Annotated Bibliography

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Sherry Kinkopf

ENG 330 Online

10/2/2019

Autistic Meltdowns: Understanding, Recognizing, and Intervening as Educators

Are teachers able to prevent autistic student’s meltdowns by understanding the reasons why they occur, recognizing them before they happen, and intervening early? The inquiry question is intended to cover autistic meltdowns from start to finish. The included sources will cover understanding autism, recognizing and preventing meltdowns, and methods of intervening. Considering the amount of time that educators spend with students, they should remain well informed of the newest methods and techniques regarding autistic meltdowns. This will not only help the individual student but limit distractions and interruptions for the entire class. Making a student feel safe in their classroom environment should be something that every teacher strives to do. Focusing on students as individuals with unique needs helps teachers address certain issues that each student may face.

I have chosen a wide range of authors in order to establish a well-rounded paper based on the different facets of the issue at hand. I have provided the viewpoints of a medical doctor, a teacher based foundation, topic related researchers, as well as a woman with autism. Each of these articles added crucial information to my discussion and has answered my original inquiry question. As expected, some articles were stronger than others or focused on the educator’s role in autistic meltdowns more. Overall, the articles were individually strong and allowed me to answer whether teachers are able to prevent autistic students’ meltdowns by understanding the reasons why they occur, recognizing them before they happen, and intervening early.

Bedrossian, Louise. Understand Autism Meltdowns and Share Strategies to Minimize, Manage Occurrences. Wiley Periodicals, Inc., Feb. 2015, https://onlinelibrary-wiley-com.lynx.lib.usm.edu/doi/epdf/10.1002/dhe.30026.

In this article, the author acknowledges the need for educator’s understanding of autism and triggers that may cause meltdowns. Bedrossian defines a meltdown as “an involuntary physical and emotional reaction to a situation from which there is no perceived escape.” (Bedrossian. 2015.) Stressors vary from student to student but the most common are usually sensory, emotional, or information overloads, removal from routine, and overwhelming tasks that are given too quickly. The student is unaware of the progression of the sensory overload until it is too late and can result in a meltdown used to release their frustration. This is an example of a pivotal moment when a teacher’s knowledge of autism can prevent meltdowns from occurring.

If teachers intervene and assist students in recognizing their stressors before a meltdown, then it is possible to avoid it altogether. Stressors sometimes cause physical symptoms like chest tightness, palpitations, tremors, tingling, headaches, or pressure in the head. Emotional symptoms are also common and usually consist of anger-related feelings such as irritability, frustration, rage, or paranoia. If a student can recognize their physical and emotional stressors it may help them gain back control of their environment. If prevention fails, teachers should intervene and allow the student to have a mental break from class and sit in a comfortable and quiet area until they feel safe again. Teachers spend an immense amount of time with students each day and as a result, can positively or negatively influence their experiences within the classroom.

Bedrossian’s article highlights the reasons that teachers should intervene in autistic student’s meltdowns and how to recognize common stressors. If teachers can recognize a student’s stressors and assist them when calming down, then a majority of meltdowns can be avoided. Bedrossian demonstrates through the article that students cannot handle these situations alone and need the help of an adult. Student’s experience in school, especially early on in their education, reflects their level of involvement later on. Students that feel supported and safe in their classroom environment learn more effectively.

Kripke, MD, FAAFP, Clarissa. Understanding Autism, Aggression and Self-Injury. Office of Developmental Primary Care, 16 Aug. 2016, https://odpc.ucsf.edu/training/best-practices-behavior-support/understanding-autism-aggression-and-self-injury-transcribed.

