Meltdowns/temper tantums

[mum22boys]

Today M had a appointment with the peadiatrician who will assess him later this year. He was totally unco-operative, just what we expected really. He shouted at the nurse when she wanted to weigh him. When we saw the registrar he refused to talk to him except to tell him he wanted to talk about his wires. When the registrar asked him if he could listen to his heart M went mad. He was already stressed out from being somewhere different and meeting strangers so he lashed out and tried to hit and kick him. We told m that it was not the right thing to do . When the consultant came in she tried to ask him if she could listen to his heart and he shouted over and over 'NO' He was very angry and red in the face and getting very distressed. We tried to explain to him you can't shout at people but he is so angry he doesn't appear to listen.

What I am wondering is how do you handle the aftermath of the anger, temper tantrums and abuse. If I was to wait until we got outside and tell him off for the outbursts he would get even angrier and we would then have a full blown temper tantrum on our hands.

 

Does anyone have any ideas on how to handle it? What do you do? Do you tell your child off or be understanding that they have trouble communicating? I try the understanding approach but i'm just not sure whether i should be firmer?

 

Oh by the way M is five.

 

Any ideas would be welcome.

 

mum22boys

[OPooh]

My son is 9 and not yet diagnosed.

 

Where possibly we get him to have time out where he sits on a chair (surprisingly he does this even when he wont do anything else he is asked to do).

 

We've explained to him that it is to help HIM, and to calm down etc.

 

Not so easy when we're out and about. I always think it's important to talk about what is happening at the time.

 

Good luck with it.

[Brook]

Hi mum22boys,

 

With my son, I always try and find the reason that triggered the meltdown, although I know only to well

that this is not always possible. I have taught my son a calming technique, but must say if I dont get

him to use it early on when anxiety is just begining to rise then it doesn't help much, that's why if I know

something is going to trigger him off then we use it. I first started by sitting quietly with him and showing

him how to take deep breaths, then I said can you feel your body go all sleepy like, I then said that this

is a feeling of calm, we practised this everyday with no distractions or noise.

Then I began to whisper the word 'calm' as we did our breathing, I also would motion my hand down gently

as we breathed out, still whispering 'calm'.

 

I then began to use this when I could see anxiety begining to rise, but as I said before if I dont use it

early enough then it is useless!

Now I dont have to use any words, I get his attention and motion my hand down gently, he then starts to

take some breaths. This has worked on many occassions and also hasn't, but it's certainly worth doing.

 

Your son sounded very anxious about being examined, my son used to be like that too, they maybe should

have let him examine the stethescope and let him do it to you first etc...

Also in appointments like that my son feels too much pressure on him to do things he is unsure of, then the

anxiety level shoots through the roof!

 

I always try and remain calm during a meltdown (although somedays you want to shout and scream and

cry yourself!) I always try and use a very low key tone of voice, as well as removing my son from what

has triggered him if poss! I think the paed could have applied a few strategies for your son to make him

more relaxed and prepared for what was going to happen.

 

Sorry if I've just spouted off a load of old tosh that's no use, but it is our experience of things.

 

Brook

[mum22boys]

Thanks OPooh and brook,

 

I think one of the problems i have with m (which i think is classic As behaviour) is the fact that he always thinks he is the one in the right, he is NEVER wrong!!!!! So I know by challanging the behaviour it will be like waving a red flag to a bull!

I think the calming technique sounds a very good idea I just need to get him to agree to practise with me (could be easier said than done).

I think the problem yesterday just escallated when they wanted to do his height and weight so by the time we got to the registrar he was so stressed nothing would have helped. He tried getting m to hold the stethescope and asked him if he wanted to listen to his own heart but he was so distressed by then the only way he thinks he can get this across is by hitting or shouting.

I know m needs help with his behaviour but there seems to be no help coming our way. CAMHS have been useless and he has been re-refferred there already with no response. The consulatant yesterday was very good and she was very angry he has had no help and is writing again. Hopefully they will be able to give him some calming techniques.

 

Thanks for your replies.

 

mum22boys

[KarenT]

Hi mum22boys. Sounds as your ds was incredibly anxious about a strange situation before he kicked off. You might find it helps to find out as much as you can before hospital appointments what they will entail, so that you can talk to your son about it beforehand and explain to him that the nurse might want to do X and the doctor will do Y, but it's OK and you'll be there with him all the time. Although my ds (7, and STILL not yet dxd) doesn't have rage outbursts in appointments there's usually an aftermath but I've found that being prepared in advance does help to reduce the stress.

