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Help!  My child is regressing behaviorally!                             By Dr. Karen Levine, Ph. D.  Psychologist

4/13/2020

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I have heard from many parents that their child with special needs is regressing behaviorally. For some kids, old behaviors have returned, for others new ones have appeared. Here are some behaviors some parents have mentioned:
 
  • Asking endless repetitive questions
  • More ‘stimmy’
  • More tearful; crying more easily
  • Can’t sleep in own bed again
  • Can’t focus on schoolwork
  • More easily angry, hitting again
  • Low frustration tolerance, giving up more easily
  • Refuses to do mastered things (dressing self; putting clothes in hamper)
  • Glued to old favorite videos over and over
  • Needing hugs, reassurance constantly
  • Hyper focused again on old cause and effect toys
 
Unfortunately, I don’t have quick solutions for fixing this, but I can tell you that:
 
It is normal, expected, for kids to be having a really tough time right now, for their baseline anxiety level, even depression, to go up, and for old behaviors to resurface. Here are some of the reasons why we are seeing this. None of this is anything we don’t all know but when you list it all out, it makes total sense that kids may be showing more behavioral challenges:
 
  • Kids are experiencing sudden unexpected and drastic changes in their daily lives, and of course kids are hugely helped by the predictability of their lives.
 
  • Most kids are also experiencing many abrupt losses of important relationships. There are many adults at and outside of school who kids have relationships with that are important and suddenly disrupted, such as teachers, instructional aids, various therapists, even neighbors, medical people, and then also friends and other peers at school. These are hopefully not permanent losses, but suddenly having these people not in the child’s daily life with uncertainty about if and when the child will see them is, naturally, a big deal emotionally for many kids. 
 
  • There is huge uncertainty about when we can do normal things again like go back to school, maybe go visit grandparents maybe go on a planned trip, and so on.  This uncertainty is challenging for all of us, but more so for kids with anxiety. We can’t really, at this early point in late March, even give kids a good time estimate about this.
 
  • And then there are, for many kids, the real fears related to coronavirus, whether they might get sick, and especially whether parents or grandparents could get sick, whether anyone could die. We certainly didn’t intend for kids to be worrying about all this.
 
  • And of course, kids now have parents with all sorts of huge and unexpected worries and responsibilities. Finances, extended family well-being, family health, global health, just to name a few things that are worrisome for most people these days. As we know, so many kids are super sensitive to the moods and anxieties of their loved ones.
 
This list is not to get us all down, or to say kids can’t manage this, but to spell it out why it is not surprising that we see emotional and behavioral regression, and related spikes in anxiety, in emotional dysregulation, in many kids. While it may not be easy to fix this, it may help keeping in mind the following:
 
  • These behaviors are happening for a specific known reason.
 
  • Kids (and adults) will likely over time increasingly adapt to the ‘new normal’ hard and different as it may be, and be less anxious or distressed.
 
  • For kids showing returning behavior issues, these are the issues they did overcome once and so they can again. They have the capacity, when the world is less upsetting, to overcome this. 
 
  • There are strategies to explore now that may be helpful.
 
 
While each child, each problem and each situation is different and will warrant different approaches, some general strategies for decreasing baseline anxiety may be useful:
 
Try having many short-sweet moments per day with your child that are just enjoying something, however small, together.  This might be three minutes here, five minutes there. This can reduce that high baseline of stress that builds up in all of us these days.
 
Consider ‘savoring’ times when the child is happy, is doing well, doing something they enjoy. There is a lot online about savoring and I find it a strong helpful technique that I use myself and with my patients.  Savoring is about deeply mining, and stretching out moments of joy. These can be social or sensory experiences or both. The idea behind this is that for the time of savoring, for those moments, the child is filled with good feelings, together with you, anxiety and dysregulation are down.
 
For instance, let’s say you and your children are having eggs for breakfast and you put your fork down to help a child with something and the dog sneaks in and gently licks the egg off your fork without making a mess or taking the fork. You and the children crack up laughing at how clever and sneaky the dog was. This is a shared moment of joy. You draw it out by re-enacting the dog’s sneaky ways. A child wants to join you in this and you act it out again, everyone laughing. Another family member, a grumpy teen or spouse stumbles in and you share this with them. You take a picture of one of the re-enactments. 
 
You can savor tasting food treats or something you or someone in the family has cooked, seeing if the kids can notice the taste, the texture, the after taste, the way an oyster or a good wine might be savored, the tastes analyzed for deeper enjoyment. There are lots of online guides to this, often called the raisin meditation https://ggia.berkeley.edu/practice/raisin_meditation
 
When you pull off a nice moment together, capture it any way you can, with a picture, a quick video, share it with other family members later, talk about doing it again and so on.
 
Consider for old behaviors what helped last time and see if trying the same strategies might help this time.
 
Then there are the recommendations below that you probably hear over and over that may or may not be do-able:
 
      Try to have somewhat of a schedule that is somewhat predictable in these days.
 
      Try to include regular times of outdoors if you are able, of movement, of music and dance.
 
      If school work is stressful explore if there are other ways of doing it, if you can cut back in amount of the stressful    subjects and so on (see my  ‘Help! My child is Regressing Academically” handout)
 
      See if your child would enjoy doing something to help others, such as making a video for a nursing home where they may have worked, or making a video card for a teacher etc.
 
      Explore face-time or other video chat with familiar beloved people even if they can’t do it regularly, such as an assistant or school tutor who may not be involved in online work

      Try scheduling video chats that are predictable and generally in your control, at   predictable times (e.g. Grandma every Tuesday and Thursday after breakfast) even if you also chat with this person at other times. Spend a few minutes planning things your child might show or tell or ask with this person.
 
      Have some weekly ‘special’ things to look forward to in these less marked weeks (e.g Wednesday mac and cheese night)
 
In general, it is likely adults and kids will gradually adapt to this ‘new normal’.  And one day life will be much more like we knew it. At that point, if the behaviors haven’t resolved, they will likely become much easier to treat. 
 
We all need to remind ourselves often that just getting through these days with everyone intact, just finding a few minutes of happiness for ourselves and with our kids, is an enormous accomplishment. 
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