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Tantrums, Outbursts:
Parent Strategies To Eliminating Outbursts

Tantrums and outburst for children affected by autism can be one of the hardest, most pressing issues for parents and professional team members to address. These often crop up at the worst times, most public locations and can go for hours. These outburst can also generate intensity much beyond a typical child tantrum and can last 1 to 12 hours. And if not addressed, as a child on the spectrum ages these can become violent and dangerous for everyone involved – including the child.

Tantrums with children on the autism spectrum typically don’t start over night – they take a little time to develop in frequency and intensity. These outburst build up from frustration usually based on communication issues or lack thereof. The time it takes to tame, trouble shoot, and to find a solution to these tantrums takes time, consistency and hard work.

Providing ways for a child affected by autism to communicate, understand their daily schedule and make choices will help tantrums from cropping up. It is also important to have some behavioral support and services for shaping the desire behaviors and minimizing the undesirable ones. Understanding your child and knowing the signs of a potential tantrum and yield important clues for heading up potential tantrums before they happen.

Tantrums are also a form a communication. They just happen to be a form that most parents don’t like. For my son out burst were a way to express frustration that could lead to a fit that would sometimes last up to 1 hour. For other families their children on the spectrum could have tantrums for up 7 to 12 hours and there was no stopping them once they started. These tantrums typically have to run their full course and there was always damage in their wake.

Helping your child understand their schedule, creating and sticking to routines, and providing them with options during their day will help in preventing most outbursts. As these tantrums are handled parents can introduce more flexible non scheduled activities once a system for communication is understood and in place.

It is important to note that dealing with tantrums while a child is young - preferably under the age of three - can greatly shape the future in the right direction. Letting outburst go or avoid outings altogether can be a disaster especially as the child ages. This article attempts to outline some strategies for easing the tantrum king or queen in your home and on the road.

Personal story:

A large tantrum in a public place – like a supermarket or store – can be the worse nightmare scenario for many parents. Even more traumatic can be the child’s safety by either running away or hurting themselves or others during the process.

This happened with my son on New Years Eve 2002 during a quick run at my local supermarket. He began to tantrum out of control after I would not allow him to get a toy, after all we were in a hurry. He got so frustrated he ran away from me and then I ran after him and slid across the wet floor. Someone caught my son and 2 men had to help me carry him to the car all the while screaming and crying. Hands down, this was the most traumatic experience I have had. I drank my weight in champagne that night and prayed for new year to get better.

While I had experienced tantrums before – this experience made me want to change my strategy because it was not working. For Jeff’s safety I had to come up with options to curbing future outburst. Even more importantly Jeff was just about five years old now was the time to nip the tantrums in the bud while I could. I had to think of a plan to help that process along.

What to do?

The biggest area of need: I wanted to help my non-verbal son communicate more to me and I wanted to communicate to him.

Since my son had a great team of specialist, I worked with them closely on reforumulating the current strategies in resolving the tantrum beast. Working with professionals allowed me to tap into their experiences, work on a strategy that would help my son, and keep it updated as his needs changed.

While working with a behavioral team we looked to four key areas:

1) BACK TRACK – HAS ANYTHING CHANGED?

When something dramatically changed we would carefully back track the diet (foods eaten,) new medically based issues, and biomedical treatments in process to look for suspects that may be causing the tantrum. All the recent additions and changes were carefully scrutinized to rule in or out an offender that could be causing the trouble. A careful review of possible new issues that could have cropped up during this time were also listed as part of the usual suspects.

A check list that can aid this process can be found here

It is important to remember that as LONG AS I DOCUMENT my childs daily food, drink, and supplement intake, I find the culprit every time. Here is a sample daily documentation sheet.

Not doing any biomedical intervention? That can also be part of the issue for tantrums and communication deficiencies. There can be medical issues lurking beneath the surface exasperating the problem. Please check this link for details.

2) Behavior modification & Communication Facilitation:

The team and I created a social story of the tantrum event and talked about it as not a good event or strategy. The outcome was both mom and child were crying, he could of gotten hurt and worse: he did not get the toy! Pictures were used to explain these concepts. This process was not hard to explain – even to a non-verbal child - using pictures and social stories to outline the main issue and provide alternative actions.

