Tag Archives: aggression

Want Better Self-Regulation in Young Children? Help Them Manage Aggression

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You might think as a pediatric OTR, I would be writing a post about sensory-based treatment for self-regulation.  And I have in the past.  Not today.

But I have been an OTR for decades, and what I know about today’s children is that agitated and dysregulated kids often need help managing aggressive impulses and negative emotions first, in order for me to assess whether or not their behaviors have a sensory basis.

That’s right:  a young agitated child cannot be assumed to have sensory processing difficulties if they haven’t learned any self-management tools.  It is too easy to assign them a label, and I refuse to do that.  But I can and will use effective techniques to manage aggression before I jump in with all the bells and whistles from my sensory processing treatment bag.

What works for me?

I get a lot of mileage out of Dr. Harvey Karp’s Happiest Toddler on the Block strategies.  Once I learned these simple techniques, I applied them to every situation in which a young child was oppositional, aggressive, defiant, or threatening/delivering a tantrum.   That could be every session!  Toddlers aren’t known for their easy-going ways.

His Patience Stretching, Fast Food Rule, and Time-Ins are my three-legged stool that supports my therapy sessions.  Read Use The Fast Food Rule For Better Attunement With Your Child and Stretch Your Toddler’s Patience, Starting Today!  Kids aren’t born with the ability to handle frustration and manage impulses.  Adults teach them how to deal with their feelings.  When they aren’t taught what to do when they are disappointed, when they want attention, or when they are angry, things can get pretty unpleasant.  The good news is that learning can begin around their first birthday.

Job number one should never be unclear to anyone, but as time has gone on, fewer and fewer parents seem to communicate it clearly:  physical violence from anyone isn’t acceptable at any time.

Are parents committing violence against their child?  No.  It is the child that is biting, hitting, or damaging items.   “We don’t hurt people or animals in this house” isn’t always communicated clearly to a child.  I never hear a parent say that they like being smacked across the face by their child, but they also seem to struggle to clearly communicate that this behavior is unacceptable.  Resorting to responding with violence is not helpful.  Teaching how to manage aggression can be done without spanking a child or even raising their voice.  Changing their tone of voice and rapidly putting the child out of arm’s reach will make it clear to their child that they have crossed a line.  But so many parents seem hesitant to set limits, and some seem to worry that being firm will harm their child or hurt their feelings.  This is coming from,  remember, the same child that just smacked them in the face or bit them.  By not reacting clearly, parents are in fact communicating that aggression toward others isn’t a problem.

I try hard to teach parents that it is kind and loving to teach children that they can have their feelings but they cannot express them with aggression.  There are limits in the wider world, and if they act this way with people that don’t love them, the consequences aren’t going to be good.  Learning to hear “no” from someone that loves you is a lot easier.

Young children need to learn the vocabulary of negative emotions like anger, disappointment, frustration and sadness.  They need to practice waiting and need to be spoken to in a way that makes it clear that they are understood but may not get their way all the time.  Negotiation and appreciation go hand in hand.  Dr. Karp’s techniques really work for me, and they aren’t difficult to learn or use.  I wish every parent would try even one and see how easy they can be incorporated into daily life with young children!

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How Dr. Harvey Karp Helps Kids AND Adults with Regulation Issues

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Can you do DBT with toddlers?  Well, Marsha Linehan probably would say no, but the Fast Food Rule and Patience Stretching come as close as you ever could!

Many child psychologists and psychotherapists are focusing on attachment theory and the problems of poor emotional regulation in children.  The rise of self-harm behaviors in teens and aggression in children as young as 3 can be related to difficulties handling emotions and experiences that increase arousal levels but never get resolved.

Not every child who throws their book down in frustration or slams their bedroom door needs to see a therapist.  But I do wonder how many of those teens that cut themselves, starve themselves or get suspended for putting their hands on a teacher or fellow student, actually needed Dr. Karp’s techniques when they were 3 or 4.  Maybe, just maybe, if they had been helped with Patience Stretching when they wanted that toy, or if someone had used the Fast Food Rule with them when they had a tantrum Use The Fast Food Rule For Better Attunement With Your Child, maybe they would be in better shape at 13.

Why?

Because these techniques don’t just work on the child.  They work on the adult using them as well.  And adults who can self-regulate raise kids who learn to do it too.

