Just a quick update. Munchkin is still loving the videos. He gets very focused on them while they are on and they are making it easier for him to grasp the concepts. We are working on "m" right now. He's only verbalized the sound three times but he's doing well with the rest of it. That he's verbalizing at all is a success in my book but I've got adaptive tools at hand for when it becomes a problem for him. But I really, really try to get him to verbalize the sound as much as possible when the videos are running. That's when we've had the most success. Most likely because he thinks it's a game.
At first he was really confused because the HaveFunTeaching video uses the same music for each letter. Then he realized that he really had to listen! And that video brought that point home for him. It's been interesting to see that knowledge appear in his eyes and see the changes in his behavior. Something clicked for him. Despite years of people making the sounds for him and trying to get him to make them, the videos seem to be getting through. And this video in particular seems to have helped him realize that he needs to process and pay attention to the "noise" that is coming in his ears.
I'm also using videos for numbers and handwriting that are working well. He's especially fond of the handwriting videos and they seem to be breaking his resistance to handwriting. I'll share more on both of those topics another time.
All in all, things are going good. Munchkin really looks forward to lessons if just for the video section.
Saturday, September 7, 2013
Thursday, September 5, 2013
Meltdowns III
Again, this is a situation that occurred with my Munchkin. But it highlights that some meltdown triggers can be long term issues and new ones can come out of nowhere.
Munchkin was generally a peaceful child at school. Then he started having more meltdowns at school and at home. And he was getting back into needing a rigid unchanging schedule. On the weekends, if we were busy, Munchkin would be prone to misbehaving on a grander scale then normal with the occasional meltdown thrown in for spice. Despite multiple talks with his teacher, we just couldn't see where things had changed to trigger this.
Then one of his aides discovered that he was getting headaches. She was seeing all the signs of this. So I started giving him OTC medicine for the headaches when I saw the signs of them. And the signs were pretty distinctive if you were aware of the problem. But it's not in my nature to medicate continually so I started looking for the causes of the headaches.
It didn't take us long to figure out that untreated the headaches got worse throughout the week. Even with medications, sometimes they just got worse. That, of course, lead to the realization of why changes in our weekends were a problem. Munchkin spent the weekends getting rid of the headaches. Any changes in our normally lazy weekends meant that the headaches didn't fade quite as much. Now imagine that compounding over several weeks and you understand why his meltdowns increased.
But again, while that helped in treating the headaches, it didn't tell us what was triggering the headaches. So of to the neurologist we went, after his family doctor maxed her knowledge. The neurologist checked for multiple things, including epilepsy. And after going through Munchkin's medical history, and our family medical history, and a whole stack of medical questions we finally started figuring out what the base issue was. And what could be done about it.
The base issue is the teenager hormone changes. Yup, nothing that we could alter in any way and no solid way of predicting which days were going to be worse than others. He does have a mild indicator on some days but nothing that we can use solidly. On some days he will run a continual low grade fever that is not connected to any illness. It took multiple visits to his regular doctor with testing to finally figure that out. And on a few rare days that temperature will be more than low grade.
But regardless of all of that, it basically meant that we were only going to be able to treat the headaches by prevention or medication. All of that research with the neurologist, and all the information that I had been tracking on his headaches and behaviors, quickly narrowed down the triggers. Especially since all of the simpler headache triggers had already been eliminated in our lives.
It turns out that we already knew one solidly, and had adapted for it because it is one of his sensory overload issues. That one was loud noise. It was already in his IEP that he couldn't attend pep rallies or large meetings because of this. And at home we kept noise canceling headsets with us when we went out so that he could put one on when he couldn't handle the noise level. But this explained why there were days that he went around with the headset on, even when it was quiet. Basically, the headaches had reached a level where any noise was painful. You and I would take a nap at that point, but Munchkin doesn't have a nap ability unless he's extremely ill. That's just the way he is.
The second issue was new but also one we had already dealt with to a degree at home. Munchkin is sensitive to strong scents. We didn't know more than that at the beginning. And the reason we hadn't tripped across it before, at home, was because I have a bad reaction to chemical scents and strong scents. So to keep me from having headaches those were not present in our home. Unfortunately, Munchkin was being exposed to strong scents at school.
The third issue was new to us completely. Munchkin is sensitive to fluorescent lighting. Apparently very sensitive. This is actually something that is in the family but I didn't know about it until we went digging. I have family members who are so sensitive to fluorescent lights that they bring lamps in to their offices and don't use the overhead lighting. This was made very clear when the neurologist observed Munchkin turning off all the fluorescent lights but leaving on the small incandescent lamp. I had noticed the habit of shutting off all lights before but had just generalized bright lights. It didn't take me long to confirm the neurologist's findings. We are still changing out fluorescent bulbs in the house for incandescent bulbs but it was done immediately in the rooms that Munchkin spends the most time in. Unfortunately, that is not an option at school.
Now, I was given an option to medicate Munchkin in a manner that would possibly help with the headaches. And have the side effect of sedating him to a large degree. The medications were blood pressure medicines for adults. So I went researching. And in the end, I chose to not medicate and to home school. Those decisions were based on Munchkin's medical history and the additional side effects that would have been dangerous to his health from those medications. You might have chosen otherwise.
