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SPECIAL PREVIEW: SENSORY MELTDOWNS

So, first off a little bit about me. My name is Meredith. I'm a certified occupational therapist. I've primarily been working with the geriatric population, so elderly folks for the last seven years, but my clinical roots actually started in pediatrics. So I am very, very fully aware of autism spectrum disorders and sensory processing disorders on a professional level, as well as an intimate level. So I come from a family in which I had to assist one of my siblings with very profound autism and very profound sensory processing disorder. So I'm very familiar with how south things can go very quickly when you don't have certain things in place.

So I'm speaking to you guys as a clinician, but I'm also speaking to you guys as a parent and as a family member, who's had many, many, many years of experience with this. And then as a parent, I am not currently raising any children who have autism spectrum disorder. They're very typically developing, but they do get to kind of be my little experimental guinea pigs for sensory related techniques. So it's fun for me. I don't know how fun it is for them, but it works for me. It gives me some practice.

So what we're going to talk about today, because we had a very high vote to discuss sensory meltdowns, and what makes those different from temper tantrums. Some of you well-seasoned parents who have children on the spectrum and who also have some sensory processing issues, you probably already know what a meltdown looks like.So if this is kind of a repetitive thing for you, bear with me, I'm going to cover some of the basics because I know there are some parents on here who are very brand new to the whole thing, so I'd like to thoroughly explain it without confusing some of you. 


TEMPER TANTRUM VS SENSORY MELTDOWN

Let's talk about your typical child temper tantrum. When a child is throwing a temper tantrum in the back of your head, the parents vibe kind of turns on, you are very well aware that this child is in pretty much complete control of their behavior. They have an agenda, they know that they're out to get something. So they throw themselves on the floor, they scream at mommy and daddy, they throw something at you, they hit brother sister, because there's an agenda. There's something that they want. And so they'll tantrum until that agenda is met or until the parent can intervene and extinguish the behavior.And some of us can do that quite smoothly and some of us not so much. It's not going to always turn out in our favor. So there's your typical temper tantrum.

Then a sensory meltdown, now we're dealing with a completely different beast. It may look pretty similar to a tantrum for somebody that's not familiar with what's going on, but some of the signs you want to look for, if this is turning into an actual sensory meltdown is all of a sudden, it's not about the parent. It's not about some tangible item, like a toy or a favorite food, or something that they want. It's usually about something that the parents can't identify immediately or something that even the child has no idea what they're trying to identify or what they need. Their system kind of goes into this overload. There's just too much going on, too much input from the environment, too much input from the parent, too much input from their body.It's coming from somewhere and it's just too much to handle.

And so the meltdown, as I said, isn't about you or what you said to them. It's just that their body is going into overdrive, and so they're not really making a lot of eye contact with you. There's probably some hyperventilation going on, a lot of really quick, deep breathing happening and nothing, no words can prevent or slow this down. Now that it's in motion, whatever you say isn't going to stop it. They're now in a full fledged meltdown and they are upset. Now some questions I've had in the past, a typical childhood temper tantrum can actually morph into a sensory meltdown. I mean, why not? It does happen. My kids have done it even though they don't actually have any sensory processing disorders, at least not that I know of.Their temper tantrums, if they're escalated high enough and they're getting enough input into their body, they're just really mad, they're angry. I'm talking too much. Daddy's talking too much and things are just... they can't explain themselves and they can't quite control what's going on around them. Then that tantrum could very well turn into an actual meltdown. And to that point, nothing that I can verbally say is going to stop that meltdown. They are now in it, and now we got to figure out how to de-escalate it.


WHAT CAUSES A SENSORY MELTDOWN?

So let's move on here to the next one because there is a lot of material and I do want to cover quite a bit of stuff with you guys here. So what causes a meltdown? I don't expect a lot of parents here to have a very, even a basic or profound understanding of what sensory integration is or how the body communicates with the brain and all the senses to make things go. That could definitely be discussed on a later date, if that's a topic in which you guys want to cover, I can go into that in great detail, but let's talk about some of the causes of a sensory meltdown.

