I felt her pain as she shared her story about the threat of lawsuit and reports to be made to the police, if her family did not replace the neighbour’s laptop. The laptop was damaged during an episode of her autistic son’s meltdown. She opined that managing her son is quite a challenge since he frequently breaks or damages items around the house and at the grandparent’s house. Damaged items varied from kitchen faucets to eyeglasses, inter alia. Damaged items are often repaired or replaced but would be repeatedly damaged with another meltdown, and the cycle continues. In contrast to how I felt, she concluded that God knows why He gave her an autistic child.

When questioned about the possible triggers for her son’s meltdown, she advised that he is always in the company of his father; however, the father was overseas on business at the time. It then made sense to me, having an appreciation for the possible triggers such as unexpected changes in plans or routines.

While I am concerned about my friend and the challenges she faces on a daily basis, I am particularly concerned about the neighbour’s threat to report the matter to the police, and a possible lawsuit. The child was not a random visitor; he was known to the neighbour.

I am not an expert on autism but felt compelled to write this article. It is clear that there is much attention, early intervention, and support for children with autism. In contrast, this level of support for adults living with autism is lacking. All is not lost, however, as there is a growing recognition that appropriate assistance is required for autistic adults.

What is autism?

According to World Health Organization (2024), autism spectrum disorders (ASD) are a diverse group of conditions related to the development of the brain. Characteristics include some degree of difficulty with social interaction and communication, atypical patterns of activities and behaviours such as difficulty with transition from one activity to another, a focus on details, and unusual reactions to sensations.

Meltdown not a tantrum

A meltdown is often confused with temper tantrums, but they are dissimilar. A meltdown is out of the person’s control, driven by physical shutdown, while a tantrum is often driven by will. A tantrum is slowed with self-regulation, while a meltdown is beyond the ability of the self to regulate (
Psychology Today, 2021). Meltdown, while not exclusive to autistic individuals, occurs when the individual is overwhelmed by stimuli and is overpowered by the overwhelming situation. They may also experience complete loss of control of their behaviour. This may be evidenced by crying, yelling, lashing out, suicidal ideation, self-harm, inability to talk, lack of ability to think, or rage. Of note is that meltdowns are also not exclusive to autistic adults.

Offering support during a meltdown

People may assist the autistic individual during a meltdown, in several ways. They should never be seen as crazy or mentally disturbed; in fact meltdowns are viewed as normal occurrences for the autistic individual. Validate them, and allow them to be themselves. Additionally, according to Autism West Midlands (2019), (1) you should know the person you are supporting, as each person will need to be supported in their own way; (2) if they are not at risk of harming themselves or others, leave them alone and keep calm; (3) do not ask them too many questions; (4) do not tell them to calm down, instead give them guidance; (5) consider whether you can use their special interests to help them relax; (6) give them the time to withdraw and recover; (7) consider whether you can use their special interests to help them come out of the meltdown; and (8) some autistic people may like some contact during a meltdown, like a hand on their shoulder, or a quiet word.

Even though the focus of this article is on meltdowns in the autistic individual, I wish to emphasise that to effectively manage the autistic adult, a holistic approach is required. It is also essential to adopt a person-centred approach that acknowledges individual differences and preferences. Another key point to note is that families and communities are important in managing autistic adults; this level of support cannot be underrated. Further, educating neighbours, family members and caregivers about autism helps to foster empathy and understanding. The anecdote above reminded us of this fact. It is also true that parents or caregivers are vulnerable to burnout, as such respite care services should be accessible to prevent burnout and reduce stress.

Managing autism and meltdowns require supportive environment, for instance, one that minimises sensory overload. This may be achieved by providing sensory-friendly environments such as creating quiet spaces for relaxation which also allows for sensory breaks when necessary, using noise-cancelling headphones, and providing sensory tools like fidget toys. The effect of clear communication, explicit instructions and visual aids cannot be undermined. Equally important is establishing routines and predictability. Undoubtedly, this will reduce anxiety and facilitate a sense of control.

The anecdote above suggests that the child’s meltdown was triggered by the father’s absence and his inability to be engaged in his daily routine. Further, sensory sensitivity affects the autistic individual and can significantly impact their well-being and functioning.

Noteworthy is the effort made by the WHO to raise consciousness about autism. They have articulated the following facts about the disorder: (a) autism may be detected in early childhood, but is often not diagnosed until much later; (b) the abilities and needs of autistic individuals vary and can evolve over time; (c) some people with autism can live independently, while others have severe disabilities and require life-long care and support; (d) evidence-based psychosocial interventions can improve communication and social skills, with a positive impact on the well-being and quality of life of both autistic individuals and their caregivers; (e) care for individuals with autism needs to be accompanied by actions at community and societal levels for greater accessibility, inclusivity and support.

As a matter of fact, the WHO efforts emphasise that there should be: (i) increase commitment of governments to taking action to improve the quality of life of people with autism; (ii) guidance on policies and action plans that address autism within the broader framework of health, mental and brain health and disabilities; (iii) strengthening of the ability of the health workforce to provide appropriate, effective care and the promotion of optimal standards of health and well-being for individuals with autism; and (iv) inclusive and enabling environments for individuals with autism and other developmental disabilities and providing support to their caregivers.

Conclusion

In view of the above articulations, one can conclude that managing individuals with autism and more specifically the autistic adults requires a community and multifaceted approach that acknowledges their unique strengths and challenges across the lifespan. These individuals can lead quality, meaningful and fulfilling lives in environments that offer tailored support, empowerment and inclusivity. A point to remember is that having a meltdown does not mean that the autistic individual is crazy or broken. Importantly, they have rights that should be advocated for. Therefore, governments, the relevant policymakers and stakeholders, must ensure that equal opportunities and support services are available to these individuals and their caregivers.

Adella Campbell, PhD is associate professor and dean, in the College of Health Sciences, University of Technology, Jamaica.