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Saturday, May 14, 2011

The value of taking tantrums seriously


Lately I've been doing a bit of 'homework' on Autism Spectrum Disorders (ASD), as I'm working with some children who've been diagnosed with a variety of conditions within that range.

One piece of advice that stood out was that when children with Asperger's Syndrome show extreme distress over some seemingly small and unimportant matter, their concern should be taken seriously- even if acting on it seems silly to you- as their anxiety is real and is based on actual physical or psychological discomfort. Yes, it can physically hurt when they are forced to look you in the eye. Yes, a change in their routine can cause extreme anxiety. And so forth.

Yesterday I used this information to deal with a little girl's meltdown over a small dirty mark on her clothes. 'Bree' had tried to remove the mark by wetting half her sleeve on a freezing cold morning, and another carer had immediately sent her inside to change- at which point the hysterical crying, screaming and thrashing started. I was handed a package of loud and violent 4-year-old misery to deal with, complete with stern directions to make her put on a dry top.

Yes, Bree has Asperger's. But as I wrestled with her specific issue using my new-found knowledge, I started wondering if this way of coping with a small child's distress was really so ASD-specific, or whether it might be useful to keep in mind for all children who seem to be making a mountain out of a molehill.

This is not to downgrade the relevance and importance of the information to the welfare of children with ASD- not at all- but I found much wisdom in the advice which could be transferred to general parenting and benefit all children.

Has your child ever had a ridiculous tantrum over, say, a minor clothing issue, or the fact that you broke their block building, or an item they aren't allowed to take with them when you go out, or some other seeming non-issue (to adults)? How did you deal with it?

Let's do a bit of a breakdown of Bree's problem and see if we can use an ASD strategy to help us deal with out-of-control neurotypical children too.


So- first of all, I ignored adult logic and took Bree's anxiety seriously, assuming there was something real at the bottom of it.

Does a child- any child at all- really scream about nothing? There's usually something wrong, surely. What they're concerned about mightn't make much sense to an adult, but does a child really LIKE screaming and crying and kicking the floor? I don't think they do it as a conscious choice- do you? Do you ever feel like lashing out when you feel powerless to change something that's really worrying you? I know I do.

Instead of insisting that she change her clothes immediately despite her hysterical resistance, I got down to her eye level and started asking quiet, calm questions to identify the source of her anxiety.

I can't understand your words when you're crying. Can you take some big breaths and then tell me what the problem is?”

I- got- dirt- it's- my- BEST- TOP!” (pulling at her sleeve- the wetness was clearly causing discomfort.)

Hmm. Real anxiety about spoiling something special. I guess any child might feel like that. And any child might have a limited concept of the size of a problem; I could see that the mark would come out in the wash, but could a four-year-old?

Time to offer a calm, reassuring, respectful response and some choices; I'd read that raising your voice only ramps up the situation with Aspy kids.

Hang on a minute... raising your voice ramps up the situation with ANY kid. It's just that it turns a kid with ASD's anxiety and ability to understand you up to the max in one fell swoop, so it's absolutely vital in that context.

That mark will come out when Mummy puts your top in the washing machine. And you're feeling cold, aren't you, because your sleeve is all wet? You could take this top off and put on another top, or we could try to dry this sleeve. Mummy can fix the mark later.”

The responses to this, interjected along the way as I spoke, included several “NOOOO!”s (most accompanied by the stamping of little feet, the last uttered while adopting the 'straightjacket' arm position so her top couldn't be removed), followed by a final screamed “Fix it NOW! More choices!”

Hmm. I could put the level of anxiety down to Bree's Asperger's, I think; the dirty mark that wasn't there this morning was putting her whole world out of order in some way. Although, you know, some neurotypical kids with Type A personalities would also be radically upset about (in their minds) 'spoiling' their best top.

And the use of casual time language, such as 'later', isn't easy for any young child to decipher. Children live very much in the present.

And yes, fair enough, I also learnt that routine is vitally important to kids with Asperger's, and that may explain why she doesn't want to take that top off- we get dressed once a day and undressed once a day.

Although actually, routine is important to all kids... again, the difference is one of degree- changes of routine can cause instant blowouts with ASD children. But it may well stress any child to have to repeat a routine unexpectedly.

'More choices'... okay, clever kid; time for a little gentle humour...

I can't put YOU in the washing machine with your top on, can I?” (Laughter- from both of us! -a breakthrough there.) “So the only other choice I can think of is to rub some soap on your sleeve to get the mark out and then try to get the wet bit dry.”

Yes, do that!” Tears magically stop.

Not the solution a busy mother or childcare worker would come to first, is it? But it worked.