In this article, Dr. Kripke uses her medical knowledge and understanding of autism to explain the best approaches to use towards aggression and self-injury seen in autistic meltdowns. She emphasizes that two-way communication is the key to receiving the subtle messages given from those with autism. She states that “Even if people are non-speaking, even if people communicate in a variety of ways, even if they don’t have a formal communication system: our job is to try to figure out how that person communicates best, and partner with them.” (Kripke. Paragraph 3.) This quote is directed towards medical professionals first and foremost but is also important for educators to hear. Dr. Kripke argues that a majority of meltdowns stem from medical conditions and that this contributing factor should be looked into first. She described a nonverbal patient of hers that consistently went up to strangers and punched them in the chest. As expected, this sign of aggression was not taken well and she was eventually consulted. Instead of immediately medicating the man, she took his physical contact with strangers as a means of communication and began cardiac screenings. She was able to attribute his meltdown and aggression to physical pain related to chest pain. This is a prime example of why communication is key whether it is in a medical appointment or a classroom setting.

Dr. Kripke references Deborah Lipsky’s S.C.A.R.E.D. method and integrates it into her article. This acronym stands for safe, calm, affirmations, routine, empathy, and develop. The S.C.A.R.E.D. method begins by finding a safe place to have a meltdown or assist those having meltdowns. The focus of a safe space is to remove others and unsafe objects from it. Calm focuses on simple instructions, affirmations are positive words spoken, and routines are specifically the student’s safe routines that help them work through meltdowns. Empathy uses questions like “What happened?” instead of “What’s wrong with you?” to avoid blaming the person for this outcome. Lastly, develop refers to the intervention plan. If one has not been established then it is a good idea to create one in preparation for next time. These techniques can be implemented into meltdown procedures especially if the person is agitated or aggressive.

Dr. Kripke validates her reason for assuming that most meltdowns are a result of physical pain by using several patients’ experiences as examples. This provides the audience with enough information to understand her reasoning and argument. She not only provided medical professionals with the H.U.R.T.S. method for medical diagnoses for nonverbal patients, but provided information on Lipsky’s S.C.A.R.E.D. method for parents, teachers, and other non-medical bystanders. Her article produced a new understanding of meltdowns and the reason they exist.

Lipsky, Deborah. From Anxiety to Meltdown How Individuals on the Autism Spectrum Deal with Anxiety, Experience Meltdowns, Manifest Tantrums, and How You Can Intervene Effectively MLA (Modern Language Assoc.) Jessica Kingsley Publishers, 2011. APA (American Psychological Assoc.) Lipsky, D. (2011). http://web.a.ebscohost.com.lynx.lib.usm.edu/ehost/detail?sid=8ffd7f5f-0a3a-4579-8f4c-78de8fa095c0@sdc-v-sessmgr03&vid=0&format=EK#AN=387989&db=nlebk

In this book, Lipsky uses her personal experiences with autism to educate readers on how overwhelming sensory overload can be. She reminds the audience that “Many individuals with autism have heightened senses so it is very common for us to experience sensory integration overload or difficulties in areas overlooked by non-autistic people.” (Lipsky. Chapter 1, Paragraph 11.) She explains that for some people with autism, something as simple as eating spaghetti sauce can feel like swallowing jalapeno peppers. She enforces this idea by using an experience that she had with a seven-year-old. The child drank an ice-cold soda after playing and immediately entered meltdown mode. She described the scene and said that even the boy’s mother thought his meltdown stemmed from the cup used or the fact that he wasn’t served first. Understanding sensory overload herself, Lipsky acknowledged the boy’s needs and brought him a room-temperature beverage. She said that he was instantly gratified by the temperature of the beverage and calmed down. This proves how powerful sensory overload can be and why understanding meltdown stressors can be useful.

When discussing sensory overload, Lipsky used examples that non-autistic people would understand to demonstrate sensory overload. Both examples represent sensory feelings that most people overlook or take for granted, but for autistic children, these are very real issues. The point of view that Lipsky has allows non-autistic people the opportunity to see what autistic children experience. For current or future educators, this idea is critical in shaping the understanding that each student should be treated as an individual. Lipsky’s article illustrates the importance of understanding and intervening in ongoing autistic meltdowns.

