Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. Through stories from my behavioral pediatrics practice (with details changed to protect privacy) I will show how contemporary research in child development can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.

Tuesday, September 11, 2012

Never leave a child alone during a meltdown

Controversy is brewing over the recent New York times op ed: A terrifying way to discipline children, in which Bill Lichtenstein describes his five-year-old daughter being held in a seclusion room at a Lexington school when her behavior was out of control. A Globe headline asserts in response: Account of putting pupil in isolation disputed. Of course I do not know what actually happened. However, I do know that a very commonly held belief among parents is that one should leave a child alone, or "ignore" him, when he is having a meltdown. Yet all of the best of developmental science tell us that this approach is completely wrong.

When I work with families who are struggling with a child's out-of-control behavior, I explain that in the middle of a meltdown, a child feels completely helpless. If left alone, he will feel not only frightened, but also abandoned. I explain that at such a moment, the higher cortical centers of the brain responsible for rational thought are not functioning properly.

These types of severe meltdowns are common in children who have experience early trauma, at the time when the higher cortical centers of the brain were not yet fully developed. Stress of a seemingly minor nature can lead the rational brain to in a sense go "off-line."  The child will have access only to the lower brain centers that function more instinctively.

I recall working with the parents of a four-year-old child who had been adopted from another country. There he had lived on the street with his mentally ill mother, from whom he had been separated at one year of age and placed in an orphanage. His adoptive parents where both horrified and overwhelmed by what they interpreted as "anger." He would scream at them,  spit at them, kick and hit them. Not only would they get angry in return, interpreting his behavior as "defiant," but they would send him to his room, saying, "I'll be back when you can calm down and behave nicely."

When I explained that during a meltdown he was developmentally more like a newborn than a four- year-old, their approach to him completely changed. Rather than react in anger, they would ask calmly, "Do you need a hug?" Or they would try to hold him. If he were too out-of-control to allow physical contact, they would take him to a place where he was physically safe, and speak to him reassuringly until he began to calm down. Not only did the tantrums subside, but his parents began to learn to recognize when he was about to descend into what they now understood as a lower center of brain function. They would try to engage him when the thinking part of his brain was still working.

Similar mechanisms are at play in a child who has not had this kind of severe trauma. Frequent meltdowns are common in the setting of sensory processing problems and developmental problems such as speech and language delay (as apparently was the case for Rose, the child described the New York Times piece.) When a child is repeatedly abandoned both physically and emotionally in the middle of a meltdown, that experience in itself may be traumatic. In such a situation frequency and intensity of meltdowns often worsens.


Parents often feel that holding a child in this way is counter intuitive. "Won't I teach him that he can get whatever he wants? " they often ask. But the opposite is true. When a child feels held and understood, with time he learns to manage these difficult moments on his own. 
Discipline, both in the home and in the school setting, should be founded in contemporary developmental science. This science tells us that when we aim to see the world through the child's eyes, and approach his behavior from a stance of empathy and understanding, he learns to regulate emotions, think clearly, and manage himself in a complex social environment. 

1 comment:

  1. Bravo Claudia!
    As a mom of 7 kids I LOVE your posts! I just shared your article on my facebook page and also recommended it to the many parents who visit my GoMommyGO site. Here's where I put your link:
    http://www.gomommygo.com/consequenses.html#claudiagold
    Keep up the good work!
    Blessings,
    Ruth

    ReplyDelete