But back to meltdowns, in figuring out the cause and the triggers we were finally able to deal with the meltdowns. In our case, if there are signs of pain from one of the triggers we take immediate steps to remove the trigger and relieve the pain. You can do this with or without medications but it can't be done until you know the triggers. While Munchkin is still going through the hormone shifts, and probably will for another 5 years or so, the meltdowns due to those triggers have decreased amazingly. And Munchkin is now able to provide better hints that he is starting to react to a trigger, although I still long for the day that he can just tell me that he has a headache. It's harder to work on the communication for that when the headaches are so few and far between now.
After 1 1/2 years of dealing with this at the trigger level, Munchkin can now tolerate periods of exposure to his triggers without big problems. So now we can get more errands done in a day. Going into multiple stores with fluorescent lights is okay when the exposure is only a day or two here and there. Walking by displays of strongly scent items, or stores filled with them, is okay for him if not for me. Again, as long as it's not a regular thing. And that's another thing to realize, even when you know the triggers and start to relieve them, the improvement is not immediate. It took over six months before headaches were no longer so easily triggered in Munchkin. For six months I couldn't go to more than two stores for more than a half hour each, regardless of the break in between stores. Munchkin's sensitivity was that high because of the level of exposure before we realized the problems. And one of our surest signs that he's dealing with a headache is still that he turns off every fluorescent light that he can find a switch for.
So, please, don't jump to the assumption that meltdowns can't be dealt with. Just keep looking. And don't ignore even the smallest clue. Finding triggers like the ones here takes time and a lot of observation. Taking notes helps a lot because then you aren't likely to forget something. And sometimes one issue can seem like another. Some of the reactions that Munchkin had with the headaches looked an awful lot like petite mal seizures. But they weren't. So keep looking. Ask others to look when you feel you aren't seeing something. It took the school aide noticing the symptoms for me to recognize them for what they were! And I'm so incredibly grateful that she noticed. I don't want to imagine how much worse those headaches could have gotten before we would have finally discovered them.
Munchkin was generally a peaceful child at school. Then he started having more meltdowns at school and at home. And he was getting back into needing a rigid unchanging schedule. On the weekends, if we were busy, Munchkin would be prone to misbehaving on a grander scale then normal with the occasional meltdown thrown in for spice. Despite multiple talks with his teacher, we just couldn't see where things had changed to trigger this.
Then one of his aides discovered that he was getting headaches. She was seeing all the signs of this. So I started giving him OTC medicine for the headaches when I saw the signs of them. And the signs were pretty distinctive if you were aware of the problem. But it's not in my nature to medicate continually so I started looking for the causes of the headaches.
It didn't take us long to figure out that untreated the headaches got worse throughout the week. Even with medications, sometimes they just got worse. That, of course, lead to the realization of why changes in our weekends were a problem. Munchkin spent the weekends getting rid of the headaches. Any changes in our normally lazy weekends meant that the headaches didn't fade quite as much. Now imagine that compounding over several weeks and you understand why his meltdowns increased.
But again, while that helped in treating the headaches, it didn't tell us what was triggering the headaches. So of to the neurologist we went, after his family doctor maxed her knowledge. The neurologist checked for multiple things, including epilepsy. And after going through Munchkin's medical history, and our family medical history, and a whole stack of medical questions we finally started figuring out what the base issue was. And what could be done about it.
The base issue is the teenager hormone changes. Yup, nothing that we could alter in any way and no solid way of predicting which days were going to be worse than others. He does have a mild indicator on some days but nothing that we can use solidly. On some days he will run a continual low grade fever that is not connected to any illness. It took multiple visits to his regular doctor with testing to finally figure that out. And on a few rare days that temperature will be more than low grade.
But regardless of all of that, it basically meant that we were only going to be able to treat the headaches by prevention or medication. All of that research with the neurologist, and all the information that I had been tracking on his headaches and behaviors, quickly narrowed down the triggers. Especially since all of the simpler headache triggers had already been eliminated in our lives.
It turns out that we already knew one solidly, and had adapted for it because it is one of his sensory overload issues. That one was loud noise. It was already in his IEP that he couldn't attend pep rallies or large meetings because of this. And at home we kept noise canceling headsets with us when we went out so that he could put one on when he couldn't handle the noise level. But this explained why there were days that he went around with the headset on, even when it was quiet. Basically, the headaches had reached a level where any noise was painful. You and I would take a nap at that point, but Munchkin doesn't have a nap ability unless he's extremely ill. That's just the way he is.
The second issue was new but also one we had already dealt with to a degree at home. Munchkin is sensitive to strong scents. We didn't know more than that at the beginning. And the reason we hadn't tripped across it before, at home, was because I have a bad reaction to chemical scents and strong scents. So to keep me from having headaches those were not present in our home. Unfortunately, Munchkin was being exposed to strong scents at school.
The third issue was new to us completely. Munchkin is sensitive to fluorescent lighting. Apparently very sensitive. This is actually something that is in the family but I didn't know about it until we went digging. I have family members who are so sensitive to fluorescent lights that they bring lamps in to their offices and don't use the overhead lighting. This was made very clear when the neurologist observed Munchkin turning off all the fluorescent lights but leaving on the small incandescent lamp. I had noticed the habit of shutting off all lights before but had just generalized bright lights. It didn't take me long to confirm the neurologist's findings. We are still changing out fluorescent bulbs in the house for incandescent bulbs but it was done immediately in the rooms that Munchkin spends the most time in. Unfortunately, that is not an option at school.
