Many young children have so-called “temper tantrums” at one time or another in their lives. This type of behavior may continue for years in children with autism. Children with autism have perfectly “normal” appearances. They usually do not have any distinguishing features or characteristics that would make them appear different from any other child. Their behavior might be the only thing about them that makes them seem “different.”
People who witness a tantrum tend to make judgments on tantrum behaviors, often without anything to base their judgments on other than their own personal experiences. They will make hasty evaluations about the parents of the child, about the situation, and assume that the child is a “spoiled brat,” when that may not be the case at all.
I have heard many rude comments about my son, with “spoiled brat” being just the beginning. I have been told that he is “stubborn,” “bad,” “obstinate,” and “strong willed.” Once, he echoed “What the Devil do you want?” from the movie Christmas Vacation, and convinced a Baptist Minister that my son is possessed by a demon!
The purpose of this presentation is to address the difference between a “spoiled brat” temper tantrum and an autism tantrum. We will explore some of the many reasons why children with autism present similar “temper tantrum” -like behaviors and what we, as adults, can do to cope with these behaviors.
What Does a First Class, Grade A, Number One Tantrum Look Like?
In Webster’s Dictionary, a tantrum is defined as “ a violent, willful outburst of annoyance, rage, etc. as in :The spoiled child had a tantrum whenever she did not get her own way.”
An autism tantrum is different in many ways from the average type of temper tantrum. A regular temper tantrum usually starts at the mall, a grocery store, or other public place. A child sees an object such as candy, or a toy, and makes a request. The parent refuses the request. The onset of the tantrum begins with this initial refusal to grant the wish. The tantrum will last until the child’s wish is granted or the child loses the desire for the wish. In this circumstance, the tantrum is indeed “a violent, willful outburst” performed by the child to manipulate the environment for the purpose of obtaining the desired object.
Adults have all types of reactions to a temper tantrum. It is very embarrassing to have a child kicking and screaming on the floor. Some parents will “ give in” to the child in order to escape such a scene, which is about the worst thing a parent can do. Other parents will take the child to a more private area for an “attitude adjustment,” which works some times. If it is really out of hand, the parent will remove the child from the store and go home. These are just some of the more typical reactions, but there are as many ways to deal with a temper tantrum as there are parents. How to react to a temper tantrum is a very personal choice for parents to make.
Now, I’m going to show you a video clip of the “spoiled brat” tantrum, taken to the extreme. Later on in this presentation, I will show you a video clip of an autism tantrum, so that we can compare the two.
VIDEO CLIP: In this scene from Willie Wonka, a little girl named Veruca Salt is using a temper tantrum to get her father to find a “golden ticket.” The golden ticket is a prize that has been wrapped inside of a Willie Wonka chocolate bar, and there are only 5 tickets in the whole world. Her exasperated father has closed down his peanut shelling factory and has his production workers shelling millions of chocolate bars instead. Once the golden ticket is found, little Veruca happily skips away, waving her golden ticket high in the air. Her parents look at one another and the mother makes the statement “Peace and harmony all that matters in a happy family.”
I think everyone will agree that this child, Veruca Salt, has learned how to throw a temper tantrum to get her own way ! Her tantrum was a “ violent, willful outburst of annoyance, rage, etc.” Now let’s compare that type of a temper tantrum to an autism tantrum.
First of all, when an autism outburst occurs, many times the triggering event is not obvious. The child will just start kicking and screaming for no apparent reason. We have no earthly idea what might have caused the onset of this behavior !
Second, the outburst or episode can last for HOURS! We don’t know what has started it, and we don’t know what we can do to end it! Rocking, comforting, scolding, spanking, and other measures we usually take do not help the situation. If anything, the outburst just escalates and the behaviors become even more extreme. We, as adults, are left feeling helpless and frustrated.
Third, no two autism tantrums ever look quite alike. Children with autism can throw crying tantrums, where they just cry and cry for hours and they can not be comforted. They might throw screaming tantrums, where they screech at the top of their lungs at such a high pitch that you are sure it can break glass. Children can also throw giggling tantrums, though I hesitate to call it a tantrum exactly, it is more like a “fit” or a “spell.”
