Autism Spectrum Disorder and the Cycle of Rage

By November 13, 2020 Uncategorized

When The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, Asperger’s Syndrome was removed as a diagnosis and was placed as part of a larger category called Autism Spectrum Disorder (ASD).  Then known Asperger’s Syndrome is now classified as ASD with specifications.  Out of this respect, I will be using the acronym ASD to describe the previously referred to Asperger’s Syndrome.  Some symptoms of ASD in children include, but are not limited to eye contact resistance, missing social cues (body language or facial expressions), minimal emotion expression, and may dislike change.  Only mental health experts can diagnose ASD.

It makes a lot of sense why children diagnosed with ASD experience more stress and anxiety that may lead to more behavioral problems compared to a child without the diagnosis.  I couldn’t image how frustrating and confusing it would be to be challenged daily with understanding social cues in an unpredictable world.  Following research from Albert (1989), Beck (1987), and Myles and Southwick (2005) The Cycle of Tantrums, Rage, and Meltdowns was developed to help parents, teachers, and professionals understand and prevent tantrums of children with ASD.  This cycle is broken down into three stages:

1. The Rumbling Stage:  This initial stage can often times be over-looked as signs of this stage may be as minor as the child clearing their throat or a seemly harmless grimace.  Other potential signs of the rumbling stage may include, but are not limited to tapping their foot, lowering their voice, a scowl, rapid movements, or fidgeting.   You know your child better than anyone, so with some intentional observing you’ll begin to see patterns in behavior changes leading up to a potential meltdown. Once you’ve been able to identify precipitating events prior to challenging behaviors, these interventions can be used:

    1. Antiseptic bouncing which simply means removing the child from the environment in a non-punitive manner.
    2. Proximity control meaning standing near the child, as this simple gesture can be calming.
    3. Signal interference is discretely getting the child’s attention, making eye contact, and letting them know they are rumbling with a pre-agreed upon “secret signal”.
    4. Support from routine is creating a visibly-displayed schedule of events that can help provide security and predictability for the child.
    5. Just walk don’t talk is that, simply stated, walking with your child while remaining silent. Again, be sure this removal is done in a non-punitive manner.  The child should be presented with a safe comfortable environment to share whatever they wish without fear or judgment.
    6. Redirection is refocusing the child’s attention on something else that is not what may be causing the rumbling stage.
    7. Home base is a safe room or area of the room for the child to access with only a couple of items or activities for the child to use. Be sure the items and activities are meant to be calming and relaxing.  Overstimulation can increase escalation of the child.

***It’s important to note these tips are meant for de-escalation purposes “in the moment” and are not self-regulating or reflecting techniques.

2. The Rage Stage:  At this point the child has escalated past the rumbling stage and is now exhibiting more noticeable and/or disruptive signs.  These are including but not limited to yelling, kicking, withdrawing, swearing, biting, self-harming, or destroying property.  In this stage the number one emphasis should be on safety of all involved including the child.  Safety plan development prior to getting to this stage is pertinent.  Most often this plan will include calling for assistance, removing others from the situation, assessing for safety risks and removing them, therapeutic restraint (only if certificated and confident in your ability to perform), and lastly contacting dispatch if the child continues to escalate and safety is a concern.

3. The Recovery Stage:  It is not unusual for children with ASD to not remember what occurred after a meltdown.  In this stage, children may feel physically and emotionally exhausted, withdrawn, or even reject the antecedents occurred.  It is important for parents to address what happened with the child and re-establish or adjust the safety plan with them, but during this stage children are typically not in a place to learn and contribute.  Addressing it at a later time is recommended as if addressed in this stage it could just lead to another escalation.  Parents can help kids adjust out of the recovery stage by proposing the child complete a simple, highly-motivating task, specifically related to something the child is interested in like walking the dog or helping mom with the grocery shopping.

This blog post was written by Post Adopt Coordinator, Brittney Engelhard, LBSW

For more information about the cycle and resources to help facilitate sensory awareness, reference the following:

https://researchautism.org/

https://www.pdsd.org/cms/lib/PA01000989/Centricity/Domain/7/The%20Cycle%20of%20Tantrums.pdf

How Does Your Engine Run:  The Alert Program for Self-Regulation (Williams & Shellenberger, 1996)

The Tool Chest for Teachers, Parents, and Students (Henry Occupational Therapy Service, Inc., 1998)

Asperger Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World (Myles, Cook, Miller, Rinner, & Robbins, 2000)

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