image courtesy of exciteddelirium.org

Weekly Autism Tips for Emergency Responders: Excited Delirium or Sensory Meltdown?

image courtesy of exciteddelirium.org

image courtesy of exciteddelirium.org

During my last Autism training class for law enforcement, someone brought up an excellent question immediately following the Sensory Meltdown section of my program. They commented that many of the signs and behaviors of sensory overwhelm that lead to a meltdown sound exactly like those of Excited Delirium (ExDS) and wanted to know how to tell the difference.

I absolutely LOVE getting tough questions during my training programs! It’s because of everyone’s valuable input that this training remains fluid and continually improves after each experience.

I have been researching ExDS extensively and, while sharing some signs of sensory processing issues, the outcome is very different. Michael Curtis, MD, who created a field guide to help EMS and Law Enforcement recognize ExDS, refers to the condition as a “freight train to death.”

Excited Delirium typically accompanies the use of stimulants, most commonly but not limited to cocaine and methamphetamines, as these drugs block the re-uptake of dopamine, resulting in elevation of dopamine levels in the brain. This is amplified if the person already has a pre-existing psychiatric condition that is treated with dopamine re-uptake inhibitors.

According to the JEMS website, elevated levels of dopamine cause agitation, paranoia and violent behavior. Heart rate, respiration and temperature control are also affected by dopamine levels, with elevation resulting in tachycardia, tachypnea and hyperthermia. For this reason, hyperthermia is a hallmark of excited delirium.

Look for persons partially clothed or naked, exhibiting violent, almost primal behaviors. They may appear to have “super human” strength, but in actuality merely it’s the loss of pain receptors that creates the illusion.

Excited Delirium is a MEDICAL condition, with a grim outcome once a person enters arrest. The best way to manage it is to prevent cardiac arrest. Prehospital therapy should focus on treating the increased metabolic activity and hyperthermia first.

The mnemonic “NOT A CRIME,” developed by Michael Curtis, MD, clearly sets out the signs and symptoms of ExDS:

  • N – Patient is naked and sweating from hyperthermia
  • O – Patient exhibits violence against objects, especially glass
  • T – Patient is tough and unstoppable, with superhuman strength and insensitivity to pain
  • A – Onset is acute
  • C – Patient is confused regarding time, place, purpose and perception
  • R – Patient is resistant and won’t follow commands to desist
  • I – Patient’s speech is incoherent, often with loud shouting and bizarre content
  • M – Patient exhibits mental health conditions or makes you feel uncomfortable
  • E – EMS should request early backup and rapid transport to the ED

Sensory Processing Meltdown

A sensory meltdown is when a person’s nervous system has been so bombarded by sensory input that it enters survival mode, perceiving that it is under attack. These may occur in autistic adults just as much as children.

An adult experiencing a meltdown describes the experience on SPDSupport.org:

“All sensory systems start firing! Everything pierces you like a knife! Every sound, every speck of light, every texture against your skin, and everything you can smell. It surrounds you and cuts right into you. Trapped within your skin, like a caged animal under attack, you are basically helpless. You thrash, you heave, you scream, you do whatever you can, because you are perceiving something killing you. You need to escape! Everything is hurting you, things that no one else can even believe would be affecting you. The smallest noise makes you want to claw your ears off, the slightest movement of you head might make you sick, and even the dimmest lights in the room make your eyes feel like they are bleeding.

Nothing matters anymore. You only have a few options: fight, flight, or freeze.”

Not unlike ExDS, some of these signs may present as agitation, violent behavior, resisting, tachycardia and tachypnea. If your nervous system believes you are in imminent danger, it will employ survival techniques.

There is typically no hyperthermia involved with a sensory meltdown. Additionally, once you reduce sensory triggers or remove a person from the environment, the meltdown begins to lessen. The person may begin to self-calm and use relaxation techniques in order to return to their baseline behavior.

It is always best to try and prevent meltdowns by learning to recognize the signs and behaviors leading up to them. If that cannot be achieved you want to immediately remove harmful stimuli and reduce sensory triggers. Once their nervous system begins to stabilize, you can then add positive stimuli. Tools such as deep breathing, gum chewing, handling a fidget item, redirection and distraction can all help the nervous system relax and block the stressors. It is only then that you can gain compliance or begin communicating.