Now, I was given an option to medicate Munchkin in a manner that would possibly help with the headaches. And have the side effect of sedating him to a large degree. The medications were blood pressure medicines for adults. So I went researching. And in the end, I chose to not medicate and to home school. Those decisions were based on Munchkin's medical history and the additional side effects that would have been dangerous to his health from those medications. You might have chosen otherwise.
But back to meltdowns, in figuring out the cause and the triggers we were finally able to deal with the meltdowns. In our case, if there are signs of pain from one of the triggers we take immediate steps to remove the trigger and relieve the pain. You can do this with or without medications but it can't be done until you know the triggers. While Munchkin is still going through the hormone shifts, and probably will for another 5 years or so, the meltdowns due to those triggers have decreased amazingly. And Munchkin is now able to provide better hints that he is starting to react to a trigger, although I still long for the day that he can just tell me that he has a headache. It's harder to work on the communication for that when the headaches are so few and far between now.
After 1 1/2 years of dealing with this at the trigger level, Munchkin can now tolerate periods of exposure to his triggers without big problems. So now we can get more errands done in a day. Going into multiple stores with fluorescent lights is okay when the exposure is only a day or two here and there. Walking by displays of strongly scent items, or stores filled with them, is okay for him if not for me. Again, as long as it's not a regular thing. And that's another thing to realize, even when you know the triggers and start to relieve them, the improvement is not immediate. It took over six months before headaches were no longer so easily triggered in Munchkin. For six months I couldn't go to more than two stores for more than a half hour each, regardless of the break in between stores. Munchkin's sensitivity was that high because of the level of exposure before we realized the problems. And one of our surest signs that he's dealing with a headache is still that he turns off every fluorescent light that he can find a switch for.
So, please, don't jump to the assumption that meltdowns can't be dealt with. Just keep looking. And don't ignore even the smallest clue. Finding triggers like the ones here takes time and a lot of observation. Taking notes helps a lot because then you aren't likely to forget something. And sometimes one issue can seem like another. Some of the reactions that Munchkin had with the headaches looked an awful lot like petite mal seizures. But they weren't. So keep looking. Ask others to look when you feel you aren't seeing something. It took the school aide noticing the symptoms for me to recognize them for what they were! And I'm so incredibly grateful that she noticed. I don't want to imagine how much worse those headaches could have gotten before we would have finally discovered them.
Monday, September 2, 2013
Meltdowns II
My Munchkin is much better at connecting with the world around him now then he used to be. Nowadays he can let me know if he's hungry or thirsty. If he thinks I'm taking too long, he knows how to get certain snacks or drinks all by himself. And I have to admit, if he goes after those items, I am typically taking too long to respond to his needs. It doesn't happen often but it can happen when I'm mowing the lawn or cleaning. But at one point Munchkin couldn't do any of these things and it made for some real meltdowns. Especially if he was hungry and a meal was late. It wasn't the meal being late that was the problem, the problem was that he was hungry and didn't have a way to tell me.
One of the first things you discover when you give your child a way to communicate is that the need for rigid schedules starts to fade.
Now how to do this. Well, at first, I was dealing with the meltdowns that triggered because he was hungry, or thirsty, or both. A lot like a baby or young toddler, he would get upset. Unfortunately, the hunger or thirst wasn't usually enough to trigger a meltdown. So we'd end up with a scene that most parents are familiar with. A toy would break. Or something he wasn't supposed to play with would get taken away. Or maybe something would drop making a really loud sharp sound. And the meltdown would start. And once the meltdown started it wouldn't be enough to fix the toy or let him have the item that got taken. And the noise not happening again wouldn't have any effect.
Those "cures" didn't work because they were only addressing a small part of the actual issue. And my child did not have the tools to let me know what was actually wrong. This was when I learned that the "baby" checklist of things was going to always be a part of our life. I learned to check his diaper to see if it needed changing. Yes, he was in diapers until he was 7. Then I learned to check for easily visible hurts. To this day I still have to do this because he doesn't recognize pain the way most people do. Then I offer food and drink. Typically by this point, I've found and dealt with at least one of the core issues. That is good because it means that the level of the meltdown decreases.
Then I'd look to see if maybe the video he was watching had stopped. Or a toy was missing. Any number of things could be the problem and I learned to look for even the tiniest thing and fix it if possible.
Now that's during the meltdown. Afterwards I worked on ways that he could tell me what he needed so that there wasn't a pile up of issues. I found talking postcards that I mounted to the fridge with a picture of drinks and another of food. Whenever I gave him a drink, I would have him push the button and make it say "I want a drink, please". I did the same thing with the food picture and snacks. At that point in time the fridge had a safety lock because he would play in whatever he found in the fridge. So using the postcards was a way that he could let me know, and I could normally hear it if I was in the other room. Now it wasn't perfect by any means because I couldn't hear those cards if I was more than one room away. And Munchkin didn't have enough of a world connection yet to understand to bring me a card. But it was a start on the path. As years went on, and the playing in random food disappeared, he was allowed access to the fridge. Now he brings me the jug containing what he wants to drink and the cup. Then he puts the jug back in the fridge. Sometimes, when he's really processing well, he will set the cup down on the table and fill it himself.