Giggling “fits” are much less annoying than the crying or screaming, but they can occur at the most unusual moments or inappropriate times. Too often, when they start giggling, the event is no laughing matter. My son, Christopher, often has these giggling fits when he is very tired. He will sometimes lay in his bed at night and literally giggle himself to sleep.
Now at the beginning I asked you “What does a first class, grade A, number one tantrum look like?” Here it is : (Show transparency of atomic bomb explosion). During a “Ballistic” Tantrum a child loses all control of everything. They may scream, kick, soil their clothes, bite, gouge, and possibly injure themselves or injure you. I can name only one or two times in which Christopher has ever really gone “Ballistic.”
Why Does a Child With Autism Have These Tantrum Behaviors?
In order to understand why these behaviors in a child with autism are occurring, we must first look at what we have to base our discussion on. Let’s look at the criteria we must follow to make a determination of autism in the first place. (Show transparency of Autism Eligibility Determination)
There are other criteria we can follow to determine if a child does indeed have autism, such as the DSM-IV, which gives us a more clinical definition, or the KAR’s definition , which gives us the state regulations, but for the sake of keeping this discussion less complicated, I am going to use the form that our district uses to determine autism eligibility. It is pretty much the same as all of the other eligibility regulations, it just breaks it into easy steps for us to look at.
The child or youth has deficits in developing and using verbal or non-verbal communication systems for receptive or expressive language.
I think I should stop here and explain that autism is a spectrum disorder (Show transparency of Autism Continuum).
Some children with autism can and do have language, but that does not mean that they are very good at communicating. There are people who have a form of Autism known as Asperger’s who are very articulate. Some people with autism actually talk a great deal, but there is a lack of communication because they often fail to understand the purpose of language. Other people with autism do not have the ability to speak, but they learn to communicate through other means. Children may be somewhere in between, they may echo back what you say to them - this is one way that children with autism actually develop speech skills. However, just because a child can echo your words does not mean that the child understands what those words mean.
When a baby is born, its first method of communicating to the parent is by crying. It does not take very long for the infant to figure out that “If I cry someone will come and feed me.” or “change my diaper,” or “rock me and make me feel better.” Crying is a very primitive form of communication. Because autism is a neurologically based disorder, infants later diagnosed with autism even have impairments in this area. A child who is not developing language often will continue to use crying, or even temper tantrums, to indicate wants and needs. (Show transparency of Communication of Basic Messages)
How many of you have ever heard of Temple Grandin? She is a very outspoken person about autism, because she herself was born with autism. You might have heard about her “squeeze machine” that she designed and built to help herself and other people with autism. She has written a couple of books about what it is like to be a person with autism.
In her book, Thinking In Pictures, Temple Grandin describes the tremendous frustration of not being able to talk at age three. This frustration caused her to throw tantrums. She tells us that she could understand what people said to her, but that she could not get her own words to come out. She can remember logically thinking to herself that she would have to scream because she had no other way to communicate.
Tantrums are a very primitive form of communication that can be used to indicate “no,” “I don’t want to,” and so on. It is also a way to communicate choices and preferences. (Hold up some of Christopher’s favorite objects.)
To give you an example of what I mean, when my son was a toddler, he would not drink out of any cup except this one. This poor little cup used to have a nice little handle on it. At one time it had a cute little doggie face painted on it, and it wore a little plastic cowboy hat. If I poured his drink into any other cup, he would throw a big tantrum. If I poured his drink in this “cowboy” cup, he would drink out of it. He was letting me know what his preference was. His preference for this particular cup may have also been a sensory issue, which we will discuss later.
This little blue bowl was the same way. I stood a much better chance of getting him to eat his food if I fed him out of this bowl as opposed to other bowls that I have in my cabinets at home. He would cry if I put his food in the “wrong” bowl. Again, sensory issues may have been involved. This bowl is dark and has a matte finish. This bowl (show one of my ordinary bowls) reflects a lot of light because it is mostly white and has a high-gloss finish on it.
This tattered and torn blanket is the same thing. He would scream and cry when I put him to bed at night until I gave him his blanket. It had to be this one, no other one would do. He did not want his blanket all of the time, but when it was time to go to sleep this was the blanket that he had to have. If you feel the texture of this blanket, you will find that it is very soft.
Let’s return to the Autism Eligibility Determination form, shall we?