 

I think it's a difficult problem when you're in an assessment situation to know whether or not to discipline your child - is it your job or the doctor's at that point?! - but I'd say you were right to try and help your son at the time, though it's far from your fault that he didn't respond to your efforts. He seems to have been too far gone into the rage and by that time it just has to take its course - prevention does seem to be more effective than cure.

 

I used to sit with J during rages but am less inclined to now as I feel there's the potential for manipulation if I do it too much. If he's exceptionally wild and distressed then I'd make a judgement call as to whether he needs my support or will calm down himself, but often he gets very afraid and I don't like to leave him when he's like that. He himself will argue that he doesn't want me with him but if I make to leave the room his distress increases, so now I'll say to him "I want to be able to help you and if staying here helps then I will, but you must promise not to hit me or hurt me in any way or I will have to leave". Often he'll hide behind the curtain, hating the very sight of me but needing my presence to calm down all the same. Eventually he comes down, almost as instantly as flicking a switch.

 

I try to do the 'post-mortem' thing after an incident but sometimes the mere memory of it triggers him off again so I have to tread with caution. Between us we try to establish what set him off and look for ways of preventing it happening again. I believe J has to learn eventually how to judge his own mood and find ways of coping with his difficulties, so my aim is to help him learn enough about himself to be able to do that.

 

I think ultimately you have to find a balance between discipline and understanding - it's hard to work out what is deliberate and what's not, and the goalposts have a habit of moving with every incident. It's not an easy ride, but with time and experience you'll learn to differentiate and will find your way.

 

Karen

x

[Paula]

The meltdowns are always easier to handle at home because you can just let them get on with it and for us it tends to blow itself out faster.

 

But when youre out and about and it all kicks of its a nightmare.You feel put under pressure by onlookers and tutters to do something and sort it out.Then like me agaisnt what you know is right you try to stop the behaviour and it makes it all worse.My son is never ever wrong either and he never looses a game but thats another issue.

 

Ive learnt the hardway though that even if out and about its best to not engage in any conversation whilst the meltdown is happening use minimum restraine just enough to stop him running into a road and try realy hard not to do what other people who aint a clue whats going on want or expect you to do just to please them because it doesnt work.

 

Afterwards i find its best never to mention whats happened eles he sets of on a tantrum all over againe.

[DAS999]

I guess I am lucky. If the GF melts down she just clams up and tries to be "super good" if I can get to the reason of the melt down I talk her through it which works most of the time.

Flashing lights help and calming music.

If it is a super big meltdown their is not much I can do just see it through. Give her time alone to chill which is what she asks for.

Oh and when it is all over give her a big <'> if she lets me

[smiley]

Not sure if this will help - we have the same problems at home. But if we are able to 'catch' the meltdown early enough (much easier said than done!!!!) we are teaching M how to 'relax'. Its from a book called 'When my autism gets too big'.

 

http://www.nas.org.uk/nas/jsp/polopoly.jsp...sm+gets+too+big

 

Its a great little book to work through together.

 

Hope it helps. xxxx

[Elanor]

Hi Mum22boys

 

Once the tantrum get to a certain stage (and you'll know what I mean - around the point where a tantrum becomes a meltdown) then you simply can't do anything to stop it - it has to run its course.

 

He's not able to rationalise, he's seeing a red mist, and he cannot do anything to control himself. Don't ask him to do things he can't do when he's in this state, and don't punish him - he's isn't responsible.

 

If you can, then head off the tantrum with distractions, or time out - I don't mean the naughty step (which is a punishment and will just enrage the child), but giving him a space or place where he can calm down without any further input.

 

It might mean you have to abandon things (shopping, hair cuts, dentist, school, parties, medical appointments - I could go on, the've all been dropped like hot cakes when my son has become overwhelmed).

 

As time goes on, you get better at spotting the signs - my son flaps his hands (very slightly and he might hide it), clenches his fists, goes white, becomes very still, gets fixed eyes - all the kids are different. This is the time to act - once he becomes stressed, you can forget about what you were trying to get done, all you can do is help him to de-stress and get back in control.

