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    Safety Considerations for Caregivers of Children on the Autism Spectrum

    Topics: Autism & Emotions, Advice for Parents and Caregivers, Infant/Toddler (0-3), Elementary (4-12)

    Safety is an important topic when caring for autistic children. We covered how to keep autistic children out of harm’s way in Safety First! 8 Ways to Keep Children on the Autism Spectrum Safe, but there is another side to the story. Safety can also be an issue for the parents and caregivers of children on the spectrum. 

    While caring for my grandson and working with autistic children in various settings for over a decade, there have been numerous safety concerns and incidents. Thankfully, training in safety procedures and putting what I learned into practice helped avert serious personal injury—but there were some close calls. 

    There are a variety of safety training programs on the market, with and without certification, to help parents or caregivers of children on the spectrum, but these are often costly, so here are some of the basic strategies that have helped me during crisis behavior that can help de-escalate or manage a potential meltdown and aggressive behavior, and keep both the child and the parent or caregiver safe. 


    Four Behavior Levels and Safe Responses

    To prevent a crisis, we must first recognize that four main behavior levels generally lead up to meltdowns or aggression, and learn how to best respond to each level of behavior:

    1. Anxiety—When an autistic child becomes anxious, it is often marked by a notable change in behavior. They may rock, cry, clench their fists, or hide under a desk or in a corner to show their distress. Our approach and response should be empathic and non-judgmental. Contrary to what some believe to be the case, children on the spectrum are very sensitive to other people’s feelings and emotions, so responding very calmly is very important and will often help prevent the child from escalating. The safest place to position yourself is to the side of the child, about an arms-length away, with open, relaxed body language and a friendly facial expression. Facing the child and looking directly at them may feel threatening and confrontational to them. Using a soft voice and tone, you can offer help with a task that is frustrating the child, take a walk with them, give them options, and reassure them. This approach will often prevent a crisis from happening. 
      boy with autism having a tantrum
    2. Defensive Behavior—If the child does not respond to these initial calming techniques, they may begin to lose rationality and escalate into defensive behavior. They may throw things, refuse to talk, and/or start blaming you or others. This is when it’s important to take a more directive approach to try to decelerate their escalating behavior. You may need to give them space, wait them out, and redirect them with calm, short, and direct instructions. Using the First/Then strategy often works well, asking them to do just one simple thing, followed by a preferred activity. “First sit down, then you can play with your toy.” At this point, don’t engage in conversation, and make sure you stay at least a leg length away from the child, out of direct contact range. Also quickly and discreetly remove anything the child could hurl at you, such as pencils, devices, and other objects that could harm you or others. 
    3. Risk Behavior—If none of these strategies work, the child may escalate to risk behavior, which can potentially present a risk to the child, you and others. The child may bite, try to run away, hit, kick, or try to throw furniture. This is when physical intervention is needed to keep yourself and others safe. Of course, first and foremost, other children present should be moved out of harm’s way. It is also important to call for backup or help if available. You may need to block the child from running out of the room, and evade the child when they try to hit, bite, or kick you. This is the time to remain very calm and refrain from talking to the child. Make sure to position yourself in such a way that you cannot be backed into a corner or against a wall, and never turn your back to the child. If biting has been an issue in the past, you will hopefully have already donned your protective sleeves or a sweater to keep your arms covered. Stay as calm and quiet as possible during risk behavior, but be prepared to move quickly. Talking to the child will be ineffective, and keeping the child, yourself, and others safe is the priority. 
    4. Tension Reduction—Once the meltdown has run its course, the child will usually display a decrease in physical and emotional energy. The child will start to breathe deeper, and they may cry, apologize, and become quiet. Some children will even go to sleep. The child will often feel embarrassed and bad about losing control. This is the time to re-establish communication and give non-judgmental support, empathy, and encouragement, and meet their basic needs by giving them a drink of water or taking a walk and helping them to reset. Wait with talking to the child about what happened until later. Talking about it too soon may trigger a reaction and re-escalate the behavior. Telling them, “We all have bad days,” will assure them of your unconditional support. Remember, an autistic child does not purposely melt down to the point of losing control. There is always a reason. 

    See our article on Autism and Aggression: A Four-Step Approach.

    Even though my grandson had his moments as he was growing up, when I started working with non-verbal children with moderate to severe autism I was taken aback at the severity of the first full-blown meltdown I witnessed. I froze and didn’t know what to do to help. Thankfully, another more-experienced staff was nearby who handled the situation brilliantly. Afterward, she shared some great information with me.

    mother comforting young girl with autism

    Evaluate Yourself

    She realized I was new, of course, and that I had little to no experience working with mod-severe autistic children. She explained what I witnessed that day was something that everyone tries their best to prevent, but these situations do happen, so each of the staff must evaluate themselves and know what their reactions may be in case of a crisis. Some may freeze, while others may overreact or respond loudly and inappropriately—all of which are unproductive responses. Productive responses, on the other hand, would include staying calm, increased speed and strength to prevent injury, and decreased verbal communication, which in the middle of a meltdown will be ineffective. 


    Maximize Productive Responses

    She also shared that one of the things that will not help is to take things personally if a child in my care were to become upset or aggressive. This is a common reaction of parents and caregivers of autistic children. While something you did or said may have triggered an upset, no one is perfect, and feeling guilty is not going to help the child recover their calm. To help the child and to keep yourself safe, stay calm, don’t take things personally, minimize any factors that may escalate the behavior into a crisis, treat the child respectfully, and use a team approach where possible.


    Debrief and Recover

    She stressed that after a crisis, it is important to have a way to vent to someone about what happened. Discuss the incident with your partner, a family member, or team and talk about what could have led up to it, what you think you could do better next time, how you felt and feel now, and do a calming activity together to recover from the emotional stress you experienced. Self-care is very important after crisis interventions and is also part of keeping yourself safe. Not having this time to debrief and recover from crisis incidents can lead to burnout. 


    For some great self-care ideas, check out Cut Yourself Some Slack: Parenting and Autism.


    In conclusion, safety is not just an issue for autistic children, but can also be an issue for their parents and caregivers. Knowing basic strategies and safety procedures can help de-escalate or manage potential meltdowns and aggressive behavior, and keep both the child and those caring for them safe.

    What are your experiences involving safety as a parent, caregiver or teacher of an autistic child? We’d love to hear from you in the comment section below.

    We hope you enjoyed the information in this article. STAGES also offers free downloadable resources to support teaching and learning with individuals with autism. Start with our free Picture Noun Cards and see our collection of other downloadable resources here!

    Ymkje Wideman-van der Laan

    Written by Ymkje Wideman-van der Laan

    Ymkje Wideman-van der Laan is an author, public speaker, and Certified Autism Resource Specialist from the Netherlands. After working abroad as a teacher and humanitarian for 25 years, she moved to the US in 2006 and assumed the care of her then 6-month-old grandson, Logan. There were signs of autism at an early age, and the diagnosis became official in 2009. She has been his advocate and passionate about promoting autism awareness and acceptance ever since. Logan is the inspiration behind the Autism Is...? (tinyurl.com/5aj73ydd) series of children’s books she initially wrote for him and later published. Ymkje currently lives in California with her now 15-year-old grandson, and besides writing, presents autism training workshops for early childhood educators, parents, and caregivers. You can read more about her story in her newly released book, Autism on a Shoestring Budget, [Early] Intervention Made Easier (https://tinyurl.com/ysxhxbmf). For more information, you can visit www.autism-is.com, www.facebook.com/AutismIs, and/or contact her at autismisbooks@gmail.com.