The child or youth demonstrates abnormal responses to environmental stimuli.
The reason why I put this as a second cause in this discussion is because it can be a major reason for those “out of the blue” temper tantrum-like behaviors. This type of reaction to environmental stimuli is not uncommon for children. (Show Autism Continuum Transparency)
A child with autism may be hyposensitive (senses may be dulled) or hypersensitive (superman hearing) or anywhere in between. One or all senses may be affected.
Temple Grandin describes her responses to sensory stimuli like “tripping a circuit breaker.” One minute she was fine, and the next minute she was on the floor “kicking and screaming like a crazed wildcat.” (Show transparency of Sensory Profile)
Dr. Grandin states that two things she hated as a child were washing her hair and dressing to go to church, because she has overly sensitive skin. She is very “tender headed” and washing her hair actually causes pain to her scalp. The petticoats that her mother made her wear to church felt like “sand paper scraping away at raw nerves.” I am sure that her mother misread her tantrums as not wanting to go to church, when really it was just Temple’s reaction to the clothing.
Dr. Grandin’s best piece of advice to parents to avoid sensory induced tantrums is to dress kids in soft clothing that covers most of their body. It used to be a battle every morning to get Christopher ready for school. I would put his clothes on, then he would pull them all back off again before we could get to the car. After reading Dr. Grandin’s book, I started buying his clothes a couple of sizes too large, and putting extra fabric softener in the wash. He happily dresses himself each morning and it is no longer a daily struggle. (We are still working on keeping our shoes on.)
Other sensory related stimuli that might result in tantrum-like behaviors can include reactions to certain sounds, tastes or smells, bright lights or textures. Think of all the sounds, smells, lights and sensory experiences you have when you walk into a department store. Now imagine what it must be like for a person who is extra sensitive to all of these things! Tantrum-like behaviors in those places just might be a reaction to sensory overload.
Another reason children with autism might have tantrum-like behaviors is because they fail to understand social situations. This is certainly one of the criteria for autism. (Return to Autism Eligibility Determination transparency)
The child or youth has deficits in social interaction, including social cues, emotional expression, personal relationships, and reciprocal interactions.
Let’s take a look at some of the areas a child with autism might have deficits in: (Show transparency of Social Skills Checklist)
Sharing and taking turns are VERY difficult for my son to understand. He also has difficulty in sitting and participating in a large group, but he is getting much better at that. He does not know how to give a reliable yes or no response, but he has learned how to say “No, thank you.” when he does not want something.
We went Trick-Or-Treating for Halloween and it is interesting to watch how he relates to the whole experience. First of all, he thinks Halloween Costumes are “stupid.” I did manage to get him to wear an astronaut flight suit that I made for him, but you can just forget any type of helmet, mask, or face paint! We practiced how to knock on the door and say “Trick or treat,” and how to hold out the bag to get candy. So the big night came and we went to several houses in our neighborhood. He did not understand why he could not have the entire bucket of candy that one nice lady was handing out. We rushed him on to the next house before any trouble erupted. We also had some problems with him walking right on into the house, but we caught him before any real harm was done.
The night was even more interesting because it was his little sister’s first Halloween to go Trick Or Treating. She was afraid of just about everything and clung to me, while Christopher rushed on ahead to the next house and it was all his Dad could do to keep up with him.
Christopher does not “pick up” on social conventions. He has to be specifically taught what the social convention is and what all the little “unwritten” rules are. It is an unwritten rule that you only get one or two pieces of candy from each house, not the whole bucketful. It is an unwritten rule that you must stay on the porch and wait for the person to give you some candy, you can’t just walk right on in and grab it. He is not trying to be naughty or mischievous, he just does not understand. Fortunately, we live in a very small community and our neighbors are very forgiving people.
It is very difficult for us to help Christopher to learn abstract concepts like “Halloween” and “Christmas.” Here is a video clip of Christopher, taken on Christmas morning, 1995. (Show video clip.)
This a piece of rare footage, because usually when Christopher acts like this we turn the video recorder off, but for some reason we did not do that this time. (I don’t think that any of us want to catch our children behaving badly on film, do you?) Notice some of his reactions when he fails to understand that some of the gifts under the tree are for his little sister, particularly the Doll House. This type of tantrum-like behavior is a lot different than the “spoiled brat” tantrum that we saw on the first video clip, mainly because he is not able to comprehend the situation fully. Darling little Veruca knew exactly what she was doing when she threw her tantrum.
