Medicine:Autistic meltdown

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Short description: Symptomatic behavior

Autistic meltdown is a term that has been used to describe an intense and uncontrollable response to an overwhelming situation in some people on the autism spectrum. Irritability or tantrum is the term used historically to describe the behavior.

Angry outbursts in people with autism have been referred to as meltdowns which manifest as an intense reaction.[1] They are linked to maturity and may escalate with age.[2]

There is no scientifically agreed upon distinction between a meltdown and a tantrum. In the literature, the terms are often used interchangeably or depending on the population being studied.[1][page needed][3][page needed][4][5] Temper tantrums are developmentally normal, but for neurotypical children, their frequency decreases as the child ages; in autistic children, however, meltdowns can persist longer, and in a third of cases, they worsen as the child ages.[2]

Luke Beardon states that an autistic meltdown is an "intense response to overwhelm".[6] The distinction between a tantrum and a meltdown as tantrums being primarily verbal (screaming, crying) and meltdowns having a physical component (such as violent behaviour), is not broadly agreed upon.[7][8] Autistic meltdowns are not manipulative and arise from distress.[9]

Meltdowns can be misinterpreted by first responders and law enforcement officers, leading to escalation of situations.[6](pp2033-2034)

References

  1. 1.0 1.1 Sukhodolsky, Denis G.; Gladstone, Theresa R.; Marsh, Carolyn L. (2021). "Irritability in Autism". in Volkmar, Fred R.. Encyclopedia of Autism Spectrum Disorders (2nd ed.). Cham: Springer. pp. 2561–2562. doi:10.1007/978-3-319-91280-6_102263. ISBN 978-3-319-91279-0. "Historically, the term irritability was used in ASD literature as an umbrella category for severe disruptive behaviors including temper tantrums, aggression, and non-compliance ... anger outbursts in ASD have been described as 'immature' with labels such as 'meltdowns' being used to reflect the uncontrollable nature of these behaviors.". 
  2. 2.0 2.1 Sukhodolsky, Denis G. (2021). "Irritability in Autism". in Volkmar, Fred R.. Encyclopedia of Autism Spectrum Disorders (2nd ed.). Cham: Springer. pp. 2561–2564. doi:10.1007/978-3-319-91280-6_102263. ISBN 978-3-319-91279-0. "The intensity and number of tantrums tend to decrease with age although typically developing children continue to outwardly display anger and frustration, behaviors that parents often label as tantrums. This decrease in the frequency of temper tantrums as children age is paralleled by the development of emotion regulation skills and the acquisition of socially appropriate ways to express anger (Blanchard-Fields and Coats 2008). In children with ASD, if temper tantrums and disruptive behavior are present in childhood, they are likely to persist and may escalate in up to one third of adolescents (Shattuck et al. 2007; Simonoff et al. 2013).". 
  3. Myles, Brenda Smith Smith (2005-03-15). Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums Second Edition (2nd ed.). AAPC Publishing. ISBN 978-1-931282-70-3. 
  4. Mayes, Susan D.; Lockridge, Robin; Tierney, Cheryl D. (2017-08-01). "Tantrums are Not Associated with Speech or Language Deficits in Preschool Children with Autism" (in en). Journal of Developmental and Physical Disabilities 29 (4): 587–596. doi:10.1007/s10882-017-9546-0. ISSN 1573-3580. https://doi.org/10.1007/s10882-017-9546-0. 
  5. Beauchamp-Châtel, Alexis; Courchesne, Valérie; Forgeot d’Arc, Baudouin; Mottron, Laurent (2019-06-01). "Are tantrums in autism distinct from those of other childhood conditions? A comparative prevalence and naturalistic study". Research in Autism Spectrum Disorders 62: 66–74. doi:10.1016/j.rasd.2019.03.003. ISSN 1750-9467. https://www.sciencedirect.com/science/article/pii/S1750946719300443. "“Rage attacks” or “temper outbursts” are mostly used for older children or adults with Gilles de la Tourette syndrome or Obsessive-Compulsive Disorder ... “meltdown” is more frequent for autistic children in lay literature, and "temper tantrums” is more universally used for young neurotypical children ... The difference between normal and abnormal tantrums is ill defined ...". 
  6. 6.0 6.1 Beardon, Luke; Chown, Nick; Cossburn, Kleio (2021). "First Responders and Autism". in Volkmar, Fred R.. Encyclopedia of Autism Spectrum Disorders (2nd ed.). Cham: Springer. pp. 2031–2039. doi:10.1007/978-3-319-91280-6_102159. ISBN 978-3-319-91279-0. https://openresearch.lsbu.ac.uk/download/ef4cd6674fa423067fcbb2a445eaf463f0006b0a16162c6b143e4ec2b5f0111d/61884/First%20responders%20%26%20autism%20accepted%20manuscript%20%2B%20VoR%20statement.docx. "Many autistic people experience meltdowns. The public often finds it hard to tell meltdowns and temper tantrums apart, but they are different things. A meltdown is an intense response to a situation an autistic person finds overwhelming. To cope with such a situation, the autistic person may need to engage in repetitive body movements (stimming). Interrupting this may increase levels of anxiety exacerbating the situation.". 
  7. Benaron, Lisa Dorothea (2009). Autism. Internet Archive. Westport, Conn. : Greenwood Press. ISBN 978-0-313-34763-4. http://archive.org/details/autism0000bena. 
  8. Brooks, Cheryl A. (2010). "Review of Freedom from Meltdowns: Dr. Thompson's Solutions for Children with Autism". Education and Treatment of Children 33 (4): 647–652. doi:10.1353/etc.2010.0002. ISSN 0748-8491. https://www.jstor.org/stable/42900574. 
  9. Patnam, Venkata Sindhoor Preetham; George, Feba Thankachan; George, Kiran; Verma, Abhishek (August 2017). "Deep Learning Based Recognition of Meltdown in Autistic Kids". 2017 IEEE International Conference on Healthcare Informatics (ICHI). IEEE. pp. 391–396. doi:10.1109/ichi.2017.35. ISBN 978-1-5090-4881-6. http://dx.doi.org/10.1109/ichi.2017.35. 

Further reading