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!