Meltdowns

What is a meltdown?

In general use 'Meltdown' is employed as a term to describe a situation of internal collapse. We might think of a nuclear meltdown or perhaps a financial market going into meltdown. Both of these examples are states of collapse that are a consequence of over stimulation or overheating and a failure of monitoring and regulation systems to keep things under control.  The 'meltdown' scenario is one that is deteriorating, seemingly unstoppable and running completely out of control.  Likewise, in everyday use, 'meltdown' is also employed to describe the condition of a person who under pressure or stress has reached a point where they can no longer cope and have 'snapped' or 'lost it',  becoming angry, tearful or over react in an emotional meltdown.

The term 'meltdown' is also used more specifically to describe the extreme actions of children on the autistic spectrum, when they are in an intense 'out of control' state of behaviour. Applicable to individuals with PDA as well as ASD's , meltdowns can include behaviour such as throwing themselves on the floor, hitting, kicking and screaming, running away, raging, throwing or breaking things, attacking people or causing harm or injury to themselves or others. Whilst these outwardly explosive meltdowns are probably the most common, some are more like an implosion and the child may largely internalise the meltdown. Visible symptoms of this may include withdrawing from communication, hiding, self-harming, curling up in a ball, rocking intensely and may make random sounds and noises to drown out the world around them.

Meltdowns can be outbursts that pose a serious risk to safety and cause significant disruption to the environment where they occur. Parents, carers, teachers or other supervising adults will usually find that they are unable to successfully interrupt a full blown meltdown and the explosive behaviour tends to run its course until it is over. The priority for action is therefore to make the situation as safe as possible for the child themselves and everyone around them.

What causes a meltdown?

At the most basic level, a meltdown is caused by a feeling of being overwhelmed and a sense of loss of control, the child is no longer able to cope and the behaviours are an attempt by the child to regain some control over themselves, those around them, their environment or a combination of these. It is most helpful if these meltdowns are understood as panic attacks, rather than wilfully naughty or defiant tantrums.

Although meltdowns are typically associated with children or young people with an ASD/PDA, the state of panic and acute anxiety that drives meltdown behaviour can still cause profound difficulty for adults with the condition as well. Whilst older children and adults may have learnt some coping skills and be better able to contain their behaviour, the potential for an internal meltdown to incapacitate an individual must not be underestimated. Equally, although adults may be more robust and may have developed improved self-regulation, it is entirely possible for them to experience a loss of control that is so great, it causes them to explode outwardly with challenging behaviours. A meltdown is a state of mind and acute anxiety, rather than a description of a type of behaviour. The behaviour, when it occurs, is merely an external expression of this internal meltdown.

Meltdowns vs tantrums

Most of us are familiar with tantrums in children. We have all seen temper tantrums and these, like meltdowns, can be seriously disruptive and pose a safety risk. Tantrums are usually regarded as being developmental. They are something that most children will do at some stage but can be reasonably expected to grow out of. They are shown by children in the early stages of their development and will decrease in frequency and intensity as the child matures. This would be typified by the oppositional and defiant behaviour that many parents experience with their children during the aptly named ‘terrible twos’. However, not all children do grow out of these tantrums, they may continue through the teenage years and may even persist into adulthood.

So if tantrums and meltdowns are so similar, why is there a need for separate terms? After all, a child with PDA/ASD experiencing a meltdown, looks very much like a typically developing child who is merely having a severe tantrum.  There may be the same levels of risk and very similar challenging behaviour, but there are several underlying difference. Naturally there is some overlap between the two and the distinction between meltdown and tantrum is not black and white, furthermore there can be considerable behaviour variations amongst individuals.  Also, on occasions, a child with PDA/ASD may ‘act up’ out of wilful naughtiness. However, even if this is ‘chosen behaviour’ it can quickly deteriorate into uncontrolled meltdown, if it is dealt with in the same way a tantrum would be handled in typically developing child. The following comparisons provide some flavour of the differences between a meltdown and a tantrum, but must not be taken as a definitive guide.

Duration

Meltdowns usually last for lengthy periods of time and may only end through exhaustion. Tantrums are often short lived and can come to an abrupt end if the child’s needs or wants are met. Tantrums can usually be brought to a halt, but meltdowns are often unstoppable and will normally have to run their course, generally winding down slowly or ‘burning’ themselves out.

Triggers

Tantrums are usually caused by very clear and specific triggers, the tantrum is generally directly linked to this ‘need’. Eg A child may ‘need’ to get their own way. Triggers are usually external.

For meltdowns, triggers may be less apparent and largely internal. Frequently they are a result of a build-up of anxieties or an accumulation of factors leading to overload. These could include sensory issues, communication and social problems, or a general sense of not coping or being overwhelmed.

For children with PDA, a demand imposed on them will often be the last straw that triggers a meltdown. However, it is often the case that the child is already at a state of elevated anxiety and a meltdown will be triggered indiscriminately by more or less any demand.

Self-control

A child is usually in control of a tantrum, behaviour appears to be highly wilful and they can be stopped by appropriate intervention. With meltdowns, it is usually apparent that a child has lost control. Whilst they may appear purposeful, they are unable to readily stop their behaviour and interventions are largely unsuccessful.

Awareness

A child having a tantrum is likely to be very aware of who is watching and how they are reacting to their behaviour, tantrums tend to need an audience and are exploitative of those involved, seeking to manipulate a situation to their own ends. A child in a tantrum may act in a way to attempt to maintain a certain credibility with peers or adults, for example they may be oppositional but not wish to appear too immature. By contrast when in a meltdown a child is often very unaware of those around them and care little about what others think of their behaviour and be inattentive to how others react to it.

Development

Tantrum behaviour is usually developmental and the child will grow out of them. Meltdowns will often become less frequent or intense as the child matures, however they are usually more tenacious than tantrums and may persist into adulthood.

Safety

A child in a tantrum generally has sufficient control not to hurt themselves. However, a child in a meltdown may show total disregard for their own safety as well others. They may hurt themselves as a consequence of high risk behaviour, self-harm or carry out self-injurious behaviour.

Main purpose

The main reason for a tantrum is to control the environment or those around them.

The meltdown state of mind is one of  acute anxiety and loss of control. Challenging behaviour is a panic response to this and it’s purpose is a ‘fight or flight’ attempt to regain some control and thereby reduce anxiety.

Exceptions to the rule

In some cases a meltdown may appear quite purposeful and the actions taken by the child may seem quite controlled. This level of apparent control is generally a response to a very clear stress or cause for anxiety. The child is very aware of the trigger that has tipped them over the edge and makes a highly targeted response to this. Frequently for a child with PDA, this may be a response to a demand that they find particularly difficult or stressful, the child may therefore take very specific action to avoid the demand or react aggressively toward the person perceived to be responsible for the demand. In this sense only can the behaviour be regarded as controlled, as generally the child’s behaviour remains unstoppable, unresponsive to interventions and shares few of the other characteristic of a tantrum.

>>Managing meltdowns