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Sara Pahl, MS, BCaBA, NCC

Beth Pitchford, MA
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Dear Beth,
I have a 30-year old daughter with Asperger's syndrome. She recently had to move back in with us after an unexpected job loss. My husband and I have been surprised by her behavior - sometimes she acts like a toddler throwing a tantrum over the most trivial things - I thought she was over acting like this! Why is she doing it? What can we do?
Bewildered in Blaine

Dear Bewildered in Blaine,
Adults have meltdowns, too! Your daughter just went through two of the most stressful events an adult can experience: job loss and moving. She most likely is experiencing a constant level of stress and worry. I'm not surprised that she's frequently melting down.

She's likely extremely stressed and possibly humiliated (many adults don't want to move back in with their parents) and most likely has had to alter her preferred routine. If something else happens that is either out of routine (having to talk to someone first thing in the morning?) or unpredictable (not being able to find where she packed her favorite shirt) that increases stress and anxiety. A "little thing" can be the final event that triggers a meltdown.
Resources for helping prevent, handle, and manage meltdowns mainly are focused on children or on how to help people who are more significantly impacted by autism. While it may be appropriate to use some of the interventions that work for youth, such as suggesting a break, typically adult meltdowns/shutdowns should be handled differently:

1. Prevention and Management of Known Triggers
Just as with anyone on the spectrum, identifying antecedents can be helpful in preventing or managing a meltdown. If you know a schedule change is coming and it is something that is stressful for your daughter, prepare for it by putting it on the calendar and talking about it. If you know loud noises lead to being overwhelmed, plan for breaks, headphones, or earplugs. Bear in mind your daughter is already heightened. Perhaps she is constantly at a "3" on the 5 Point Scale. It might be beneficial to either meet with a therapist to develop more coping strategies or to put together a plan with your husband so that both of you are aware of potential triggers.

2. During a Meltdown
It might seem as if there's nothing you can do once a meltdown starts, but with some preparation, you can help your daughter through a meltdown with minimal pain for all of you.

It's important that you already know what helps during meltdowns and the only way to know this is to have talked with your loved one about what she needs or doesn't need during a meltdown. For example, some people cannot handle being touched during a meltdown while others need deep pressure. Some people can hear what you're saying to them even when they can't respond, and there are ways to talk them back to calm. Yet others will feel bombarded by any verbal input or sound and will need to cover their ears.

During the meltdown it is of utmost importance that you stay calm. Don't worry about onlookers: focus on your loved one and yourself. Ultimately, the onlookers don't matter (unless it's the police - then disclosure of the autism diagnosis to the police is often the safest option).
Also remember that, for most people on the spectrum, once the meltdown has happened it's over for them. To go back and rehash it may or may not be effective. You can talk it out with them in order to identify triggers or what would be more helpful in the future, or you can use a technique such as cartooning if they are open to it. Most of the adults I have talked with about meltdowns express embarrassment, and some even shame, that they melted down in public. Be compassionate about this - if they don't want to talk about it, it's best to not push the issue yourself. It may be time to look into seeing a therapist with whom they feel comfortable processing these events.
3. Don't Keep Pressing the Trigger
If you know your loved one is heading down Meltdown Avenue, DON'T CONTINUE DOING WHAT YOU'RE DOING, especially if there's a chance that you're (wittingly or unwittingly) part of the trigger. Stop and check in with them to see what's going on. If you can get rid of the trigger before the meltdown happens, everyone will be happier.
I recommend reading a book called No More Meltdowns by Dr. Jed Baker. The book seems to address parents of younger children, but much of the information can be applied to adults as well. In particular, the "Four Types of Meltdown Situations" can be helpful. Dr. Baker lists those as demands, waiting, threats to self-image, and unmet wishes for attention.  
In addition to reading, please come to the family member support group. Here you can have support from peers who may have similar experiences with their children and may even have advice or comforting things to share.
Also, it may be a good time for your daughter to have some formal supports in the way of a therapist or counselor. Having someone to help her process through the stress, identify new coping strategies, and to listen to her with no threat of judgment or disappointment could really help her get through this stressful time.

Good luck!

Beth Pitchford, M.A.
The AuSM Counseling and Consulting Team offers therapy and support:
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Established in 1971, the Autism Society of Minnesota (AuSM) is a self-funded organization committed to education, advocacy and support designed to enhance the lives of those affected by autism from birth through retirement.

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