SPD meltdowns are incredibly intense and often traumatic for the individual experiencing them. However, unlike ExDS, the person is aware of the way they acted during, even though they were not in control of their behaviors. There is no blackout or acute altered mental status. It is essentially a response to a nervous system overwhelm and will eventually subside. The goal is to keep the person safe and do whatever you can to reduce sensory triggers.

Recognizing a sensory meltdown is extremely helpful, but as always, DO NOT IGNORE LIFE-THREATS such as stroke, brain injury, seizures or hypoglycemia just because your patient has autism or you suspect they do.

Have you responded to a call involving excited delirium or a sensory meltdown? What were your indicators? How was it handled? Share your thoughts below or send me a confidential email with your comments! Input from the field is ALWAYS valued.

Mario Emotional Stage Index Cards

Using Emotional Stage Index Cards for Sensory Processing Issues

Mario Emotional Stage Index CardsWhen speaking about Emotion Cards, there are two different types of uses and benefits: helping the child identify others’ unspoken emotional cues and helping identify the child’s own stages before a potential meltdown.

Both are extremely helpful in introducing emotional identification, understanding, and regulation. During tonight’s Web TV show, Austin and I talked about  Emotional Stages index cards that my son and I created. During his first grade year I believe they were responsible for a real quantum shift toward our goal of helping him identify and self-correct some of his pre-meltdown behaviors.

The challenge

What we were finding in school was that during certain transitions throughout the day he would start exhibiting behaviors that indicated his difficulty adjusting in some capacity. Handled incorrectly or ignored, these behaviors would quickly spiral toward loss of control.

My idea was that I wanted him to start to recognize when his body or senses started feeling a little squirrelly so that he could either self-correct if able, or ask for help appropriately (e.g., a sensory break or a walk around the school with the special ed professional).  By teaching him to identify the signs and stages of losing control, he could hopefully have access to the support he needed and decrease the number of incidents where his behavior did reach that point of no return.

The cards

Justin and I took five index cards and numbered them one through five. He then drew a Mario face on each one, with number one being calm and happy. These faces progressed with two and three – feeling a little uncomfortable and weird – and on to four and five, which represented needing help and finally a complete meltdown.

We then laminated them, punched holes in the upper left corners and put them on a key ring for him to carry with him. Each morning I walked into class with him, did some sensory exercises, and asked him to identify how he felt with one of the number cards. In most cases, the amount of exercises done would directly correspond to his number, and our goal was to have him at a one or two before I would leave the classroom for the day.

The result

This number system quickly became a simple means to have him check in with himself throughout the day. For numbers three and four he had a set list of appropriate suggestions to help him get back to a one or two. Even when we experienced days where a five was reached, the stage was at least identified quickly, allowing the teachers to activate an “emergency plan” we wrote into his IEP.

I honestly feel that having Justin create these cards with me and begin to use them really helped him get to know himself in a systematic and linear way that he could clearly understand. They helped him with his feelings, they helped take the guesswork out of the picture for the teachers, and they helped our family both at home and any public outings.

What have you used in your house that helps identify emotions and stages of behaviors? I’d love for you to share!

Spirit of Autism Puberty

Puberty, Autism and Emotional Shutdowns

Spirit of Autism Puberty“The universe hates me!”

My son came stomping out of his room and collapsed onto the floor, heaving a huge sigh of frustration.

Unfortunately, this is not a new scene in my house, as I also have a 16-year old daughter. ‘Nuff said. But more importantly, puberty and autism can create a vicious cocktail that seems to bring on extremely magnified sensory issues, increased hyperactivity, regressive behaviors, and a whole lot of unexplained emotions. My boy just turned 12, but we started experiencing a profusion of puberty related issues as early as nine.

“The universe is incapable of hating, sweetie. What’s wrong?”

Evidently he had built a statue of his Minecraft skin in one of the game’s worlds and he told me that his friend destroyed it.  Minecraft is a unique multiplayer computer game where you learn survival skills and build custom worlds. The creative and building aspects of Minecraft allow players to build constructions out of textured cubes in a 3D world.

First and foremost, I was extremely proud of his ability to articulate to me that he was upset, the reason he was upset, and that he had worked very hard on the statue and it had taken him a long time. This is a HUGE milestone for us! But before we had a chance to begin talking about it, everything started going wrong for him. Everything he touched seemed to break or malfunction. He tried to pet the dogs and they ran away from him. His sister yelled at him for seemingly no reason.

