Managing Challenging Behaviour and Meltdowns

Amber at her finest ~ covered in foam at a ‘Messy Play’ session.

Challenging behaviour and meltdowns are something that I deal with every day. After working in Childcare for 12 years, (6 years with children with additional needs,) nothing could prepare me for dealing with my own child’s challenging behaviour in the home environment. I have soon learnt that the relationship I had with my pupils is completely different to the emotional connection that I have with my own daughter, Amber (4.) I have learnt that certain strategies that may have worked with the children I looked after do not work with Amber.
I quickly had to learn the important huge difference between a ‘temper tantrum’ and a ‘meltdown.’ As Amber has Sensory Processing Disorder (SPD) with traits of ASD and ADHD, she can experience ‘Sensory Overloads’ and this often results in a ‘meltdown.’ This is when I describe that she is no longer in control of her emotions, I’m often describing that Amber is neither ‘naughty’ or ‘spoilt,’ these are meltdowns are occurring because there’s a sudden loud noise, a change of routine or she has become overwhelmed in a supermarket from the noise, the lights, the sheer volume of people. Amber has difficulty recognising that she’s feeling overwhelmed and therefore will display her feelings via kicking, hitting, pushing, throwing items, pushing her younger sister over, pulling stairgates off walls, thrashing herself about, banging walls or doors, spitting, screaming or shouting.

At 18-months-old I first noticed that Amber was a ‘sensory seeker,’ she would actively seek out anything that would provide a sensory input, for example, she enjoyed running the taps in any bathrooms and feeling the water run through her hands. I found that her temper tantrums were frequently and I was constantly told that this was “normal for her age,” and that she would “grow out of it.” By the age of 3 she became a big sister and I had prepared myself for her behaviour to become more challenging, the advice I was given was that this should only be a ‘stage’ and that after she was used to having a new baby in the family, then her behaviour would improve, however it didn’t, and as time went on she became increasingly worse, and would display on the whole as compliant in her Early Years setting but extremely challenging at home, she would target her baby sister by pulling her legs and trying to tip over her Moses basket, the jealousy she felt toward her baby sister was quite extreme. By the age of 4 I started to recognise certain things that Amber didn’t like, that she would avoid, for example, physical contact – she would only give out cuddles on her terms and when she did they were very tight cuddles! She also became anxious around unexpected loud noises like motorbikes when outside and she could hear aeroplanes and grass cutters long before I could! It was around her 4th birthday that I would say that Amber’s ‘extreme meltdowns’ started. These were sometimes around 10 times a day and some would last over an hour, and I found it incredibly difficult to deal with as it was such unknown territory for me. The main triggers for a meltdown are:

• Unexpected loud noises,

• Changes to routine – finds school holidays very difficult.

• Wanting something that she cannot have – usually centred around food, as Amber cannot tell when she feels full.

• Public places – usually indoors – supermarkets, libraries, sports halls, swimming pools, cinema, theatre.
I can usually gauge when Amber is on the verge of a meltdown, she becomes extremely restless, will talk quickly and will jump, clap her hands in front of her face or try and climb onto anything she can to jump off.

I use a range of strategies to help avoid a possible overload:

• Visuals – to display routines of what is happening during each day, traffic light system – to help Amber identify if she needs to free play (green,) find a calm activity such as playdough (orange,) or go to her ‘calm zone, (red.) I also use individual cue cards and fans, e.g to show ‘kind hands.’

• Always carry Ear defenders – in case of loud noise, e.g. at the train station.

• Listening to fears, worries, frustrations and what makes her angry – talking through exactly what the problem is if she is willing to share. This is a recent strategy that has worked once I noticed more challenging behaviour days before a Halloween party, we talked and Amber said “Mummy I’m scared of Halloween.” I could then address this to avoid an overload.

• Keeping calm myself – this is easier said than done! It is one of the most difficult things that I’ve ever had to go through and I’ve always been told that I’m a calm person but it’s very difficult to handle when you are being challenged daily, and you’re the main person that your child outlets with, there was a time when I felt completely hopeless and my self-confidence took such a knock. But staying calm allows situations to be diffused, if my voice is raised then Amber will also raise hers, but If I remain calm, then she calms quicker.