To start and for about 6 months every time we went out to do errands I gave my child a list of where we were going and what we were buying at each location. We used PICTURES - similar to the no smoking symbol “X” around DISNEY and OTHER TOYS (It can be customized to include the latest logo and obsession / toy with a red X thru it to indicate NOT BUYING THIS.)

Start by creating these lists by using pictures of everything, move to words with pictures and then just to using words. This process can be a great exercise in helping pre-reading skills. I made it my son’s job to check off the errand locations and items bought at each step. This became his job and he loved being helpful. I saved these items on the computer for easy pull up and re-use during this time period.

Important note: If it was not on the list - we did not buy it. If the errand location was not listed – we did not go there. We discussed it before we left and on route in the car. It is important to remember I REALLY had to plan my day and what we needed as well cause if it was not on the list I could not get it either! (This turned into behavior modification for MOM & CHILD!)

3) Create a clear definition of the house and school rules.

A sample of simple rules are available later on in this document. Be sure to customize the rules to meet your child’s needs. Set up clear communication for what those rules are by using social stories for definition and explanation. Another way to facilitate learning would be video taping good and bad behaviors to teach your child the right way versus the wrong way followed by discussion.

4) Help Communicate emotions:

Have a way for your non verbal or verbal child to communicate their emotions. Even verbal children on the spectrum have a hard time communicating their needs or emotions when they have escalated to a point of anger or frustration.

A beginning chart of emotions is available later in this document.

Must We Live with Lists Forever?

Over time as this routine got easier and the tantrums minimized. Team members can use these suggestions to continue the process to allow for flexibility and change.

Some suggestions include these next steps:

- Go from a picture shopping list to word shopping list.

- Add new items on the list such as "mommy's free choice X3” for leeway and to start possible flexible behaviors.

- I even added to our lists “toy for CHILD’S name that is $3 or less.”

- Then I added things that were not available at the store, such as PINK ELEPHANT, ORANGE GRAPES, etc. I made a big deal saying “Oh well, cannot find that one! That is silly. That’s ok! What’s next on the list??”

- On the way to a destination I would switch things up and go to the 2 nd errand location first and the 1 st location last. All the while communicating to my son and letting him know “don’t worry, we will get to it. I love how flexible you are being!”

- Finally then I faded the list to just telling them where you are going and what you are buying (starting with a short list of 2-3 items and made it his job to remember the list.) All the while encouraging him and repeating the items in the car on route to your destination and prior to entering the store.

These are important steps to help expand flexible thinking and be ok with change in a controlled environment. Over time, these twists and turns became silly stories and funny for us both. It is important to try these new flexible items when there is time to explain and the day appears to be on the better side versus and tough day.

Create a Reward System to Help Tame the Tantrum Beast

Implementing a reward system for every day life is something that works for every child especially children on the spectrum. Reward systems can be implemented to help motivate a child’s busy schedule and keep the process fun and new every time a new reward was selected.

Following the text in this article are pictures of the reward monitoring items with descriptions. I have also outlined what is beginner, how to work it forward to the advanced ideas.

First Reward System for Young Children:

The first reward system for my son was a puzzle piece board. This board was a weekly reward that looked like an empty puzzle board to start and over the week would reveal a picture of the desired reward.

At the top of the page was a small picture of what he was working for. At the end of every day he got one to two pieces for doing a good job that day. It is important to note that the board could be a 5-20 piece puzzle to start.

It is extremely important to make these rewards something your child REALLY WANTS and have the first time using the reward system in allowing the child to EARN IT FAST.

For initial rewards: It is a good idea to set up the initial prizes ready to go wrapped and waiting hidden in a closet or go out and shop for it. A caveat – be careful! You can introduce a tantrum early on if the prize is not in stock at the first store once the reward was earned!

We used frequent reminders that good behavior or finishing a job would yield the desired puzzle piece. We also remembered to take this reward system on the road for quick visual reminders.