 

So, if you're tempted to be firmer, I'd suggest you don't. From your son's point of view, he's had a very difficult time, has been trying really hard to cope, has been pushed beyond his ability to cope, and is then being told off about it, which isn't fair, so he'll really have to throw a wobbly now!

 

Elanor

[mum22boys]

Thanks Elanor,

 

Sometimes you need someone to tell you that you are doing everything you can and I read your post and felt much better. i know M can't help the way he is and i never punish him but I have learnt not to even mention it after it has happened because he would go into a rage again.

 

I can see the sighns of distress, with M he frowns a lot and looks down. This is the start of it but like yesterday he had to stay in the hospital even though he tried to escape. Somethings have to be done and that means a very stressed M unfortunately.

 

I suppose it is because he looks like a very naughty child when he goes into a tantrum that I feel i should have done more. My SEN health visitor phoned me today and made me feel a lot better by telling me it wasn't my fault and they had seen it all before so not to worry.

 

mum22boys

[Steve_colour-se7en]

Hello everyone,

 

Sensory overload as I see it; takes the form of a severe kind of tantrum, which itself brings about a complete colapse of coping abilities. Some Autistic people tend to shut down when they reach this stage. For me, if too much information is happening audio, visually I get to a stage where I cannot take in any more information because of this I may start to miss certain bits of information and as such, get extremely stressed out as a direct result. I can only describe it as my brain appears not to register all that my senses are seeing and feeling etc.. so this may mean too much information all at once, the result of which is actually incomplete due to the senses missing snippets of information - therefore I feel things don't make sense and so its this feeling, for me that seems to set off the maxing out session/ sensory overload. This is where I cannot seem to think, almost as if my mind has gone completely blank. As this stage is reached I need to retreat to a quieter zone and to included the Mathmos type coloured lighting (pebble variety) helps to create a calming atmosphere and basically wait for the feeling to subside, this is how sensory overload seems to affect me. There are some Autistics that, as they reach this stage may kick and scream, or even self harm as a direct result of reaching sensory overload. It would seem, some professionals do feel that some of the so called typical autistic behaviours may even be a direct result of sensory intergration difficulties.

 

Steve..

 

I think the boy means well but he is distinctly inclined to be inattentive......

Tutor of Winston Churchill to Lord Randolph Churchill,

Winston's father

[cmuir]

Hi

 

I know exactly what you're talking about! I took my 4 year old son to the dentist with me the other day and he took an instant dislike to the reception. Poor woman! She gave Robert stickers, etc, but even so he was very cross with her for no obvious reason. He pointed at her and shouted at her. A trip to the shoe shop is a nightmare. I find that I have to go when the shop will be quiet (eg 5pm/45 minutes before closing time) and forewarn staff. Robert dislikes anyone touching his feet and I've had to stop him from hitting the shop assistant. The list goes on. I'm afraid I may come across as being hard, but I don't even consider what other people think or say any longer ? my priority is calming Robert down. Robert is able to tell me he is angry, but not give a reason. I believe he has some understanding of happy and angry and althought it's early days, I'm encouraging Robert to give me 'thumbs up' when he's happy and 'thumbs down' when cross. Often, the signage comes too late, but I feel that if he understands how to sign, he may surprise me and forewarn me what's may be ahead. I believe this will teach Robert to recognise his feelings. With regard to how I deal with things . . . Well, I always lower the tone of my voice and physically get down to the same level as Robert. I tell him firmly, eg not to hit me because I don't like it and it's very sore. I don't use put him in a specific area eg naughty step (that enrages him!). I leave him where he is and advise him that I want him to calm down and only once he's calm we can continue playing. He usually grabs the nearest object around and throws it or even bangs his head off the walls. I'm afraid I completely withdraw attention, eg I transfiix my eyes on the TV (even if he switches it off!). I find that Robert usually calms down quicker that way ? if I try to reason with him further, I'm giving him attention and adding 'fuel to the fire'. This may sound soft, but I've found that if eg a favourite toy is withdrawn or favourite tv programme is switched off, the issue then becomes about that and not about the behaviour and makes the situation even worse. When we're out and Robert behaves badly towards someone, I just hope that they're understanding and when necessary, explain Robert's difficulties. It's really difficult, because I know if you have a child that's physically disabled, people tend to be much more sympathetic. I'm not expert, but hope this helps.

 

Best of luck. Caroline.