VIDEO CLIP: It is very early on Christmas morning, and Christopher wakes up and comes into the living room. He looks under the tree to find a whole stack of presents that Santa Claus has left!
(Ah, the beginnings of a Normal Rockwell, Bing Crosby, Jimmy Stewart -type “Happy Christmas” - NOT!!!)
Enter his baby sister. As she begins to open her gifts, Christopher is sort of looking at her gifts and then at his gifts. When I watch this video I am reminded of that old saying “finders keepers, losers weepers.” I wonder if Christopher thinks that every gift under the tree should belong to him?
At any rate, the situation escalates and both children are fighting, crying, pushing, pulling, and shoving over the doll house that Santa Claus has left under the tree. I take Christopher to his room and scold him (I doubt if he understood one single word I said, but he knew that I was not happy).
Then Christopher sits on the floor beside the Christmas Tree and makes “laughing” sounds but clearly not because he thinks anything is funny, he is upset and confused. He shrieks and cries and throws his toys across the room. He wants the doll house and he doesn’t understand why we won’t let him have it. He is not having a “a violent, willful outburst of annoyance or rage” in the sense of getting his own way about something. This tantrum is just a little one.
One other reason that a child might have a tantrum-like behavior is because his or her routine has been upset or changed in some way, usually without advance notice. (Return to Autism Eligibility Determination transparency)
The child or youth demonstrates repetitive ritualistic behavioral patterns including insistence on following routines and a persistent preoccupation and attachments to objects.
People who have autism have a very difficult time making sense of their environment. They can not always rely on their sense of touch, taste, smell, vision, or hearing to give them accurate information. This is one of the reasons why they prefer to have everything exactly the way it was yesterday.
The need for following routines in order to feel safe, is biologically based. In her book, Temple Grandin quotes Therese Joliffe, who sums up the confusion caused by autistic sensory problems:
"Reality to an autistic person is a confusing interacting mass of events, people, places, sounds and sights. There seem to be no clear boundaries, order or meaning to anything. A large part of my life is spent just trying to work out the pattern behind everything. Set routines, times, particular routes and rituals all help to get order into an unbearably chaotic life."
Dr. Grandin also describes the severe anxiety attacks she experienced as “living in a constant state of stage fright, the way you feel just before your first big job interview or public speaking engagement.”
We used to have a lot of trouble taking Christopher on long car rides, because he would scream during the whole entire trip. He could understand taking short rides to run errands to the store, post office and so on. He could not understand a trip to Grandma’s house in Florida. Even with short trips, we would have to take the exact same route that we usually travel. Any deviation from the route resulted in a tantrum. Sometimes the only way a child with autism can react to a change in their routine is by having tantrum-like behaviors, particularly if the behavior results in a return to the routine.
What Should I Do When A Child With Autism Has a Tantrum?
(Show Family Circus transparency) - A child is trying to turn off his little brother with the TV remote - Wishful Thinking!
When a tantrum occurs it is a good idea for a child to have a “renewal area.” A renewal area is just a place for a child with autism to go and calm down. The renewal area should be a quiet area away from any extra sensory stimuli. A spot at the end of a hallway is good. My son has a little tent in his room that he made from a folding card table with a blanket over it. He just crawls in there when things get to be too much for him to handle.
It is sort of like a “time out” spot, but differs in the fact that once the child does calm down they can leave that area. In time-out, the child is expected to sit in that spot for a set number of minutes. If a child is kicking and screaming, you are not going to be able to make them sit in time-out. It is more beneficial to have a spot for them to go when the “lose it.” Then once they are over the episode, you can decide what you want to do about the behavior.
It helps to think of an autistic tantrum more as an epileptic seizure. Just like a seizure, the tantrum has to run its course. It will help the child to calm down, if you are able to keep yourself calm. If you become angry or excited, this will make the tantrum worse. Never take an autistic tantrum as a child’s defiance of your authority. There might be any number of things at play here, just as I have described.