I know from experience that when you have the “everything sucks” filter on, your experiences will follow suit. You know, like when you start out having a bad day it seems that your car won’t start, you spill coffee on yourself, you mess up a client proposal… have you ever had a day like that?

So the first thing I had to do was help diffuse his “universe hates me” perspective, starting with three deep and centering breaths together.

Delayed responses are another typical experience for Autistic children, and once I thought he was in a calmer place (about 30 minutes later), he started crying uncontrollably about the loss of his statue. It was that real guttural crying, too; I felt horrible. I consoled him and acknowledged that he felt upset that his statue was destroyed.

We then talked about choices. I told him he could either play one of his other favorite games (offline) to help get his mind off of it for now or he could choose to talk to his friend and tell him that his feelings were hurt. He could ask him why he destroyed the statue and open the lines of communication.

He had already removed his friend from his Skype list and blocked him from his server! His impulsivity coupled with an intensity of emotions he wasn’t accustomed to had caused him to overreact and shut down.

Once the tears were dry, we played a game called “5 Other Things”. I learned this gold nugget of a coping skill as a teenager and it’s never failed me. The idea is that it’s not what happens to us that causes emotional distress, rather our interpretation of it.  For instance, if a person doesn’t show up for a meeting with me I might immediately feel hurt and angry, assuming I had been blown off. This could rapidly lead to a barrage of negative thoughts: “Did they even INTEND to show up? Am I not good enough for a simple text or phone call letting me know? Who do they think they are?!” etc.

“5 Other Things” forces you to step outside of that neural pattern and look at some other possibilities for the event in question. Was there a family emergency? Are they simply running late? Car trouble? Did one of us write down the wrong day?

Naturally, if someone does this sort of thing to you regularly, “5 Other Things” is not the answer… getting a new friend is J

Being that my son didn’t SEE his statue being destroyed (it was simply gone when he logged back in to the server), we looked at some other possibilities:

  • Did another person playing on that server do it?
  • Did the game malfunction somehow?
  • Could his friend have accidentally done it?
  • Was the site hacked?
  • Did aliens land on earth and destroy all human forms of online entertainment? (Silly can be good if you’re trying to break neural patterns!)

“5 Other Things” worked! After some investigating (and a proven screenshot alibi of the suspect, ha!) he and his NOW UNBLOCKED friend discovered that the server crashed and the world was restored from an earlier version… before he had built the statue.

What a great learning opportunity this was for us! When puberty, autism and emotional shutdowns occur, we now have a blueprint:

  1. Take three deep breaths together
  2. Encourage him to share what is wrong, and praise him for being able to name it
  3. Help diffuse the “everything sucks” filter or mindset
  4. Acknowledge the feelings he is experiencing without judgment or criticism
  5. Play the “5 Other Things” game – without fear of getting a little silly!

For the Mom Who…

…has to drive her infant around at 2 in the morning because being in a moving car is the only way he will go back to sleep.

…sometimes cooks three separate meals for dinner because her picky eater will only have pizza – but the crust has to be right, it can’t be too cheesy, the pepperoni better not be the spicy kind and there can’t be too much sauce. Oh and definitely not the sauce that is too sweet or has any green stuff in it.

…on some days actually falls asleep standing in the shower.

…most likely has read “Goodnight Moon” to her child at least 6, 947 times and still does the funny voices.

…gave up grown-up music in the car for about ten years in favor of Kidz Bop, Disney, and Pokemon CDs.

…can fix her child’s toys or computer, put together a shelving unit, replace worn appliance parts, mow the lawn, and still remove splinters with the precision of a surgeon.

…wants so badly to fix everything for her children but knows she must stand by and let them have the experience on their own.

…will be there to help pick up the pieces when they don’t quite get it right the first time, and encourage them to try again.

…always makes sure the house is never completely out of any grocery item, and the lunchboxes and coffee are always ready in the morning, without exception.

…simply doesn’t have time to be sick. Ever.

…has to endure the glares of people that think she simply doesn’t spank her special needs child enough when he’s having sensory meltdowns in public.

…eats the burnt toast so everyone else can enjoy their breakfast and nothing has to be wasted.

…sometimes cries when no one’s looking.

…knows that her children are here to teach her, too.

