How to tell a tantrum versus a sensory meltdown? Here are some ideas:) Thanks Autism Discussion Page! Differences between Tantrums and Meltdowns It is very important for parents and teachers to understand the differences between tantrums and meltdowns. Although they can consist of similar behavior (yelling, screaming, crying, dropping to the floor, flailing, hitting or biting self, etc.), it is important to distinguish between the two. Why? Because it has major implications for how we interpret the behavior and how we intervene to help the child. Tantrums With tantrums the child usually has: 1. Some control over the behavior. 2. Chooses to engage in the behavior. 3. Usually occurs specific to wanting something or escaping something he doesn’t want. 4. Can end quickly once he gets what he wants. 5. Child can focus on others around him; often looking at them, yelling at them, and drawing their attention to him. 6. Looks for reactions from others when being disruptive. 7. May have the ability to talk and negotiate, although yelling and demanding. 8. If aggression is displayed he will often seek out others to hit or kick, or get up and seek out property to disrupt. Usually the behavior is a means to an end (wants something or to avoid something) and the child acts out to get a specific reaction from others. Although tantrums can lead to being overwhelmed, they usually start under the control of the child. Tantrums often occur in nonverbal children when they lack other ways of communicating and getting needs met. The child will often calm down once he gets want he wants or feels that he needs. Meltdowns Meltdowns usually occur when the child’s brain is overwhelmed with stress chemicals and has reached the panic, flight or fight stress reaction. The stress builds up to the point that the brain overwhelms and loses the ability to cope. With meltdowns the child usually: 1. Appears to be in panic mode. 2. Does not appear to have control over their behavior. 3. Often cannot talk or problem solve; loses ability to negotiate or reason. 4. Often cannot follow directions or argue; too overwhelmed to engage. 5. Feels “unsafe” and appear to be reacting out of deep fear. 6. May be difficult to identify the cause of emotion, or obvious “want or demand.” 7. Often occurs from sensory overload, too much cognitive stress, or ongoing social demands that tax and drain the brain. 8. Usually is trying to flee or escape the situation around him, rather than seeking out attention. Child is seeking to escape what is overwhelming him, not seeking to gain something. 9. Usually do not hit, kick, or bite others unless others approach and attempt to calm or redirect. Aggression often subsides when you back away, give them space, remove demands, and withdrawal all interactions. 10. Can take a while to calm down (rather than calming immediately when they get what they want); need time to escape and rebound. 11. Often expresses remorse for actions afterwards. The child in a meltdown is reacting out of fright and fear. The “fight or flight” panic reaction is set off, and the child is (1) trying to escape the source of stress, and (2) seeking proprioception (hitting, kicking, biting self, head banging, etc.) to release stress chemicals. He often does not want to interact with others, is not seeking their attention, and often wants to withdraw and isolate. However, if the child does not feel like he is safe he may act out on property or others to get people to back off, or to release stress chemicals. Intervening How we interpret the behavior (tantrum or meltdown) may affect the way we intervene. If the behavior appears to be a tantrum we would want to: 1. Identify what function(s) the behavior serve (getting something he wants, or trying to escape something he doesn’t want). What is he trying to gain from the tantrum? 2. Try to focus on teaching the child more appropriate ways of getting his needs met (requesting, saying “stop”, break cards, etc.). Provide an appropriate way of communicating the same thing that the tantrum does. Practice and role play to teach the desired response. 3. During early stages of getting upset, intervene quickly and coach the child to use his replacement behavior (desired response that was practiced). 4. Avoid “giving in” to the tantrum (to gain something or avoid something); prompting the desired response instead. If the child is throwing a tantrum to end a task he doesn’t like, then “If you want us to stop then say ‘stop’”. As soon as desired response is given immediately back off. You want to make sure that the tantrum behavior does not work, and the desired response works immediately. 5. Minimize both verbal and emotional reactions to the negative behavior (stay matter of fact, no scolding, bribing, counseling, minimal emotion), directing all attention to what your want him to do. 6. Reinforce the child for using the desired replacement behavior. 7. If the child refuses to respond, pull all attention away and walk away if possible (if not destructive or injurious). Ignore behavior, but supervise to ensure safety. Once child calms down redirect back to the task or to use the replacement behavior. 8. If needed (only if the above fail), implement mild consequence (time out, loss of privilege, etc.) for not responding. These are just basic starter procedures. If the above does not work, seek out professional advice. For more destructive aggression or property destruction, seek professional assistance to complete a detailed “functional behavior assessment” for designing safe and effective treatment strategies. Only implement the above for less aggressive tantrums (screaming, flailing, falling to floor, etc.) where safety can be assured. Meltdowns 1. When the child is melting down typical behavioral techniques are not effective. The child is too overwhelmed to think, respond to directions, or reason with. He will not understand or respond to directions or consequences at this time. Punishing and threatening will only make things worse. 2. Reducing meltdowns is most effective by designing preventative strategies for avoiding meltdowns in the first place. Identify the sensory, cognitive and social challenges that overwhelm the child and build in proactive strategies for reducing the stressors. This usually consists of modifying the environmental demands to match the child’s abilities, providing accommodations to lessen the stress, and teaching coping skills for dealing with the stressful situations. 3. Redirection and intervention works best if we intervene very early in the behavior chain (first signs of getting overwhelmed), assist and support the child as possible and practice coping skills. 4. Once in the heat of the moment, pull the child away from the situation, remove all demands, reduce all stimulation, and minimize questions or demands. We need to lessen the demands on the brain; let it regroup and reorganize. 5. Focus is on helping the child feel safe. Remove stimulation and demands, reassure the child that he is safe, and allow the child to space to calm down. 6. Some children will let you help sooth them but often they want no interaction. Respect their comfort zones. 7. Program strategies usually consist of (1) lessening the stressors with modifications and accommodations, (2) teaching coping skills to deal with the stress and cope when first getting overwhelmed (say stop, present break card, leave setting, etc.) and (3) teaching a safe routine once overwhelmed (withdraw, pull away, immediately exit, rock and calm, etc.). Practice this routine until it becomes predictable and familiar. Then in the heat of the moment the child will feel safe implementing it.
Posted on: Mon, 01 Sep 2014 18:00:00 +0000
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