I put a postcard on the TV unit that said "movie please" with a picture of the TV. I put one on the backdoor that said "outside please". For a few years those little talking postcards were all over my house in any place where there might be something that my child would want. And whenever possible I would use them to help him express his wants during normal times.
Over time I learned to keep drinks and snacks with us at all times. Mainly drinks because my Munchkin drinks a lot. And it's not soda, it's juice or ice tea. Then Munchkin got a portable DVD player to help him shut out sensory problems when in public. And I can honestly say that meltdowns nowadays are because he got in trouble for something, not because he's locked in sensory overload. And, well, those meltdowns are normal.
But I wanted to avoid the meltdowns so I also started being very observant of his body language whenever I could. Especially during calm times when he wanted something. I learned what signs he gave off that would let me know in advance that there was an issue building. And I would defuse it by reacting at that point. For example, if Munchkin wanted a new movie he would start pressing the buttons on the front of the TV. This would inevitably result in him turning the TV off and getting upset, although not always to meltdown level. So when I would see him start to press buttons, I would redirect him to press the postcard that asked for a movie. Then I would help him get a new movie and put it in. Over the years, he learned to pick out the movie himself and bring it to me. Nowadays he's experimenting with putting the movies in himself.
The point though is that Munchkin couldn't recognize the signs that he was getting upset or what to do about it. By my actions I let him learn to identify the emotion, then taught him how to deal with it. All without having to go into meltdown.
This is one of the gaps that exist for our children. Normal babies and toddlers jump this gap with ease and express their needs or wants. Our children need help bridging this gap. They need help making the connection to the world around them and how to express themselves in it. It can be time consuming and stressful to do this at first. But it is so worth the effort when you discover that youHr child has learned to express their need in a positive manner.
Honestly, no one ever told me that raising Munchkin would be easy. In truth, most folks told me it would be extremely hard. And there were quite a few folks who told me that he would become violent and dangerous which meant I would have to put him in a residential facility. So any way I can find that makes it easier for both of us is something I'm going to use. Anything we can use so that he can communicate I'm going to try and adapt as needed. Sometimes dealing with autism makes me think of Helen Keller and what it must have been like for her, and her helpers.
One of the first things you discover when you give your child a way to communicate is that the need for rigid schedules starts to fade.
Now how to do this. Well, at first, I was dealing with the meltdowns that triggered because he was hungry, or thirsty, or both. A lot like a baby or young toddler, he would get upset. Unfortunately, the hunger or thirst wasn't usually enough to trigger a meltdown. So we'd end up with a scene that most parents are familiar with. A toy would break. Or something he wasn't supposed to play with would get taken away. Or maybe something would drop making a really loud sharp sound. And the meltdown would start. And once the meltdown started it wouldn't be enough to fix the toy or let him have the item that got taken. And the noise not happening again wouldn't have any effect.
Those "cures" didn't work because they were only addressing a small part of the actual issue. And my child did not have the tools to let me know what was actually wrong. This was when I learned that the "baby" checklist of things was going to always be a part of our life. I learned to check his diaper to see if it needed changing. Yes, he was in diapers until he was 7. Then I learned to check for easily visible hurts. To this day I still have to do this because he doesn't recognize pain the way most people do. Then I offer food and drink. Typically by this point, I've found and dealt with at least one of the core issues. That is good because it means that the level of the meltdown decreases.
Then I'd look to see if maybe the video he was watching had stopped. Or a toy was missing. Any number of things could be the problem and I learned to look for even the tiniest thing and fix it if possible.
Now that's during the meltdown. Afterwards I worked on ways that he could tell me what he needed so that there wasn't a pile up of issues. I found talking postcards that I mounted to the fridge with a picture of drinks and another of food. Whenever I gave him a drink, I would have him push the button and make it say "I want a drink, please". I did the same thing with the food picture and snacks. At that point in time the fridge had a safety lock because he would play in whatever he found in the fridge. So using the postcards was a way that he could let me know, and I could normally hear it if I was in the other room. Now it wasn't perfect by any means because I couldn't hear those cards if I was more than one room away. And Munchkin didn't have enough of a world connection yet to understand to bring me a card. But it was a start on the path. As years went on, and the playing in random food disappeared, he was allowed access to the fridge. Now he brings me the jug containing what he wants to drink and the cup. Then he puts the jug back in the fridge. Sometimes, when he's really processing well, he will set the cup down on the table and fill it himself.
I put a postcard on the TV unit that said "movie please" with a picture of the TV. I put one on the backdoor that said "outside please". For a few years those little talking postcards were all over my house in any place where there might be something that my child would want. And whenever possible I would use them to help him express his wants during normal times.
Over time I learned to keep drinks and snacks with us at all times. Mainly drinks because my Munchkin drinks a lot. And it's not soda, it's juice or ice tea. Then Munchkin got a portable DVD player to help him shut out sensory problems when in public. And I can honestly say that meltdowns nowadays are because he got in trouble for something, not because he's locked in sensory overload. And, well, those meltdowns are normal.