Some of those causes, we may not readily know in the moment what's going on, but we can at least prepare in the event that our child is already prone to having these meltdowns. We could already prepare and be way ahead of the game so that if it does happen, we can either prevent it or we can de escalate it quickly so the child doesn't get hurt or anyone around him doesn't get hurt.

As far as causes go, I'll give you a couple examples because not every child is the same. Not every stimuli is going to set somebody off the same way.So I'll give you a couple examples. There could be a child with moderate to severe autism already went through the testing with an occupational therapist or other certified sensory integration specialist, and say their biggest thing is that they are auditorily sensitive, so they're hearing the things around them. The sounds around them are very, it's too much. It can be too much. So if you have a typical growing child and they're talking to a group of friends, they, in their brain and their senses and the way they've developed, they can figure out how to tune people out.

A child talking to a group of friends, typical growing brain connections, sensory connection. They are able to filter out conversations. So if one person is talking to them, they can filter out other people's conversations with other people... and for crying out loud..So the child's able to filter out other people's conversations with other people while they're, "Yeah, yeah, yeah, yeah," gabbing with their other friends, this child can focus in on the one person who's actually talking to them, which is good. But for a child with auditory processing issues or some sensory processing issues, they may not be able to filter all that out. So they're actually getting all the information from everybody in the group. They can't just focus on just one person talking to them. They are now bombarded with all the sound and it becomes very stressful, very overstimulating and they shut down.

Another example is let's say a child who's got some sensory processing issues can't handle going to the mall because there's just too much. Too many people talking too much noise. The lights are too bright, the smell. There's just too much coming on all at once. It's the same thing if you take him to a baseball game or a heavy metal concert. One that I've come across personally many, many times, especially in my oldest daughter. When she was really small was a very, very picky eater, and I attribute that to some sensory issues because she's picky at eating, but it was also because she does not do messy play. She's gotten a lot better at it, but when she was a baby, she hated having stuff on her hands. She hated having things on her face.

If she spilled water on her shirt, that shirt would just come right off and it would turn into a full fledged meltdown where it didn't matter what I said, didn't matter what kind of food I put in front of her. It didn't matter what I bribed her with, there was no stopping it. And it was just a fruitless effort on my part. I couldn't get her to actually eat anything. Anyway, so what I ended up having to run her through was a series of messy plays to address those feeding issues, which I will talk about later when I talk about preventing sensory meltdowns. But yeah, at first that was her thing, and if she had anything on her hands, if she had too much food on her plate, it was too much and she would shut down.


OVERCOMING SENSORY MELTDOWNS

So in summary, a sensory meltdown is an overstimulation. It's too much information going on at once, and sometimes it's things that we don't as parents realize what's going on because in our systems it's perfectly normal. The environment's normal. It is what it is. But for a kid, especially if you say, "Well, I have a little bit of glue on my finger, whoopee ding. I'm going to go rinse it under the faucet, no big deal. That little glue on that child who doesn't like... it has a very sensitive, tactile situation. It's you've just ended their life. It is now the end of the world and they're going to go crazy because there's glue on there and there's no way that can possibly be fixed. So if you think about that, that is probably what your child is experiencing, is a sense of complete hopelessness when they have this meltdown. So that's why it's important for our next part to follow some of these steps, so we can help them deescalate from the meltdown.

Now, some of you parents already understand and already know that there is no way in heck, you're going to be able to prevent your child from experiencing every single meltdown. There's just, there's no way. You're going to have to keep on top of it all day, every day, 24/7. All we can really do is do our best and when the kid does eventually experience a meltdown, know how to de escalate it quickly. It's going to be different for every kid, because it depends on what input irritates them and what they're going to respond to. So I have just a few tips here and there that might help with that. So your child has now gone into a full blown meltdown, that is a point of no return, no amount of talking is going to bring them back. This is not a tantrum. This is an actual meltdown. So what do you do?

Well, you figure out where you are first off. Is this meltdown happening at home in a familiar environment? Is this happening out in public? Is this happening at a doctor's appointment? I mean, think about the environment around you and you're going to have to think quickly. Oh good. Yep. So let's start with a public incident. I've had this happen a few times and it wasn't good. Sometimes cops were called.