I have always told Christopher’s teachers that not every tantrum is a “bad thing.” Sometimes we have to tolerate tantrums in order to make gains in his progress. He had tantrums when I potty trained him, but I did not let the tantrums stop me from pulling his pants down and putting him on the toilet. I just let him have his tantrum, then once he was calmed down, I put him on the potty chair. He had tantrums when he was learning how to talk. He had tantrums when he learned how to dress himself. If I did not keep working with him and only did things that avoided the tantrum behaviors, he would have never learned how to do any of these things for himself.
The first step you should take when you are trying to change a child’s behavior is to first figure out what the appropriate behavior is that you want to teach. It isn’t enough to just stop a tantrum-like behavior, you have to replace it with some sort of appropriate behavior. What does the child need to learn?
When you are trying to decide how to stop a child’s tantrum-like behaviors, you have to become a detective. Negative, punitive measures don’t work very well with children who have autism. You can take a child’s recess away for the next 100 years, and the kid will still have a tantrum every time he hears a fire truck. Just what do you want the child to do when he hears that fire truck coming down the road?
The second step is to analyze the purpose of the inappropriate behavior. You have to try and figure out what the behavior means from the child’s point of view. This is not as easy as it sounds, because children with autism view the world completely different from the rest of us. According to the Technical Assistance Manual on Autism for Kentucky Schools (hold book up) we should be thinking about what happens before the behavior occurs, what is the exact behavior of the student, and what happens just after the behavior ?
So a fire truck comes roaring down the road past the playground, sirens blaring, strobe lights flashing. This happens just before the behavior occurs.
The child grabs his ears and falls to the ground, kicking and screaming. This is the exact behavior of the student.
A teacher’s aid picks the child up and takes him back into the building. This happens every time just after the behavior occurs.
What are some possible reasons this child throws a tantrum-like fit every time the fire truck comes down the road? (Sensitive hearing, to get away from the noise)
The third step is to teach the appropriate replacement behavior. What does the child need to learn? How about a more appropriate way to ask to go indoors? Instead of writhing on the ground in pain, when he first hears the siren he could go to the aid and give her tug on the sleeve, or indicate by pointing that he wants to go inside for a few minutes. Then after the fire truck is gone, he can resume the usual activities.
Now let’s think back to a behavior like getting dressed in the mornings, which triggered tantrum-like behaviors in Christopher. I assumed that he did not want to go to school. We should not look at tantrums as power struggles.
Now that I have learned more about autism, I think he probably had those tantrums because he could not tolerate the texture of his clothing. Once I changed the way I thought about the tantrum, I tried to do something to correct it. I bought Christopher some nice soft sweatsuits, two sizes too large, then I put a lot of fabric softener in them to make them even more comfortable. Guess what? He did not have tantrums anymore when it was time to get dressed in the morning. Even better, he started putting his clothes on all by himself!
Here are some behavior goals and objectives that we should consider as we work with children who have autism: (Show Behavior Goals ,Targeted Behavior Log, and Behavior Charts transparencies)
In conclusion, I hope that I have impressed upon you these three very important facts:
1) Never take a tantrum as a personal threat against your authority.
2) With appropriate intevention strategies, tantrums do occur less frequently , so hang in there !
3) A child with autism who has tantrums is NOT a “spoiled brat,” “stubborn,” “bad,” “obstinate,” “strong willed,” or even “demon possessed” child, the tantrum like behavior is one of the manifestations of the disability.
I hoped that I have helped you to understand the differences between the “spoiled brat” tantrum, which is a “violent, willful outburst of rage or annoyance” and the autistic tantrum, which can be a form of communication, a reaction to sensory stimuli, failure to understand social situations, or an insistence on following routines.
(THANK YOU FOR YOUR TIME, HAVE A NICE DAY!)
Temper Tantrums In Children With Autism: The Terrible Two’s and Beyond
presented by Janet Lawrence
Date of Presentation:
1. What are the strengths of the presentation and the content presented?
2. What are the weaknesses of the presentation and the content presented?
3. Describe how you will apply the information, concept, or strategy to your school, classroom, agency, or program.
4. Please evaluate the overall session. 1 2 3 4
One is poor, two is fair, three is good, four is excellent.
I wrote this presentation for my Intro to Autism Class a year ago, and I have presented it several times to Parent Groups, Teacher Inservices, and at an Autism Conference at Eastern KY University. If you would like me to speak to your group please contact me!
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