But I wanted to avoid the meltdowns so I also started being very observant of his body language whenever I could. Especially during calm times when he wanted something. I learned what signs he gave off that would let me know in advance that there was an issue building. And I would defuse it by reacting at that point. For example, if Munchkin wanted a new movie he would start pressing the buttons on the front of the TV. This would inevitably result in him turning the TV off and getting upset, although not always to meltdown level. So when I would see him start to press buttons, I would redirect him to press the postcard that asked for a movie. Then I would help him get a new movie and put it in. Over the years, he learned to pick out the movie himself and bring it to me. Nowadays he's experimenting with putting the movies in himself.
The point though is that Munchkin couldn't recognize the signs that he was getting upset or what to do about it. By my actions I let him learn to identify the emotion, then taught him how to deal with it. All without having to go into meltdown.
This is one of the gaps that exist for our children. Normal babies and toddlers jump this gap with ease and express their needs or wants. Our children need help bridging this gap. They need help making the connection to the world around them and how to express themselves in it. It can be time consuming and stressful to do this at first. But it is so worth the effort when you discover that youHr child has learned to express their need in a positive manner.
Honestly, no one ever told me that raising Munchkin would be easy. In truth, most folks told me it would be extremely hard. And there were quite a few folks who told me that he would become violent and dangerous which meant I would have to put him in a residential facility. So any way I can find that makes it easier for both of us is something I'm going to use. Anything we can use so that he can communicate I'm going to try and adapt as needed. Sometimes dealing with autism makes me think of Helen Keller and what it must have been like for her, and her helpers.
Sunday, September 1, 2013
Meltdowns I
Meltdowns are few and far between in our house now. This post is actually in response to someone requesting help with a child having regular severe meltdowns. I thought it would be good to share the information. I doubt I'll get to everything in one post. And if you have thoughts to share, please do.
First off let me explain meltdowns. Most parents have seen their toddler have a meltdown. Typically you can quickly shift your child's attention and pull them out of it and move on with your day. That is not a typical autism meltdown. First off, autism meltdowns can build up for hours or days before they blow. Second, autism meltdowns can have physical, mental, or emotional triggers that take lots of time to recognize. Third, the triggers do not necessarily occur immediately at the start of the meltdown. Fourth, once the meltdown starts it is normally very, very difficult to stop until it burns itself out and redirection can be problematic.
Sounds like fun doesn't it?
By the way, before I get into the rest of this let me share one tip. If your child goes into meltdown in public, stop and help your child. View it the same way as you would a severe body injury. What other people think doesn't matter. What you were doing doesn't matter. What needs to be done to heal your child is what matters. If you have to leave - drop everything, grab your purse/wallet, and walk out with your child. For your child, whatever is triggering the meltdown is the equivalent of a severe body injury. It's just unseen and occurring in their nervous system or brain. If you need a point of view, imagine you suddenly got struck with a migraine that made your entire head scream in pain and blinded you. What would you want someone with you to do? I can guarantee you wouldn't want them telling you to shut up or wasting time explaining to strangers what was going on.
Now if you're a parent dealing with this on a regular basis, you may or may not have discovered a lot of these things for yourself. My first point of advice for parents dealing with this is to view their child as someone who is extremely stressed out. I tell them to look for things that stress the child and work on eliminating them. I also tell them to look for things that calm the child and start using them before the meltdown.
Okay so you are going to do this, but for right now you still have meltdowns to deal with. First, when a meltdown occurs, clear the room. Everyone leaves except for the parent who is dealing with it. That right there will eliminate a whole level of continuing meltdown triggers. Note - do not move the child having the meltdown if it is at all possible. Move the other children/people. If you must move the child, try to move them as little as possible to get them to a safe zone. Otherwise create the safe zone where the child is. After people are gone, move easily shifted furniture and other objects out of reach.
Okay, now you've just kicked the entire family out of the living room and handed off a whole bunch of stuff to your SO or another child through the door. (or preferably they took it automatically) While you are doing this your SO is quietly trying to determine what happened if neither of you saw it. If you don't have an SO, then teach your other children to quietly, calmly, with NO upset tell you what happened from the doorway. You can listen but your focus, at that moment, needs to be on the child who is melting down. And you need to be the picture of calm. Yup, I know, it's nowhere near as easy to do as say. I mentally have a box that everything else gets shoved in for this length of time. If it's not life threatening, it's in the box. Nobody ever said life was fair. And imagine how boring it would be if it was. And I know, if you are a single mom with just your one child, that safe zone isn't very big because you've got to focus on the child, not the objects. My house is permanently kid proofed up to 7 feet because of this.
So your child is screaming, hitting, banging, shrieking and you have boxed everything mentally. And you had all of 2 seconds, maybe to do that. When my child was younger I was taught safe holds to use so that he could vent yet not hurt himself or me. The one I used most commonly was a variant of a bear hug from behind. (watch for the head). These are things that you need to get a professional to show you if you are going to use them. I'm not going to do it here. You can also just let them blow it out until they calm. I've done that as well. Your call.