• Avoiding the word “No” – we use strategies to avoid demands on Amber, if she hears the word no, she can become even more angry. We phrase instructions carefully, for example, when getting dressed for school: “You put your socks on, or I can help.” This can be quite challenging for us to think of at times!

• Distraction – Amber thrives on sensory and messy play experiences as part of her ‘Sensory Diet,’ If I plan experiences when she’s at home, such as playdough, sand and water play, foam play, etc she is satisfied in terms of her ‘sensory seeking,’ and I find that her level of concentration is much higher whilst engaging in this type of play.

I have learnt over time that there are specific strategies that can help during and after a meltdown:

• Breathing exercises, e.g. lying down and counting to 10 with a teddy on her tummy. Smelling the flower (breathing in,) and blowing out the candle (breathing out.)

• Calm area – a specific area of the house, including blankets, cushions, bubble tube, sensory toys.

Amber’s ‘Calm Area’ is under the stairs, as she prefers smaller spaces.

• Wrapping up in a blanket – Amber responds to a ‘weighted blanket,’ and likes to feel safe and contained.

• If in full meltdown mode, (as I haven’t had up-to-date restraining training,) I have been advised to ensure that Amber is safe, e.g. that she cannot bang her head and that I leave the room with her younger sister for safety, but keeping Amber in sight.

• Offering a reassuring cuddle once a meltdown is over, to talk about what happened later, once she is much calmer and try to establish what the problem was.

• Rocking and cuddling tightly can help to calm her.
I felt completely lost after having my second child when Amber’s challenging behaviour peaked, I would have appreciated someone to advise me that everything would be alright. Now I try and help other parents as much as I can, this is one of the reasons why I started my Blog in March 2016, I’ve always said that if I could just help 1 other person it would be worth it.

My top tips for parents who experience challenging behaviours from their child are:

1. Connect with other parents – via social media support groups and local support groups. I attend a parent’s support group, for those that have children with additional needs, which is run from my local children’s centre I have also joined a local support network where there are meet-ups for parents to connect and for the children to interact. This is such a huge support for both myself and my partner, to talk to other parents who know where we’re coming from and have been through similar experiences, this allows us to share tips and ideas and provides a reassuring emotional support.

2. Research – time is precious and we lead such busy lives, but I’ve found it so useful to research the reasons behind challenging behaviours in children, via internet searches and reading various books. There is a fair amount of reading material out there and I’ve found a lot of helpful books that offer information on dealing with anger in children. I have soon learnt that ‘there is a reason for every behaviour,’ and this has put it all in perspective for me, to stop and ask myself: “Why is this particular behaviour happening?”

3. Never be afraid to ask for help and support – in the beginning I saw asking for help as a weakness, I was embarrassed after working in childcare and that I was struggling to cope with my own child’s behaviour at home. But once I contacted my local children’s centre, and was offered Family Support this turned our whole family life around. Our family support worker made weekly visits to offer advice and strategies to support us to deal with the challenging behaviours that Amber displays. Without this vital support our whole family life would have suffered.

4. Always carry a ‘Fiddle’ bag or box wherever you go! This has prevented many meltdowns, especially whilst out and about, providing a distraction and something to focus on if I recognise the signs of Amber becoming restless, or on the verge of a sensory overload.

Squeezy/stretchy toys and fiddly toys – such as a ‘Tangle.’

5. Believe in yourself! – As someone who’s parenting strategies have been constantly scrutinised, this has really knocked my self-confidence, as Amber is a very good masker of her difficulties and she tends to offload mainly with me, I’ve now learnt that this is because she feels most safe with me and that it is nothing that I’m doing wrong. Believe that you are doing a good job. Take a deep breath and try to offer yourself little ‘brain breaks,’ I go upstairs for 5 to 10 minutes and sit quietly in a dark room once Amber’s daddy returns home from work. It is very difficult to find time for me, bit this is so important.

Thanks for reading 🙂

Spectrum Sunday

PDA part 2!

Wow how much I missed in my last post about our experiences of ODD and PDA!
The following article popped up on my news feed this morning:
www.autism.org.uk – What is PDA?

Cue doing what I do best and scoring Lou against the PDA ticklist from the PDA Society and printing off the relevant information for her Paediatrician, I think I’m in ‘fighting mummy’ mode and “What have I got to lose?!”