And it really wasn't a huge inconvenience for me to spray her sleeve with a little non-toxic soap, rub like mad while holding the sleeve off her arm, fold it up a bit so the wet area wasn't on her skin and then keep her inside and otherwise distracted until her body heat dried the damp spot. Five minutes later we had a dry sleeve and a calm child.

As I realised how effective the whole strategy was when used on this little girl with Asperger's, I started thinking that actually, ALL distressed children deserve to be taken seriously. A neurotypical child who had been looking forward with all her heart to wearing her favourite dress to a party, only to discover it had a dirty mark on it, might have had a similar meltdown if you told her to change. How would you react? Would you think about the 'why' before ramping up the situation because you were running late? Would you take the time to make wearing that dress possible, because it mattered to her?

It pays to ask questions before you write off a small child's tantrum as 'silly', and it pays to think before you disparage a parent or carer for 'pandering to a child's whims' if they take the time to deal with these situations with respect. Yes, that child may be living with ASD. Or maybe that parent or carer is just walking a mile in a neurotypical child's moccasins.

Finding this all a bit too touchy-feely? Hey, from a purely practical viewpoint, sometimes taking a child seriously is a whole lot quicker and less distressing for everyone than writing their concerns off as negligible. Yes, you might in fact be less late if you take the time to take your child's distress seriously.

Sure, the child who loses the plot at the checkout because you won't buy them a chocolate bar is in a different category, but it would pay you to think about why that child had such a short fuse and take THAT seriously. Are they too tired to be out shopping? Have you been out way longer than their attention span allows? Do you usually say 'yes' when time is short or you're tired, even if it's unwise? Do you often use food to make that child feel valued? Is your child exposed to a lot of commercial TV where that product is advertised at saturation level? Hard questions, but worth answering honestly if you value your sanity.

And if you conclude that in fact this is just a touch of sensory overload or boundary-testing that's got out of control, it might be time to take a deep breath and walk a few steps away (out of range of being kicked)... and just wait quietly instead of yelling. Giving in to your own frustration is understandable- we've all been there- but it won't help short-circuit the situation.

So next time you have to deal with a small child who loses the plot over 'nothing', try to stop and think before you react along logical lines- take a moment to look at the world through a child's eyes.

7 comments:

  1. Hello! I have only just found your blog, but enjoying going back and reading all your posts!
    What wonderful pearls of wisdom you have!
    My daughter is only a few months old but I will be storing away all your advice for the future.. thanks for taking the time to share all your experience and wisdom

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  2. Thanks emmie gemmie! Glad you're enjoying the reading matter! :)

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  3. I completely agree! Many times the child just wants to be listened to and feel that he is understood. (Don't we all?) When my children were very young and repeated the same phrase over and over and over again, I learned to repeat it back to them to show that I understood them. It calmed them down and quickly moved our conversation forward to resolution and away from the meltdown.

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    1. Lory, that's a great strategy. It showed that you were listening, and we ALL want to be listened to- especially when we're upset!

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  4. I love, love, LOVE this story, and I agree whole-heartedly with you. The strategies we use for children with strong needs are often strategies that really support *all* learners (adults and children alike!!). Thank you for this. Warmly, Emily

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  5. Oh my, oh how absolutely wonderful! I would love you to get to know my almost 8-year old fascinating, challenging son who has High Functioning Autism. (In fact I'd rather like you to be working with him!)

    His series of meltdowns today were a transition from the warmth of a car to an extremely cold playground with a bitter biting wind. He was so cold that he couldn't move his legs, the ground was slippery so he fell and was 'stuck', the wind blew against him and caused him to run and throw himself into the walls of buildings ... and that was just on the short walk to find the playground!

    It looks so much like a drama queen until you see that there is no advantage to the responses - falling to the floor in the ice makes you more uncomfortable, not less, flinging yourself into the wall of a building 'because the wind is really strong' hurts. He recovered a little upon seeing the playground but had several more mini incidents just in checking the place out (we had already decided the weather made it impossible to stay, but needed to follow through with 'going to the playground') Each time the incident was shorter and easier to recover from and there was a longer period in between collapses/getting 'stuck' until we had a child who was cold, and not enjoying the wind, but able to rationalise that and make a planned response/solution to the problem.

    The huge over-reactions to sensation or stimuli are so so frustrating because the child is making the situation worse/more uncomfortable/longer exposure to the problem because of the way they are reacting ... and all you can really do is protect them from harm and ride the storm through, guiding their responses/coping strategies as best you can until they regain control of their actions.

    And ... of course ... screaming at them, belittling the way they are experiencing the situation, or punishing them doesn't help the situation at all ... "Don't be such a baby" "Who's making a silly fuss?" etc. etc.
    Thank you for such a thoughtful and well-explained article.

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