Whatever you do, you need to start watching and trying to figure out what the triggers were and how to defuse them. At this point, unless your child is being very specific, go down that checklist you learned when they were a baby. Are they hungry? Are they thirsty? Are they dirty? Are they hurt? You know the one. Each mom/dad has variants for their kids. Eliminate each item, not by asking, but by offering. I have spill proof sports cups for drinks and snack size bags of treats. If they get tossed it's no biggy. But if that's part of the problem, then it's eliminated and the meltdown comes down a level. Is there a favorite shirt? or a blanket they can burrow under? At this point you are focused on calming. And realize that even when they get to a calm level, you may trigger a new outburst very, very easily. Try very hard to eliminate every single little thing that could be wrong within reason. Once you've done this, try to move the child to their safe place. Don't push, don't force - offer and make sure everyone else is out of the path. For the next while you are treading on thin ice so move carefully and slowly.
And actually, even if your child is being very specific, go down the checklist. Your child may recognize the final trigger but still not realize what built up to that being such a trigger. A lot of time they end up confused as to why it was a trigger if it's not a normal one for them.
Now, it sounds like I'm telling you to let your child rule your life. And for a short period, you would be right. How long your child needs the delicate treatment depends on your child. When I first started out with Munchkin it could be days depending on the level of meltdown. Nowadays, I'm surprised if it's hours. Normally we can get past something as soon as the triggers are settled, although I'll avoid overt stressors if it was particularly bad. Actually, nowadays, I normally catch on to the triggers before they pile up enough to trigger a meltdown and use calming measures quickly. It makes life much easier on both of us. And other, broader life changes have brought his base stress level down a lot, as well as mine.
Now if you've been doing all the above and it's not working, well without professional help all that's left is the next part. This part everyone should do, not just those who aren't getting the above to work. Because we don't want to spend great chunks of our lives treading on thin ice. That's just no fun. And it can get dangerous as they get bigger and older. It may be something you can handle at 3 years old, it's not something you can handle at 13 or 16 or 18.
The meltdown is past, one way or another, and you are now going to do the follow up work. First, what was the apparent trigger? Second, what were other things occurring at the same time that could have made it worse (loud music, screeching, arguments, etc)? Third, what things on the checklist helped to calm the child down, and how much? Fourth, what things from the above lists did the child try to signify were an issue? In any way!
Going to the first item - the apparent trigger. Is this something that has triggered meltdowns in the past or was this the first time? Is it something that would be an irritant typically? For example, the trigger was you telling your child "no" when he reached for something of yours. Does your child typically go into meltdown when told no? Have you been dealing with the child wanting this item for a while? Is the child normally allowed to have the item and this was an exception? You have to think of all of these variables and more. And then answer them.
Going to the second item - surrounding environment. Was the TV on loud? Was it on a show the child can't stand? What about the radio? Were your other kids fighting with each other? Or with that particular child? Think back on what the area was like and then think about your worst most horrible day when you couldn't tolerate anything and put the two together. Then list anything that would have set you off. And list anything that would have calmed you. Then consider how to reduce the irritants on a permanent basis. And increase the calming items. And yes this is something typical parents do. My folks had volume limit controls on the TV and radio, even in our bedrooms. And on how loud we were allowed to be in the house, argument or not. There were time periods that we were not supposed to be in certain areas. These seem so small but they can actually make big changes for everyone, not just the child with autism. Not all irritants can be eliminated or reduced, but the more that you can get rid of the easier it becomes for everyone.
Now the third item - the check list. That's a no brainer folks. If something on that list calmed them, make sure it's easily on hand for next time. And the more positive effect it had, well then the more easily accessible and ready that item should be. But be aware that over time the things that work will change. Especially if you start changing things in their environment. Regardless of change though, I always fall back on that checklist if other measures don't work.
And lastly, number four - what did your child try to do to warn you? Did they plug their ears? Did they bring you an empty cup? Did they try to drink your drink (or someone else's)? Did they try to take a snack? Do they have a stim behavior that they started doing? Anything? These are the behaviors that you want to start keeping an eagle eye out for. By identifying these items, and responding to them, you will start to eliminate the meltdowns. If they are plugging their ears, make sure the volume levels are reasonable. If the volume is good, offer to go do something with them somewhere that is quieter. If they are thirsty or hungry, give them something. It doesn't matter if there is going to be a meal in 10 minutes. They don't have the mental tools to get to that point. Keep small portions of items on hand to settle the appetite and hold them over while explaining that there will be more in X number of minutes. Use a visible timer. Eventually they will learn and be able to wait. Remember, to your child this is an immediate emergency. Learning that it is not takes time. And they don't learn it as quickly as typical children.
As far as stim behaviors, that is going to depend on you. If my child is stimming, I automatically go down the checklist and start doing things to eliminate those items. Then I check on the rest. Sometimes stimming is triggered by the environment, sometimes by something internal. In our experience, as long as I stay on top of the environment stuff, stimming tends to reduce and doesn't lead to meltdowns. There have been exceptions, such as when he was developing an ulcer. So keep your eyes open. But stimming is their way of dealing with an overload, so it's a good warning sign that's something is wrong. And if your child continually stims, well it won't hurt anything to try to eliminate environmental issues so that they may not need to continually stim.
Over time, as you guide your child into avoiding triggers and removing themselves from situations, they will learn to do it for themselves. If an environment is too loud for my son now, he will get his noise canceling headset and put it on. That's a heads up for me and I keep an eye out to make sure that it's under control. If lights are bothering him, he will shut them off or burrow under a blanket or make a fort. If he can't do that, he will let me know to move quickly through a store. By learning the triggers and helping your child deal with them, you are also teaching them how to do it on their own. And they are most definitely motivated to learn this.