When I use Patience Stretching( Stretch Your Toddler’s Patience, Starting Today! ) with a toddler that wants one toy while I want them to work a bit longer on a therapy task, I am actually receiving the benefits of the technique as well.  I am both teaching and experiencing the reduction in frustration and the decrease in agitation as this strategy calms down the whole situation.  Oxytocin gets released when we calm down with a child, and adults need that hit as much as children do.  If we “go there” with an agitated child, we feel worse, even if we think we won because we have the power to deny or punish.  It doesn’t feel good to do either, but it also doesn’t feel good to give into a screaming child.  Not really.  Even the most permissive adult will say no to something dangerous, and then the child who is unfamiliar with hearing “no” will really explode.

The good news is that you don’t have to get an advanced degree to use Dr. Karp’s strategies.  You have to practice them so that your delivery is flexible and confident, but anyone can do it, not just therapists.  In fact, if these techniques don’t work well once you improve your delivery, that could be one way to decide that you need to consult a child specialist.

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End Toddler Biting Using Clear But Compassionate Messaging

I couldn’t resist it.  Nip. Biting. Bud.  But toddler biting is no joke.  According to one of my clients, a child can be asked to leave preschool or daycare if they are a repeat offender.  The problems that lead to biting are easy to see, the solutions are not.  Here are my explanations for why toddlers bite, and what you can do to turn this around before your child is asked to leave preschool or shunned from play dates.

I categorize toddler biting into two distinct behaviors:  biting with aggression, and biting as communication.  The first will happen with adults and peers, the second happens almost exclusively with caregivers.  Your reactions are almost the same with both, so let’s deal with the most common variation first: biting with aggression.

Children become frustrated, don’t get what they want or can’t say what they want, and they bite.  The long answer:  address their ability to manage frustration with language and build their patience.  Not easy, not immediate, but totally possible. Use Dr. Karp’s Patience Stretching and Toddler-Ese style of communication to build these skills.  My posts on both subjects will give you some tools you can use right away.

Adults have to be present when the majority of biting episodes happening order to manage them, and willing to intercede with both limits (“No biting.  Biting hurts” ) and consequences for the biter.  The victim needs to get the majority of the attention, no matter how upset the adult is with the attacker.  If the biter is old enough, it is a time-out.  If not, it is a junior time out.  At the very least, it is removal from whatever activity they were engaged in.  You put them down off your lap after they bite you.  You are sending the clear message that this is big, really big.  We don’t want this to happen.  Ever.  

The greatest mistake that a caregiver can make when dealing directly with biting?  Quickly comforting the biter after they start to cry in realization that they did something wrong.  They are so little, and they are not in full control of their behavior.  But they do have some control! Even a seven-month-old that nips on your breast during nursing can learn that they will be taken off the breast if they continue to do that, so why would you assume that a toddler has no control at all?  Because they are better at wailing with emotion, and tug at your heartstrings.  If you scoop up the biter and comfort them right away, they do not get to have the very emotion that you want them to develop: regret and remorse.

It is hard for loving parents to see their child sad.  I appreciate that.   But their child has committed a behavioral felony, and for a few moments a toddler needs to experience a negative consequence in order to understand that biting is not OK. They are concrete, literal thinkers at this age.  If all you do is tell them, in a sweet tone, not to bite, then they will do it again.  And again.  Developing the ability to use their words is going to take some time, maybe months.  Developing impulse control is going to take even longer.  There are four year-olds that struggle with impulse control, but they don’t bite even when they are upset.  They have learned that this is simply not done.

It is also hard not to be angry with the biter.  That takes some self-control as well.  Yelling, threatening, and spanking really don’t change this behavior as much as you would think.   Showing your displeasure but keeping your cool is hard for some parents.  Truthfully, one mom said she is just so tired at the end of the day that she knows she is yelling and can’t stop herself.  I get it.  But this is the reason to take care of yourself every day, and dig deep into your inner strength for these moments.  This is “showtime” as a parent.

The moment when you can warmly talk with your child is after the time-out is completely done.  For young toddlers, it is only a minute or two, but it was the most important minute of their day.  It can be less.  I watched a mom put down her 18 month-old after he nipped at her neck for attention.   She didn’t yell, she just said “no biting” firmly and put him on the floor.  He cried, and then recovered in about 15 seconds.  He walked upstairs quietly to see what Daddy was doing.  He got the message and wasn’t scarred for life.  He already knows that biting is not OK, he just didn’t know that he couldn’t bite HER.  Until that moment.  All she did was stop holding him, but he got it.  To get biting-as-communication to end, develop a toddler’s skills at positive interactions.  These biting behaviors usually happen when a child sees no difference between the consequences for positive and negative attention.  It is all attention to them.  Make them reconsider their choices by creating negative consequences for negative behaviors, and teach them how you’d like them to get your attention.  Words, laughter, and positive play.

Good luck with this one.  The magic is in the swift and firm reaction, and managing your own emotions in order to teach toddlers how to deal with theirs!