By Melanie Schmidt, LMSW

Originally published in Adoptalk 2021: issue 1. Adoptalk is a benefit of NACAC membership.

Melanie Schmidt is an adoption social worker providing support to Adoption STAR’s A-OK (Adopt an Older Kid) Program in Buffalo, New York. With close to 15 years of experience in the foster care adoption field, Melanie was instrumental in developing attachment and trauma-informed client education and support services for the A-OK Program. One of her most meaningful professional experiences before coming to Adoption STAR was finding adoptive homes for waiting youth in danger of aging out of care. Outside of work, Melanie enjoys spending time with her two children and husband. Special thanks to Megan Montgomery of Adoption STAR for her contribution to this topic. For more information, contact Melanie at melanie@adoptionstar.com

 

Parenting children who have experienced trauma and who have had attachment interruptions drives families to embrace new, creative strategies to help children heal, attach, and thrive. Problematic behaviors are often symptoms of an underlying unmet need that will not resolve until the root cause is addressed. This unmet need is often a need for felt safety that stems from a deep sense of abandonment and rejection. To satisfy the need, child must develop an internalization of a permanent parental commitment. The internalization of a permanent commitment requires: 1) the unconditional and forever commitment of one or more stable adult and 2) time for the parent(s) to prove—over and over again, through the attachment cycle—that they are following through on their unconditional commitment. There must be time to demonstrate the parent(s) are following through, even—and especially—when the child is communicating hurt and pain through out-of-control behaviors. 

The strategies below are intended to help families honor their commitment to their child who presents moderate to severe behavioral challenges. This philosophy is most productive in reducing escalation/crisis behavior and establishing attachment in the context of a permanent parent-child relationship. 

Co-regulation

We know that we cannot regulate someone else when we are dysregulated. If, instead of offering calm in an outburst or moment of crisis, we meet the child in anger, we will miss an opportunity for attachment and add fuel to the flame. Regina Kupecky, co-author of Parenting the Hurt Child, explains it perfectly, “Angry parenting will keep the mean child mean, the wild child wild, the scared child scared, and the hurt child hurt.” 

So how do we remain a child’s safe space and source of comfort and calm during frequent out-of-control behaviors that push us to our limit? 

We must first examine our own triggers and build our coping skills. Our mental and physical health is central to nurturing our child’s mental and physical health. This means we must give ourselves time to recharge and care for our mental and physical health. To say this is a challenge, especially with the busy, demanding lifestyle of most parents, is an understatement. However, our own regulation tools will allow us to calm a child and model a positive and healthy self-care regimen. As we use our own healthy coping skills, we can both communicate these skills to the child and provide a positive model for managing strong emotions.

Just as we become curious about the root of a child’s behavior, we must also get to the root of why some of these behaviors are so difficult for us to manage as parents. Could certain behaviors be triggering our own traumas or something central to our identity as “good parents”? If we get really angry when our child lies, for example, is it due to how our parents emphasized honesty or how we felt when someone lied to us? Our parents may not have understood confabulation and we have to understand how lying can be a survival skill for some children. We must ask ourselves what button a behavior might be pushing for us, so we can get to a place where we can meet stress with calm.

Consider the de-escalation interventions below first from the perspective of a parent’s self-regulation and then from a perspective of strategies to regulate a child.

Preventive De-escalation Interventions

Most of the work to reduce challenging behaviors is preventive and proactive. We cannot do nearly as much to address a child’s trauma and attachment difficulties mid-tantrum. 

Consider the structure of the day

Are certain times more challenging for your child or you? How might you prepare for that time? Perhaps it’s the morning routine. Is there a way to give the child some choice and control over what needs to be done in the morning or what can be done the night before? Does the child have a meltdown after school each day or around bedtime? What are could be going on behind the behavior and how can we avoid them? Maybe the child can help come up with a plan to change the schedule or routine to reduce the challenges.

Remember to ask what is going on for you in various moments of stress. Are you usually distracted or rushed? Can you first make time to share 5 to 10 minutes together before getting dinner on the table? 

