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A meltdown is when a person with autism acts out after being overwhelmed or sensorially overloaded. Some people will become aggressive towards people or objects, either verbally or physically. Others will engage in self-injurious behavior, such as hand-biting or head-banging. Some people, like me, may do both - although nowadays I mostly become verbally aggressive. Other people will just have a crying fit.

What Causes a Meltdown?

There are many things that may cause a meltdown. Sometimes, an unexpected change in routine may overwhelm the person to the point of meltdown, because routines may provide safety to the autistic person. However, overstimulation is also a very common cause. This may involve too much noise, bright light or being touched, but social interaction can also be very stimulating to an autistic person. Also, please be aware that what a non-autistic person doesn't consider bothersome, may cause sensory overload for someone with autism. Paradoxically, for me, isolation or emptiness (as in, not knowing what to do, and consequently being overwhelmed by my own repetitive thoughts) is also a possible trigger for a meltdown. Lastly, some medical conditions may agravate meltdowns. For example, if an autistic is in pain and unable to express this, he may react by becoming aggressive or self-injurious. A very small proportion of autistics have random, purposeless episodes of aggression as a symptom of (subclinical) seizure activity. For these reasons, autistics with limited communication skills or intellectual disabilities, or those who have random episodes of aggression or self-injury, should be evaluated for possible physical problems that might cause the behavior problems.

What Can I Do to Prevent a Meltdown from Escalating into Aggression or Self-Injury?

When learning to prevent or stop a meltdown, I've noticed that being aware that one comes on in time is important. I am still in the process of learning to deal with severe meltdowns, and at this moment, the most common reason why my attempts to prevent a meltdown fail, is that I didn't notice that one was coming on soon enough to seek alternatives to aggressive or self-injurious behavior or to be able to communicate my needs. Also quite commonly, alternatives may help to delay a meltdown, but will not actually prevent it. Here are some actions I can take in preventing a meltdown. As you can tell, most strategies are aimed at regulating my arousal level. Please note that one strategy may work one time, but not the next.

• Retreating into my room or another quiet place (if I am overstimulated by social interaction, or just to avoid a meltdown in public);
• Walking (usually it helps to walk the same short route over and over again);
• Other forms of physical activity, like fitness;
• Yoga or relaxation exercises;
• Showering;
• Listening to music.

Meltdowns for the stereotypical social reasons often mentioned by parents and professionals ("attention-seeking", etc.) are extremely rare for me, but I do have meltdowns when a situation is unclear or inconsistent. In this scenario, doing a relaxing activity in my room will get me to stop raging and start reasoning, but it will not solve the problem, because the inconsistency or unclarity will still be there when I'm done "distracting" myself. For this reason, I sometimes end up in long cycles of repetitive activity that can escalate into further meltdowns. If you know that this is a problem for you, too, speak to the important people in your life about how they can help you gain as much clarity as possible and what may help you if you can't get the clarity you need.

There is also the possibility that I have a meltdown because I am not able to communicate my needs effectively. For example, I might get overloaded when in a busy crowd, but not be able to communicate to the other people in the crowd that I am leaving for a break. If this is a problem for you, I recommend you discuss with the people important in your life - such as your family, friends, or support staff - how you can communicate most effectively. For example, when I still lived in the independent living training home, I often had meltdowns that I knew were coming on but couldn't prevent, because I couldn't communicate that I needed to retreat, and hence staff wouldn't let me take a break. When I discussed this with my treatment provider, she suggested I sign instead of talk, and we agreed on a sign that everyone knew meant I wanted a break. It was and is still difficult for me to communicate my needs when approaching a meltdown, so I also make sure that my support people know about early warning signs.