Saturday, December 12, 2009

Managing screaming and crying

When your child is screaming and crying, just seconds feel like minutes and minutes feel like hours or years and when it seems like there is no end in sight and you feel like you are going to lose your mind, its time to get control.

One thing that you must remember is when a child (or anyone for that matter) is screaming or yelling or crying, they are out of control. When someone is out of control, they can not communicate effectively so there is no point in trying to have a conversation with them. Let me give you and example. I am currently working with a family who have a son with autism and his screaming and crying is preventing the family from going out in public. We were out in a child friendly restaurant which was filled with fun games, pizza, rides and all that fun stuff, when the child became completely overwhelmed with the sounds of the environment and refused to walk any further with his mom. He laid on the floor screaming and crying, there were stares and concerned looks from strangers, mom became embarrassed and desperate. So she gave him non stop directions to get up and keep moving, that sounded a bit like this: screams and cries from child,"get up" noise of games,"we need to go over" noise "to your brother" of children "do you" playing, "want" background "pizza?" music, "get up" adults "stop" talking,"screaming" chairs "show me" moving "quiet".

There was so much going on in that environment, that it was impossible for this child to process what his mother was asking him. I had to step in and ease the situation. I knew the child just wanted to be out of this overwhelming environment but he first needed to comply with our goal of sitting at the table for pizza. I could asses the situation and see that sitting down for pizza was highly unlikely. So I modified my expectations to sitting down quietly then taking the pizza to go. I had mom go ask for the pizza to be boxed up and I sat down next to the child, who had worked himself up so much that he screams were frantic and his cries were sobs and he was out of breath. I put my hand on his knee and held a finger to my lips indicating quiet. Right now talking to him would just be irrational. I was letting him know that he was being cared for but his actions were not being rewarded. I said "shhhhhh" and gave him a tissue. He began to calm so i gave him some water and let him get his breathing under control. I always listen to the child's breathing to let me know when it is okay to talk to them and if the child is comfortable enough with me I put my hand on their chest to feel how fast their heart is beating for another indicator. When the breathing and heartbeat is slowed and close to normal, it is a sign they are gaining control of their body and emotions and will be more likely to process what you are saying. At this point I gave the simple, gentle,calm, command of "show me a quiet mouth" with a smile on my face.

"Show me a quiet mouth" takes some practice for a some children to learn depending on their capabilities. we practice this at times through out the day when meltdowns are not occurring to prepare for situations like these. It's always good to be prepared.

So once he showed me quiet for a few seconds I then told him that we would sit quietly at the table then leave. This teaches the child that he must listen to the adults that take care of him but that we also care about him and respect his needs. His screaming was not rewarded but it was ended on peaceful terms. we sat quietly at the table, then left with the pizza in the box.

A behavior such as screaming happens for only three reasons: the child wants access to something, the child wants to escape something, or the child is in pain. You can evaluate any situation that arises in these terms to decide how you should react.

  • Is the child injured? Help calm them and treat the injury.
  • Is the child trying to gain access to something? think about if you give him that object how you are teaching him that SCREAMING/CRYING=I GET ITEM (so I will keep on doing this, it really works for me) Take control and decide what the child must do in order to earn that item or saying "no" is always an option. After 3 situations of you saying no and meaning it your child WILL understand the correlation.
  • Is your child trying to avoid something or escape a situation? Decide if your child is in serious danger or believes he is in danger. Calm the child with out talking, in a non rewarding way (if the screaming/crying is a serious behavioral issue you are trying to end). Some parents tend to soothe and hug their child every time he screams and cries even if the screaming/crying is inappropriate. Here you are teaching them that SCREAMING/CRYING=I GET HUGS AND LOVES AND LOTS OF ATTENTION (so I will keep on doing this it really works for me). Take control and decide what the child must do in order to complete the task at hand, this may require shortening the task, like sitting quietly at the table for a minute instead of eating pizza at the table, or cleaning up a few items then being praised and helped with cleaning up. After 3 situations of you taking control and meaning it your child WILL understand the correlation.

19 comments:

Alan said...

Screaming can also occur for sensory reasons, especially in children with autism. If that's the case, teh strategies to overcome or deal with it would be very different. You would be looking at providing equal but appropriate stimulation somehow.

Good article for tantrum type screaming though.

Alex said...

I am a Teaching assistant for children with autism. I have just started to work in a new school. It's a mainstream school and I have to take care of one autistic girl in the class. I was warned that she was very difficult, but I believe that with method and patience, things can get better. On my first day, I was observing the situation. On second day, I came up with a plan: a routine for the the day with a mixture of fun activities (indoors and outdoors), respecting the routine of the class (sitting down for the register, break time, goodbye...). I am using Pecs first stage (Now, then). I praise the child whenever she is being good but I stay firm (and calm) when she is not. My problem is that she keeps on screaming and going into tantrums (which becomes dangerous for herself, myself and other children) every time she doesn't want to do something. On good days it happens at least three times, but on bad days, it can be all day. It usually last at least half an hour. I have never given up and always stayed calm, I have tried to vary activities and find things she loves doing, but when she wants something she doesn't give up. I don't know what else to try or how to help her improve. Because the school is mainstream, it doesn't have the resources needed, but the parents refuse to put her in a special need school. For the past 6 months, she had different TA, as nobody wanted the job, and I don't want to give up, she is very bright when she is good. She has so much potential. Does anyone have ideas, or could help?
Thank you.

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