By Professor Tony Attwood
Those who have an ASD are prone to have a catastrophic reaction or meltdown when overly stressed, anxious or frustrated. The meltdown may be externalised, with an intense despair that manifests as an expression of anger, perhaps with destruction of property or aggression towards a person. The meltdown can also be internalised, with intense self-blame and hatred and even suicidal thoughts and actions or ‘depression attack’. There will need to be a plan for how to cope with a meltdown, either externalised or internalised, to help restore reasonable thoughts and behaviour and for the person to regain self-control. There are some guidelines. The first guideline is for the family member to be calm and to only talk about what the person can do to rectify the situation and the emotions. A useful analogy, first developed by Sue Larkey, is to become the voice of a navigational GPS in a car. The automated voice does not criticise or pass judgement on the driver, but simply and calmly explains how to rectify the situation. It is important in a meltdown to focus on what to do, not on the unacceptable behaviour. The next guideline is not to ask about the cause of the distress. The person who has autism is experiencing intense emotions and needs to move through and beyond those emotions, not return to the original cause of the distress, and re-live those feelings, which will only add to the depth and duration of despair. In addition, during a meltdown, the person with an ASD will have great difficulty articulating their feelings or providing a coherent and sequential explanation. This further frustration will only add to, and prolong, the distress. It is also wise to focus primarily on restoring emotional control; reference to consequences will only increase the level of distress. If considering affection as an emotion repair mechanism, such as a hug, it is important to ask the person if he or she would feel better if they had a hug, before encroaching on their personal space. It is important to acknowledge and validate the depth of distress and explain that the intense feelings will eventually pass. Sometime access to the special interest can act as an effective thought blocker or ‘off switch’, facilitating the return of self-control.