Nine months into the COVID-19 pandemic, parents of children with special needs are reporting an increase in tantrums and other disruptions—hitting, whining, and yelling—due to the stress of staying home or learning remotely. In a recent survey by the Child Neurology Foundation of almost 2,000 families, 81 percent of parents report aggressive outbursts at least once a month.

To curb these outbursts, parents are looking for strategies, says Eileen Devine, LCSW, a behavioral support coach for parents based in Portland, OR. The first thing she advises parents is to understand that their children’s brains “work differently than other children's.”

“Parents tend to view their children through a behavioral lens,” Devine says. “They think their child is being disrespectful or that they just want things done their way, when really their child's brain is working differently, and their frustration comes out through difficult behavior.” For example, kids with autism or attention deficit hyperactivity disorder (ADHD) who have trouble transitioning may act “rigid” when asked to adjust to changes in routine or shut down verbally. “When a child has a physical disability, we provide accommodations,” she notes. “We should provide accommodations for a neurologic difference as well.”

For adults with neurologic conditions, these accommodations are especially crucial, says Tanjala Gipson, MD, FAAN, director of the Neurodevelopmental Disabilities Clinic at the Center for Developmental Disabilities. “The number one problem I see is that parents have expectations that don't meet that individual's disability,” she says. “Parents insist, ‘You’re 18, you should be able to do this.’ But if developmentally, the person is 7, then the expectations of behavior should be for a 7-year old.”

Dr. Gipson encourages parents to get a neuropsychological evaluation for their child to find out at what age he or she is functioning developmentally, rather than chronologically. Then, scale expectations to that age. An 18-year-old who functions like a 7-year-old, for example, can’t learn algebra like other teenagers. “It's OK to challenge your adult child,” Dr. Gipson says. “But you want to do it for the appropriate developmental age, then push them gently to that next developmental age. Unrealistic expectations are a recipe for disaster.”

If parents scale their expectations for behavior and make accommodations and the disruptions continue, Dr. Gipson says something more serious might be going on. “If a kid is being disruptive and isn’t motivated externally by anything and doesn’t find anything enjoyable, I would want to make sure there's not something internal that's wrong, such as dental pain or gastrointestinal problems,” she says. “If someone is really struggling, there might be an underlying physical or mental problem that needs to be treated medically.”

Overall, Dr. Gipson says, the stress of the pandemic has been hard on everyone. Take heart, she says. COVID-19, remote school, and the behavioral disruptions that come with it won't last forever. “I really want parents to take it easy on themselves,” she says. “You might have to make some adjustments right now, but this is temporary. Never give up on hope.”

In the meantime, she and other experts suggest these strategies.

1. Make safety a priority. “If you’re in the thick of a tantrum, the first priority should be to make sure you and your children are safe,” says Dr. Gipson. “If not, try to block the child from harming himself or others while still giving him the ability to release what he’s feeling.”
2. Say less. “I tell all parents that if they’re in a back-and-forth battle with their child they should stop fighting, no matter what,” says Devine. “Use fewer words and stop talking altogether if you can. In the midst of a tantrum, kids are cognitively overloaded, and listening to parents’ words will only agitate them and make the behavior worse.”
3. Focus on yourself first. “The greatest parenting tool we have is our own regulated state,” says Devine, who advises parents that they will be more successful calming an angry child if they’re calm themselves. Parents can then use their best judgment to help bring their child back to a regulated state—either by gentle physical touch, going on a walk, helping the child into a bath, or leaving him or her alone.
4. Be forgiving. “Kids shouldn’t be in trouble for throwing a tantrum,” Dr. Gipson says. Instead, after the disruption is over, parents should try to gently figure out the source of the problem in order to prevent another one. “I advise parents to engage with their children and ask, ‘How do you feel? What do you need? How can I help?’”
5. Access resources. “Kids with autism spectrum disorder need an explanation of why we’re doing something, and they need it in their own terms,” says Dr. Gipson. For these families, she recommends Social Stories, a learning tool that presents concrete information to children with autism in a narrative form. A story about safety, for instance, might describe how and why people wear seatbelts and follow traffic laws. Parents can also use Social Stories to explain why people are wearing masks, what the coronavirus is, and why schools are currently closed. Learn more at carolgraysocialstories.com.
6. Find support. Connecting with other parents can help families feel less isolated, says Devine. To that end, Devine has established a membership-based online community called the Resilience Room for parents to meet and share resources. Membership includes a Facebook group for parents, moderated by Devine, along with access to educational programs and the opportunity to schedule Zoom calls with Devine herself.
7. Use assistive technology. Devices and tools, such as talk-to-text apps or e-readers, can be transformative for children with dyslexia or sensory integration deficits, says Heather Johanson, a special-needs advocate in Northern California. An affordable option for reading online content is Web Reader. For voice dictation, there’s the app Speechy.
   
   

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