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Source: http://www.pdasociety.org.uk
For children a score of 50 and over…

“Identifies individuals with an elevated risk of having a profile consistent with PDA.”

Lou scored 68!

I’ve found out so much more from the article from the National Autistic Society (NAS,)
I think it’s probably easier to bullet point what I’ve read in terms of our current situation with Lou:

● PDA is anxiety based on a need to be in control – feel secure when in control.
● Boys and girls can be equally effected, unlike Autism and Asperger’s Syndrome.
● PDA presents as controlling and dominating. Lou controls every situation, e.g up and down the stairs “I have to be first,” first to dress, first to finishing eating, will get distressed if I finish my lunch before her saying: “I wanted to be the winner.”
● In the PDA Society Booklet ‘Awareness Matters,’ it talks about children who “put on a performance, hiding all of their difficulties, for limited periods of time,” it does on to say that the people who spend most time with these children,  ie parents, notice their problems more.
● I’ve been noticing so much lately about the way in which Lou talks to us as adults, I find it quite rude and bossy. Children with PDA are often seen as ‘mini adults,’ Lou has said to me frequent times, (especially when she’s angry,) that “Mummy you are the child and I’m the adult.” Only yesterday she demanded that I “get up and get some food, now!” When I explained that this isn’t how we should ask for something she counted from 1 to 10 several times then told me to “go onto time out – NOW!” Which is the counting for processing time that we offer as parents when asking her to do something.
● Lou will tell other children how to behave but often doesn’t apply the rules to herself. E.g “you need to hold your mummies hand when crossing the road,” but she doesn’t do it herself.
● Lou will often talk in an adult way, using adult manorisms, for example, she will tell other children off, especially Moo saying “look at my face, good listening now, or its ‘Time out!’
● Lou will often blame other children for her actions,  for example she said “Billy did it” after she drew on her trousers with pen. (Name has been changed.)
● Lou will deny actions even if she’s caught red handed, for example, if a book has been ripped she’ll say “Moo did it” even if she’s been asleep upstairs or sat in a high chair nowhere near!
● Lou will show little shame or embarrassment if she throws a tantrum in public, she will not be bothered by people starting or commenting if she’s rolling around having a tantrum on a supermarket floor! It’s taken me a long time to cope with the stares and comments!
● In order to avoid a demand or request, Lou will answer politely: “No thank you,” and often says “I’ve got a sore back,” “my leg hurts.” Or “I’ve got a headache,” to avoid doing something.
● Eye contact – Lou generally uses eye contact especially if things are going her way, although she never uses eye contact when asking her to do something, often making it look like she hasn’t heard us. We have arranged for her to have a hearing test in July to rule out any hearing problems, but deep down I just know that she’s hearing us, but choosing not to listen.
● Links to SPD – another light bulb moment when I read that PDA has links to sensory difficulties in processing information in terms of light, sound,  smell, taste and touch.  This can also have an effect on Proprioception difficulties (bodily awareness) and vestibular awareness (balance.) I have had concerns about Lou’s spatial awareness and the amount of accidents she has and appears clumsy.
● Severe behavioural difficulties can be present,  can have problems controlling temper, and many people can appear passive and compliant at school, but appear very anxious at home. This describes Lou perfectly!

So where do we go now?
I’m currently testing some strategies that involve:

“a less directive and more flexible approach,” http://www.autism.org.uk

Only this morning we have tried an approach where we offer choices if Lou cannot cope with being asked to “get dressed” we then said “we’re going to leave your clothes here, you can get dressed or we’ll get Moo sorted first.
‘First’ being the operative word, make Lou spring up and collect the clothes saying: “I’ll get dressed now!”

I had used a more wordy but subtle approach with Lou last week after she demanded we go to the park and was scrutinised for “letting her control me” and “not being tough enough with her,” making me think whatever I do I’ll be judged! This is why I’m constantly researching as knowledge = understanding (which I bang on about!) But I just wish everyone could understand!

Further information.
I found that advice in getting a PDA can be found at:
www.norscaca.org.uk
At the Elizabeth Newson Centre (Autism East Midlands.)

I’m going to email for more information at

http://diagnostic-centre@autismeastmidlands.org.uk

Thanks for reading 🙂

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Pathological Demand Avoidance (PDA) and Oppositional Defiant Disorder (ODD)

Research Series:
Oppositional Defiant Disorder (ODD) and Pathological Demand Avoidance  (PDA.)