Merrill, Anna. “Anxiety and Autism Spectrum Disorders.” IIDC, Indiana University Bloomington, 2016, https://www.iidc.indiana.edu/pages/anxiety-and-autism-spectrum-disorders

In this article, Merrill expresses her belief that children with autism spectrum disorders (ASD) are usually faced with phobias, obsessive-compulsive disorders, anxiety disorders, or panic disorders. She uses a study from 2008 to confirm her theory and attributes debilitating anxiety to a majority of the social struggles children with ASD face. She insists that cognitive-behavioral therapy should be used as treatment. According to Merrill, “CBT seeks to train an individual to reconceptualize the way they process the world and then acquire skills that will allow them to apply this new way of looking at things.” (Merrill. 2016.) In other words, CBT is used to reconstruct the child’s environment and how they react to it. The main issue with CBT is that it relies heavily on verbal communications and not all children with ASD can communicate verbally. However, this method has been proven to work well with high-functioning children with ASD. Merrill recommends that adults treat anxiety in children with the Face Your Fears intervention. This method implements encouraging and rewarding the child for effort and engagement, ignoring excessive displays of anxiety, distinguishing between realistic and unrealistic fears, conveying confidence in the child’s ability to handle their anxiety, modeling courageous behaviors, working with other involved adults to make a plan for facing fears, and discussing coping skills.

Merrill’s theory regarding links between ASD and anxiety-related diagnoses could have been more convincing if she used more studies with different age groups. She used a broad study that covered children under the age of 18 with ASD and one that focused primarily on children between the ages of 10-14 years old. The use of cognitive therapy also damaged her argument because it only covers high-functioning children with ASD not non-verbal. It’s common for children with autism to struggle to communicate verbally so this method would be ineffective in most cases.

“Understanding Autism: A Guide for Secondary School Teachers.” CSESA, Organization for Autism Research (OAR), Mar. 2013, https://csesa.fpg.unc.edu/resources/understanding-autism-guide-secondary-school-teachers

In this article, The Center on Secondary Education for Students with Autism Spectrum disorders provides teachers with a guide for understanding autism. The guide first addresses the definition of autism and students’ ranges in function. CSESA quoted Brenda Myles, Ph.D. when she said “You have children with autism who are non-verbal, and then you have children with autism who know more words than a university professor. You have children with autism who would rather be by themselves. And then you have those who want friends, but who do not know how to make them.” (CSESA. Page 2.) Autism is broken down into four characteristics: impaired communications and social interactions, repetitive behaviors, restrictive interests and difficulty with change, and sensory sensitivities. CSESA also lists five essential support strategies to make students with autism comfortable within the classroom. These five support strategies are priming, academic modifications, home base, visual supports, and reinforcement. From there they take the time to define each of the five strategies.

The next few pages describe the stages of challenging behaviors which are rumbling, rage (or meltdown), and recovery. Stage one is rumbling which consists of the warning signs of a meltdown. During this stage, the teacher should intervene using calming methods or sending them to a home base in preparation for a meltdown. Stage two is the meltdown itself if it cannot be avoided. The student loses control of their emotions during this stage and relies on the teachers’ understanding and assistance to help them through it. Teachers are recommended to stay calm and make sure all students remain safe. Last is the recovery stage; this stage allows the student to take a few minutes to collect their emotions and avoid overwhelming themselves again. CSESA advises that teachers give students a simple task related to what was missed and have them reenter the classroom this way. If teachers understand, recognize, and intervene during autistic meltdowns, students are more likely to feel comfortable in their classroom environment.

CSESA used their targeted audience, teachers, to go through step by step explanations and demonstrations of autism. The foundation made an easy to follow guide that can be useful for any grade level and at any school. Teachers were not only told what autism is but how to handle it once meltdowns have escalated. The guide also listed three books at the end that can be used as additional resources in order to understand autism and how it can affect students learning. Overall, this was the most informative and best-structured source in this paper.