If your child is having a meltdown out in public, first thing's first, you want to remove them from a very dangerous situation. So if your child's initial approach to a meltdown is to either hurt themselves, like self injurious behavior or to attack someone around them, it's time to pull them out of that situation so they can't hurt themselves and they can't hurt others.

So if your child is doing this in public, you are most likely going to be picking them up and pulling them out of the environment and putting them somewhere safer, so they're away from people. Then they have some stretch room, so they can't hurt themselves and they can't hurt others. After you've done that, you need to figure out and think about, and remove whatever the triggers are. In the moment you might not know what they are. So you run through all the senses. You think, "Okay, is it light? Is it touch? Is it sound? Is it taste? Is there here that he just can't stand?"


UNDERSTANDING MELTDOWN TRIGGERS

You kind of have to figure out and go through and know your child - what's setting them off and remove that trigger the best you can. And so when you're in a public situation, say you're at the mall and you got to figure out how to get your kid out of there. You're going to probably be heap hauling them out of the mall and into a room or a smaller store, or even just outside, somewhere where there's very limited echo, and the lights are dimmer, and the input is less. Yes, you're going to have people staring at you. Yes, it's going to be embarrassing and it might be a little humiliating. But at that point, that's not the point. It's to get your child somewhere safer so you can manage the meltdown.So the next step after that, and this is kind of one of those pick your battles sort of things, and it depends on the parent and it depends on the child. We are so quick to try to introduce the good in order to take away the bad, that can actually be damaging, and we don't want to do that. So let me explain what I mean.

If your child is having a meltdown and he's overstimulated, sometimes as parents who've got some sensory integration background, we've talked to a specialist, we've ordered products. We have all these toys. We have all these comfort tools, we so quickly want to give them those comfort tools, shove that chewy toy in their face, shove that teddy bear or that blankie in their face. That is still considered stimuli. It's good stimuli and you probably know that from the history of what your child has done in the past, but it's still stimuli. Never overestimate the power of the absence of stimuli.

So what I mean is your child is going to be having this horrible reaction. They're overstimulated, they're angry. The last thing you need to do is shove something in their face that they don't have control over. So what you do is you give it a little bit of time. It might be loud, it might be uncomfortable, and you yourself may feel like you're out of control because your child is still going crazy. But having that absence where you take away the bad stuff, the too much noise, the too much touch, the too much talking. If you take that away and let them sit and just absence of stimuli for a few minutes, then introduce the comfort toys like dimming the lights, like giving them a blanket, giving them that favorite teddy bear, giving them something calming that you know has worked in the past. Then that might work. If you're too quick to give them the good stimuli, it might backfire and might overstimulate them.

So part of the meltdown is to take them down slowly, not to rush it. Some parents feel the need to rush it because, especially when they're out in public, because it is embarrassing and it is very difficult to handle. You also don't want to hurt anybody, and you really don't want the cops called on you, and I get that. I understand that personal experience all the way. I salute all of you who've had to go through that. But if you want that meltdown to go down quick, you have to take your time.

Another little tidbit that I know has worked for me, at least in the past, personally and professionally, because all of us do it. We all do it when we get nervous, we just talk, talk, talk, talk, talk, and we want to be so quick to verbally tell our child, "It's okay. It's okay. It's okay. It's going to be okay, and it's going to be okay." Yeah, it's not. And in their head it's, it's not okay and by you telling them that it's okay, your voice and your pacing and your nervousness, it only adds to the behavior because the sound of your voice is a stimuli and it will probably add to the over-stimulation.

Sometimes I tell parents and I have to tell myself, if my child or someone else's child is experiencing a meltdown to shut up. Just try your best, not to say all word. This is hard. This is a very developed skills that parents need to work on, and it's very difficult. But if you can master it, you're doing your child a favor here. Throughout the entire meltdown and throughout the entire calming process, shut up. Don't let anything come out of your mouth, do everything non-verbally so it can help them kind of come down to a close in their meltdown.You'll kind of get reached by that intuitive need to figure out when you can start talking. You know your child, you know when they're going to be calm. You know that breathing is starting to slow down. They're starting to make more eye contact with you. They're coming back to the real world, then it might be time to start talking. Not very much, just a very calm, soothing voice. And then we slowly get back into real life and we go back to what we were doing before.

