Need suggestions for meltdown control.

[Lost_In_Ohio]

My daughter is five and was diagnosed with PDD-NOS a little over four months ago.  She has had an amazing amount of progress since diagnosis.  I was very worried that when she went back to school that it would be like last year, hiding behind the bookcase at circle time, not playing with the other children, not being able to communicate well enough to be understood by others but that was not the case!!  The very first day she asked for a classmate to color with her, sits in the mat at circle time, and she is speaking in small sentences!!  Of course, the diagnosis made all the difference, I'm more aware of her needs and the school has adjusted her IEP to include the therapy that she needs (PT, OT, and doubled up on the ST). Sorry that I'm rambling, just so excited at progress made.

She has recently started to express fear, sometimes she's just being silly but other times she truly is afraid.  She says she's scared so much that I don't know when to take her seriously which can be a real problem because it can turn into a meltdown quickly.  Which gets to the point, everytime I take her to the eye doctor the meltdowns get worse and worse.  What can I do to help her cope with having her eyes checked?  How do I get her to understand that she needs new glasses because the old ones are scratched and bent?

She gets so attached to her stuff (for lack of better word) and her routine that it always gets ugly when it's time for a change.  Examples of this would be; she refuses to drink out of anything but the same 4 sippy cups she has had since she was 8 months old, still ***** her left thumb, still carries favorite receiving blanket around constantly.  Any suggestions as to how to get her to drink from regular cup and stop sucking thumb would be appreiciated, too.

[Sally44]

It is very common for child with autism not to understand class or whole group instructions.  My son has to addressed personally by name until he is listening and then he has to be given a simple instruction.  Difficulties with speech and social interaction are not necessarily linked with cognitive difficulties.  My son is assessed as being higher than average IQ, yet he cannot read or write or hold a two way conversation.  
Ask the Speech and Language Therapist and Educational Psychologist for advice about your difficulties.  It might be down to generalisation or gestalt perception.  

[Lost_In_Ohio]

Thank you for your suggestions.  I have tried most of these, but the more specific questions might work.  As far as her glasses, she is attached to them and when I try to explain to her that she needs new ones with no stratches, etc. she says "No, my glass."  She isn't allowed to take blanket or sippy cup to school, I do send cup with straw and her berry water (only thing she will drink) to school with her and she has started to drink from it a little.  Which is an improvement, she used to refuse and go all day without drinking anything.  I not sure how to get her to understand Social Stories because she doesn't have the cognitive skills to understand this.  eg. The teacher says time to line up boys and girls, she doesn't move until teacher calls her by her name.  She is a very literal thinker and has an impeccable memory but has a hard time understanding questions.  She asks questions but often doesn't understand answer.  She does have SID, also and since we started therapy she is getting better about touch and having fewer meltdowns at home and school.
If you say anything to her about her thumb, she often becomes very defensive and shuts down.  Other times, if you ask her if she is ever going to stop, she tells you "no, my thumb."
Once again thanks for your input and I welcome any more thoughts and suggestions you may have.

[Sally44]

As she is verbal you can start asking her what about the situation is upsetting her.  You may have to ask specific questions to get an answer.  Eg. If you ask 'why' are you getting upset, she may just say 'I don't know'.  But if you ask 'does the eye test hurt you? she might reply 'yes' or 'no'.  Or ask her 'does the smell of the hospital bother you?'  Rather like the game 20 questions.  But if you elminate some things it might give you a better idea of what it is about the process that bothers her.
It might be that she gets attached to her old glasses and changing them upsets her.  If that is the case then use Social Stories to explain about eye tests and how children need new glasses because the lenses get stratched, or their eyes need a different kind of lense etc.  My son also gets very attached to familiar things.  We have got builders in at the moment, and he is coping remarkably well with all the changes (walls have been knocked down and new stairs put in etc).  But he got upset when he saw the old staircase out in the garden.  He wanted me to keep it!  So I took him upstairs and explained 'why' the old stairs did not fit anymore because we had moved a wall.  He was happy after that.
Try the same approach with her drinking cups, explain to her that as children grow up they don't drink from a sippy cup anymore they drink from a xxxxxx cup.  Let her choose the one she wants.
Regarding a blanket, again talk to her about growing up and that children don't need a blanket anymore, but that some children like to choose a cuddly toy.  Then give her the option of a cuddly toy (but make it one that is strong eg. an elephant, tiger, shark etc).  These toys represent strength and alot of autistic children change over to a cuddly toy.  My son has a shark that he usually wants to take with him if we are going somewhere for the first time, or when we go on holiday, or when we go to the cinema.  After that he is usually okay.