Those dreaded public meltdowns. Most parents of kiddos with autism have faced this ugly beast of a problem at least once—and once is more than enough. Fortunately, such meltdowns needn’t be a fact of life with autism.
A parent asks: My son is nearly four and has high functioning ASD. We have had some challenging times lately with battles of wills. We just had a failed trip to Target because he no longer wants to ride in the cart and if I let him walk, he runs the aisles and pulls things off shelves. When I catch up to him and tell him he must get in the cart, it’s an absolute screaming fit and we have to leave the store kicking and screaming. I could deal with this when he was two and I could easily pick him up, put him in the cart and strap him in for his own safety, but the straps barely fit around him now and soon he will be too heavy for me to easily control. I need better strategies. I am a big believer in positive reinforcement and creating situations where he will succeed, but sometimes we just need to go to the store whether it will be a success or not.
Ellen answers: After an outing like this, both of you may feel apprehensive about the next trip. But with planning and patient, consistent teaching, outings with your son needn’t be a battle of wills. The key is to build competence and tolerance in increments that are manageable for him. As a parent who has lived this myself, here are my suggestions:
1. Four is not too young to begin teaching that some things we do because they are have-to’s. This is true for everyone at every age, and you can help him understand this by pointing out things in your own daily routine and those of family members and people in the community that are have-to’s. Explain also that have-to’s can be followed by want-to’s, then follow up by demonstrating this. When you impose a have-to on him, such as that trip to the store, his success will earn him a want-to. Be very explicit about what constitutes success and what the reward want-to will be. Support this with visuals.
A word about rewards vs. bribes: reinforcing his cooperative behavior with a want-to is not a bribe. When we do our jobs, we get paid. His want-to is the currency of the moment for doing his job, which in this case is helping you with the shopping. He’s not too young to begin learning the concept of age-appropriate responsibilities within the family.
2. No surprises. Respect that impromptu outings can create anxiety for many children with autism, and can invite resistance. Schedule the trip to the store ahead of time and build it (and the want-to to follow it) into a visual schedule of his day so he knows what’s coming and what he can look forward to afterward. You might even want to give 15-minute or 5-minute warnings leading up to the outing, using a visual timer.
3. Timing is everything. Don’t pre-dispose your son to failure by scheduling the outing for a time when he is likely to be tired (end of day or right before nap), hungry (right before lunch) or unhappy (is missing his favorite show). Minimize the time needed for the outing and the potential sensory overload by shopping at times when the store will be less crowded.
4. Mitigate sensory factors as much as possible. Huge, windowless, artificially lit stores can send children with autism into sensory overload. Fluorescent lighting flickers and hums, tens of thousands of items on the shelves create visual overstimulation, sounds (echo-y, screechy—loudspeaker, overhead music, kids crying, people all talking at once) and smells (people, products) overwhelm him, the store may be air-conditioned or heated to an uncomfortable degree. Giving him something to do and focus on while you’re shopping can help. Try giving him a set of index cards on a ring, with photos of the items you’re buying that day (cut pictures from the store’s ad or get them off the Internet.) Ask him to help you match the item on the card with the item on the shelf (does double duty as teaching the beginnings of independent living). Or simply keep a set of fidget toys that he only plays with when seated in the cart at the store. This keeps his hands busy and his eyes focused on a single thing. Listening to music on headphones might also work. You might also create a visual of the parts of the trip so he can see at all times what comes next: 1) get in car, put on seat belt, 2) drive to store, 3) walk from parking lot, 4) get items (sitting in cart or walking), 5) go through checkout line (give him job such as handing over money or swiping card), 6) walk to car, strap in 7) drive home, 8) reward/want-to!
When transitioning to walking rather than riding in cart, establish rules such as, perhaps, hands in pockets and/or not moving farther away from Mom or cart than he can reach out and touch. Have a visual prompt handy, or develop a one-word prompt or fun code word to remind him when he strays.
5. Keep the trip as short as possible. Have a list, share it with him, then stick to it. Keep your word. If you tell him you will be buying a birthday card for Uncle Steve, a box of laundry soap and batteries, buy only those things and don’t even browse for others. Even when the outing is going well, resist the temptation to squeeze in “just one more thing.” That may be the tipping point between success and disaster. It also teaches him that he can’t trust what you tell him.
6. Praise his success, both immediately following the outing, and by telling family members about it later so they can acknowledge his accomplishment too. Reinforce that he has helped you; this will work to instill in him that he is a full-fledged member of the family, with responsibilities appropriate to his developmental (not chronological) age.
7. A social story can reinforce the behaviors you expect of him on an outing, and reaffirm his ability to do it. If you are unfamiliar with social stories or unsure how to write one, visit http://www.thegraycenter.org/social-stories/how-to-write-social-stories.
8. Remember that the way things are today is not the way they will always be. Honor your child’s needs and abilities while you teach and build his skills, knowing that he will grow and progress.
Follow up question: when the sensory issue the child is having is the need to just get down and run and run and run the inviting, wide open aisles, how do you curb the tantrum? Because even if I find a quiet corner of the store and hold him down in a time out and try to ride out the tantrum, I am just making him more furious because the running is not going to be permitted. Perhaps some strenuous activity before we make the trip? But that’s not always practical. I am not very familiar with weighted vests, but is it possible they would be of some help in this situation?
Once a meltdown is in progress, it’s too late to teach him anything in that moment; he’s just not emotionally available. Think of your own emotions; when you are angry or distraught, are you open to someone trying to teach you something? Running up and down the aisles of a store is not acceptable behavior by any one at any age, as you can point out at a time when he is calm, adding that safety for everyone is the reason. In all your teaching leading up to the outing (the visual schedule, the social story, etc.), you can stress that running in a store or parking lot is not an option. If he loves to run, brainstorm with him places he can run, before and/or after the outing. He may even have some good ideas you haven’t thought of.
Weighted vests, blankets or objects can be very helpful, but require the advice of an occupational therapist or other professional before using. Getting the weight wrong can cause injury. I’ve known several children who carried a weighted object with them at all times–a heavy book, a roll of raffle tickets, other favored item. If it looked a bit odd, their moms didn’t care because it helped the child be successful in group settings–an acceptable trade-off, and one that is usually transitional, doesn’t last forever.
My 8 year old granddaughter has autism. She had a meltdown at Disneyland while in line at Peter Pan, people were staring! I I took her away to the restroom and washed her face with cold water. It not only cooled her off, but it calmed her down and she was able to focus on what I had to say.
Cold water i would say no! People staring??? Afterva while you dont see it all the time. I made bussiness cards for those situations, i hand the card to busybodies, on the cards it sais in a friendly way thanks for your interest some blah and a advice to google autism. That way i can focus on what is important. My son. When things go wrong i try to get him out of the situation. No cold water in his face , that would have an opposite effect. I try to make situations clear and easier by using social stories wich i make myself.