Now, a point to make - while I have a child with autism and I've used all these methods over the years, I'm not a professional. If your child's doctor tells you to do something differently, do so. If you choose not to then that is your choice and decision. I have chosen not to medicate my child if I can avoid it. That is my choice and decision. That may not be yours. I'm not in your shoes so I'm not judging. All of our children are different.
And there's more on meltdowns. I'll try to do some posts using Munchkin's issues as examples so that you can have ideas of what to look at. And hopefully others will share their experiences as well.
Oh, and by the way, now that it's over and your Munchkin is, hopefully, in bed asleep, you can open that box and climb in a hot bath before you get back to the rest of life. Well, maybe keep the box closed, until after the bath. ;-)
First off let me explain meltdowns. Most parents have seen their toddler have a meltdown. Typically you can quickly shift your child's attention and pull them out of it and move on with your day. That is not a typical autism meltdown. First off, autism meltdowns can build up for hours or days before they blow. Second, autism meltdowns can have physical, mental, or emotional triggers that take lots of time to recognize. Third, the triggers do not necessarily occur immediately at the start of the meltdown. Fourth, once the meltdown starts it is normally very, very difficult to stop until it burns itself out and redirection can be problematic.
Sounds like fun doesn't it?
By the way, before I get into the rest of this let me share one tip. If your child goes into meltdown in public, stop and help your child. View it the same way as you would a severe body injury. What other people think doesn't matter. What you were doing doesn't matter. What needs to be done to heal your child is what matters. If you have to leave - drop everything, grab your purse/wallet, and walk out with your child. For your child, whatever is triggering the meltdown is the equivalent of a severe body injury. It's just unseen and occurring in their nervous system or brain. If you need a point of view, imagine you suddenly got struck with a migraine that made your entire head scream in pain and blinded you. What would you want someone with you to do? I can guarantee you wouldn't want them telling you to shut up or wasting time explaining to strangers what was going on.
Now if you're a parent dealing with this on a regular basis, you may or may not have discovered a lot of these things for yourself. My first point of advice for parents dealing with this is to view their child as someone who is extremely stressed out. I tell them to look for things that stress the child and work on eliminating them. I also tell them to look for things that calm the child and start using them before the meltdown.
Okay so you are going to do this, but for right now you still have meltdowns to deal with. First, when a meltdown occurs, clear the room. Everyone leaves except for the parent who is dealing with it. That right there will eliminate a whole level of continuing meltdown triggers. Note - do not move the child having the meltdown if it is at all possible. Move the other children/people. If you must move the child, try to move them as little as possible to get them to a safe zone. Otherwise create the safe zone where the child is. After people are gone, move easily shifted furniture and other objects out of reach.
Okay, now you've just kicked the entire family out of the living room and handed off a whole bunch of stuff to your SO or another child through the door. (or preferably they took it automatically) While you are doing this your SO is quietly trying to determine what happened if neither of you saw it. If you don't have an SO, then teach your other children to quietly, calmly, with NO upset tell you what happened from the doorway. You can listen but your focus, at that moment, needs to be on the child who is melting down. And you need to be the picture of calm. Yup, I know, it's nowhere near as easy to do as say. I mentally have a box that everything else gets shoved in for this length of time. If it's not life threatening, it's in the box. Nobody ever said life was fair. And imagine how boring it would be if it was. And I know, if you are a single mom with just your one child, that safe zone isn't very big because you've got to focus on the child, not the objects. My house is permanently kid proofed up to 7 feet because of this.
So your child is screaming, hitting, banging, shrieking and you have boxed everything mentally. And you had all of 2 seconds, maybe to do that. When my child was younger I was taught safe holds to use so that he could vent yet not hurt himself or me. The one I used most commonly was a variant of a bear hug from behind. (watch for the head). These are things that you need to get a professional to show you if you are going to use them. I'm not going to do it here. You can also just let them blow it out until they calm. I've done that as well. Your call.
Whatever you do, you need to start watching and trying to figure out what the triggers were and how to defuse them. At this point, unless your child is being very specific, go down that checklist you learned when they were a baby. Are they hungry? Are they thirsty? Are they dirty? Are they hurt? You know the one. Each mom/dad has variants for their kids. Eliminate each item, not by asking, but by offering. I have spill proof sports cups for drinks and snack size bags of treats. If they get tossed it's no biggy. But if that's part of the problem, then it's eliminated and the meltdown comes down a level. Is there a favorite shirt? or a blanket they can burrow under? At this point you are focused on calming. And realize that even when they get to a calm level, you may trigger a new outburst very, very easily. Try very hard to eliminate every single little thing that could be wrong within reason. Once you've done this, try to move the child to their safe place. Don't push, don't force - offer and make sure everyone else is out of the path. For the next while you are treading on thin ice so move carefully and slowly.
And actually, even if your child is being very specific, go down the checklist. Your child may recognize the final trigger but still not realize what built up to that being such a trigger. A lot of time they end up confused as to why it was a trigger if it's not a normal one for them.
