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The Cycle of Tantrums, Rage, and Meltdowns and Strategies to Help Prevent Them

The Cycle of Tantrums, Rage, and Meltdowns and Strategies to Help Prevent Them. Brenda Smith Myles www.asperger.net. Theory of Mind. Difficulty in … Predicting Reading intentions Understanding emotions Explaining own behavior Perspective or reference

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The Cycle of Tantrums, Rage, and Meltdowns and Strategies to Help Prevent Them

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  1. The Cycle of Tantrums, Rage, and Meltdowns and Strategies to Help Prevent Them Brenda Smith Myles www.asperger.net

  2. Theory of Mind • Difficulty in … • Predicting • Reading intentions • Understanding emotions • Explaining own behavior • Perspective or reference • Reading and reacting to others’ interests • Understanding social interactions

  3. Language and Social Challenges • Nonverbal communication • Initiating and maintaining social interactions • Literalness • Perspective taking • Hidden curriculum • Cause/effect relationships • Difficulty conveying own thoughts • May not use social “niceties”

  4. Central Coherence • Idiosyncratic focus • Preference for the known • Difficulty in choosing and prioritizing • Difficulty seeing connections • Lack of compliance

  5. Problem Solving • “One way of viewing a problem” • Stuck thinking • Sees facts instead of a whole • Problems with cause and effect • Does not see problems as having more than one option • Problem solving is often literal

  6. Use Their Own Kind of Logic • Sense of social justice • Use logical, but the logic is very unique based on that student’s perspective • Spencer and his exams • If my parents love me and they have one child, how much will they love me if they have two children? 1/2 as much. This is called Pseudo-Logic

  7. Executive Function • Difficulty in … • Imitating others • Planning • Starting and stopping • Organizing (time, self, space) • Thrive in a predictable environment

  8. Do Not Understand the Seemingly Obvious • Expectations • Assumptions • Unstated social rules, mores, guidelines This is often called the Hidden Curriculum

  9. Special Interests and Obsessions • Narrow interests • Not permanent • Often appear “uncontrollable” • Role of the interest: interest; fun; security, comfort; relaxation; stress reduction

  10. The Sensory Systems …(it all starts here)

  11. Anxiety and Sensory Issues • Anxiety pervades the everyday life of a child with AS even if she does NOT report it! • Sensory issues impact EVERYTHING!

  12. Behavior Basics • Behavior always occurs for a reason • Children and youth with ASD have difficulties detecting how they feel and do not know how to calm themselves down • The ability to verbalize what they are to do and doing it are two different skills • Behaviors are generally not on purpose

  13. Annoying behavior Activity interrupted Losing a game Object breaks Event cancelled Event delayed Materials run out Item misplaced Sequence changed Momentary separation Top 10 Situations that Trigger Insistence on Sameness Green, Sigafoos, Pituch, Itchon, O’Reilly, & Lancioni (2006). Assessing Behavioral Flexibility in Individuals with Developmental Disabilities. Focus on Autism and Other Developmental Disabilities, 21(4) 230-236.

  14. Prevention is one of the best interventions!

  15. Rumbling Stage • Most important stage • Building up to rage • Some thinking ability still intact • Individual children have their own patterns of “rage behavior” Note: The role of verbalizations in escalation.

  16. Rage Stage • This is the lightening stage when the neurotransmitters are not working correctly. • The child or youth may shout, swear, kick, or hit. • He or she is clearly out of control.

  17. Recovery Stage • The child or youth may sleep for awhile. • He/she may apologize or be contrite. • Withdrawal may occur; a fantasy world may be the target. • The student may deny meltdown. • Some do not remember what happened during the Rage Stage.

  18. Teach Self-Calming/Self-Regulation • Individuals with ASD often cannot tell when they are becoming upset or overly excited • They don’t know how to self-calm

  19. Myles & Hudson

  20. Colton is in the 6th grade. He has problems getting along in school. He likes to be in control and gets upset if he perceives something is wrong. Colton’s ability to control his behavior varies from day to day. Colton enjoys school despite having challenges with others who do not follow his way of thinking. Colton The Incredible 5-Point Scale by Buron & Curtis

  21. Looks Like Feels Like I Can Try To Kicking My head will Call my or hitting probably explode mom to go home Screaming, Nervous Go see Mr. almost hitting Peterson Quiet, rude Bad mood, Stay away from talk grumpy kids Regular kid Good Enjoy it Playing A million bucks Stay that way

  22. Control is a funny thing. It helps to learn more and more about myself. It’s okay to want to be in control. Being in control can you make you feel more relaxed about things. Sometimes I have lots of control. I am relaxed and feeling good. I call this being at a 1 … Colton’s Social Narrative

  23. The Incredible 5-Point Scale YELLING LOUD CONVERSATION WHISPER NO SOUND

  24. The Incredible 5-Point Scale YELLING LOUD CONVERSATION WHISPER NO SOUND

  25. Poster-size, 2-sided, laminated Check In/Anxiety (Buron, 2009)

  26. Poster-size, 2-sided, laminated Check In/Anxiety (Buron, 2009)

  27. When My Worries Get Too Big By Buron

  28. Stress Thermometer Most stressed ever When my Lego toys fall apart Ask for help When I have hard homework Call my mom for help Putting stuff in my backpack after bus arrives Pack before bus time No stress

  29. Outsmarting Explosive Behavior, Endow, 2009

  30. Trained Social Peer Group • Develop “lunch bunch” with chosen peers • Define new skill for student (i.e. topic maintenance, giving compliment) • Demonstrate how peers can encourage and demonstrate social skills during “lunch bunch” • Generalize skills throughout day

  31. The Child’s Social Itinerary

  32. Factors That Make Social Situations More Challenging

  33. What are EBP? What criteria are used to define them? How were these criteria identified? Have they stood the tests of time? EVIDENCE-BASED PRACTICES (EBP)

  34. Practice supported by research findings and/or demonstrated as being effective through a critical examination of current and past practices. DEFINITION OF EBP

  35. Centers for Medicare and Medicaid Services (CMS) National Autism Center (NAC) National Professional Development Center on Autism Spectrum Disorders (NPDC) REPORTS ON EBP

  36. At least two experimental or quasi-experimental designs carried out by independent investigators or … At least five single subject design studies by three independent investigators or … A combination of one experimental or quasi-experimental designs and the single case designs from independent investigators No comprehensive treatment or multi-element programs or intervention packages Some interventions were grouped together NPDC ON ASD ON EBP

  37. Developed a Scientific Merit Rating Scale (SMRS) Research design Independent and dependent variable Participant selection and assignment Generalization Used a 5-point rating scale with 3,4,5 indicating rigor Some interventions were grouped together Categorized as established, emerging, unestablished NAC ON EBP

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