Over time the puzzle pieces can increase in number and take longer to earn. In addition, later in the process - about 6 months in - we starting taking away puzzle pieces when there were negative behaviors. Keeping good behavior in check and eliminating bad behaviors became HIGHLY MOTIVATING.

Printing pictures of items does not take a lot of time or money. Use web sites for favorite restaurants, digital pictures of favorite people or www.amazon.com for the latest in music, movies, and toys in securing just the right photo for motivation.

Graduating the Reward System:

Once the puzzle piece system is in place for a year or so move we moved to money. Your child can now work for quarters that add to dollars that equal up to the price of something the child is working for.

Graduate the puzzle piece system to the "I am Working for" 8 1/2 x 11" poster. This poster can be updated and managed for achieving the reward goal about 1 time a month. Samples of this reward system can be found later in this document.

Ideas for what your child can work for:

The reward system options are endless. The goal is to keep them highly motivating for your child and have them help pick out the next “I am working for.” They also can be designed to meet every budget – whether you have one or not!

Items include:

• favorite restaurant
• favorite meal at home with the ultimate desert
• new toy or movie
• rent a new movie
• fun movie with mom or dad
• trip to a zoo, amusement park, beach, or park (It is important to watch weather choices in winter on these items!)
• see a much loved relative
• add your child’s favorite item here

We now cut things out of magazines and catalogs or write items down on a list in my child’s room for future reward items. That way we are never out of ideas on what to work for.

Watching for Tantrum Signals and Heading them off at the pass:

Many tantrums that occur in different locations including home, on outings, during therapy can be situations that have many similarities that bring the undesired beahvior to the forefront. It is important to figure out what the similarities are and watch for the ingredients that make the “perfect storm” for your child.

These components can create a tantrum especially when a child has had a long day, is not feeling well, is hungry or tired is not the time to tempt them an outburst by introducing something new or changing up the schedule. Often parents find themselves doing one step forward, two steps back by not observing the signs or just being too busy. Careful planning, consistency, and observation is key in taming the tantrum beast.

Make note of the tantrum causing ingredients unique to your child and be an expert as spotting the signs. Then work with your professional team on having a plan to minimizing them before they happen. There are some great resources later in this document to help.

Be sure to have the entire team on board with curbing tantrums and the reward system. That includes: mom, dad, siblings, speech pathologists, aides, all para professionals, and family members. This system works when everyone around the child is working the same way – as a perfectly run team.

In conclusion:

It seemed our family was always buying our child toys to avoid tantrums and keep my son happy that this reward system turned out to be cheaper in the long run. These strategies work both for verbal and non-verbal children. Since the implementation of these strategies my son now is able to talk – so I have worked with him using these steps in both scenarios of communication.

The resounding benefit was not saving money on toys but completely eliminating tantrums and having a much happier child. The good news: we have been tantrum free since that New Years Eve trip to the store in 2002. Even family and friends get into the act seeing the positive change in behaviors. Now grandma, dad, aunts, and everyone can reward him with quarters (or in the past a puzzle piece.)

Book Resources:

When My Autism Gets Too Big! A Relaxation Book for Children with Autism Spectrum Disorders by Brenda Smith Myles

Incredible 5-Point Scale Assisting Students with Autism Spectrum Disorders in Understanding Social Interactions and Controlling Their Emotional Responses

by Kari Buron Dunn

Activity Schedules for Children With Autism: Teaching Independent Behavior (Topics in Autism) by Lynn E., Ph.D. McClannahan,

Solving Behavior Problems in Autism (Visual Strategies Series) by Linda A. Hodgdon

Teaching Children With Autism to Mind-Read : A Practical Guide for Teachers and Parents by Patricia Howlin

Some additional related reading:

PECS www.tacanow.com/pecs.htm

Start in-home program

The rest of the document are some social stories and ways to provide rewards to your child.

DISCLAIMER: PLEASE REMEMBER THIS INFORMATION SHOULD BE USED AS GUIDELINES. IT IS IMPOSSIBLE TO DOCUMENT ALL INDIVIDUAL ISSUES FOR ALL CHILDREN. WORK WITH PROFESSIONALS THAT CAN ASSIST YOU WITH IMPLEMENTATION, CUSTOMIZATION TO YOUR CHILD’S NEEDS AND MODIFICATION AS NECESSARY.