When researching ADHD, ASD and SPD I have come across ODD and PDA, particularly PDA I’ve seen a lot about recently.  I’ve not come across either of these in my childcare career, so I was keen to find out more. I’m no expert and I’m definitely not a Paediatrician! But Lou does almost tick every box of the symptoms for both, but particularly PDA. I was confused before about why she was acting in such ways and this does explain a lot. I’ve been particularly worried lately regarding Lou’s behaviour at home and recently re – referred to Family Support via a local Children’s Centre.

ODD.

Symptoms of ODD may include:

• Throwing repeated temper tantrums
• Excessively arguing with adults
• Actively refusing to comply with requests and rules
• Deliberately trying to annoy or upset others, or being easily annoyed by others
• Blaming others for your mistakes
• Having frequent outbursts of anger and resentment
• Being spiteful and seeking revenge
• Swearing or using obscene language
• Saying mean and hateful things when upset

ODD often occurs with those that have ADHD.

Source: www.webmd.boots.com

From reading these symptoms I could immediately relate to what we are currently experiencing at home.
– Lou throws up to 10 temper tantrums per day.
– She will argue with myself and partner and even pushes boundaries with my dad – who to this day I wouldn’t!
– Any requests or rules Lou is given she will usually ignore and point blank refuse. For example: “Pyjamas on” response = “no” or completely ignores and/or runs away.
– Lou will deliberately annoy and pester Moo, which she does for the majority of the day, Lou is equally annoyed if Moo enters her person space and she will usually push her away.
– Lou has anger outbursts frequently throughout the day, she will scrunch her fists together and growl loudly. Sometimes she will say “I’m really cross.” She will then often throw objects,  especially toys.
– Lou can be quite spiteful, if she’s been refused something such as food (if she’s already eaten plenty,) she will say things like “I’m going to climb over the stairgate and get it myself.” This is said in a forceful and angry manner. She will often say things like “I’m going to pick this up and hit you” if she doesn’t want to go to bed.
– We try our upmost to ensure that our children are not exposed to those who swear, which has caused a bit if controversy! But it’s for their best interests,  I don’t want Lou repeating this language, which she doesn’t understand.
– As discussed, Lou will often say hurtful things when she’s upset, these can be: “I hate you,” “don’t even look at me.”

PDA.

When looking up PDA I found the PDA society website (link below) most helpful.

People with Pathological Demand Avoidance Syndrome (PDA) will avoid demands made by others, due to their high anxiety levels when they feel that they are not in control.

PDA is increasingly recognised as part of the autism spectrum.

Many children avoid demands to some extent, but children with PDA do so to a far greater level than is considered usual. This is why it is called pathological.

The main features of PDA are:

• Obsessively resisting ordinary demands
• Appearing sociable on the surface but lacking depth in their understanding (often recognised by parents early on)
• Excessive mood swings, often switching suddenly
• Comfortable (sometimes to an extreme extent) in role play and pretending
• Language delay, seemingly as a result of passivity, but often with a good degree of ‘catch-up’
• Obsessive behaviour, often focused on people rather than things.

Many parents describe their child with PDA as a ‘Jekyll and Hyde’. Many parents of children with PDA feel that they have been wrongly accused of poor parenting through lack of understanding about the condition. These parents will need a lot of support themselves, as their children can often present severe behavioural challenges.

Source: www.pdasociety.org.uk

Many children with ASC/PDA can behave very differently with different people and in different situations.  They may be able to sufficiently hide their difficulties within the school setting and in other setting such as when visiting relatives or going to a friends house.  This can cause real difficulties for the parents because may often feel not believed, not listened to and unsupported by professionals, friends and family members.  Also this ability to mask is often at the expense of behaviour at home where the child will release this pent up anxiety.

Source: pdaguidance.wordpress.com
This article also has links to relevant information on PDA.

When reading about PDA it was like a ‘light bulb’ moment,  I’m still currently struggling to define between Lou’s difficult behaviour being due to a sensory issue or just defiant behaviour like maybe another 4 year old may also experience?

