THOUGHTFUL RESPONSE TO AGITATION, ESCALATION AND MELTDOWNS

THOUGHTFUL RESPONSE TO AGITATION, ESCALATION AND MELTDOWNS ...for individuals with autism spectrum disorders Rebecca Klaw, MS, MEd

Based on the work of Dr. Ross Greene (author of The Explosive Child) and many others who contribute to what is known about autism and related disorders.

Part 1:Understanding the inflexible-explosive individual WHY?

Common Characteristics of Meltdown-Prone Individuals • Difficulty managing and controlling the emotions associated with frustration • Difficulty thinking through ways to resolve or cope with frustration

Common Characteristics of Meltdown-Prone individualren • Frustration often leads to cognitive debilitation • Can’t remember how to stay calm • Can’t recall consequences of previous episodes • May not be responsive to reasons • May deteriorate even further in response to limit-setting and punishment

Common Characteristics of Meltdown-Prone Individuals • Low frustration threshold • Frustrated more easily than others • Low tolerance for frustration • The experience of being frustrated can be very intense, disorganizing and sometimes overwhelming

Common Characteristics of Meltdown-Prone Individuals • Tendency to think in a concrete, rigid and black-and-white manner. • Persist in their inflexibility and poor response even in the face of meaningful consequences

Common Characteristics of Meltdown-Prone Individuals • Explosive episodes can have an out-of-the-blue quality. • May be particularly inflexible about one or more issues • May be especially inflexible when tired, hungry or ill

Does this sound like anyone you know?

If people with an autism diagnosis fit perfectly into this model of the inflexible and explosive individual, what gets them there?

Bad parenting – no! Bad teaching – no! Neurologically determined pathways – yes!

Pathways to inflexibility and explosiveness • ADHD • EXECUTIVE FUNCTION DEFICITS • LANGUAGE PROCESSING DIFFICULTIES • MOOD • DIFFICULT TEMPERAMENT • ANXIETY • SOCIAL SKILLS DEFICITS • SENSORY INTEGRATION DYSFUNCTION

CONCLUSION TO PART 1 If you don’t understand the basic characteristics that can cause distress in a individual with autism, you might think they are being “bad” or “manipulative”, or “controlling”.

CONCLUSION TO PART 1 You might also choose inappropriate techniques to manage these crises, thinking that if you just keep piling on consequences, you will win the battle.

CONCLUSION TO PART 1 But when you understand the characteristics of the inflexible, explosive and autistic individual, and how these characteristics are determined by neurological difference, you realize that it is never a battle where someone wins and someone loses.

CONCLUSION TO PART 1 Becoming so frustrated that you lose control of your body and of your rational mind is distressing – for the individual and for you. No one ever, ever wins.

Part 2:Understanding the stages of crisis, leading to meltdowns MELTDOWN Demand to shift gears ESCALATION AGITATION RECOVERY

AGITATION • Triggers: • Not getting what he/she wants • Not doing what he/she wants to do • Not being able to regulate to environmental stimuli • Not being able to regulate to internal stimuli

AGITATION All triggers represent a demand to shift gears… Shifting to a new activity Shifting away from a routine Shifting attention away from something uncomfortable externally Shifting attention away from something uncomfortable internally

Thought provoking research…. Susan Bryson and Reginald Landry at York University and Hospital for Sick Children in Toronto have discovered that in children with autism, there is a universal problem with visual orienting. This is the most basic form of attention. It describes the ability to move one’s attention in space. It is critical for survival.

They found that children with autism, even those with normal or above normal IQs, have marked difficulty in disengaging attention.

When shown multiple TV screens, it is hard for children with autism to stop looking at one in order to shift attention to the newer visual stimuli.   

One of their conclusions….  It is neurologically difficult to shift attention if you are an individual with autism. children with autism aren’t being bad or non-compliant. They are being autistic. This problem is not just a problem for us. It seems to be a problem for the children as well.

Escalating agitation… Vapor lock In cars, vapor lock is caused by excessive heat that creates a bubble in the gas line. This prevents gas from flowing to the engine and causes the engine to stall. No matter how many times the driver pushes the pedal or turns the ignition, the car won’t start until it cools down.

Escalating agitation… When our students are frustrated and their agitation is growing, they are in vapor lock. Frustration causes a breakdown in the capacity to think clearly, causing him/her to become overwhelmed and irrational.

Escalating agitation… No matter how many times the adults reasons, insists, rewards, punishes or whatever, the individual can’t start thinking clearly until someone helps him/her cool down.

MELTDOWN Dr. Daniel Goleman, the author of Emotional Intelligence refers to the meltdown phase as “neural high jacking”.

MELTDOWN Irrational Incoherent Destructive Abusive Out of control = A DEBILITATED STATE

MELTDOWN What the individual does and says during the meltdown is “MENTAL DEBRIS”

MELTDOWN An escalating and deteriorating inflexible-explosive individual is not a pretty sight. Not for you Not for others around you And certainly not for the distressed individual

Part 3:Reacting to agitation, escalation and outburst A word about consequences…

Individuals who are developmentally compromised in the areas of flexibility and frustration management usually: • Lack the capacity to manage emotions associated with frustration well enough to think clearly in the midst of crisis

individualren who are developmentally compromised in the areas of flexibility and frustration management usually: • Lack the capacity to manage emotions associated with frustration well enough to think clearly in the midst of crisis • Lack the ability to shift their thoughts from their agenda to your agenda even when faced with very meaningful consequences

Think about these quotes… “ For a consequence to achieve its desired effect – that is, for a consequence to make it less likely that a individual will explode the next time he is frustrated – you have to have the faith that the consequence you administered on the back end the last time (i.e. following the last explosion) is going to be accessible and meaningful to the individual on the front end the next time he becomes frustrated”

“Consequences can be very effective if an individual is in a state of mind to appreciate their meaning, but don’t work nearly so well if a individual is not able to maintain such a state of mind” Dr. Ross Greene

So we are going to talk about other strategies for managing agitated and escalating behaviors

First, how do we know when the cycle of agitation escalation MELTDOWN begins? What are the typical signs?

REFUSAL NO!

Interventions Proactive: • Access to communication • Access to choice

Interventions Proactive: • Predictability

Interventions Proactive: • Environmental adaptations

Interventions Proactive: • Analysis of common challenging behaviors and the motivation behind these behaviors • Understanding that meltdown behavior doesn’t happen “out-of-the-blue” but happens for reasons that are extremely important to the individual

Interventions Proactive: • Utilization of strengths and special interests as a mechanism for teaching •  quality of life

But sometimes, no matter how well you set the stage, your students become agitated

Reacting at the Crossroads

Interventions Reacting at the crossroads: Prioritize your demands Level A demands Level B demands Level C demands

Level A Demands • Non-negotiable • Safety of self and others • Health • Basic life expectations

Level C Demands • Not important • May fly in the face of convention, but not really matter • Not important for that particular student • Doesn’t impact the a big picture

Level B Demands • Important but not essential • Level B demands are the stuff of teaching • Level B demands are most effective when a student is available for new learning

Level B Demands • Level B demands can and should be withdrawn or compromised if this is not a good teaching moment. • If you decide not to follow through with a Level B demand because it is a rough day for this student and you see him growing agitated, that is a wise choice. It will not cause the student to regress or backslide.

THOUGHTFUL RESPONSE TO AGITATION, ESCALATION AND MELTDOWNS