As adults, we tend to be able to hide the effects better, although they are still present, but one can see the lack of this "energy hygiene" most obviously in children. Often, I hear reports of children "misbehaving" in the afternoon, after school or in the evening. In most cases this is not a behavior issue, more than it is an issue of socio-emotional overload. If the child (or adult) is giving time to relax, and let go of the energy and anxiety of the day, and perform a "reset" as it were things would look a lot different.
Personally, by the time evening rolls around, both my cognitive and memory processes, let alone my socio-emotional capabilities most often experience an extreme decline. During this, I cannot perform the simplest tasks or functions. If then, I am pushed beyond my limit while in this space, it can get very severe. I've experienced more than a few times complete fugue states, forgetting my name, not able to speak nor respond in any intelligible manner, not knowing where I was, etc... The decline is pretty dramatic and destructive if I cannot get to a place of complete silence and privacy.
Skills that I have gained, especially managing my energy input and output have helped. I practice meditation twice daily, I take power naps, I arrange to have alone time. The alone time doesn't even necessarily need silence, it is the lack of engagement that I need in order to reset myself. I am practically "religious" about when I go to sleep and when I wake up. Even with an hour long nap during the day, I usually need more than 8 hours of sleep at night. If I keep up my meditation routine, the need for sleep lessens but is still there.
In retrospect, thinking about the times I tried to work (I have been on disability more years than I have worked now) I recall being on the verge of a complete meltdown (at work) on a regular basis. Me thinks had I the ability to get alone, quiet and reset often enough, this outcome may have looked very different. But, as I had not known about my ACC at the time none of this information was available to me.
If all of this is true for me as an adult, it would seem that it is all the more true for children with ACC who have not yet developed the coping skills available to (most) adults.
The downside to all of this is that I have had to, as I said, be quite regimented about sleep hygiene and protecting my energetic and emotional space. I could not even imagine what this would look like for someone working at a job. Even with such skills as those learned in D.B.T., which, I might add have helped tremendously, the need for regulating my energy and my environment remain at the forefront of maintenance for my mental and emotional health.
This immense breakdown of cognitive, memory, social and emotional skills, this sundowning is a terrifying experience, especially if one cannot escape the stimuli that trigger it. If I allow myself to get to the point where this occurs, the resultant effects of it can last days before I can fully recover from it...as long as I continue good hygiene in the matter this is far less likely to occur...
...a (not so comfortable) day in the life of this man born without his Corpus Callosum...
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