Throughout each day, it is beneficial to ensure that time is built in for each family member to have: 1) physical activity, 2) down time, and 3) connection. Increasing opportunities for movement and play will improve one’s ability to manage difficult emotions, improve focus, and retain information (Gobbel, 2018). On the other hand, we need to balance activity with down time to recharge and relax so that we don’t burn out. 

Perhaps most importantly, there needs to be time for connection and to have fun together. The more time there is for positive connection, the stronger the attachment, and the eventual lessening of acting-out behaviors. Family bonding activities should never be taken away as a consequence for behavior (Becker-Weidman, 2011). This would communicate that love is conditional upon behavior. When the child is presenting behaviors that most seem to be pushing others way, that is usually the time the child needs connection the most. During connection time, consider some of the ways attachment is built with infants (touch, smell, speech, motion, warmth, food, eye contact) and use them as they are tolerated. And don’t forget to have fun and laugh! Laughing together is a wonderful way to build attachment and de-stress.

Identify triggers and warning signs of escalation

Identifying triggers will allow parents to best address the root cause of behaviors and avoid meltdowns. Triggers can be times of day, seasons, months, or holidays connected to traumatic memories. Other triggers include yelling or loud noises, showers/hygiene activities, physical affection, chaos, structure, sensory experiences, hunger or thirst, change, being told no, or when things don’t go according to plan. As we examine behavioral incidents, we may be able to find a common pattern and then can address an unmet need or fear to reduce the incidents.

Paying attention to a child’s body language will help us identify when they could be becoming dysregulated. It is easier to step in quickly and provide comfort or distraction before a child escalates further. A change in eye contact, clenching hands, feeling dizzy, physical complaints, pacing, fidgeting, and changes in breathing could all be indications that the child is becoming dysregulated and needs to access their coping skills. 

Saying to a child that you notice a change in their body language and offering a coping skill can prevent further escalation. If your child does not respond quickly or well when being talked at, physically change the dynamic through dancing, walking, tossing a ball, or doing another activity together. This could also be a good time for a re-direction or gentle humor to defuse the situation. Over time if you verbalize what you see, a child may become more aware themselves. To do this well involves stopping what we are doing and giving the child our full attention in that moment to help them calm down and make a good choice. 

Talk to the child when they are calm

Use the calm moments to pile on the positives as you instruct your child how to manage their emotions. Describe the positive things they do: “The way you show special care and love to our cat tells me you have a beautiful heart.” Don’t let positive behavior and even small accomplishments go unnoticed. 

When they are calm, it is also a good time to debrief about challenging times and provide simple, clear steps for planning to access coping skills, putting words to their feelings, and making healthy choices. 

Join a support group or use the buddy system

The importance of a support network cannot be understated. It is isolating to manage the challenging symptoms of your child’s past hurts. Talking to others and learning from their experience can offer you a new perspective and energy. If there is no local parent support group, find a virtual group or form a relationship with even one other adoptive/foster family. The support and validation is beneficial and healing. 

Have a plan

Creating a plan to manage difficult feelings and behaviors will help you and the child be better prepared when they surface. You can create a plan in small steps, focusing on one time of day or one behavior at a time. It may help to use a therapist or social worker to facilitate the plan. Engaging other caretakers (teachers, childcare providers, etc.) in developing the plan can also help ensure success. A written crisis or safety plan may be helpful for situations where there is danger of physical harm to the child or others. Even less severe behaviors might benefit from a written, visual reminder. A written plan could be as simple as phrases or pictures to guide a child toward better choices. It could also be very specific and discuss each feeling, what each person will do, and provide a list of positive options in several scenarios, depending on the child’s age and unique situation.

When we empower the child to help develop their plan, they will feel accomplished when they see each small success. After talking with them, include the child’s triggers and warning signs. Identifying what their body feels like when they are anxious, angry, etc. will help them learn to self-soothe.

I have found that children usually enjoy brainstorming coping skills to add to their plan. Some examples are deep/calm breathing together, blowing bubbles, making silly faces in the mirror, cuddling, physical exercise, getting outside, playing with play dough/slime, and listening to or making music. Look for images or posters of coping/calming skills online (especially on Pinterest) to post at home as a daily reminder. Maybe the child could draw their own favorite calming activities. 