This really is a skill set. It takes many years of practice. And I feel for all you parents who have to go through this at home and in public, it is very difficult. It's very hard. It is heart wrenching to watch your child go through that. But in the end, from a parent's standpoint or a caregiving standpoint, you have to remember, it's not about you. It's not about how embarrassed you feel or how humiliated you are. You also have to understand that taking offense to your child's behavior also doesn't help. Your child is in the middle of a meltdown is not out to purposefully kill you. It may seem like it, especially if they lash out, if that's their way of dealing with it. But the hardest thing for parents in this instance is to not take it personally, and that is very difficult when it's your own child. So if you can do that, remove yourself from the offensiveness, from the personal attacks, you're good. It'll be okay. It'll be hard, but it'll equip you really well for how to handle a meltdown.


HOW TO PREVENT MELTDOWNS

So let's talk a little bit about how you can prevent meltdowns. Like I said, you're not going to prevent every single one. There's no way. You would have to be watching them 24/7. You would have to be on top of it, 24/7, and no one expects you to do that. That's a lot of work, but we can try our best. So preventing meltdowns. Let me get some notes up here so I say it right. 


1. Know Your Child Intimately and Understand How They Function

The best way to prevent your meltdowns in your child is to really know them intimately and understand how they function. Just being a parent, being an active parent, being a very present parent in their life and understanding what your child's interests are, what their habits are, what irritates them. Just being able to actually understand your child intimately will help you immensely when these things happen and to prevent them as well.


2. Minimize Exposure To Triggers

Another thing and handle this delicately, but avoid enabling avoidance. What I mean on that one is we don't want to turn our children into bubble children. We can't protect them from every stimulus that's going to irritate them. We can minimize them. We can kind of help minimize their exposure to certain stimuli in the environment. But in the end, we all live in a very unpredictable environment.

Your child, you as the parent, when they're this young, you have a lot of control and a lot of say about what goes on in their life.You can establish the routines. You can establish the structure. You can physically emotionally, psychologically protect them a lot better because they're children and they're living with you in your home. Eventually your child grows up, they get bigger. They start participating in other things. They go to school, they have more access to other people in the community and other instances. The world we live in is not a predictable world. We can't stop all the stimuli around us. We can't keep them in a bubble. So what we can do and start them young, is slowly expose them to certain stimuli that we know they don't like. I'm not saying go out and sign your child up for a mud run. Have you done one of those before?

I've done several of them and they're great. There's so much fun, covered head to toe in mud. I'm okay with that.If your child is tactfully sensitive and doesn't like messy play, then you probably have just killed their soul and they will never forgive you for that. So I'm not saying sign them up for a mud run or take him to a baseball game if they've never been to one, or sign them up to go to a heavy metal rock concert. Slow the jets. It's controlled exposure, is what we're going for. So with their young, you kind of have an advantage. You have several years to work on this and to expose them to things in a controlled way. 

So for an example, my... coming back to the feeding thing that my daughter had to go through. She hated messy play, and so as an OT, I went, "Oh, I have an idea." We're going to do this right. So what I did was I would put big piles of cool whip in the bath tub, no water, just cool whip. And so what I would tell her, and she was about maybe 18 months when I tried this. So she could understand a little bit of what I was saying, and I would tell her, "Okay, we're going to take a bath in the cool whip." Oh and the look she gave me. She... oh, the biggest scuzzy. I'll never forget it, but because she didn't want to do it. She doesn't like having stuff on her hands, and she certainly doesn't like to rub messy things in on her body. So what we did was, "Okay, all you have to do is stand on the side of the tub and just look at it, just acknowledge that it's there. Be okay with the fact that it's there." Then we slowly increased the exposure steps.

So for the first couple of days, days not hours, days, I would put the cool whip in the tub and she would just stare at it kind of longingly from the edge. Then the next few days, she was more willing to just take her clothes off and climb into the tub, stand next to the cool whip but not actually play with it. Then it took about three weeks of exposure where she was finally actively playing with it in her hands, and we were able to do that for several weeks after that, with cool whip, with finger paint, with peanut butter. 