…gets up every single day and does what needs to be done no matter what kind of mood she’s in.

…accepts that right now it’s okay that her child with Autism is 10 and still needs help showering, using the bathroom, dressing, and brushing his teeth. She performs these tasks with grace.

…celebrates every success, large or small, and takes nothing for granted.

…knows that her children love her, but sometimes wishes they would show it a little more. However, she doesn’t require it to keep her heart open.

…goes to bat for her children, unconditionally, because their success is non-negotiable.

…always encourages her children to be their unique and authentic self.

…realized early on that there’s no turning back – this is a lifetime job and it isn’t for weenies.

…still knows how to dance with confidence, even if it’s in her living room. On the coffee table.

…learned long ago that the workload will never be “even” or “fair,” and that’s okay.

…considers the simplest pleasures a big deal, because life is precious and all we really have is the now.

…knows that her children chose her before coming to this crazy, adventurous place, and she is grateful.

…remembers that shining her light and being her true self is the greatest gift she can give to her children, for it inspires them to do the same.

…simply does her best, because there is no manual for this gig!

I salute you. All of you. Single moms, married moms, “unplanned” moms, adoptive moms, older moms, teenage moms, special needs moms…we have a bond – a circle – that is unbreakable. You are all amazing – don’t wait for others to honor you. Celebrate and honor yourself and the successes that YOU create.

Happy Mother’s Day!

What about you? Post some other “for the Mom who…” sentences below or share them on the Spirit of Autism Facebook page!

5 Quick Ways to Stop a Meltdown

You know how it happens. You’re in a store and your child starts making loud noises, jumping out of the cart, running around, falling on the floor. You beg, you bargain, you threaten but the noises get louder. Or maybe it’s a restaurant and your son is holding his ears, sprinkling grated cheese all over his seat, kicking the table of the couple sitting behind you, and simply not listening to you. You offer rewards, you raise your voice, you may even pack up and leave in a hurry with your food untouched. I have done these things more times than I can count.

Once I learned more about sensory integration and the way my child is under assault by his senses daily, the more I understood why all of the exhausting and frustrating techniques above had no impact or even made things worse.

Here are 5 techniques I created over time and now keep in my toolbox whenever we go out:

Tell a story. What is your child’s current obsession? Is it a cartoon character? A video game? This is a great opportunity to introduce a social story starring the number one persona that will get your child’s attention. For my son, I will use Mario, Luigi and Yoshi to illustrate the issue, list options of preferred and exaggerated non-preferred responses from them, and then ask his opinion on which he thinks would be a better choice. To really drive the message home, I ask him to show me how he would teach that character to make the right choice.

Assign a job. Amidst the chaos, I like to suddenly feign a problem that I absolutely can’t solve myself and then ask for his help. I tend to make it ridiculous enough to get his attention but not so much where he doesn’t believe I can accomplish the task myself.  An example would be to cry out, “Oh my goodness – I can’t figure out which of these items are cold so the cashier can ring them up together! Can you help? I don’t know WHAT to do!” He usually immediately gets out of his head and body and gets excited about helping Mom :)

If you build it… Often troubled times occur while waiting for our order at a diner or restaurant (if the odds are in our favor and we attempt such a thing!). Many times, without speaking, I will start building a pyramid or structure out of coffee creamers, pats of butter, single-serve jams, or even sugar packets. His curiosity is piqued when he sees my attempted creation and will typically start to mimic me.

Reboot. Ideally, it would be wonderful if you could explain to your child the benefit of closing her eyes, taking deep breaths, and “restarting” her system. When in meltdown, it is most likely too late; once sensory overwhelm has occurred, reasoning flies out the window. The brain can be jolted out of its current state with an unusual statement or unexpected silly gesture. Once that occurs, it searches for an answer or new idea to latch onto, so you have about 3-10 seconds to redirect the current activity or reaction. Sometimes all it takes is a really silly face or Jim Carrey-like clumsy fall to instantly disarm my son.

Direct within. Using a series of questions that aim to keep your child in the present moment can be a lifesaver. “What is that on the wall? “What does that place mat feel like on your fingers? Do you hear that funny bird outside the window?” This also can prove challenging if your child has spatial issues and doesn’t feel where her body ends and space begins. Technology can help! A cheap set of headphones and an iPhone app with nature sounds (or even a game) can help your child tune out the rest of the world that is currently  assaulting her nervous system.

