Autism Vox

Engaging Floortime (5): Tantrums and “free speech”

by Kristina Chew, PhD on July 21st, 2006

I am hardly the only autism parent who has had to hang on to their child in the midst of a serious tantrum or meltdown. Meltdowns—or, “behavior squalls that are, as another autism mother writes, like “thunderstorms blowing through”)—are something all autism parents have found themselves witnessing and often in public places. The Autism Every Day video can be said to portray life with an autistic child as one meltdown, one difficult behavior, after another, and while my own view of life with autism is not that at all, an autistic child (especially one, who like my son Charlie, is 75 pounds, 4 1/2 feet tall) in meltdown mode is not the easiest of situations to find yourself in.

I do see Charlie’s tantrums (like the one in the backseat of my car last night) as his honest attempts to communicate his frustration and what he is thinking. Nonetheless, there are less, well, taxing ways of expressing all that then banging one’s head on windows and a good portion of Charlie’s education at school and at home is focused on teaching him, indeed, to communicate and handle his own anxiety, in addition to academics.

The chapter on “Meltdowns and Regressions” in Dr. Stanley Greenspan’s new book Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate and Think is eight pages long (pp. 361-368; the entire book is 434 pages). Greenspan’s advice on this topic is primarily to tell parents to “go back to the basics” (p. 368)—the basics being the principles of the DIR/Floortime model that have already been extensively detailed in the book. He also suggests that the reason that a child has a tantrum in the first place is due to a parent’s not properly relating to their child. Tantrums in older children are briefly discussed in reference to school situations and the primary suggestion made is to have a “big strong person available” (p. 363). (One wonders if this additional person’s presence might impede the development of the “circles of communication” between teacher and student?)

The chapter begins with an explanation of why meltdowns happen in children in general before making the point that “for many children with ASD, the challenge is to get them more engaged in relationships” (p. 362)—-that is, before Greenspan inserts one of his basic Floortime principles, the need to encourage emotional relatedness in children with ASD. Thus, ignoring the meltdown is an “overly simplistic, deplorable strategy” (p. 362), as is shutting the child in his room in a timeout; as Greenspan writes, “extinguishing the tantrum is a small goal compared to convincing the child that he is loved and that he can rely on you” (p. 362). Nonetheless, Greenspan suggests that a parents might want to “give him a little space—maybe staying across the room so he doesn’t have to look at you”—a rather puzzling statement in light of Greenspan’s emphasis on keeping up a stream of relations and interactions with a child.

A parent is advised to figure out “what is going to help him calm down”—-what any parent indeed tries to do for an upset child, I would think. Greenspan has two specific suggestions, “rhythmic rocking and a calm, soothing voice” and “talking them through it with your voice (”‘It’s okay, we can calm down, sweetheart’” (p. 362) )—-and then, another suggestion to move away from the child by “giving them a couple feet of space” (p. 362)—-which might not be the best thing to do if one’s child is, for instance, lying on the sidewalk and thrashing.

In the next paragraph, Greenspan does note that “if the child is trying to hurt someone, you may have to contain him with a firm bear hug from the back and apply firm pressure….” (p. 363). He acknowledges that keeping a child safe at these moments “is more difficult as they get older.” The rest of the paragraph is in parentheses and is addressed specifically to teachers:

(For teachers who are confronted with kids having meltdowns at school, if the children are big and can be aggressive during a meltdown, and you are not a very big person, there needs to be a big strong person available—–someone who can be both gentle and firm with an aggressive child. He or she might be a volunteer, aide, or teacher who has some training in how to deal with these situations.) (p. 363)

More discussion of meltdowns in older children, or in children who are aggressive to the point of hurting themselves or others, is not provided (and chapter 17, which is about using the DIR approach with older children, adolescents, and autistic adults, says little about how to deal with “behavior problems”). Greenspan only directs his suggestions about having an extra “big strong person available” to teachers—what is a parent to do in their home? He does not specify the “training” such a “big strong person” ought to have——Floortime?

The rest of the chapter on meltdowns (”regressions” are barely discussed) describes “warning signs,” “warding off a meltdown,” and “factors that may contribute to meltdowns and regressions.” Meltdowns in autistic children are “an indication of real helplessness” (pp. 364-365), hence it behooves a parent to attempt the “long-term solution” of “improving a child’s ability to communicate and solve problems with you” (p. 366)—-again, Greenspan refers back to one the basic principles of his Floortime approach as the ultimate answer. “Negotiation, discussion, and compromise” are to be attempted and are indeed “options before the tantrum starts” (p. 363), as if to suggest that a child has a tantrum because his or her parent has not tried these, or tried enough, and hence is not relating well enough to his or her child. That is, a child has a tantrum because (it is implied), the parents are not being responsive enough to the child. As Greenspan then writes,

Rather, the protocol is “Let’s calm down and then we’ll talk about it.” We believe in free speech. There should be no punishments for crying, yelling, or screaming, because after all, we are trying to help children with ASD to be communicative and express emotion. (p. 363)

A child tantrumming, that is, is simply expressing his or her right to “free speech”—-a phrase which rings rather oddly in the midst of what is supposed to be a discussion of meltdowns in autistic children and which suggests that parents who do not view tantrums as such self-expressions of a child’s individuality are denying a child their “rights” and repressing their freedom. Indeed, Greenspan ends this chapter by noting that “a child under stress may often have more meltdowns and tend to regress,” so that “it is wise to go back to the basics” (p. 368)—–those basic Floortime principles of relating, communicating, and thinking, that is. As to why the child is “under stress,” Greenspans suggests that he or she is feeling “not only overwhelmed but also lost” because

He may be experiencing a decreased sense of where he is in physical space (cannot picture Mom in the next room), in time (when will he get to go home?), and in organized thought (a lot of fragmented ideas rather than logical patterns). (p. 368)

I find this final portrait of the child prone to meltdowns puzzling and, indeed, a little eerie. Is the child Greenspan means to describe at home or at school, or elsewhere? Is he suggesting that the child “cannot picture Mom in the next room” because “Mom” is not there? The phrase “when will he get to go home?” seems the thought of a child stuck in some unpleasant place, waiting for his (absent) “Mom” to please take him home—-a “Mom” who, it is implied, needs to get started doing Floortime for parents.

Greenspan’s suggestions on meltdowns would not, I think, be too effective with children whose tantrums are like those in the Autism Every Day video. That is to say, they are not very helpful for parents who, indeed, live with autism every day.

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