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Keep It Calm

by Martin L. Kutscher, M.D.


Keep It Calm

[Reprinted from the book Kids in the Syndrome Mix of ADHD, LD, Asperger's, Tourette's, Bipolar and More! by Martin L. Kutscher, M.D.; copyright © 2005 Jessica Kingsley Publishers. Reprinted with permission. This article may not be reproduced for any other use without permission.]

Be a defusing influence, not an inflammatory one

The life of a special needs child is overwhelming. The treatment for his over-reaction is to defuse the situation, not inflame it. This applies whether the child has ADHD, oppositional defiant disorder, bipolar depression, anxiety disorder, or just about any condition. Actually, this principle applies to just about any human interaction.

Seek to defuse, not to inflame. When tempers or anxieties flare, allow everyone to cool off. Remember, the caregiver may have to cool off as well. Serious discussion can only occur during times of composure. Remember: negative behaviors usually occur because the child is spinning out of control, not because he is evil. For kids that Dr. Ross Greene (1999) refers to as "explosive," the first step is to "Just STOP!"

Most typical children will respond well to typical enticements and threats of punishment. If you made it this far, your child probably isn't one of them. Here, our focus is on preventing over-heated meltdowns. We anticipate problems and try to head them off: we stop, we stay calm, and we negotiate if possible.

Here are details of the defusing technique -- labeled "Plan B" by Dr. Ross Greene (1999).

Head off big fights before they begin. When things start going badly, redirect to a positive direction rather than criticizing the misbehavior. For example, if the child is arguing with a peer, then suggest a new activity such as having a snack, rather than handing out a punishment.

Pick your fights. Is this fight worth chipping away at your relationship with the child? Remember, this is not war. Psychologist Dr. Steven Covey (1989) reminds parents to keep in mind what you want your child to think about you when he delivers your eulogy. If you are a teacher, keep in mind how you want the child to remember the school year.

Give transition warnings. Many special kids have trouble with transitions. Discuss in advance what is expected. Give plenty of warnings. Have the child repeat out loud the terms he just agreed to. Some children need to negotiate for those "two more minutes." A little extra patience on the caregiver's part may help avoid a useless meltdown.

Watch the "stress speedometer." Imagine that a child (or you) is a car with a stress speedometer. When that speedometer reaches 60 miles per hour (mph), the back wheels will spin out and nothing can prevent a crash. Attempts to intervene during the spin out will just prolong the system failure. The goal, then, is to keep anyone from hitting 60 mph. So imagine you enter the scene when the child is at a stress level of 40 mph. For the child, the anxiety of the current situation is getting to him. You laugh -- or you divert, or you negotiate -- and the stressometer comes down to 30 mph. Great! You are on the right track. Keep it up. However, the next day, the same intervention brings the child up to 50 mph. Back off! You are just a moment away from 60 mph, and the horrible meltdown that will then be unstoppable. Just STOP, and walk away.

This is not the time to give in to our impulse to just get done with it. You might have the self-control to do that, but your special child may not have been born that way. Don't assume that just because you can handle it, he can as well. All brains have equal rights, but all brains are not constructed the same.

"Just STOP!" is the key -- for the overwhelmed person and for you. Incredible things happen if everyone is able to just STOP:

+ It works! Even five or ten minutes are all most people require to regain their composure and ability to think clearly. These few minutes spent to avoid a crisis certainly beat enduring a much more negative and lengthier meltdown.

+ With the benefit of time, most people will come around to the right conclusion on their own, and comply.

+ Once you have calmed down, the correct method of behavioral management will seem almost blatantly obvious. For example, we try to keep it positive. We discuss seeking to understand and making the child part of the problem-solving process. We discuss choosing only productive punishments. When you are calm, these approaches are not exactly rocket science, and are almost self-evident. When you are overwhelmed yourself, these approaches are not available.

Further stressing the child does not work and is actually counterproductive. She is already overwhelmed. She is already overloaded and over-stimulated. Being further stressed just inflames the situation, and ultimately makes it harder for your child to achieve her goal: regaining composure so that her own brain can reach the right decision.

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