These things have worked for me many, many times. I shudder when I recall my responses and attempted solutions before I really understood how differently my son perceives the world around him. Putting myself in his shoes first is the ONLY way any of these suggestions will truly help. He is old enough now where I can actually ask him if his body is hurting or if something else is causing his outburst. He is much more in touch with his body these days and can actually verbalize his experience, as well as ask for what he needs with prompting. It wasn’t always like that, though.

Keep trying, don’t worry about what anyone else around you is saying, and stay flexible – you will see the payoff!

How do you typically put a halt on meltdowns? Do you have tips to share with other readers? Post them here in the comments below or on the SOA Facebook page – I’d love to hear your ideas!

Bad Behavior or Shedding Old Skin?

Have you experienced some exciting, big changes in your child with Autism after an intensive therapy program? Did you find that shortly after you noticed great progress you were also witnessing some less than desirable behaviors?

When you start to “retrain” the brain, It’s like peeling layers of an onion and getting your child closer to their true self. Being previously veiled by sensory overload and expending most of their energy simply trying to navigate through day-to-day experiences, your child is most likely now starting to take interest in people rather than objects, become curious, and feel many emotions for the first time. Do they know how to deal with these emotions? Probably not!

You may start to see some challenging (and downright ugly) behaviors and automatically assume your child is regressing or your therapy is ineffective.

Remember that it’s like starting over in many ways. They are experiencing the world around them with new senses. While in survival mode, your child was incapable of learning some of the tools necessary for coping with everyday situations. After substantial progress is made in the way they process sensory input, they are now open to understand and practice these skills for the first time. But it does take patience.

Maybe they just found their voice and are starting to express extreme likes and dislikes, or preferences for people and activities. Maybe they are so curious they are asking incessant questions about every sentence that comes out of your mouth. Perhaps they are touching things more, or having a new kind of tantrum when they don’t get their way. Take a step back and remember this is all new.

Last night my son was in his room and I started hearing unearthly screams from behind the closed door, each swelling louder than the last, with increasing frustration. He was trying to make something work that wasn’t cooperating. My first instinct as a mother was to run in and comfort him and perhaps even correct the problem; I hated hearing him so upset! There was also a part of me that was flinching with each piercing scream, and I admittedly had control the urge to yell even louder to get him to stop.

Either action would have been a true disservice to him. What I needed to do was sit with him and explain what happens when we let ourselves get that frustrated with things. I needed to teach him a manageable protocol for dealing with those feelings, before they get to the point where he’s breaking items because he can’t get it them function correctly.

I made it clear that it was always okay for him to feel whatever he was feeling, but that there were other things he could do to deal with those feelings. We talked about how to handle it when something isn’t working – not continuing to do the same thing repeatedly (only harder), but to stop, take five deep breaths and either ask for help or start asking questions. What am I not seeing? Is there another way to do this? If it can’t be done, can I be okay with that? Can mom help? Should I call for her?

Social stories and visual cues are great tools – it’s a good time to revisit some past attempts that may or may not have been successful for you before. My son and I started employing American Sign Language and certain codes from the police and fire scanner to alert each other that it’s time to use one of our new behaviors. As often as possible, I lead him to try and work out the progression on his own instead of solely giving him exact instructions.

It’s a new and exciting time when this kind of progress is made. It’s also easy to have expectations about coping skills and behaviors you assume should come with that progress. It’s my experience that I can always use a “refresher course” on the very things I’m teaching my son for the first time.

How about you? What are some behaviors you’ve mistaken for regression? What are some ways you worked through them with your child? I’d love to hear your stories, so please comment below or post them on my Facebook page so we can help each other!

Regression or Progression?

