Free From Restraints: Gentle Ways To Help A Child With Autism Manage Meltdowns

Free From Restraints: Gentle Ways To Help A Child With Autism Manage Meltdowns

As parents and supporters of children with autism, we are often put in situations where our children are being physically restrained during meltdowns. Whether it is in a school situation or at home, restraints and holds have been the norm for many years for individuals on the spectrum. What I love about the Low Arousal Approach is that it offers a gentle alternative that works. That’s the key. It’s not just a nice ideology; it’s effective. It leaves the person who would traditionally be doing the restraining, and the person that would have been restrained, with both their dignity and actionable tools. This article has been adapted from a longer piece written by one of our Danish colleagues, Scott Larsen, who implemented the Low Arousal Approach at the Pindstrup School in Denmark.  Pindstrup is a special needs school for children with autism, ADHD, moderate learning difficulties and associated behavioural difficulties. – Maureen Bennie

Low Arousal offers effective crisis management in a world of noise

“The vast majority of challenging situations are inadvertently triggered by supporters, and we are often unaware that we can trigger situations”, Andrew McDonnell, founder of the Low Arousal Approach, 2010.

The above statement outlines the underlying premise behind “Low Arousal”, a behaviour management approach that seeks to reduce the points of conflict that lead to challenging behaviour when working with people with autism. But what can the statement tell us? First of all, it tells us we need to explore our own behaviour and emotional responses that arise in the intense, complex and developing work with children and adults with additional needs. It also tells us that even though we are a part of the problem, we have plenty of opportunities to be part of the solution.

Stress causes stress

Highly stressed children, emotional meltdowns and challenging behaviour are undeniably a part of everyday life in a school for children with additional needs. That is why crisis management became a significant focus at Pindstrup, and why Low Arousal was implemented at the school five years ago. When asked about the effect Low Arousal has had on the school. Vice-principal Lone Bridal Hansen immediately mentioned a decrease in the number of physical restraints at the school. As Lone Bridal put it:

“When you can better understand why children sometimes enter high states of arousal, you are also better able to act in a different way.”

How does low arousal work to reduce the need for restraints?

Many of the core principles of the Low Arousal approach can be distilled into a single phrase: before you attempt to change or manage another person, you need to reflect on your own behaviour.

It is precisely in the tension of a challenging moment that parents, teachers and support staff can look at how they were a part of the problem, but also how they can be a part of the solution.

But how is this implemented in practice? Dr Andrew McDonnell – founder of Studio 111 and the Low Arousal Approach – explains that there are four key elements to consider in crisis situations:

1) Reduce staff demands and potential conflict triggers around the child. Take into account a child’s sensory challenges or different cognitive functions that can affect their experience of a situation. By curtailing trigger situations, you may be able to avoid a meltdown before it happens, or lessen one. You can learn more about how to notice and keep track of triggers in this past blog post about Tantrums vs Autistic Meltdowns.

2) Avoid arousal triggers. When a child seems like they could be heading for an overload meltdown, stay away from direct eye contact, touch, and excuse any onlookers to the event that who could potentially elevate the child’s level of stress or excitement.

3) Ensure that parent/staff/support person is aware of their own attitudes and body language. When you are dealing with a highly stressed or sensory overloaded individual, it is important to avoid a confrontational posture, or attitude.  Confrontational body language can cause further stress in a child you are trying to calm down – and on the flip side, appropriate postures and attitudes can reduce a child´s level of stress and reactions.

4) Make sure that all caregivers are on the same page. Make sure that parental, educational and support staff beliefs about short-term management of challenging behaviour are looked at and discussed, e.g: when and why we choose confrontational approaches such as physical restraints – and not avoidance strategies.

Peace of mind is contagious!

People working with stressed children need to be centred and emotionally aware when working with vulnerable groups of people, and able to reflect on how we/they respond to someone in a crisis situation.

It may sound simple, but conflict situations in practice are multifaceted and complex. This is why Pindstrup school regularly has training courses on the subject in order to learn more and to keep the principles fresh in mind. Over the years, the approach has become an implicit part of the school culture.

Vice Principal Lone Bridal observed changes in staff beliefs since the Low Arousal Approach was adopted:

“Today, we talk about children who have difficulties. You would very often hear a teacher say: ‘I think this child seems a little more stressed at the moment, we need to take very good care of him right now’. Before [Low Arousal], you would hear different narratives about challenging behaviour, and you would see children who were constantly fighting the world, because they were being met in inappropriate ways. At this state, the narratives within the school signal that we understand that these are children with difficulties who need help and support”

For more information on The Low Arousal Approach, please read:

Managing Aggressive Behaviour in Care Settings: Understanding and Applying Low Arousal Approaches

Managing Family Meltdown: The Low Arousal Approach and Autism

 If you would like information on how you can bring the Low Arousal Approach training to your area, please contact Maureen Bennie at maureen.aaci@shaw.ca or call 1-866-724-2224.

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