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Saturday, February 17, 2007

Count ‘down’ for meltdowns

At breakfast he screams at me in a rage of frustration. We have progressed to the stage of 'bowl and spoon acquisition,' a precusor to cereal consumption. The bowl is empty, the spoon close to hand. He yells at me again, “what about the milk?”
I give in and give, fetch the milk and pour it into his empty bowl, as I don’t have enough voice volume to compete after jaw surgery. This act provokes a full meltdown of even greater frustration and rage. Although he has a rule about cereal first then milk, he missed that step in the sequence.

Simultaneously, junior is having a horizontal meltdown on the kitchen floorboards, caused by an absence of his preferred bowl, without which, he is incapable of eating his breakfast. The combined level of screaming is impressive.

Why? To the casual observer these meltdowns seems unreasonable, because the underlying logic is hidden. As adults we have preferences. If the favourite blend of coffee, made in just the right manner is unavailable, we might be miffed, put out, it could ruin the start to the day, but we have learned coping mechanisms to deal with the frustration. For some autistic children, not only have they yet to acquire coping strategies, often they are not able to articulate the source of frustration in the first place. Even if they are verbal, their emotions are so volatile and overwhelming, that this may override the ability to communicate effectively.

The preferred bowl is the easier of the two to explain. Many children have a special something or other. The problem for the autistic child, or rather the parent of that child, is that the special something or other category, applies to just about everything.

As with typical children, generally, this development doesn’t happen all at once, but creeps up on you by stealth. First it’s just a couple of things of no great significance, all perfectly harmless, makes the child more content and everyone’s life more peaceful. Gradually, the list of special items applies to just about everything in that particular child’s life. If you align this principle to both children, before you know it, you have effectively trapped yourself and your children into a rigid cage. Rigidity or what I prefer to term ‘predictability,’ becomes the new ‘norm.’ Deviation from the norm invokes meltdowns.

Whilst there are often complicating factors, depending upon the make-up of your child, the theme is the same; safety, comfort and security are provided by the availability of these props, even if sometimes they serve no practical use, as with the many tiny or particular talismen that accompany every waking, and sometimes sleeping, moments. Preferences for colour, texture, smell, sound when touched, and so on, all can all play a part in the choice, due in part to the sensory make up of the individual.

I know that it is a mistake to slide into this situation in the first place, but it is hard to resist. Once you find that you have buried yourself in this pit, is it a long climb out again. The temptation is to maintain the status quo, to transform yourself into the most efficient air steward in existence, so that they are never ‘without’ whatever it is. [times two] This was the path that I initially chose, although I can’t say that I actively chose it. It was more the line of least resistance, because I was out numbered.

The child that ‘tantrums’ at two for the big yellow duck or die, brings an indulgent smile to the parents. The same behaviour, when the child is 5, 6 or older, is quite another matter. It would be handy for the parent, to cut these ties and free themselves from the yoke. It might also be of some relief to the child, if some of these rigidities could be softened, to relieve them of the agony that they experience each and every time that perfection cannot practically be achieved. It is likely, that as they get older, greater degrees of control will need to be relinquished, because whilst it may be possible to control your own home environment, the world at large has more variables.

18 months ago, junior had 6, level 10 major [translation = severe] meltdowns in the same 40 minute morning period. His older brother varied upon that average. Both could sometimes squeeze in a few more meltdowns into those time period.

Eighteen months prior to that, there were so many meltdowns from both of them, within the same time frame that there were too many to count.

Then and now, it’s a great ratio.

A note [possible solution for some children]
This is a ‘do as I say’ note, not a ‘do as I do,’ note.

The primary commodities required for success are patience and calm in the parent, which are also two attributes that are a bit thin on the ground around here. All children pick up on their parent’s frustration and agitation. Neither assists either individual.

First determine the cause of the frustration. This is the greatest difficulty with my children due to their emotional state causing an inability to communicate. To help find out what it is that’s causing the bother, PECS may help. Even those, or other clues won’t help, unless your child is calm enough to be willing to attempt communication. There are a great number of calming strategies available. For mine, breath control via example [doing it together] and massage, help considerably. Taking the one that is having the ‘problem’ away from the situation that is causing the ‘problem,’ also helps. [I think this is because the visual reminder of the ‘problem’ glaring at him, only makes matters worse, although this is tricky if there are other children around]

The super crush bear hug works for the other. It calms him and lets him know that it’s o.k. to feel this way.
Once you can tease out clues, you then have an opportunity to find a variety of different solutions. This may also be tortuous because many of my ‘adult’ solutions, don’t hit the mark. E.g. he wants a blue bowl, several are available, but none are the right shade of blue. This may be a long exercise to teach the concept of ‘compromise.’

These strategies help at the moment, now. They may not be effective next week, or tomorrow for that matter. Previously, other skills helped, but they don’t now. As your child grows, different things will work or fail, but fortunately this is positive proof of ‘change’ and development. Life would be so boring if it remained the same.

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