Monday, December 23, 2013

Helping 6 yr old in school

Thanks for publishing this article. My 6 and 1/2 yr old son seems to be exhibiting the behaviors associated with anger overload. He has no other diagnosed medical issues, his grades are phenomenal and is a loving kid most of the time. Once he gets in this state of rage, usually over something minuscule that he takes offense at, it becomes difficult to get him out of this or redirect.  I have just started him in therapy and we will be visiting his primary care doctor after the new year. The school he attends is not helping that much. They are only focusing on punishment and tracking despite my best efforts to work with them.  I need redirect and coping advise. I realize that every kid is different, but would like to try something so that alternative placements will not be put on the table.  What is urgent is appropriate responses and preventive measures for teachers and other staff during school hours. Happy holidays sir. 

Hi, My parent's manual has suggestions for home that can be adapted for school.  The first step is to observe the situations when he loses control.  Can the teachers keep track of them, and then look for some patterns.  Does the anger overload occur when he is frustrated or disappointed with certain assignments, tests, grades, comments from a peer or teacher, or some other precipitant?  There will not necessarily be a pattern for every instance of anger, but try to find some types of situations when he is more likely to get angry.  

The next step is key.  Can the teachers anticipate or catch early signs of frustration?  It is difficult to do because anger overload can occur so quickly and with little warning.  But if you have identified certain situations when the child is more likely to get frustrated, your radar can be up when theses situations occur again.  If you can catch anger in the early stages, it is easier to prevent overload.  If your son gets frustrated by certain grades, for example, then the teacher could try to lower your child's expectations ahead of time, let him know he is supposed to get some wrong because he is just learning.  Another option is to change the sequence.  If the grade is going to disappoint him, hold off on the grade until a fun activity is about to begin, or leave the grade off the paper altogether.  A fun activity, like gym or recess, can be distracting and help change your son's emotional state before anger gets too difficult for him to handle.

A related suggestion would be to have in place some distracting activity, such as helping the teacher with something, running an errand, or going to a place in the school where he could calm down.  Some schools have an OT room with a mat or exercise ball, where a child can go to relax if he is beginning to get stressed.  It is not a punishment, and should be a place the child is familiar with and has enjoyed.  The distraction needs to be engrossing--it doesn't have to be fun but needs to be something the child is really interested in doing.

Once a child is in anger overload, the teacher would engage as little as possible.  The goal is to provide a setting where the child will not disturb others and not get a lot of staff attention.  This place could be inside or outside the classroom and would not be the same place as the OT room, or the activity that is used for distraction.  If the child is loud and bothering others, there would need to be an aide to escort him out of the room.

There are other strategies I describe in the manual that aim to reach children how to recognize their emotional state and how to develop self-soothing strategies.  These strategies would be taught when your son is calm, and could be worked on with the school social worker or psychologist in conjunction with the teachers.  For example, some young children can learn to use verbal labels for different degrees of anger or frustration.  The second half of my manual outlines six different skills to teach children to help them better manage their anger.  The difference is that these strategies involve teaching the child skills over time, and the first set of strategies I mentioned in the above paragraphs are directed by the adults and do not require the child to anticipate or understand his reactions. I would recommend starting with the adult directed strategies because these can be implemented more quickly.

All the best, Dr. Dave Gottlieb

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