How to Handle the Meltdowns of an Autistic Child

Managing the behaviors of an autistic child can be stressful and difficult. But, many methods exist for effectively addressing the behavior of an autistic child which are both helpful for the caregiver, be it a parent or therapist, and safe for the autistic child. Probably the most difficult behavior of the autistic child to manage is when the child is in a meltdown.

A meltdown is when the child is completely out of control and is crying, screaming, and flailing about. The most dangerous part of the meltdown is the physical aggression, which is present in many, if not most, children. Not all children become physically aggressive during a meltdown, but many do, and some go to the point where they are breaking household objects and hitting or harming brothers, sisters, parents, or pets.

The most important thing to keep safe during the meltdown is the caregiver. If the caregiver is harmed to the point where he or she is unable to control the child either verbally or physically, the potential for harm to the caregiver, child, and the home in which they reside increases exponentially. The caregiver must be ready to block flying objects and parts of his or her body that are easiest to harm.

The next most important thing to keep safe is the child. Autistic children are not aware of the harm that they can cause themselves, and when melting down, they are not in control of themselves at all. Should a melting down child harm him or her self physically, two things can happen: first, the child might harm him or her self severely enough to warrant a trip to the emergency room, and second, when the child does hurt him or herself, there is a great potential for an increase in the intensity of the meltdown.

Finally, the least important thing to keep safe is the person's house and property. Broken objects and items can be replaced at a cost, but they are easier to replace than parts of a person's body. While this sounds obvious to many, scores of people exist who do not know how to think through this process as shown.

The best way to actually handle a meltdown is to know what the things are that trigger a child and work to either eliminate those triggers or reduce them to the point where they will only anger the child, rather than actually causing a meltdown. The caregiver can be taught to be aware of a child's triggers and environment so that they can manipulate those items so that they cause the child the least distress, and the child can be taught to manage his or her emotion so that they do not actually reach the point of a meltdown.

But, all meltdowns cannot be avoided, and things exist which cause meltdowns that cannot be controlled. When a meltdown actually begins, the caregiver should model calm behaviors so that the child can follow these cues and calm down as well. This will not stop a meltdown from happening, but it will keep it from escalating further. Next, the caregiver should be ready to provide instructions to the child, either verbally or physically, so that the child can be directed to a place where he or she can safely calm down. The instructions should be very simple, no more than a single gesture or a few words. A caregiver may touch the child and shove him or her the direction of a spot previously identified as being a safe sport, or a verbal direction of, "Go to your safe spot," may be used. The child may refuse or be so upset that he or she does not understand the directions. If this is the case, the caregiver should just watch the child and let him or her be so long as the child is not physically harming anything. If the child becomes physically destructive and has failed to calm down or find a spot to do so safely, then the option of restraint must be considered. Restraint is a last-ditch effort in every case. Any position can be used so long as it does not compromise the child's or parent's safety. Never hold the child face down to the floor; this has suffocated children in the past.

One potential position would be to stand behind the child, cross his or her arms in front of her and hold them, and then hold the left hand of the child at the top of the child's right shoulder and the right hand of the child at the top of the child's left shoulder. Then, the caregiver should cross his or her legs over the child's waist or upper thighs. This has the effect of immobilizing the child's entire body so that he or she cannot hurt himself or someone else, but simultaneously the position itself will not harm the child. Keep in mind that restraint is always the last option, but sometimes it is necessary for the safety of the child and the caregiver; it is always better to use other methods to work through the meltdown, however it is not always possible.

This article examined effective ways to handle an autistic child's meltdown; however, working on meltdowns is a process that is complex; this article was very specific in its coverage of meltdowns. Many other methods and techniques exist for helping an autistic child to manage his or her meltdowns, and when these are used altogether, meltdowns can be very safely managed. The bottom line to know is that meltdowns can be successfully worked through to the point where they become very infrequent and much less intense. This process can take months or a couple years, but it can and does work if used properly.