Author Information:

Lisa Ackerman is a parent, not a professional with any credentials or background in inclusion or teaching special needs children. Her experience includes one child: her son, Jeff. She has quit her full-time job in management to work full-time with her son and other families with a group she founded called Talk About Curing Autism (TACA) in California. TACA started with 10 families in November 2000, and by January 2006, had more than 2000 families and seven meeting locations in California.

Special thanks to Autism Spectrum Consultants and especially Sean for helping creating a strategy for helping my son. For more info: www.autismconsultants.com

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Sample of Social Stories for Controlling Anger

First steps first, make sure your child understands the difference in emotions such as: Happy, anger, frustration, etc. There are some great cards and games from www.superduperinc.com in helping teach this process.

Also use HOW AM I FEELING CHART

How do I feel?

Include childs picture HERE

Have the child be able to let you know there feelings by selecting cut outs either of the cartoon pictures below or pictures of your child, family or friends experiencing emotions

Pictures to use for cut outs:

Sample of Waiting

Notes:

• This beginning tool can be used to teach a child to wait for something that is a preferred activity or item. Again, it can be customized in the bottom half to incorporate the waiting time period and why we need to wait.
• Rewards for positive behaviors like waiting should be lots of encouragement and smaller tokens (like free time, favorite snack, etc.)

Sample Reward Charts (Beginner)

Notes:

1. This reward system allows the child to PICK what they are working for, have a picture to remind them the end goal, and the ability to see the goal being met in a visual and fun way. These pictures can be easily acquired from online resources such as www.amazon.com and be printed off any printer.
2. This simple tool allows you to show a child on the spectrum what they are working for throughout the week. This also allows the child to count the number of pieces to go for the reward.
3. Over time these can be expanded to 2 or more weeks by just changing the top description.
4. Children will be rewarded a puzzle piece for their daily activities.
5. This puzzle board can easily be moved up to 20 to 30 or more pieces for expensive items, reward more puzzle pieces during the day, or to drag out the reward itself.
6. As the child understands the reward concepts puzzle pieces can be used as a deterrent for negative behaviors as well. If clearly understand the rules and they misbehave a puzzle piece can be removed.
7. It is important to work with your behavior team on this reinforcement system for positive rewards and negative consequences behaviors.

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The next chart “ I am working for ” is the graduation from puzzle pieces to a useful learning tool – introduction of money. Children can work for pennies, dimes, quarters and inevitably dollars for desired items.

This reward system can have the same desired behavior reward and negative behavior consequences as outlined above. Rewards can be doing good at school, speech or while on an outing and negatives can be any clearly defined rule that was broken. Quarters or any money can be taken away for negative behaviors.

I am working for

Charlie &

the Chocolate

Factory Xbox
Game! -

$0.25
$0.50
$0.75
$1.00
$1.25
$1.50
$1.75
$2.00
$2.25
$2.50
$2.75
$3.00
$3.25
$3.50
$3.75
$4.00
$4.25
$4.50
$4.75
$5.00
$5.25
$5.50
$5.75
$6.00
$6.25
$6.50
$6.75
$7.00
$7.25
$7.50
$7.75
$8.00
$8.25
$8.50
$8.75
$9.00
$9.25
$9.50
$9.75
$10.00
$10.25
$10.50
$10.75
$11.00
$11.25
$11.50
$11.75
$12.00
$12.25
$12.50
$12.75
$13.00
$13.25
$13.50
$13.75
$14.00
$14.25
$14.50
$14.75
$15.00

$15.25
$15.50
$15.75
$16.00
$16.25
$16.50
$16.75
$17.00
$17.25
$17.50
$17.75
$18.00
$18.25
$18.50
$18.75
$19.00
$19.25
$19.50
$19.75
$20.00
$20.25
$20.50
$20.75
$21.00
$22.25
$22.50
$22.75
$23.00
$23.25
$23.50
$23.75
$24.00
$24.25
$24.50
$24.75
$25.00

 

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