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ASD AND REGULATION: THE BRAIN, MELTDOWNS, AND EVIDENCE-BASED PRACTICES: PART I

Brenda Smith Myles, Ph.D.

All slides are not in your handouts

My Credo THERE IS NO SINGLE FOCAL DIFFERENCE IN THE AUTISTIC BRAIN

ASD IS A HETEROGENEOUS DEVELOPMENTAL DISORDERREGULATION

Mazurek, M. O., Kanne, S. M., & Wodka, E. L. (2013). Physical aggression in children and adolescents with autism spectrum disorders. Research in Autism Spectrum Disorders, 7(3), 455-465.

Physical Aggression

Regulation ChallengesDifficulties

Recognizing emotions in self

Difficulty matching emotions to events

Staying calm or calming down when upset or overwhelmed

Regulation/Change

Individuals with ASD process small changes– such as a change in the schedule -- similar to the way another person would process a major change – such as being fired from a job (Gomot & Wicker, 2012).

The yellow areas represent a composite of fMRI scans showing the areas of the prefrontal cortexes that are significantly less active in people with autism during emotion regulation.Richey et al., 2015

Self-Regulation - Underactivity

Brain Stem Volume Reactive AggressionNot planned in advanceOccurs because the individual does not have the skills to problem solve, recognize feelings in self, match feelings, to event, and calm self

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Sensory: Auditory• For those with

ASD, the brainregions thatprocessemotions reactmore to noisethan those whoare TD

ASD

ASD

Green et al., 2013

SENSORY

Lurie, 2015

PEOPLE WITH AUTISM ARE INUNDATED WITH A DELUGE OF SENSORY INFORMATION THAT CAN TURN EVERYDAY ENVIRONMENTS INTO DISTRESSING EXPERIENCES

Hyperresponsivity to mildly aversive tactile and auditory stimuli, particularly when multiple

modalities presented simultaneously.Green et al., 2015

Sensory: Auditory and Tactile

GABA: Differences in Individuals with ASDAn inhibitory neurotransmitterStops brain cells from acting in response to information they receive from the sensesEnables the brain to process digestible pieces of information rather than try to take in everything at once

Robertson et al., 2015

THESE NEUROLOGICAL DIFFERENCES CAN MAKE THE INDIVIDUAL SUSCEPTIBLE TO MELTDOWNS

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TRADITIONAL TEMPER TANTRUMS” VS “MELTDOWNS

Temper TantrumsThe child will look to see if behavior is getting a reaction

The child can alter behavior to ensure that she does not get hurt

The “temper tantrummer” will use a situation to his benefit

The child has a goal and when the goal is met, the behavior returns to typical

The child is in control

The MeltdownThe child has no involvement in the social situation

The child is not concerned for his own safety

The child does not look to or care if others react to his behavior during the meltdown

Meltdowns appear to be under their own power and have a cycle

Are not manipulation – they are the only behavior the child has to react to the situation

Self-RegulationThe ability to

Detect how you are feeling

Match emotions to events

Change level of behavior and emotion to match environment and cultural expectations

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AND IS SELF-REGULATION IMPORTANT?

USA Today, Sept 2, 2009.

The Secret of School Success“… one of several findings in the growing body of research on “self-regulation” -- people’s ability to stop, think, make a plan and control their impulses. … it turns out that “these are really the same skills you need to do well in school” and potentially in life.”

Professor Megan McClelland Oregon State University

It Might Be a Self-Regulation Problem If …You think that she is just being stubborn.

You think for a nanosecond, “Just calm down already.”

You feel like you need to watch your every word.

You think, “Here we go again.”

You have to stop yourself from wanting to raise your voice.

You have to stop yourself from being in a bad mood around the person.

INHERENT IN ASD ARE SELF- REGULATION CHALLENGES!

The Invisible Disability“You could teach a child with AS the theory of relativity once and he’d get it. But you’d have to to tell him the rules for lining up for recess 500 times.”Prevention is one of the best interventions!

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This is important!The minute the rage cycle hits, all opportunities for learning are gone (perhaps for the rest of the day)!

Rumbling StageMost important stage

Building up to rage

Some thinking ability still intact

Individual children have their own patterns of “rage behavior”Note: The role of verbalizations in escalation.

Rage StageThis is the lightening stage when the neurotransmitters are not working correctly.

The child or youth may shout, swear, kick, or hit.

He or she is clearly out of control.

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Recovery StageThe child or youth may sleep for awhile.

He/she may apologize or be contrite.

Withdrawal may occur; a fantasy world may be the target.

The student may deny meltdown.

Some do not remember what happened during the Rage Stage.

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Student Crisis Plan SheetPage 1 Rumbling Stage

Student Crisis Plan SheetPage 2 Rumbling Stage

Student Crisis Plan SheetPage 3 Rage StageRecovery Stage

All Areas of Functioning are ImpactedAccording to Nancy Minshew, a specialist in psychiatry and neurology at the University of Pittsburgh School of Medicine: “… you cannot compartmentalize ASD. They are [sic] much more complex.”

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