The Cycle of Tantrums, Rage, and Meltdowns
October 01, 2004
Many students with Asperger Syndrome and other autism spectrum disorders (ASD) view school as a stressful environment, presenting several stressors that are ongoing and of great magnitude. Stressors include difficulty predicting events because of changing schedules; tuning in to and understanding teacher directions; interacting with peers; and anticipating differences in environments such as classroom lighting, sounds/noises, odors, etc. Students with this exceptionality rarely indicate in any meaningful way that they are under stress or experiencing difficulty coping. In fact, they may not always know that they are near a stage of crisis. Even though the individuals themselves often do not recognize that they are upset, meltdowns do not occur without some observable warning. Rather, students with ASD exhibit a pattern of behaviors that are precursors to a behavioral outburst. Sometimes these behaviors are subtle. Without a clear understanding of rage and the cycle in which it occurs, it may indeed appear as if rage occurs without warning. Tantrums, rage, and meltdowns (terms that are used interchangeably) typically occur in three stages that can be of variable length. They are (a) the “rumbling” stage, (b) the “rage” stage, and (c) the “recovery” stage (Myles and Southwick, 1999).
The rumbling stage is the initial stage of a tantrum, rage, or meltdown. During this stage, children and youth with ASD exhibit specific behavioral changes that may not appear to be directly related to a meltdown. The behaviors may appear to be minor such as nail biting, tensing muscles, or otherwise indicating discomfort. It is easy at this stage to ignore these seemingly minor behaviors; yet, these behaviors often indicate an impending crisis. Students may also engage in behaviors that are more pronounced, including withdrawing from others or threatening others verbally or physically.
During this stage, it is imperative that an adult intervene without becoming part of a struggle. Effective interventions during this stage include: “antiseptic bouncing,” “proximity control,” “support from routine,” and “home base.” All of these strategies can be effective in stopping the cycle of tantrums, rage, and meltdowns and they are invaluable in that they can help the child regain control with minimal adult support (Myles and Southwick, 1999).
Antiseptic bouncing involves removing a student, in a nonpunitive fashion, from the environment in which the difficulty is occurring. At school, the child may be sent on an errand. At home, the child may be asked to retrieve an object for a parent. During this time, the student has an opportunity to regain a sense of calm. Upon returning, the problem has typically diminished in magnitude and the adult is on hand for support, if needed.
Rather than calling attention to the behavior, this strategy allows the teacher or parent to move near the student who is engaged in the target behavior. Often something as simple as standing next to a child is calming. This can easily be accomplished without interrupting an ongoing activity.
Displaying a chart or visual schedule of expectations and events can provide security to children and youth with ASD who typically need predictability. This technique can also be used as advance preparation for a change in routine. Informing students of schedule changes can prevent anxiety and reduce the likelihood of tantrums, rage, and meltdowns. For example, the student who is signaling frustration by tapping his foot may be directed to his schedule to make him aware that after he completes two more problems he gets to work on a topic of special interest with a peer. While running errands, parents can use support from routine by alerting the child in the rumbling stage that their next stop will be at a store the child enjoys.
A home base is a place in the school where an individual can escape stress. The home base should be quiet with few visual or activity distractions and activities should be selected carefully to ensure that they are calming rather than alerting. In school, a resource room or counselor’s office can serve as a home base. The structure of the room supersedes its location. At home, the home base may be the child’s room or an isolated area in the house. Regardless of its location, it is essential that the home base is viewed as a positive environment. Home base is not timeout or an escape from classroom tasks or chores. The student takes class work to home base, and at home chores are completed after a brief respite in the home base. Home base may be used at other times than during the rumbling stage. At the beginning of the day, a home base can serve to preview the day’s schedule, introduce changes in the typical routine, ensure that the student’s materials are organized, or prime for specific subjects. At other times, it can be used to help the student gain control after a meltdown.
When selecting an intervention during the rumbling stage, it is important to know the student, as the wrong technique can escalate rather than de-escalate a behavior problem. It is important to understand that interventions at this stage are merely band-aids. They do not teach students to recognize their own frustration or handle it. These strategies must be taught in a preventative manner so that the cycle does not begin.
If behavior is not diffused during the rumbling stage, the child or adolescent may move to the rage stage. At this point, the student is disinhibited and acts impulsively, emotionally, and sometimes explosively. These behaviors may be externalized (i.e., screaming, biting, hitting, kicking, destroying property, or self-injury) or internalized (i.e., withdrawal). Meltdowns are not purposeful, and once the rage stage begins, it most often must run its course. During this stage, emphasis should be placed on child, peer, and adult safety as well as protection of school, home, or personal property. The best way to cope with a tantrum, rage, or meltdown is to get the child to home base. As mentioned, this room is not viewed as a reward or disciplinary room, but is seen as a place where the student can regain self-control. Of importance here is helping the individual with ASD regain control and preserve dignity. To that end, adults should have developed plans for (a) obtaining assistance from educators such as a crisis teacher or principal, (b) removing other students from the area, or (c) providing therapeutic restraint, if necessary.
Following a meltdown, the child with ASD often cannot fully remember what occurred during the rage stage. Some may become sullen, withdraw, or deny that inappropriate behavior occurred, others are so physically exhausted that they need to sleep. It is imperative that interventions are implemented at a time when the student can accept them and in a manner the student can understand and accept them. Otherwise, the intervention may simply resume the cycle in a more accelerated pattern leading more quickly to the rage stage. During the recovery stage, children are often not ready to learn. Thus, it is important that adults work with them to help them to once again become a part of the routine. This is often best accomplished by directing the youth to a highly motivating task that can be easily accomplished such as an activity related to a special interest.
Students with ASD experiencing stress may react by having a tantrum, rage, or meltdown. Behaviors do not occur in isolation or randomly; they are most often associated with a reason or cause. The student who engages in an inappropriate behavior is attempting to communicate. Before selecting an intervention to be used during the rage cycle or to prevent the cycle from occurring, it is important to understand the function or role the target behavior plays. This is a first step in developing effective interventions. Indeed, without determining reasons, causes, or conditions under which a behavior occurs, it is unlikely that an intervention will be effective.
Children and youth with ASD generally do not want to engage in tantrums, rage, and meltdown. Rather, the rage cycle is the only way they know of expressing stress, coping problems, and a host of other emotions to which they see no other solution. Most want to learn methods to manage their behavior, including calming themselves in the face of problems and increasing self-awareness of their emotions. The best intervention for tantrums, rage, and meltdowns is prevention. Prevention occurs best as a multifaceted approach consisting of instruction in (a) strategies that increase social understanding and problem solving, (b) techniques that facilitate self-understanding and (c) methods of self-calming.
Myles, B.S., and Southwick, J. (1999) Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage, and Meltdowns. Shawnee Mission, KS: Autism Asperger Publishing Company.
Brenda Smith Myles, Ph.D. is the chief of programs and development for the Ohio Center for Autism and Low Incidence and an associate professor in the Department of Special Education at the University of Kansas where she co-directs a graduate program in Asperger Syndrome and autism. The recipient of the 2004 Autism Society of America’s Outstanding Professional Award and the 2006 Princeton Fellowship Award, she has written numerous articles and books on Asperger Syndrome and autism including Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage, and Meltdowns and Asperger Syndrome and Adolescence: Practical Solutions for School Success.