A plan may also include brainstorming a change to the day’s or year’s schedule to address times that are particularly challenging. Don’t forget to re-visit and adapt the plan over time.

Both parents must be on the same page and discuss plan together

If there are two parents, each must give the child the same message. If both parents are not involved in developing the plan, it is likely to fail. Inconsistency and confusion between partners will communicate to the child that sometimes it is OK to act out and parents can be played against each other to get what they want.

Parents and other caregivers will be most effective if they support each other in front of the child and handle disagreements privately. One simple way to do this is to offer each other compliments in front of your child: “I love you,” “I appreciate how hard you worked today,” “That’s a great idea,” etc. These affirmations will also show your child how to use kind language, demonstrate a united front and healthy relationship, and give each adult support during a challenging time.

Interventions to Use in the Moment

In the moment of an out-of-control behavior, when tensions are high, it is difficult to remember a list of things to do. Everything we know goes out the window, and we find ourselves reacting or falling into a familiar pattern. It might be most useful to start by focusing on one thing to get you and the child through an incident. 

Dr. Becker Weidman’s concept of attunement is very helpful during a behavioral crisis. When we are in attunement, our empathy response matches the intensity of the child’s emotions. We use reassuring eye contact, a calming and confident voice, close physical proximity, responsive body language, and gentle touch (as tolerated) to show the child we are taking their emotions seriously and are available to support them. Attunement may be the only thing we are able to focus on at first, as we gradually build our skills and the child’s skills.

I love Regina Kupecky’s suggestion of having a mantra to repeat silently to your self such as, “This too shall pass,” “I love this child,” or the phrase “crabby baby” that reminds us that the child is actually developmentally an infant or toddler in need of comfort and parental help to regulate.

Perhaps we choose to start regulating by focusing on our breathing and guiding our child to take a breath. You can have responses prepared: “There is nothing you can do to make me love you less,” “I’m not going anywhere,” or using other words or nonverbal gestures the child has identified as helpful.

Below is a step-by-step guide we adapted from the Crisis Prevention Institute for adoptive families to use during a behavioral crisis. If you find yourself regularly in crisis, please ask your child’s therapist and professional team for more support. If you do not yet have a therapist, find one that has experience working with children who have experienced trauma and attachment challenges. The steps below are most effective when used with the support of a professional team.

  • Remove the child from the agitating environment, situation, or individual. If you can’t move the child, remove the audience.
  1. Remain calm. 
  2. Validate. Focus on feelings. 
  • “I know this is hard,” “This doesn’t feel fair,” “You seem angry/ frustrated/sad/scared, and that feeling is OK.
  1. Offer choices. 
  • Give 2 or 3 simple, clear options. 
  • Offer coping skills, such as deep breathing.
  • Explain consequences of each choice, including continuing their current behavior.
  1. Give child space, time and provide calm, comforting reassurance.
  • Children often need a moment to process and decide which option to choose. When providing space, continue to monitor the child to ensure safety and show that you will remain committed despite behaviors. 
  • Access emergency plan — If there is serious threat of harm to the child or others, it is time to involve crisis or emergency services. If you need to call 911, request that the dispatcher informs the first responder that the child is a victim of trauma so they respond appropriately.
  • De-brief — Once the child is calm, you can work to focus on your relationship and process feelings.

Rinse and Repeat

Using an attachment-informed approach takes practice! While learning new techniques, we need to give ourselves the same grace we extend to our children and understand that we are all learning together. Even when we feel we have failed, we must remember that each day is a new opportunity to add to our toolkit and our child’s toolkit, and to plant the seeds of attachment.

And remember, it takes time to build attachment in a relationship. There is no substitute for time. The attachments that are the hardest fought are often the strongest. Once a foundation of attachment and trust has been built, behaviors begin to stabilize. Early childhood trauma may cause hurt in some way or another for a lifetime. The good news is an adoptive parent’s love and commitment can bring healing to manage difficult emotions and accomplish more than we ever thought possible.

Categories: Featured, Parenting, Parenting Strategies

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