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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.

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thoughtful response to agitation escalation and meltdowns

THOUGHTFUL RESPONSE TO AGITATION, ESCALATION AND MELTDOWNS

...for individuals with

autism spectrum disorders

Rebecca Klaw, MS, MEd

slide2
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.
common characteristics of meltdown prone individuals
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
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 individuals6
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 individuals7
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 individuals8
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
slide10
If people with an autism diagnosis fit perfectly into this model of the inflexible and explosive individual, what gets them there?
slide11
Bad parenting – no!

Bad teaching – no!

Neurologically determined pathways – yes!

pathways to inflexibility and explosiveness
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
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 114
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 115
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 116
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
Part 2:Understanding the stages of crisis, leading to meltdowns

MELTDOWN

Demand to shift gears

ESCALATION

AGITATION

RECOVERY

agitation
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
agitation19
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

slide20

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.

slide21

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

slide22

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.

  

slide23

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.

slide24
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.

slide25
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.

slide26
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
MELTDOWN

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

meltdown28
MELTDOWN

Irrational

Incoherent

Destructive

Abusive

Out of control

=

A DEBILITATED STATE

meltdown29
MELTDOWN

What the individual does and says during

the meltdown is “MENTAL DEBRIS”

meltdown30
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

slide32
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
slide33
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
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”

slide35
“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

slide37
First, how do we know when the cycle of agitation escalation MELTDOWN

begins?

What are the typical signs?

interventions
Interventions

Proactive:

  • Access to communication
  • Access to choice
interventions40
Interventions

Proactive:

  • Predictability
interventions41
Interventions

Proactive:

  • Environmental adaptations
interventions42
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
interventions43
Interventions

Proactive:

  • Utilization of strengths and special interests as a mechanism for teaching
  •  quality of life
interventions46
Interventions

Reacting at the crossroads:

Prioritize your demands

Level A demands

Level B demands

Level C demands

level a demands
Level A Demands
  • Non-negotiable
  • Safety of self and others
  • Health
  • Basic life expectations
level c demands
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
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 demands50
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.
interventions51
Interventions

Reacting at the crossroads:

Empathize. Be the individual’s partner, not their adversary.

I know you are mad. You are really mad that it is time to go! It is hard to stop playing with that toy. I understand.

slide52

“When children are stuck in the red haze of inflexibility and frustration, they respond a lot better if they perceive adults as potential helpers, rather than as enemies”Dr. Ross Greene, The Explosive individual, p. 104

interventions53
Interventions

Reacting at the crossroads:

Give time and space.

interventions54
Interventions

Reacting at the crossroads:

Offer visual instead of auditory information.

interventions55
Interventions

Reacting at the crossroads:

Provide support in a calm, non-threatening manner.

interventions56
Interventions

Reacting at the crossroads:

Offer to do the activity with the individual.

interventions57
Interventions

Reacting at the crossroads:

Try humor or surprise as a way of helping them to switch gears

interventions58
Interventions

Reacting at the crossroads:

For our more able students, try framing the problem and getting them to help with a solution

UH-OH… WE HAVE A PROBLEM. I WANT YOU TO GET READY TO GO HOME AND YOU WANT TO CONTINUE TO PLAY. WHAT CAN WE DO ABOUT THIS THAT MAKES BOTH YOU HAPPY AND ME HAPPY?

slide59
But sometimes, no matter how well you react at the crossroads, your students continue to escalate into a full-blown meltdown
interventions60
Interventions

Beyond the crossroads, reacting to crisis:

Wait it out safely.

interventions61
Interventions

Beyond the crossroads, reacting to crisis:

Have one person manage the meltdown with others nearby to help you.

interventions62
Interventions

Beyond the crossroads, reacting to crisis:

Isolate the individual. If he/she doesn’t want to come with you into a safe spot, then move others away.

interventions63
Interventions

Beyond the crossroads, reacting to crisis:

Stop talking unless your words have a soothing effect.

Really.

interventions64
Interventions

Beyond the crossroads, reacting to crisis:

If the person is attempting to hurt himself or others, including you, you need to use protective measures so that you don’t get hurt.

interventions65
Interventions

Beyond the crossroads, reacting to crisis:

Once the individual has begun to calm down, you might offer sensory activities if you know that this is helpful in reorganizing the individual.

interventions66
Interventions

Beyond the crossroads, reacting to crisis:

Once he or she has begun to calm down, you might offer something to drink or something to eat if, and only if, you know that this will help to calm and focus them.

interventions67
Interventions

Beyond the crossroads, reacting to crisis:

You might offer to help the individual with calming strategies that he/she has practiced during non-crisis times.

interventions68
Interventions

Recovery (the long-term response):

Asking the question: What can we do next time?

Review the individual’s needs.

Review your proactive strategies.

Review the crossroads strategies.

interventions69
Interventions

Recovery (the long-term response):

Setting up regular and highly motivating rewards for the behavior you want to see.

interventions70
Interventions

Recovery (the long-term response):

Social stories

interventions71
Interventions

Recovery (the long-term response):

Practicing calming/coping techniques

slide73

Don\'t Pop Your Cork on Mondays! The Children\'s Anti-Stress Book

Written byAdolph Moser

Illustrated byDav Pilkey

slide74

Don\'t Rant & Rave on Wednesdays! The Children\'s Anger-Control Book

Written byAdolph Moser

Illustrated byDavid Melton

conclusion to part 3
Conclusion to Part 3

What you always do…

Respond to basic needs

  • Communication
  • Safety
  • Predictability
  • Sensory differences
conclusion to part 376
Conclusion to Part 3

But if these don’t work on a given day or in a particular circumstance…

Respond to agitation and escalation

  • Prioritize your demands
  • Be the individual’s partner
  • Give space and time
  • Decrease language
  • Increase visuals
  • Help the individual frame and solve the problem
conclusion to part 377
Conclusion to Part 3

But if these interventions don’t work…

Respond to crisis

  • Isolate the individual for safety
  • Use protective strategies
  • Wait, quietly, for the storm to blow over
  • Assist the individual with calming/coping strategies
conclusion to part 378
Conclusion to Part 3

When it is long over…

Team process

Regular reinforcement for replacement behaviors

Social Stories

Teach calming strategies

slide79

Did you want to share this information with others?Consider buying the DVD…Go to www.rebeccaklaw.com.

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