I recently did my mid-integration checklist and interview for Justin’s Listening Training. As he is getting ready for his next intensive, I wanted to share some amazing gains I observed – new behaviors that I attribute to his first round of EnListen® and additional supports from home, including:

  • Introduction of Chewelry to redirect chewing (I’ll be dedicating an entire blog post to this great product shortly!!)
  • Addition of digestive enzymes, probiotics, and Omega Fatty Acid oil to his diet
  • Increased yoga and fitness routines after school

Understand that every child is different and may or may not show the same gains or at the same rate, especially after only the first intensive. These are things that improved in my child:

  • He now understands and carries out multi-step instructions (e.g., “Put on your socks, brush your teeth, and meet me in the kitchen.”)
  • Bathroom experience: his body now signals that he has to go – no more accidents (thank you!); it is an easier experience – 15 minutes in the bathroom instead of 45!
  • He is aware of possible consequences before proprioceptive crashing – Justin will now run up to things and stop and think first about whether or not it might be a good idea. He redirects himself for the first time.
  • Empathy, remorse – he consciously apologizes after accidentally hurting someone and doesn’t repeat action!
  • Fine motor improvement – he is better able to dress himself; he even wore jeans for the first time and buttoned them with no assistance!
  • Initiating bedtime on his own – he’s getting tired earlier in the evenings, and bedtime is no longer a long and drawn out process (except when he’s being a typical kid!)
  • Aware of why he has certain behaviors – when asked why he is displaying a certain behavior he is able to provide a logical answer rather than tuning out or shrugging it off
  • Report card improvement
  • Little to no spinning – much less stimming (excluding the return of recent verbal outbursts)
  • Realizing where he is in space – there is much less holding the walls when walking and chair tipping when sitting
  • Coordination, balance improvement – squatting, skipping, hurdles and obstacle courses, jumping improvement
  • Tactile gains – introduction of new clothing materials that previously were not tolerated
  • Initiating affection – this is a biggie! He is equating more with people and less with things.
  • Showing more independent thought and less echolalia (and much less regurgitated TV speak!) when asked questions or engaged in a conversation

Less than desirable changes noticed:

  • Expressing more frustration – this is due to experiencing certain feelings for the first time. Listening Training has begun the process of allowing him to be receptive to and in touch with his emotions. Justin will need to now learn how process those appropriately.
  • More meltdowns
  • The return of noises, verbal outbursts and personal space issues
  • Less motivation to complete schoolwork

Although this may appear to be a regression in behavior, I realize that Justin is experiencing a reorganization of how he sees the world and processes information. It’s going to take time for these changes to be integrated into daily practice. I have to dig a little deeper. Some of these behaviors are not necessarily a regression, rather familiar ways of coping with new feelings and experiences.

He is also reflecting his new feelings of frustration through verbal stimming and needs to learn new and appropriate ways of expressing them.

The next intensive will continue to address sound sensitivity as well as introduce organizational skills and theory of mind.

It is easy to focus on the behaviors we don’t want from our child when we see them, and immediately assume things are headed south once again. I don’t know about you, but raising a child with Autism is a roller coaster ride full of gains and regressions. It’s part of the process and I wouldn’t have it any other way.

Looking at this progress now on paper, he truly has made some incredible gains. It is imperative that the school and I continue to support him with reward systems, redirection, and behavior alternatives as he learns to integrate information in a new way.

What You Think About You Bring About

How often do we find ourselves dreading an event, visit, or simple errand with our child? We look at past behaviors or incidents and expect the worst, based on what we experienced previously. We may even go so far as to picture the meltdown occurring and already start feeling frustrated and frazzled by the anticipation of it.

When we do this, we emit a certain frequency and our child picks up on it. Everything we think, say, and feel produces some kind of effect on our children.

How about trying an experiment? I’ve done this before with phenomenal results! Ready?

Expect the best from your child.

Not perfectionism, not nit-picking… just expect great behavior. Visualize it. Focus on what you WANT to happen and picture it happening that way. You might be very surprised at what unfolds!

I discovered this powerful shift some time ago, yet I often and easily forget the impact of such a simple adjustment. I had a great reminder today while reading a fantastic book: Bob Lancer’s Parenting With Love… Without Anger or Stress. Here is a paragraph that really resonated with me:

Praising or Thanking in Advance

When you want your child to do something, try praising or thanking her for doing it in advance. This tactic exhibits an uncanny power to bring out desirable behavior that has not yet happened. For instance, to encourage him to pick up after himself, try sincerely praising him for picking up after himself and genuinely thanking him for the contribution before he has done so. To encourage your child to play nicely with others at the playground, right before you launch her into activity you might say, “I want to thank you very much for playing so nicely with the other children at the playground today.”

Ironically, I found this to work with my To Do lists as well! For a whole week I created “Done” lists in lieu of “To Do” lists and I was so much more productive! They would read, “Went to bank, completed freelance project, did laundry, balanced checkbook,” etc. Guess what – I doubled my accomplishments that week!

