May 30, 2012

Meltdowns due to rigid/inflexible thinking!

Many children on the spectrum have rigid/inflexible thinking. Their thinking is very “black and white”, “either/or”, “all or nothing” absolute thinking. The world has to be as they expect it. When the world doesn’t match their expectation, then all hell breaks loose! The child does not get what they want, an event doesn’t go as planned, or a snag happens to what they expected, and the world falls apart. They go from 0 to 100 quickly and a meltdown occurs. This happens most frequently with the younger children, but can last easily into adulthood.

For many young children on the spectrum, the world is very rigid and absolute. They have very rigid, inflexible thinking, and can only see the world through their own immediate needs. For such children, you will face the following issues.

1. The child can only see things based on his immediate need. His thinking is very rigid, with minimal ability to see options or to shift gears when things are not going his way. So, there is no other way, but his way. Your child doesn’t have the cognitive skills yet to appraise the situation, understand the options available, judge the severity of need, or understand the effect his behavior has on others. The biggest problem is going to be the inability to shift gears, meaning that when things don’t go according to how he expects it to, then the world falls apart.

2. Because the “executive functioning” part of the brain is not well developed, the child has poor ability to inhibit his impulses, or to think before acting. So, immediate impulse becomes immediate behavior. This leads to two major problems; poor impulse control and poor frustration tolerance, presenting frequent tantrums when the little snags happen without warning.

3. Coinciding with the rigid/inflexible thinking is very poor emotional regulation. Emotionally, he will go from 0-100 quickly, with little ability to regulate his responses. Emotions come on like gang busters, and overwhelm the child with little defense. The child doesn’t have the ability to cognitively appraise the severity of the situation to regulate his emotional response accordingly. Therefore he over-reacts to simple snags, going from 0-100 with little warning. The world is very black and white, good or bad, happy or angry, with little middle ground.

Now given the above problems, I would recommend the following:

1. Once the child has an expectation of what is going to happen, it will be difficult for him to shift gears. So, the best thing to do is prepare him ahead of time. You need to:

a. Get used to preparing him for what is coming up before entering into situations. Preview what he can expect, what is expected of him, how long it will last, and what is coming up next.

b. Lay out any boundaries for behavior before entering the situation, so he has the right expectation and you are not adding rules once the activity starts. You want to make things very clear and concise, very black and white. The more you set his expectation set, the less he has to shift gears. If you have to add new rules or change rules in mid action, give him some time to adjust to it, so he doesn’t have to shift gears real quick.

c. Give him warning before transitioning from one activity to another. Give him a few minute warning before ending an activity and let him know what is coming up next (in a few minutes we need to stop playing the game and brush your teeth). Then give him another warning one minute before.

2. When you have to add or change rules in the middle of the action, ease into it and redirect without “demanding” quick behavior change. Try to avoid saying “no”, which means “never and the world will end.” Instead of focusing on what the he is doing wrong, state what you want him to do. Demanding that he stop doing something, or saying “no”, doesn’t tell him what to do, so it leaves him emotionally hanging without a way of responding. Focus on (1) gently redirecting him into what you want him to do, and (2) helping him out by providing gentle assistance in the right direction. It is not the time to counsel, explain or scold. Not the time to use reason. Just gently redirect without “demanding” and getting emotional.

a. Beware that your emotional reactions, or arguing, will only fuel the fire. Trying to explain and reason at the heat of the moment will not work, so the parent’s anxiety immediately freaks and they start to yell, become demanding, and try to force action. This will immediately make the child meltdown. Stay calm, focus on what you want the child to do, than gently help redirect the child to do it.

3. Knowing that interrupting and directing your child will bring on resistece, try to pick your battles. If you two are arguing a lot, most likely many of the issues are not worth the battle. The more arguing you two do, the less positive impact you will have. Try to bite the bullet for many small things and save the intervening for more major issues.

4. Since he cannot adequately appraise situations, you want to concretely explain things as they are happening so he sees the big picture. He is not going to see it on his own. You have to draw the bigger picture for him.

5. Assume that you cannot prepare everything ahead of time, so emotional reactions are going to happen. You need to identify a “calming” strategy to do with your son to help him calm once he overreacts. Every child is different in what will help calm and organize them, but try to identify and practice coping skills that you and your child will do to help calm him down. Now, I say “you” and your child, because the chance that your child will be able to calm himself is slim at this age, unless you simply place him by himself and let it run it’s course. However, this can be scary for the child since they are left by themselves, with overwhelming, scary emotions, and no help to calm. This is why I don’t usually recommend “time out.” I tend to look for a sensory motor regulatory pattern (see hand out on that), like deep pressure, neutral warmth, to use as a calming technique. Practice this coping skill every day, when your child is calm. Practice it so it feels natural for him when you try to use it in the heat of the moment. Also, try to catch him when he first starts to look upset, to use the calming technique, before he is so worked up that he will not accept the help (teaching your child to calm will come later in the tool box).

6. Watch your emotions and your language. Try to stay calm, and avoid “demanding”. Try to redirect to what you want him to do. Focus on what you want him to do, and then gently assist him in that direction. The more upset he is, the calmer you need to be. Now, saying that is so easy. Don’t beat yourself over the head for getting frustrated, upset, and emotional. The situation you are in is very hard. You often feel helpless and angry when you see your child feel and act this way. It takes time and hard work to learn to stay calm in such situations.!/autismdiscussionpage

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