Monday, September 7, 2015

Why Losing Can Lead to Meltdowns in Autism

All kids have trouble learning to lose with grace, but for children in the autism spectrum, losing can lead to an all out meltdown.  A meltdown is different from a tantrum in which the child is in control of his behavior but is acting out to achieve a goal or manipulate an outcome.  A meltdown is the moment at which someone is entirely overwhelmed by emotion and decompensates before your eyes.  The emotional moment may last a very long time; children with autism can take even hours to recover.  

Many children with ASD (autism spectrum disorders) have meltdowns in response to losing a game.  Why?  Here are several reasons:
  •  Uncertainty:   Individuals in the spectrum often want things to be routine and predictable.  They have difficulty not knowing the outcome of something ahead of time.  For some kids, if there was a predictable pattern to winning and losing (e.g., I win then you win then I win...), the individual would do better.  But that is the point of the game for most people; the outcome is uncertain and captivates our attention.  What is going to happen?!  For the individual with ASD, the uncertainty is stressful.
  • Concrete: Good vs Bad --Concrete thinking is common in the spectrum as well.  Your child may categorize everything into good or bad, or other black-and-white categories.  As my son was growing, he would ask the same thing of me ("Is that person a good guy or a bad guy" or "Is that a good word or a bad word").  It is difficult for your child to, on the one hand, know that winning is the object of a game (no matter what adults say to the contrary) and also realize she is either a winner or a loser, good or bad.  When she uses all her efforts to get into the "good" category and fails, this is overwhelming.  
  • Fixed Beliefs --Many individuals in spectrum fixed beliefs that have no clear basis in reality.  They may firmly believe with all their being that something makes the team that is playing good or bad.  For example, they may be extremely attached to the blue uniforms of a team on television, and melt down if the blue team doesn't win.  I have heard some kids say, "I don't know why, but I just feel like it is really really important for the blue team to win."  It is common for people in the spectrum to be unable to distinguish what is "really important" and what is not. 

This leads us to the topic of Emotional Control.  You can think of emotional control as part of the overall concept of executive function which is impacted by the center and front of the brain.  For a good description of emotional control, see Dr Dawson and Guare's descriptions in their books at Smart but Scattered Kids.  Executive function is a significant difficulty for individuals in the spectrum, and emotional control is a big part of that challenge. 

People who have emotional control difficulties may have different manifestations.  In the presence of overwhelming situations,  they may:
  • Shut down (withdraw, lose their words, freeze, be unable to act)
  • Act Out, Explode, or Meltdown (pushing someone away, crying, yelling)
  • Become very anxious (significant fear, worry, and upset)
Because they are less able to manage their own emotional and physical experiences, they often become overwhelmed by emotion and unable to function appropriately through the challenges.  

It is important to understand that, for these individuals, the difficulty managing emotion after losing a game has a neurologic base and cannot be generally managed hearing someone say "stop it" or "don't be a cry baby." 

Some ideas for managing these situations coming up in my next post!