What do you think? Do you have anything to lose by expecting your child to flourish and shine versus waiting for the meltdown? Thoughts are free. They can be changed and controlled with practice. Try it and let me know your results on my Facebook or Twitter page, or by commenting below!

Braving the Public… Meltdowns and “The Look”

I posted a question on Twitter and Facebook last week that stirred quite a few comments! The question was:

Parents: how many times have you gotten “the look” in public places… as if people were saying “Why can’t you control your child?”

The myriad responses I received ranged from “It is so stressful, we don’t even bother anymore” to “I don’t even notice because I don’t care what people think!”.  It was great! You know what? I can relate to every single bit of feedback I received. I have been in all of those places emotionally and even gone so far as to second-guess or blame myself and my parenting skills along the way.

No one said this job was easy. To quote a dear friend of mine, “Parenting is not for weenies.”

I can’t count how many times I’ve had to rapidly exit a grocery store, leaving a full cart, because my child escaped and was running up and down the aisles, screaming and crashing into endcaps. I can’t tell you how many times we spent $70 at the movies only to be kicked out of the theatre before the previews were even over. I can’t recall how many times we had to leave a restaurant, paying for food that never came because of meltdowns. And don’t get me started on how I know the response time of Fire Station 5 so well ;)

I have experienced parents tell me I need to spank or beat (!) my child, I have gotten countless dirty looks from others in public places, I have been told by security officers that I need to “reel in my kid”, and I have been called a bad mother more times than I can remember. It’s not fun. I don’t even want to get into airplane follies!

As a single parent, I don’t have the luxury of another adult when out in public to take my son outside for a sensory break, put him in a time out, or to leave him with at home so I can do the shopping alone. What I also didn’t have until the last few years, though, was knowledge and understanding of Sensory Processing Disorder, a list of key things that set my son off, and tools to help me make the right decisions about taking him out.

I know we can all share horror stories. I’ve probably stifled and suppressed most of mine :) BUT I thought it would be helpful for me to share what we do RIGHT now. Meltdowns these days are minimal, if not completely gone.

Know when the odds are stacked against you. Is it close to nap time? Has your child been stuck inside with no exercise? Did he just have a big, sugary snack? Or is he really hungry? Conversely, are YOU exhausted and sleep-deprived? Squeezing things into your schedule and feeling pressed for time? These are NOT good times to take your child with Autism to the store, restaurant, bank, or any other errands. It may be inconvenient, but it is worth it to wait until all the odds are in your favor so you can handle any situation from a place of calm and grounded peace. When you can respond, not react, it changes everything.

Avoid busy times. Try to go to your favorite places when they are not too crowded. So what if your schedule is different than the rest of the world’s? The extra quiet atmosphere may be totally worth it.

Understand what your child experiences. I used to just see bad behavior. Then I would try to reason with it, yell, lose my patience, bargain with it… yes, these were really effective :) The truth of the  matter is, your child may be under assault by her senses. If you can stand a little bit of bad language, this is a GREAT video to illustrate a meltdown. I love it. Sensory Overload Simulation

You can also read one of my earlier articles, Why Does My Autistic Child Scream?! which helps explain what’s going on neurologically.

Physical exercise first. Taking 5 extra minutes before going out to toss a sandbell with your child, run a quick relay race, do some animal crawls, or just run in place can change their entire mood and energy level for your outing. Fitness creates focus, provides an energy release, and gives your child a nice self-esteem boost along the way!

Anticipate and arm yourself with supports. Bring things like noise-blocking headphones, supermarket bingo, things to draw with, snacks, or even video games if you deem them appropriate. Know where exits are as well as a quiet place to go for a five-minute sensory break if needed. Illustrate clear consequences for misbehavior prior to entering your destination, but also make it clear that breaks and time outs for his body are not the same as being in trouble! It also couldn’t hurt to have a plan B.

Look for flags. You know what it looks like when your child first starts to get overloaded. Don’t wait until the situation spins out of control before addressing it. If possible, give your child choices and encourage her to make the right ones for her. I can now ask my son, “Are you screaming for fun, or does your body hurt?” (sometimes he’s just being a boy!) I’ve had him hold up numbers to tell me where his body is on a meltdown scale – 1 being perfectly fine and 5 being totally out of control.

