Stop the Rage: The Autism Files

Stop the Rage: The Autism Files

It is common to hear parents describe a child’s meltdown or tantrum as ‘coming out of nowhere’. Indeed, outbursts of anger (even in adults) can seem to materialise from the ether. But of course, this is far from the reality. There are always signs or cues that the volcano is about to erupt.

Children and adults with Autism Spectrum Disorder (ASD) often have difficulty with anger – difficulty in recognising that they feel angry and inability to manage or deal with these feelings. Myles and Southwick* have described the Rage Cycle for people with ASD. They describe what happens when the person with ASD and those around him, fail to recognise the build-up of anger.

The three stages of the Rage Cycle include rumbling, rage and recovery.

Rumbling

It is important that parents and caregivers of children with ASD pick up on the cues that anger is building (the volcanologist monitors the mountain).

What are these cues?

There may be an increase in stereotypical behaviour and stimming, for example, fidgeting, hand flapping, rocking, grimacing, excessive chewing, tapping and other repetitive behaviours.

There may be an increase in verbal behaviours such as strange vocalisations or nonsense noises, changes in volume of vocalisations (mumbling, speaking under the breath or to themselves), swearing, making threats.

An increase in movement, such as walking in circles (circuits), pacing, or leaving the room/house to get away.

Rage

When the volcano erupts there is little that can be done to reduce the fallout. The child or adult has lost control, emotionally and physically.

The noise and destruction may include screaming, explosive impulsiveness, biting, hitting, kicking, destruction of property, and self-injury (e.g., head banging).

Recovery

The eruption may be followed by crying, sleeping, denial of rage, withdrawal into fantasy, and apologising.

What can be done to avoid the Rage?

The key point to the Rage Cycle is to intervene during the Rumbling stage. It is too late during the Rage stage (and during that stage you need to focus on safety – of everyone involved). These are some of the things you can do to prevent the Rage stage:

Walk (don’t talk)

Children with ASD (especially when stressed or getting angry) have difficulty with listening and processing words – LESS TALKING PLEASE! Let them walk to calm down. Make sure someone is accompanying them. Let them talk all they want to 🙂

Chill out zone

It is a good idea to have a space or room with low sensory stimulation where school children with ASD can take their work, when they need to calm down, cool down or chill-out.

Non-judgemental removal

Remove the child from the situation (in a positive manner) by involving them in a task such as delivering a note to a teacher in another classroom or giving something to Dad in the garage. They will feel important and the Rage Cycle is being interrupted or short circuited, as their attention is diverted to something more enjoyable.

Divert attention

It is often possible to divert the child’s attention from what is bothering them by producing interesting toys (eg., sensory toys like squeeze balls, toys that light up) – it is useful to keep a bag of special toys, that the child does not normally play with, in the car or in your bag, for emergency situations, such as shopping centres or doctors waiting rooms. A discussion of special interests could also be a useful diversionary tactic for the older child with Aspergers.

Schedules and routine

Never underestimate the importance of schedules and routines for the child with ASD. The use of such things as  visual schedules, diaries, calendars, lists and charts in their daily life provides certainty, predictability and a sense of security that goes a long way to reducing the anxiety that can feed into the Rage Cycle. Give plenty of warning to the child of any changes to the routine.

What else!

These are just some ideas on how to interrupt the Rage Cycle. As the child gets older it is important that they learn to monitor their own level of anger and have their own strategies available to manage this anger.

A simple technique is to have a visual 10-point scale of anger (where 10 is the angriest) which the child can use to identify their level of anger. This is accompanied by a list of effective anger-reducing strategies that the child has identified (eg., punch boxing bag, take a bath, play music, go for a hike, swim, get a massage, meditate, drink herbal tea, read a book).

When the child identifies that their anger is climbing up the scale (say 6­ to 7) they look at their list and pick an activity to reduce the anger. The list can be kept on a small card in their pocket or school bag or wallet for ease of access. This sounds simplistic, but that is the key – when a person is angry they stop thinking clearly and need simple, visual cues to assist them in managing their feelings.

There are a huge variety of workbooks on the subject of anger management – many written for children to read on their own or with an adult (I can assist with book lists if wanted).

Helping a child get in control of anger is one of the most important things a parent can do.

Best to get in early!

_____________________

* Brenda Smith Myles  & Jack Southwick (1999). Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns. (Autism Asperger Publishing Company).

Quick Tip (transitioning): The Autism Files

Quick Tip (transitioning): The Autism Files

Mum, stop mumbling!

Quick Tip (Transitioning): Autism Files

Children and adults with Autism Spectrum Disorder (ASD) often have difficulty transitioning from one activity to another.

When my son Michael was a toddler (before his diagnosis with autism at age 3) he would tantrum when I tried to finish one activity and move him to another.

Example:

One day he was playing in a kiddies playground and when I wanted to leave, he refused. I called his name several times with no response. I came inside the play area and told him we had to leave – no response. I tried to hold his hand and walk him out – he scuttled off, crying, and scurried high up into the slippery slide tube. After about fifteen minutes of getting nowhere fast, I had to climb up into the play equipment and physically carry him, kicking, screaming and crying, out of the playground, on my shoulders. It was not a good look.

What was the problem?

1.  At first he was so engrossed in playing that he was not even listening to me speak (he couldn’t hear me).
2.  When he did hear me, he didn’t understand the words I was using (my sentences were too complex);
3.  I hadn’t given him any warning that we would be leaving soon.
4.  I had not provided a motivation for shifting to the new activity.

What to do?

  • Keep your speech simple with young ASD children.
  • Five minutes before the activity needs to end, give a simple warning. Make sure the child is listening by going right up to them and getting down to their level and speak slowly, clearly and in very few words eg. ‘Michael, going soon’. Use sign language if you need to.
  • Give another warning 2 minutes before the finish.
  • When it is time to leave, approach the child again, look at them and say ‘finished’ (preferably signing with hand and thumb).
  • Provide a fun activity or extra special toy (that is only used on special occasions, such as in the car) as a reward for transitioning without tantrums.
  • You can use the first/then strategy (say to the child: first car, then special activity/toy). This is a clear, simple verbal instruction.

This approach is a guideline only and can be adapted to your circumstances. Wishing you happier transitions.