How we managed our autistic Son's tantrums

Some of our techniques in the stores....

• Desensitization to fluorescent lighting: We got creative! We got some dark sunglasses with a hint of a yellowish hue in the lenses. We allowed Cutie to wear these in the store until we were almost finished. The last five minutes he did not get to wear them! We did this for 4 weeks. Then we increased the time at the end to 10 minutes (6 weeks) then 15 minutes, then 20.... eventually we would just carry them in the store in case he felt like he needed them! We made sure that he had a way to communicate to us if he did need them!
• Earmuffs: We chose winchester ear protection (gun range ear protection). During the first few months he wore them most of the time we were in the store- we were trying to conquer the lighting first as the sounds are more challenging. It blocks out virtually all sound so we are very careful to ONLY use them in extremely loud situations or if he is not feeling well now. He does ask for them sometimes, but can make it through normal shopping situations without them 99% of the time- Christmas sales etc are usually when he needs them.
• Weighted Vest: We started with it at the heavier end of the recommendations and every couple of months we lightened it just a little bit. He wore one every day for over 2 years. He now only wears it in stressful situations or when we go to a really loud restaurant (see my article about "taking a child with Autism to restaurants" for tips to make it less stressful for everyone). He still occasionally asks for it other times, it is always an option but it is rare that he can't find another way to cope!
• Prizes: It is always recommended that you reward a child (especially one with autism) for good behavior. The challenge then comes in about balance... What is a good enough prize to encourage the best behavior, but without spoiling the child or forcing you to mortgage the house when you must give them very often? Also, what if the child figures it out? Cutie started behaving long enough to get the prize, then the tantrum would come. We solved that by making the rule that until we were in the car, the prize could be returned to the store! Our prizes were often matchbox cars or candy (I got a pre-paid visa and added $5/week so it would not destroy us- those prizes get expensive fast!). We moved the reward time to 1/2 way through the store instead of the end as returning it was not something he got. It was heartbreaking but it only took two demonstrations- then he knew we were serious! We got the prize after he had been good for the 1st half of the trip... when he had his tantrum, we silently walked back to where we had gotten the prize and used hand-over-hand to make him put it back. Like I said, we only had to do that twice! Over the years we reduced the frequency of buying the toys by going to stores that had nothing of interest to him and giving him stickers instead, now we are able to walk through toys-r-us with no demands for a present (although there is occasionally some whining- it is the times he asks for nothing that I try to get him something and say it was for a report card or doing extra chores or something!)
• Arm pressure technique: I reserved this one for when he opted to have his flop down tantrums in areas that he could have been hurt- busy walkways, parking lots etc. It was very effective in moving him to a better location but it did tick him off more! Before going to stores with the child it is good to have a general idea of where the busy and quiet areas are, that way if you need to move them to a quiet area you are not fighting the child while you look for one!
• Bring fidgets: If the child is usually very active, being slowed down in a store may make them edgier- try bringing fidgets or a q-charm to help keep that pent-up energy from making the situation harder!
• Speech modeling: We continuously modeled speech throughout our trips both actively engaging him and allowing passive listening. This helped him to learn the words to express his frustrations- when he was able to use his words better he did not have to communicate through kicking,screaming and flopping! We also made sure to give him tools like visual cues to help him until he was able to verbalize or sign his needs.

Step By Step...

Target ONE thing at a time, but have a general plan

• Start Early: Early intervention is proven to be the single most effective thing you can do to help a child with autism. Our team started intervention before the diagnosis was formally made... our intervention started at 12 months. Keep up on evaluations. Just because your child does not meet the requirements for one service today does not mean they won't next year (or that it would not be beneficial) it just means that right now, insurance won't cover it right now and they are not eligible for that particular state funded service right now. Intensity may be just as important as early.
• Observe your child's therapists and emulate what they do: Not to the point of doing all of the therapy (unless you have a background in such things) but copy what they do that gets positive results... if explaining to your child "why we don't hit" does not work (which often doesn't with younger kids anyway) see what the therapist does- not just ask her, watch her body language and pay attention to her tone of voice- if you can copy successful techniques it may help you help your child faster.
• Don't fall for fads: Different autism therapies pop up with little to no evidence supporting their safety or efficacy. Don't start a therapy just because you read about it online. The time tested, effective therapies are ABA, Speech Therapy, Occupational Therapy (including Sensory- but ONLY when provided by a qualified individual) and Physical Therapy. Some other therapies that have been proven to be extremely effective or beneficial therapies in addition to those above are Hippo-therapy, auditory integration therapy and social groups.
• Special Diets: Don't cure autism. They MAY help alleviate certain behavioral symptoms if the child was exhibiting those behaviors as a means to communicate to you that a particular food caused them to feel ill or if they have a nutritional deficiency. That said, it is generally a good idea to at least have an evaluation by a doctor, and then a dietician- especially if your child suffers from oral aversions since a nutritional deficiency may aggravate some symptoms. Determining whether there is a deficiency must be done by a licensed professional.
• Pick one or two behaviors to target at a time. If you try to transform every single one at once you will overwhelm your child and probably confuse and anger them! Start with behaviors that could result in serious physical harm, then work toward less dangerous behaviors.
• REWARD your child!!! Whether you reward them through exaggerated praise, play, sensory fun, toys or a reward system, find SOMETHING that shows them how proud you are each and every time they make a good decision.
• Common Sense: It really comes down to common sense. If something is not working for you, try something else- just be sure to give each approach you try enough time to see if it works. Ask for help when you need it. Call your child's doctor if something worries you. If you feel that your reactions are feeding your child's tantrum, get help through counseling or talk to your own doc about it.
• Distance Yourself: from the tantrum emotionally- your child is not the tantrum, your child is not doing this to upset you. One way or another the tantrum is a method of communication (albeit an inappropriate method). Try not to panic when it happens, see if you can try to understand what the cause was (without showing your child too much attention which may inadvertently reinforce the behavior), if not don't let it take over your whole day.
• Get involved with the team If your child has a team, get involved, try to learn as much as you can from them.