Case Study – Charlotte

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Charlotte didn’t like coming to the centre, but her mother needed a rest. This meant she screamed for two hours, hit her head, vomited then went home. Nobody liked this situation, but her mother really needed a break.

Charlotte’s Meltdowns

A meltdown occurs when the child’s fight or flight part of the brain kicks in and takes over. When this occurs, the other part of the brain used for thinking and reasoning is basically switched off.  For children with Autism this is intensified by all the other challenges the child may be experiencing whether it be sensory, communication or environmental.

What we need to do is look at the child who’s having the meltdown and think, “Wow, he or she must have felt threatened or confused in this situation and the emotional brain kicked in to get them out of it.” The difficult part for us is to work out what the child’s feeling threatened or confused by. We need to see the child’s world through their eyes, not ours.

The transition was causing Charlotte’s meltdowns because she did not understand why she couldn’t just stay at home with Mum.

Professor Linda Harrison from Charles Sturt University has identified morning transition for typically developing children from home to the centre as a very stressful time for them, let alone a child on the spectrum. The morning transition is far more stressful in a family grouping room and she has suggested that we separate into our own rooms as soon as possible in the morning. What is interesting is the afternoon family groupings are not as stressful for the children as they have spent the day with you.

How we worked with Charlotte.

Step 1 The everyday event we chose was to make Charlotte’s transition from home better.

Step 2 Plan with families

Transition can be even more difficult for children on the spectrum and we need to work with parents to help create a picture plan of events that will occur and finish with the child at home with the parents feeling safe.

With Charlotte and her family we created a ‘social story’ book consisting of pictures including her routine from home, transport to the centre, activities at the centre, transport ride home again and back to the safety of mum.

Step 3 Prepare all educators

We made sure everyone knew how the book would be used with Charlotte and where it would be kept.

Initially have no more than two different educators implementing the plan.

Step 4 Practice the plan

It started to work with one small step at a time. Charlotte stopped screaming. But she ran outside and sat by the fence. We realised the room was too loud and she couldn’t cope.

Again slowly, very slowly we introduced her to the room with the help of picture cards ensuring there were activities like drawing included that she really enjoyed.

Step 5 Reflection on the work goals

Early intervention came in later to assist further, for example in coping with the noise, knowing what to expect and looking at the demands we place on children.

Demands include statements like ‘come inside now’, ‘put your shoes on’, ‘sit on the mat’. We need to change the triggers and the way we communicate. We also then looked at the situation from Charlotte’s perspective and wrote down all the things we thought she could be feeling about the transitions.

This led us to try breaking the demand down into smaller steps eg ‘Come inside’ becomes

1) Sit down with Charlotte in the sandpit

2) Play with a bucket like Charlotte

3) Tell Charlotte “2 minutes then pack away”

4) Put bucket in container saying “mine first then Charlotte’s”

5) Make it fun and use positive effects. Children with Autism often need extra effect to gain their attention. Give them a reason to want to look at you eg brush the sand off the bucket and say “oh look at all the sand WOOSH off it goes and BOING in the bucket it goes.” Ask her to copy you eg “your turn now Charlotte WOOSH get your sand off.”

6) Use lots of smiles and positive, calm, quiet talking as educator goes over to the bathroom door encouraging Charlotte to follow.

7) Educator washing hands as Charlotte follows. If needed use same technique as step 5.

Think small steps. Break the big demand down and show her exactly what to do.

One small step at a time with lots of planning. Be patient and learn how to communicate with each child in a way that works for them


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