Compassion. It’s never easy to walk that fine line between disciplining a behavior when your child can clearly help it versus giving them support and understanding when they truly can’t. The bottom line is, we are all doing the best we can. If you think you’re frustrated by a behavior your child exhibits, imagine how he feels getting in trouble for his ears hurting or his nerve endings feeling like they’re on fire. Imagine yourself not being able to tell if you’re standing up straight or falling over, and then getting yelled at for touching the wall and not knowing why. I’m not saying all behavior is okay and should be overlooked, but seeing things through your child’s eyes (or ears, or hands) can instantly melt your frustration into compassion and assistance for your child to step into his best self!

What other public tips and tools work for you? What attitudes have you shifted that changed your experience? I’d love to hear about them!

Why is My Child Crashing into Me and Screaming?!?

In my house this weekend, my son was a human (LOUD!) bumper car. Despite all of my refined calming and redirecting techniques, the past few days brought loud screams interspersed with crashing into walls, family members, doors, mirrors, and repeated jumping and falling onto the floor. Ironically, light touches and loud noises from any other source but his own mouth send him into immediate meltdown. How can that be? How can crashing and tight squeezes feel great but a hand on his shoulder make him recoil as if he were being branded with a hot iron?

It can actually be very common for children with Sensory Processing issues to be both sensory seekers and sensory avoiders. How confusing and frustrating it can be!

What is sensory seeking?

As I’ve written before, Sensory Integration is the ability of the brain to detect, modulate, discriminate, and integrate the three special sensory systems – tactile (touch), vestibular (movement), and proprioceptive (body awareness).  Although these sensory systems are less familiar than the five senses we all learned about as children, they are critical in order for humans to experience, interpret, and respond to their environment appropriately.

Sensory seeking occurs when a child’s nervous system is under-responsive to the information being received by the brain, so they continually seek intense sensory experiences for an extended time period to compensate. Some typical sensory seeking behaviors include:

  • Hyper-activity
  • Impulsivity
  • Decreased response to pain
  • Crashing and banging into things
  • Craves “tight squeezes” or bear hugs others a lot
  • Screaming
  • Poor body awareness – clumsiness, touching objects or others too hard or too often
  • Staying in a soiled diaper or underpants

What is sensory avoiding?

Children with sensory avoidant behavior commonly have nervous systems that are overly responsive to sensation, which can trigger “fight or flight” responses to sensory stimuli.  They may demonstrate some of these behaviors:

  • Withdrawing from touch
  • Motion sickness, fear of heights
  • Anxious in over-stimulating environments (public places such as malls, playgrounds, etc.)
  • Picky eater – avoidance of certain textured foods, sensitive to food smells or temperatures
  • Doesn’t like being messy and avoids mud, dirt, messy foods
  • Struggles with self-care activities; will only wear certain types of material for clothing and or wear clothing in a particular way; complains about hair brushing, tooth brushing, and hair cutting.

If your child is like mine, we can relate to almost everything in both lists! However, I did have some success alleviating some of the crashing and screaming while we were in public, and I wanted to share what worked with you.

Things that helped

There’s nothing more frightening than standing in line at the grocery store and having your child uncontrollably scream crash into displays, climb on counters, and swing off things that are not meant to be swung from! OY! When this state of sensory seeking is reached, reasoning attempts fly out the window.

While we were out I offered some tight squeezes, head and shoulder pressure, and “contests” (bet you can’t crab walk to that bench and back in 2 minutes!). These did not stop the behaviors entirely but offered some relief to his body and allowed me a few more minutes to finish our errand. It is good to carry a weighted backpack in the car as an emergency sensory-seeking tool to help get you through a situation like that as well!

Once we got home, I was able to isolate him to a quiet room and really pay attention to what his body was craving. We used blanket rolling, full body pressure on a giant yoga ball while he was lying face-down, spinning, and our newest trick: wrapping a rolling pin in large bubble wrap and rolling it over his back! I then gave him some time in his tent with a digital timer. Watching the numbers count down always calms him. It was important that he knew it was not time out for misbehaving, rather a break that would help him.

Other tools I love for sensory avoidance behaviors:

  • Noise-blocking headphones
  • Personal games to keep him focused
  • Favorite healthy snacks
  • Nature sounds on my iPhone
  • Wubbzy music :)
  • An escape plan!

What things help your child cope with sensory input?