all attempts to diffuse the situation have failed, and the individual becomes aggressive or violent. if possible, an individual who is the same sex as the individual [that requires restraint] should carry out the restraint.’

Noticing triggers for autistic meltdown

A female child - for autism articleFinally, it’s worth as an autistic individual trying to work out one’s own triggers for meltdown – especially if it involves the more private meltdown, that could include self harm (which could in turn include self medicating with alcohol, for example, or controlling food intake.) Having the self awareness to see when one is out of ‘spoons‘, is feeling anxious, and could be triggered into meltdown, is a very valuable skillset to have!

Keeping items to hand that would be useful if one’s trying to manage feelings connected to meltdown (maybe beloved soft toys, weighted blankets, headphones and preferred music, etc) is also a useful way to manage the feelings – as is retreating to a safe place to mentally recalibrate, away from triggers and sensory challenges.

A little disclaimer – here at Spectra.blog we don’t claim to be experts about Autism; the information we post here is based purely on our own exposure and experiences. We’d also love your feedback on our posts!


Also published on Medium.