Location: Bradley Hospital

Bradley Hospital

Tantrums, Meltdowns and Kids Acting Out: What to do?

Helping your child with tantrums

Almost every parent, teacher, babysitter and caregiver has been in this situation: A child is agitated and acting out, often loudly. But, according to behavioral experts at Bradley Hospital, what many adults assume is simply a spoiled child who is acting out to get his way, may really be a kid who is simply struggling to communicate in that moment. With patience and a few targeted tactics, parents may be able to better understand their children’s triggers, successfully de-escalate the situation, and reduce the likelihood that it will occur again in the future.

“The first, and most important, thing to keep in mind is that when a child throws himself on the floor screaming, he may be trying to tell us something that he does not have words for or he is attempting to get his needs met. It’s our job as the adults to try and figure out what the unmet need is,” says  Margaret Paccione-Dyszlewski, PhD, director of clinical innovation at Bradley Hospital.

Scott Sylvester, LMHC, a behavioral education development specialist from Bradley Hospital adds, “Kids act out because it’s a form of communication that works for them. Often, they don’t want to do the wrong thing, but they just don’t know the right thing to do.”

All behavior usually happens for one of three reasons:

  • The child wants something.
  • The child is trying to avoid something.
  • The child is trying to meet a sensory need, such as avoiding a noise or being touched.

“The key to managing many difficult child behaviors is to limit the number of emergency interventions and to maximize the number of proactive interventions,” says Sylvester. “In other words, try to intervene at the earliest signs of agitation, before things escalate into a full-blown meltdown.” Often, the first sign of a looming issue is a change or increase in a child’s normal behavior.

So, what happens if a child has escalated and is already in the middle of a meltdown?

“We have all either seen or been that parent at the grocery store with the screaming, crying child, and it can be maddening - a real helpless feeling” says Dr. Paccione-Dyszlewski. “The good news is that there are many strategies parents and caregivers can try to help agitated children de-escalate and become calmer.”

Strategies for Parents

  • Decrease stimulation. Lower the volume on the television or stereo, dim bright lights, minimize commotion/distractions. If possible, ask the child’s siblings and friends to leave the immediate area for a few minutes. Try to dial down the excitement and stimulation.
  • Validate feelings. Acknowledge that the situation is upsetting to your child. Displaying empathy and understanding reinforces to him that you are there to help.
  • Encourage verbalization/offer help. Ask the child to talk to you about what is upsetting him so that you can better understand how you can help him. If this conversation cannot happen in the moment, try to set a time for it to happen at a later, calmer time.
  • Reinforce the positive. Focus on the positive things that your child might be doing, such as making eye contact or using words to express his anger. Even if your child is yelling or using foul language, now is not the best time to address it.
  • Redirect, exchange, prompt. Tell your child what you want him to do, not what you want him to stop doing. For example, “Please talk to me using an inside voice.” versus “Stop yelling!” You may want to lower your voice to a whisper as you redirect.
  • Switch-off. If one is available, ask the child if he thinks that he will calm down more easily if another care giver tries to help and you step away for a while. The goal here is to step the difficult behaviors down one notch. Once the crisis is settling, you can return and have a more productive conversation at a later time.
  • Withhold attention/wait. When all else fails, wait it out.  Monitor the child from as far away as safely possible. Let him know that you will be happy to talk with him as soon as he calms down and then make it appear as if you have other things to do.  
  • Don’t rush the process- If you act as if you have all day, the situation is more likely to be better in a few minutes. If you act as if you only have a few minutes, it may just take all day.

“The reaction of the caregiver, both verbally and with body language, can be one of the most important factors in de-escalation,” says Sylvester. “For most interventions to be successful, the adult must remain calm, even though the child is not. We can’t control everything that children say and do, but what we do have control over is our own reactions.”

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Rather than engaging in a no win power struggle with the child, Sylvester recommends staying calm and looking for opportunities to praise appropriate behavior. “If the child sees you as a ‘threat,’ he will likely become more agitated or scared,” says Sylvester. As soon as the child begins to calm down, it is usually best to return him back to the normal structure of his routine as soon as it is safe to do so.

Dr. Paccione-Dyszlewski offers some final words of encouragement for parents and caregivers. “Remember that de-escalation is a gradual process of trying one small intervention after another, gauging the child’s reaction and then figuring out what to try next. Unlike the zero to 60 mph manner in which the behavior went out of control, we can’t expect to flip a switch and completely end a tantrum. As difficult as it may be, try to stay out of the emotions of the moment and think of the de-escalation process as a chess game. You can do it!” she says.