Table of Contents
Introduction 11
1 Seeing the World Through Our Eyes 15
Is autism part of an evolutionary process? 17
The importance of scripts 19
Heightened senses impact our ability to navigate social settings 20
Growing up undiagnosed with autism 24
"Scripting": the golden rule in autism 26
Going off script 27
Hating spontaneity 32
Dealing with going off script 33
2 Anxiety: Friend or Foe? 37
Neurological makeup similar to certain animal species 37
Difficulty making eye contact 38
Reason 1: sensory integration 39
Reason 2: peripheral versus central vision 41
Exercises to improve central vision 45
Reason 3: a non aggressive gesture 45
Light touch interpreted as aversive 46
The fight or flight response 47
A prehistoric carry over 48
Triggering a fight or flight response 49
1 The onset of the "freeze" response 49
2 The release of adrenaline 51
3 Loss of cognitive awareness 52
4 The danger of injury 53
The "freeze" response 54
My personal experience with the freeze response 56
3 How Anxiety Impacts Our Cognitive Abilities 59
The stress of navigating through the simple task of shopping 60
Societal inconsistencies 66
A world of absolutes: a major reason for anxiety 68
What are we "feeling"? 70
Problem solving from the autistic viewpoint 74
The fear of unpredictability 74
Stimming 76
Stimming defuses rising anxiety levels 76
Stimming done solely out of habit 79
The child who keeps badgering you with questions they already know the answer to 80
Should we use medication to help reduce anxiety levels in individuals with autism? 81
4 Rituals and Routines: A Natural Defense for Anxiety 85
The need for predictability 87
Although every individual is different, routines are universal 89
What is the function of a ritual? 89
How a ritual differs from a routine 89
Common sense, OCD, or a ritual? 90
Unexplainable rituals 93
Minor changes that could create anxiety leading to new rituals at home or school 93
Interrupting routines 94
Non functional routines established unintentionally 95
Avoiding the use of immediate tangible rewards 96
Modify a routine gradually 97
Replacing a non functional routine 98
Handling interruptions in routines 100
Unforeseen interruptions in a routine 100
The influence of stress on routines and rituals 102
A personal example of how a non functional routine was calming 103
Never interfere with a ritual or routine 105
5 What is a Meltdown? 107
Not all individuals will experience meltdowns 107
Meltdowns are not tantrums 108
What is a meltdown? 109
How I developed my interest in creating meltdown interventions 109
What causes a meltdown? 112
Going off script: a leading cause of meltdowns and catastrophic reactions 113
Not receiving comprehendible answers: another major source of meltdowns 114
Two types of meltdown/catastrophic reaction: cognitive and sensory meltdowns 115
Cognitive meltdowns 115
Cognitive overload and meltdowns 116
Too much choice causing a meltdown 117
Bolting or running away during a meltdown 119
Witnessing self injurious behavior during a meltdown 120
Can self injurious behaviors occur in the Asperger's population? 121
The physiological response of the body during a meltdown 121
Common warning signs and behaviors indicating increasing anxiety, leading to a meltdown 123
The "freeze" response heralds an impending meltdown 124
Immediately after the highly excitable part of the meltdown phase 126
Summary: phases of a cognitive meltdown 127
Sensory meltdowns 128
How a sensory meltdown differs from a cognitive one 130
Accepting sensory limits 130
Summary: sensory meltdowns 131
Cognitive and sensory meltdowns 132
Shut down responses: the other extreme of a meltdown phase 132
The aftermath of a meltdown: intense feelings of remorse, embarrassment, and shame 133
6 How Does a Tantrum Differ from a Meltdown? 135
The golden rule in meltdowns and tantrums 136
Tantrums are a choice 140
Distinguishing a meltdown from a tantrum: a checklist 140
Controlling established tantrums 142
How to handle a tantrum 143
A word of caution 145
Aggressive or self injurious behavior during a tantrum 146
Intervening successfully 148
How to test for a tantrum in the verbal individual 149
How to test for a tantrum in the non verbal individual 150
Utilizing special interests and/or objects to test for a tantrum 151
Look for the tell tale signs of anxiety 152
Non social tendencies 152
Instant gratification as a potential source of tantrums 154
Using a token system as an effective alternative 155
Today's society as a saboteur of behavioral interventions 156
Societal distractions as a sign of the times 157
A ray of hope 159
7 Meltdown Triggers 161
Novel situations: the number one meltdown trigger 161
Airports: my personal nemesis 162
Back up scripts or contingency plans: the main strategy for novel situations 164
"In the unlikely event of…" 165
A case in point 165
Multiple back up or contingency plans are beneficial 166
Communicating back up plans to the severely autistic or non verbal population 167
Back up plans for the verbal and high functioning population 168
Sensory issues compounding the stress of a novel situation: a classic example 169
Strategies to prevent a meltdown in this complicated novel situation 171
You can't prepare for all novel situations 172
Transitions: another major contributor to meltdown 172
Transitioning from class to class 173
Transitioning to a different subject 174
Substitute teachers as a transition issue 176
Other transitions that can cause a meltdown 177
Moving from one home to another 178
Transitions revolving around parental status 179
Guidelines for parental status transitions 180
First time visits to the dentist or doctor 181
Other triggers for meltdowns 182
Trying to participate in a group conversation 183
Time limits as a source for catastrophic reactions 184
Being rushed or hurried to do anything 185
Meltdown and catastrophic reaction triggers 186
Hormonal influences and meltdowns 188
8 Communication Triggers that Cause Meltdowns 191
Miscommunications are just as prevalent in the non verbal population 191
Autistic communication differences 192
1 A large factual knowledge base 192
Dealing with fears by acquiring facts 193
A teen obsessed with the macabre: a communication misinterpretation 195
Factual exchanges are mentally stimulating 198
2 Autistic individuals are more comfortable with "question and answer" communication 199
Communication as a main source of cognitive overload 200
Requests that imply ability and not a command 201
Literal phrases involving a timeframe meant to be interpreted as non specific 202
The overuse of binding words that aren't taken seriously 203
A broken promise 206
Vague time references that may elicit an extreme anxiety response 208
Vague undefined open ended questions 209
Adding a yes or no, as well as adding a time reference, clarifies your question 211
Why does the word "No" cause a meltdown? 212
9 Meltdown Interventions 215
Three main goals of intervention for meltdowns/catastrophic reactions 216
1 Safety of all involved is paramount 216
Self injurious behaviors and safety 218
2 Reducing the stimulation level 220
How you should communicate to a person in a meltdown 221
3 Addressing the problem at hand 222
When there are no alternative solutions 223
Autistic emergency tool kits for reducing the anxiety associated with impending meltdowns 224
Early recognition of signs of anxiety is the best strategy for preventing meltdowns 227
Physical movement as a calming tool for the verbal and non verbal individual 228
Avoiding a meltdown in the first place 229
Sensory triggers at crowded gatherings that are best avoided by not going there 229
A final suggestion: learning to accept meltdowns as just part of who you are 231
Getting the wind knocked out of my sail 232