Now, it sounds like I'm telling you to let your child rule your life. And for a short period, you would be right. How long your child needs the delicate treatment depends on your child. When I first started out with Munchkin it could be days depending on the level of meltdown. Nowadays, I'm surprised if it's hours. Normally we can get past something as soon as the triggers are settled, although I'll avoid overt stressors if it was particularly bad. Actually, nowadays, I normally catch on to the triggers before they pile up enough to trigger a meltdown and use calming measures quickly. It makes life much easier on both of us. And other, broader life changes have brought his base stress level down a lot, as well as mine.
Now if you've been doing all the above and it's not working, well without professional help all that's left is the next part. This part everyone should do, not just those who aren't getting the above to work. Because we don't want to spend great chunks of our lives treading on thin ice. That's just no fun. And it can get dangerous as they get bigger and older. It may be something you can handle at 3 years old, it's not something you can handle at 13 or 16 or 18.
The meltdown is past, one way or another, and you are now going to do the follow up work. First, what was the apparent trigger? Second, what were other things occurring at the same time that could have made it worse (loud music, screeching, arguments, etc)? Third, what things on the checklist helped to calm the child down, and how much? Fourth, what things from the above lists did the child try to signify were an issue? In any way!
Going to the first item - the apparent trigger. Is this something that has triggered meltdowns in the past or was this the first time? Is it something that would be an irritant typically? For example, the trigger was you telling your child "no" when he reached for something of yours. Does your child typically go into meltdown when told no? Have you been dealing with the child wanting this item for a while? Is the child normally allowed to have the item and this was an exception? You have to think of all of these variables and more. And then answer them.
Going to the second item - surrounding environment. Was the TV on loud? Was it on a show the child can't stand? What about the radio? Were your other kids fighting with each other? Or with that particular child? Think back on what the area was like and then think about your worst most horrible day when you couldn't tolerate anything and put the two together. Then list anything that would have set you off. And list anything that would have calmed you. Then consider how to reduce the irritants on a permanent basis. And increase the calming items. And yes this is something typical parents do. My folks had volume limit controls on the TV and radio, even in our bedrooms. And on how loud we were allowed to be in the house, argument or not. There were time periods that we were not supposed to be in certain areas. These seem so small but they can actually make big changes for everyone, not just the child with autism. Not all irritants can be eliminated or reduced, but the more that you can get rid of the easier it becomes for everyone.
Now the third item - the check list. That's a no brainer folks. If something on that list calmed them, make sure it's easily on hand for next time. And the more positive effect it had, well then the more easily accessible and ready that item should be. But be aware that over time the things that work will change. Especially if you start changing things in their environment. Regardless of change though, I always fall back on that checklist if other measures don't work.
And lastly, number four - what did your child try to do to warn you? Did they plug their ears? Did they bring you an empty cup? Did they try to drink your drink (or someone else's)? Did they try to take a snack? Do they have a stim behavior that they started doing? Anything? These are the behaviors that you want to start keeping an eagle eye out for. By identifying these items, and responding to them, you will start to eliminate the meltdowns. If they are plugging their ears, make sure the volume levels are reasonable. If the volume is good, offer to go do something with them somewhere that is quieter. If they are thirsty or hungry, give them something. It doesn't matter if there is going to be a meal in 10 minutes. They don't have the mental tools to get to that point. Keep small portions of items on hand to settle the appetite and hold them over while explaining that there will be more in X number of minutes. Use a visible timer. Eventually they will learn and be able to wait. Remember, to your child this is an immediate emergency. Learning that it is not takes time. And they don't learn it as quickly as typical children.
As far as stim behaviors, that is going to depend on you. If my child is stimming, I automatically go down the checklist and start doing things to eliminate those items. Then I check on the rest. Sometimes stimming is triggered by the environment, sometimes by something internal. In our experience, as long as I stay on top of the environment stuff, stimming tends to reduce and doesn't lead to meltdowns. There have been exceptions, such as when he was developing an ulcer. So keep your eyes open. But stimming is their way of dealing with an overload, so it's a good warning sign that's something is wrong. And if your child continually stims, well it won't hurt anything to try to eliminate environmental issues so that they may not need to continually stim.
Over time, as you guide your child into avoiding triggers and removing themselves from situations, they will learn to do it for themselves. If an environment is too loud for my son now, he will get his noise canceling headset and put it on. That's a heads up for me and I keep an eye out to make sure that it's under control. If lights are bothering him, he will shut them off or burrow under a blanket or make a fort. If he can't do that, he will let me know to move quickly through a store. By learning the triggers and helping your child deal with them, you are also teaching them how to do it on their own. And they are most definitely motivated to learn this.
Now, a point to make - while I have a child with autism and I've used all these methods over the years, I'm not a professional. If your child's doctor tells you to do something differently, do so. If you choose not to then that is your choice and decision. I have chosen not to medicate my child if I can avoid it. That is my choice and decision. That may not be yours. I'm not in your shoes so I'm not judging. All of our children are different.
And there's more on meltdowns. I'll try to do some posts using Munchkin's issues as examples so that you can have ideas of what to look at. And hopefully others will share their experiences as well.
Oh, and by the way, now that it's over and your Munchkin is, hopefully, in bed asleep, you can open that box and climb in a hot bath before you get back to the rest of life. Well, maybe keep the box closed, until after the bath. ;-)
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