From anxiety to meltdown-- : how individuals on the autism spectrum deal with anxiety, experience meltdowns, manifest tantrums, and how you can intervene effectively

Anxiety is the root cause of many of the difficulties experienced by people on the autism spectrum, and is often caused by things such as a change in routine, or sensory overload. Deborah Lipsky takes a practical look at what happens when things spiral out of control, exploring what leads to meltdowns and and tantrums, and what can be done to help. Drawing on her own extensive personal experience and using real-life examples to explain how autistic people think, the author distinguishes between meltdowns and tantrums, showing how they are different, how each can begin, and most importantly, how to identify triggers and prevent outbursts from happening in the first place. Practical and simple solutions to avoiding anxiety are offered throughout, and these are accompanied by calming techniques and suggestions for dealing with tantrums when they occur. This book will be an essential read for those on the autism spectrum, their families and friends, professionals working with them, and anybody else with an interest in autism spectrum conditions. Cover......Page 1 Contents ......Page 7 Introduction......Page 13 Seeing the World Through Our Eyes......Page 17 Is autism part of an evolutionary process?......Page 19 The importance of scripts......Page 21 Heightened senses impact our ability to navigate social settings......Page 22 Growing up undiagnosed with autism......Page 26 “Scripting”: the golden rule in autism......Page 28 Going off script......Page 29 Hating spontaneity......Page 34 Dealing with going off script......Page 35 Neurological makeup similar to certain animal species......Page 39 Difficulty making eye contact......Page 40 Reason 1: sensory integration......Page 41 Reason 2: peripheral versus central vision......Page 43 Reason 3: a non aggressive gesture......Page 47 Light touch interpreted as aversive......Page 48 The fight or flight response......Page 49 A prehistoric carry over......Page 50 1. The onset of the “freeze” response......Page 51 2. The release of adrenaline......Page 53 3. Loss of cognitive awareness......Page 54 4. The danger of injury......Page 55 The “freeze” response......Page 56 My personal experience with the freeze response......Page 58 How Anxiety Impacts Our Cognitive Abilities......Page 61 The stress of navigating through the simple task of shopping......Page 62 Societal inconsistencies......Page 68 A world of absolutes: a major reason for anxiety......Page 70 What are we “feeling”?......Page 72 The fear of unpredictability......Page 76 Stimming defuses rising anxiety levels......Page 78 Stimming done solely out of habit......Page 81 The child who keeps badgering you with questions they already know the answer to......Page 82 Should we use medication to help reduce anxiety levels in individuals with autism?......Page 83 Rituals and Routines: A Natural Defense for Anxiety......Page 87 The need for predictability......Page 89 How a ritual differs from a routine......Page 91 Common sense, OCD, or a ritual?......Page 92 Minor changes that could create anxiety, leading to new rituals at home or school......Page 95 Interrupting routines......Page 96 Non functional routines established unintentionally......Page 97 Avoiding the use of immediate tangible rewards......Page 98 Modify a routine gradually......Page 99 Replacing a non functional routine......Page 100 Unforeseen interruptions in a routine......Page 102 The influence of stress on routines and rituals......Page 104 A personal example of how a non functional routine was calming......Page 105 Never interfere with a ritual or routine......Page 107 Not all individuals will experience meltdowns......Page 109 Meltdowns are not tantrums......Page 110 How I developed my interest in creating meltdown interventions......Page 111 What causes a meltdown?......Page 114 Going off script: a leading cause of meltdowns and catastrophic reactions......Page 115 Not receiving comprehendible answers: another major source of meltdowns......Page 116 Cognitive meltdowns......Page 117 Cognitive overload and meltdowns......Page 118 Too much choice causing a meltdown......Page 119 Bolting or running away during a meltdown......Page 121 Witnessing self injurious behavior during a meltdown......Page 122 The physiological response of the body during a meltdown......Page 123 Common warning signs and behaviors indicating increasing anxiety, leading to a meltdown......Page 125 The “freeze” response heralds an impending meltdown......Page 126 Immediately after the highly excitable part of the meltdown phase......Page 128 Summary: phases of a cognitive meltdown......Page 129 Sensory meltdowns......Page 130 Accepting sensory limits......Page 132 Summary: sensory meltdowns......Page 133 Shut down responses: the other extreme of a meltdown phase......Page 134 The aftermath of a meltdown: intense feelings of remorse, embarrassment, and shame......Page 135 How Does a Tantrum Differ from a Meltdown?......Page 137 The golden rule in meltdowns and tantrums......Page 