Meltdowns - a guide for all audiences
Many autistic people have meltdowns. The public often finds it hard to tell autism meltdowns and temper tantrums apart, but they are very different things. If your family member or the person you support has meltdowns, find out how to anticipate them, identify their causes and minimise their frequency.
What is a meltdown?
A meltdown is an intense response to an overwhelming situation. It happens when someone becomes completely overwhelmed by their current situation and temporarily loses control of their behaviour. This loss of control can be expressed verbally (eg shouting, screaming, crying), physically (eg kicking, lashing out, biting) or in both ways.
A meltdown is not the same as a temper tantrum. It is not bad or naughty behaviour. When a person is completely overwhelmed, and their condition means it is difficult to express that in another way, it is understandable that the result is a meltdown.
Meltdowns are not the only way an autistic person may express feeling overwhelmed. They may also refuse to interact, withdrawing from situations they find challenging or avoiding them altogether.
What to do
If someone is having a meltdown, or not responding to you, don’t judge them. It can make a world of difference to an autistic person and their carers.
- Give them some time - it can take a while to recover from information or sensory overload.
- Calmly ask them (or their parent or friend) if they’re OK, but bear in mind they’ll need more time to respond than you might expect.
- Make space - try to create a quiet, safe space as best you can. Ask people to move along and not to stare, turn off loud music and turn down bright lights – whatever you can think of to reduce the information overload, try it.
Anticipating a meltdown
Many autistic people will show signs of distress before having a meltdown, which is sometimes referred to as the “rumble stage”. They may start to exhibit signs of anxiety such as pacing, seek reassurance through repetitive questioning or physical signs such as rocking or becoming very still. At this stage, there may still be a chance to prevent a meltdown. Strategies to consider include distraction, diversion, helping the person use calming strategies such as fiddle toys or listening to music, removing any potential triggers, and staying calm yourself.
Identifying the causes
A meltdown is a reaction to an overwhelming experience. If your family member or the person you support has meltdowns, identify what is overwhelming for them. Complete a diary over a period of time. Record what happened before, during and after each meltdown. Patterns may emerge. You may find that meltdowns occur at particular times, in particular places, or when something particular has happened.
Minimising triggers
Once you have a clearer idea what may be triggering meltdowns, think about ways you might minimise that trigger. Every autistic person is different, but sensory differences, changes in routine, anxiety, and communication difficulties are common triggers.
Sensory considerations
Many autistic people have sensory differences. They may be over-sensitive to some senses, under-sensitive to others and often a combination of both.
For example, for someone who is over-sensitive to touch and sound, people brushing past them and a loud announcement at a train station could cause pain and sensory overload, leading to a meltdown. In this situation, it could be helpful to listen to calming music on headphones to block out loud noises and to wait until everyone has got off the train before approaching the platform to avoid crowds of people.
In other situations, consider creating a low arousal environment (eg remove bright lights) or use sensory equipment (eg glasses with dark or coloured lenses, ear defenders, a weighted blanket).
Change in routine
Consistent, predictable routines and structure are very important for autistic people and a change to routine can be very distressing.
For example, having to go a different route to school due to roadworks could cause feelings of anxiety, that may trigger a meltdown. In this example, a clear visual support explaining the change, reassurance that the rest of the routine remains the same and adding extra support such as a calming/comforting activity to do in the car could help.
For an unexpected change, there can be a particular plan in place, such as:
- the use of a picture symbol to explain the change
- reinforcement of the rest of the day being the same (if that’s the case)
- a chance to express any frustration appropriately (such as hitting a pillow, ripping paper) followed by an activity that is known to calm the person such as taking deep breaths, listening to calming music, going for a walk, or squeezing a stress ball.
It may help to increase structure around ordinary transitions, helping the person to navigate the change from one activity to another throughout the day. Using a clear timetable explaining when the transitions will be, using timers to count down to transitions, using a favourite toy or character to be part of the transition, can all help.
Anxiety
With its unwritten rules and unpredictable nature, the world can be an extremely challenging environment for autistic people and many experience anxiety. Without tools and strategies to help manage their feelings of anxiety, they may experience a meltdown.
Develop strategies to manage anxiety, such as our Brain in Hand app.
Have a plan beforehand of what to do if the person feels anxious, such as a calming playlist to listen to at the shops or a stress ball in their pocket.
Build relaxation time into the routine. The person will generally feel calmer and therefore better able to manage when something that could trigger a meltdown, occurs. What that means will vary from person to person, and may consist of quiet activities, eg taking a walk, listening to music, playing a computer game, reading, doing puzzles, using fiddle toys, or more strenuous activities, eg jumping on a trampoline or going to the gym.
In the case of more strenuous activities, observe whether the activity really does calm the person down. If it doesn’t, but is just an activity they really enjoy, still build in time for that activity but also try and find one that does genuinely calm them down and make time for that as well.
Communication difficulties
Autistic people can find it difficult to express their wants and needs, from a non-verbal child struggling to express their need for a drink to a teenager finding it hard to express their emotions. This can result in overwhelming feelings, such as anger and frustration, leading to a meltdown.
Support the person to find ways to understand and express their emotions appropriately before they get overwhelmed, and find ways to make your own communication more easily understandable. Some autistic people may find verbal communication difficult due to misunderstanding body language, tone of voice, irony and sarcasm.
Things you can try include:
- visual supports
- social stories
- Picture Exchange Communication Systems (PECS)
- written information
- modifying your verbal communication eg by speaking in short, clear sentences
- using technology such as tablets and voice software, instant messaging etc
- increasing understanding of emotions and social skills.