I would usually have her pick what she wanted me to put in the tub or on her tray for self feeding, and then she would play in it. Eventually that did help with her feeding. I was a little bit more careful with the foods cause I, myself am a very picky eater and it freaks me out when certain things are on my plate. Then we would start in very small doses. It would be just finger foods, one type of food, two types of food, keep it very simple on her plate and let her play with it. Not necessarily eat it, but let her play with it. Maybe let her rub it on her mouth. Let her kind of play with it on her tongue. Eventually after about two and a half years, and that is long for some parents, but after about two and a half years, we were able to work it up where she wasn't as picky and she was able to experience food for what it is. Food is awesome. We don't have to be scared of it. So she has gotten a lot better and she's six now. She'll eat just about anything. She's weird like her dad. He eats just about anything and it works out very well.

For some kids, it may not be about feeding, eating. It could be about something else. It could be exposure to light. It could be exposure to sounds. We want to, over their lifetime, gradually expose them to the things that make them uncomfortable. You want to make them feel like they have the control. They can turn off the sound. They can decide whether or not they want to touch something gross. They can decide. The more control you give them the better, and it's going to be slow. But if you force it, you're going to overstimulate them and you're back into the meltdown again. So the key ingredient from this whole thing is, in order to prevent very uncomfortable meltdowns that you and your child will have to deal with in the future, you want to start now and you want to start working on very gradual exposure to those uncomfortable stimuli.

Now, some of you parents, maybe you got figured out, you've got a lot of training from people and you know exactly how to do that. For other parents who not so much, you're really new to it and you're kind of terrified of just throwing your kid into some stimulation, talk to a professional. Consult with therapists who are certified, are highly educated in sensory integration, could be therapists, psychiatrists, social workers. There's a lot of people out there that actually go for these certifications and have extensive knowledge of sensory integration. So if you don't quite know where to start or how to implement that exposure, talk to somebody with a professional opinion before you just throw your child into it. That way you have a good starting point and your child won't hate you, which is very important. So other ways to prevent meltdowns, that's kind of the key one that I wanted to drive home because it does go left on said.


3. Stay Educated with Your Child’s Needs

But another one is really just something we've already discussed, is staying very educated and intimately familiar with your own child's needs. You can compare your kids to other children, but keeping in mind that no child's ever going to be the same. They're not going to react the same way to certain sensory stimuli. Meltdowns are never going to be the same. All parents are going to handle it differently and that's okay. They aren't going to be all the same. Another thing you need to think about as a parent or as a caregiver, this is hard.

Meltdowns are very, very hard and emotionally draining, physically draining on you and other people in your life who have to figure out how to manage around these. And so what you need to think about is don't feel bad, which is hard, I know. Don't feel bad. That you're not a bad parent and you are trying your best by being on this forum and by accessing this Facebook page for resources I already know, and everybody around here, you know you're a good parent. You're really trying hard.

The best for that is really try not to be hard on yourself. You're going to have bad days. Those meltdowns are going to happen. And sometimes you're going to feel like your child absolutely hates you and you're absolutely failing. It happens to all of us, all of us who've ever had a family member or a child who's been on the spectrum. It's all intimately familiar to me. It brings back so many memories and you do feel like you fail. But if you start now, you continue on these forums, you consult with people who are intimately familiar and professionally familiar with these behaviors and they can give you some tips on how to handle them, especially sensory related tips, then you got a good start.

Start now and think about sensory integration and sensory techniques. It's not a cure. It's not meant to be a cure for sensory meltdowns. It's a whole lifestyle change. You are in for the long haul. If your child has a sensory processing issue or is on the spectrum and is prone to certain behavioral problems, you are in for the long haul. It is a lifetime of training, no cure, habit developing and lifestyle changing. If you incorporate good habits now, you work with your child well now, it'll serve you well as your child gets older. The behaviors will change. The needs will change as they get older, as they hit puberty, the stimulation is going to change. But if you start now, you start early, you'll be more on top of it when those things happen in the future.