In relation to the PDA symptoms:
– Lou resists almost every ordinary demand or request (as discussed for ODD,) I find it difficult as to why she laughs and smiles when refusing to hold onto the pushchair when walking next to the road, or when she laughs and runs away wanting to be chased when it’s time to leave the park.
– Lou is very sociable, I’ve discussed in previous posts how she’s friendly to everyone and anyone, she is able to use language to impress, she copies a lot of my language and seems to be ‘an old head on young shoulders’ although she doesn’t always understand what she is saying.
– Lou has definite mood swings, she can go from really happy to angry in a few seconds. She gets extremely frustrated if things do not go her way, for example,  if she can’t get clothes off her dolls, she will fight to do it and make grunts and screams instead of asking for help. Lou will go from rolling around on the floor in full meltdown mode, to saying “I’m calm now” only a minute later!
– Lou absolutely loves role play and she will pretend to be ‘Princess Anna’ and ‘Queen Elsa,’ she talks to herself a lot and will repeat phrases she’s heard from role playing with other children. I would say that Lou does live in a bit of a fantasy world, and I can relate to this totally! I used to create senarios where I was a certain character, I was obsessed in fantasy films, and books and still am to this day!
– Lou is obsessed in Moo, she simply cannot leave her alone! If she can hear that Moo is awake from a nap she rushes upstairs full steam ahead! If they are in a room together she has to sit right next to Moo, almost sitting on top of her!

I was interested to read the article: ‘Child masks difficulties in school’ (link above,) I immediately thought “this is Lou” the fact that children with PDA can behave differently in different situations is fascinating, this is my child! Lou masks her difficulties in her childcare setting, she is better at people’s houses like my parents,  but still shows some difficulties. If I am present her behaviour is more extreme, Lou will release her anxieties from the day as soon as she reaches home. This is the reason that I’ve been fighting since Lou was 18 months old, as it has been our parenting skills that have been scrutinised constantly. I have discussed this frustration many times through previous Blog posts, and so to receive reassurance through articles, puts my mind at rest. We are extremely lucky that Lou’s new school for September are completely on board and recognise that support can be given at school so that her time at home will hopefully be more positive. I was so relieved to hear this and very greatful !

This research has proved to me even more than every behaviour has a reason, this has helped me to understand Lou more and proves to me even more that ‘research is key, knowledge is understanding.’

 

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 A girl after my own heart! “Mummy I’m just reading this story!”

Thanks for reading 🙂

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Count to 10!

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I’m writing this post on the back of a meltdown, all is calm(er) now but only 30 minutes ago I can only describe the scene as ‘bedlam.’ It always amazes me how Lou can go from 0 to 100 mph during a meltdown.  It was triggered by food, as I had only written a few days ago in the the post ‘I’m hungry.’ Only just after lunch and Lou is demanding food again she’s eaten an ample amount. She sees red and throws my I pad onto our hard kitchen floor, how it didn’t smash I don’t know! Because I wasn’t giving in she then yanked the stairgate clean off the kitchen, I’m surprised I’ve got any door frames left!
I have to therefore remove her to her ‘safe zone’ in her ‘calm tent.’ Immediately after I get any item she can lay her hands on thrown at me and somehow I slipped down the stairs dodging them.
I return a few minutes later to find a calm Lou,  however the reason she was quiet is because she’d been ‘exploring’ some Sudocrem she’d found and it’s been rubbed into the fairly new carpet! 
It always amazes me how Lou is so ‘Jekyll and Hyde,’ can see red one minute and the next is talking as if nothing has happened!
I have wondered to myself if it’s just me that finds this behaviour extreme, I was a shy and reserved child that wouldn’t have spoken out of place or hit out at anyone. I am a fairly calm and reserved adult, I admire Lou’s spirit and hope that she will use this spirit to not allow herself to be walked all over and to be able to stick up for herself. I do wonder if every 4 year old behaves like this at home! As I’ve only ever experienced other 4 year old’s through my work. I’m often told that “many children behave like this” but when it happens everyday, up to 10 times a day I do question it.
I imagine Lou gets the same sort of head rush that I do during one of her meltdowns, it literally feels like my brain is bouncing from one side of my skull to the other, the only way to try and get through this feeling is to:

Breathe and count to 10!

Several times! And try to stay calm!

I’m often left with a massive headache after a full – on meltdown, especially those where there is destruction. I manage that Lou feels very much the same.