138 Distinguishing a meltdown from a tantrum: a checklist......Page 142 Controlling established tantrums......Page 144 How to handle a tantrum......Page 145 A word of caution......Page 147 Aggressive or self injurious behavior during a tantrum......Page 148 Intervening successfully......Page 150 How to test for a tantrum in the verbal individual......Page 151 How to test for a tantrum in the non verbal individual......Page 152 Utilizing special interests and/or objects to test for a tantrum......Page 153 Non social tendencies......Page 154 Instant gratification as a potential source of tantrums......Page 156 Using a token system as an effective alternative......Page 157 Today’s society as a saboteur of behavioral interventions......Page 158 Societal distractions as a sign of the times......Page 159 A ray of hope......Page 161 Novel situations: the number one meltdown trigger......Page 163 Airports: my personal nemesis......Page 164 Back up scripts or contingency plans: the main strategy for novel situations......Page 166 A case in point......Page 167 Multiple back up or contingency plans are beneficial......Page 168 Communicating back up plans to the severely autistic or non verbal population......Page 169 Back up plans for the verbal and high functioning population......Page 170 Sensory issues compounding the stress of a novel situation: a classic example......Page 171 Strategies to prevent a meltdown in this complicated novel situation......Page 173 Transitions: another major contributor to meltdown......Page 174 Transitioning from class to class......Page 175 Transitioning to a different subject......Page 176 Substitute teachers as a transition issue......Page 178 Other transitions that can cause a meltdown......Page 179 Moving from one home to another......Page 180 Transitions revolving around parental status......Page 181 Guidelines for parental status transitions......Page 182 First time visits to the dentist or doctor......Page 183 Other triggers for meltdowns......Page 184 Trying to participate in a group conversation......Page 185 Time limits as a source for catastrophic reactions......Page 186 Being rushed or hurried to do anything......Page 187 Meltdown and catastrophic reaction triggers......Page 188 Hormonal influences and meltdowns......Page 190 Miscommunications are just as prevalent in the non verbal population......Page 193 1. A large factual knowledge base......Page 194 Dealing with fears by acquiring facts......Page 195 A teen obsessed with the macabre: a communication misinterpretation......Page 197 Factual exchanges are mentally stimulating......Page 200 2. Autistic individuals are more comfortable with “question and answer” communication......Page 201 Communication as a main source of cognitive overload......Page 202 Requests that imply ability and not a command......Page 203 Literal phrases involving a timeframe meant to be interpreted as non specific......Page 204 The overuse of binding words that aren’t taken seriously......Page 205 A broken promise......Page 208 Vague time references that may elicit an extreme anxiety response......Page 210 Vague undefined open ended questions......Page 211 Adding a yes or no, as well as adding a time reference, clarifies your question......Page 213 Why does the word “No” cause a meltdown?......Page 214 Meltdown Interventions......Page 217 1. Safety of all involved is paramount......Page 218 Self injurious behaviors and safety......Page 220 2. Reducing the stimulation level......Page 222 How you should communicate to a person in a meltdown......Page 223 3. Addressing the problem at hand......Page 224 When there are no alternative solutions......Page 225 Autistic emergency tool kits for reducing the anxiety associated with impending meltdowns......Page 226 Early recognition of signs of anxiety is the best strategy for preventing meltdowns......Page 229 Physical movement as a calming tool for the verbal and non verbal individual......Page 230 Sensory triggers at crowded gatherings that are best avoided by not going there......Page 231 A final suggestion: learning to accept meltdowns as just part of who you are......Page 233 Getting the wind knocked out of my sail......Page 234

Anxiety is the root cause of many of the difficulties experienced by people on the autism spectrum. Drawing on her extensive personal experience and using real-life examples to explain how autistic people think, the author highlights how meltdowns and tantrums differ from each other, and discusses the sources they can stem from. She identifies how to spot triggers and prevent outbursts from happening in the first place. Practical and simple solutions for avoiding anxiety are offered throughout, accompanied by calming techniques and suggestions for ways to deal with tantrums when they occur.

Drawing on her own experience and using examples to explain how autistic people think, the author distinguishes between meltdowns and tantrums, showing how each begins, and most importantly, how to identify triggers and prevent outbursts from happening in the first place. Practical and simple solutions to avoiding anxiety are offered throughout.