Preventing Meltdowns in Kids with Fragile X (Part One)
I'm sure everyone reading this has been there.
You've organised a play date to try and build your child's social skills and they lose it and yell at their sibling in front of their friend (most recent personal example!)
Or, you're at a family gathering and your child ends up on the floor crying about having the wrong cutlery.
I don't need to go on - we all know where I'm headed with this.
Often we are taken off guard by these moments, and do all we can to manage them as they are unfolding. However, we also know our kids well enough to understand that once a child has reached the level of emotional dysregulation where they are screaming, crying, hitting etc., there's not much we can do to short circuit the process.
However, there is so much we can do to PREVENT these occurrences. In my opinion, 90% of managing your child's emotional regulation is preventative- that is, it happens BEFORE your child shows signs of dysregulation, or is only showing mild signs of dysregulation.
90% of managing your child's emotional regulation is preventative
So how do we manage our child's emotional regulation so that they don't get to the point of melting down? Let me introduce you to the stress curve.
The Stress Curve
This graph is the best visual representation I've found to help parents understand their child's (and their own) emotional regulation.
Theoretically, at birth every child starts at 0 on the scale, that is, having no stress. We know there is trauma that happen before and during birth, and genetic factors that influence how individuals respond to stress, however, for simplicity's sake, we are going to assume that everyone starts at approximately 0 on the scale.
Up Arrows
Enter 'up arrows'. An up arrow is anything that uses up your child's internal resources and pushes them up the stress curve. Obvious examples of up arrows include events like moving house and starting school, but also include small things like stepping on Lego in the morning, the family running out of your child's favourite snacks, an unkind word from a peer at school and other such incidents. Up arrows can be different sizes. Therefore, stepping on Lego might push a child up one point on the stress curve, whereas moving house might push them up five points.
Additionally (and slightly mind bending!) is the idea that POSITIVE events can be up arrows for children. Remember, up arrows are anything that uses up a child's internal resources. Therefore, events like their birthday or Christmas will inevitably be up arrows for kids, because they typically use a lot of emotionally energy anticipating these types of events. This explains a phenomenon that every parent has experienced: they throw their child a beautiful birthday party, only to have their child hit another kid with a stick and lose it during pass the parcel when they don't get the big prize at the end.
As parents, there are some up arrows we can prevent - limiting unnecessary stress is certainly a part of managing your child's emotional regulation. This usually amounts to thinking ahead and considering whether it is necessary to drag your child to the shops at Christmas time when they are highly sensitive to noise, or bringing colouring books on a long car drive that will otherwise cause them stress.
However, many of the up arrows our children experience are unavoidable. And we know from the literature, that the right amount of stress or challenge can help develop our children's skills. For example, if your child is anxious about giving a speech in class and you try and spare them that stress by writing them a note excusing them, the next time they are asked to give a speech they will be more anxious and have less skills to complete and deliver the talk.
The Ugly Zone
Most children will end up at a 9 on the stress curve. For some kids, we can see that they have reached their edge and are about to lose it. For other kids, there may be little or no outward signs. Then, something seemingly small will happen, and your child will be pushed by this stressor into the 'Ugly Zone'. Immediately, you probably know what I'm talking about, but every child will have their own Ugly Zone behaviours. Classic examples are screaming, crying, hitting or other behaviours associated with tantrums or meltdowns (if your little one has an ASD diagnosis also). But, some children who tend to internalise their emotions may eat, zone out in front of a screen, or withdraw in other ways. This is a phenomena called the 'faint' response, where if a child goes into fight or flight and cannot escape the situation physically in this way, they will 'faint' (usually not literally, although this can occur under extreme stress). This word comes from the observation of animals who will 'play dead' when they can't escape a predator in the wild.
This helps us make sense of the idea that parents often describe, where they report that their child goes from '0-100' in a few seconds. Again, often there are few or no outward signs a child is a 9 on the scale, so the meltdown appears to come out of nowhere. However, when we conceptualise it in this way, we can see that there have likely been many small stressors that have contributed to their meltdown. This seems a better explanation to me than our kids losing it over one small stressor.
Following the meltdown, a child may come out of the Ugly Zone, however, unless more is done to help them down regulate, will often sit at a 9. If this happens they may start to zig zag across the top of the graph - another small stressor comes and they're in the Ugly Zone again. Then they calm down, but if something else happens, they're melting down again.
A few other things to note about the stress curve. Notice that it is an exponential curve, that is, the rate of emotional dysregulation accelerates as you get higher on the curve. This means that it may take a child a few days to get from a 3 to a 4, but a few minutes to get from an 8 to a 9. This helps us as we start to think about intervention: The earlier we are able to intervene and down regulate our kids, the more 'emotional buffer' they will have between future stressors and the 'Ugly Zone'.
So if we can't prevent many of these up arrows- how do we counteract them? You guessed it: down arrows!
Please read on in Part Two to learn more.
Thanks to Dr. Crystal McMullen, my mentor, for first introducing me to this concept.
Thanks to Jon Busch for constructing the Stress Curve graph
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