Question
I am struggling to manage my nine-year-old’s angry outbursts. He has been diagnosed with autism and ADHD (Attention Deficit Hyperactivity Disorder) and he has a lot of sensory issues.
His outbursts are mainly directed towards me (his mother) and not anyone else. He screams at me and can be really intimidating in the middle of an outburst. He knows he’s hurting me and he says he is sorry and he doesn’t know why is he doing this. He really feel ashamed and anxious afterwards. He is trying to control it but not always able to.
I do not know what to do during those outbursts. If I leave or walk away he panics as he does not want to be left alone. I am also afraid he will hurt himself – he recently started running away when it happened when we were out.
He is on the waiting list to see a psychologist in primary care and we are looking at private psychologists as well.
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Answer
Dealing with angry outbursts and meltdowns from your children is very challenging. It is particularly difficult when these outbursts are directed towards you as the parent. It can be very scary to see your child in the height of a meltdown and very hurtful to hear personally directed angry words. It is a good sign that he is remorseful afterwards, meaning he feels “out of control” and, like you, doesn’t like the way he is reacting. This means there is plenty of scope to help him learn to regulate.
Understand stresses and triggers
Meltdowns are not usually caused by a single stress and instead are usually the accumulation of many stressors that build over time. Usually a meltdown trigger is simply the straw that broke the camel’s back. Autistic and ADHD children frequently experience high levels of daily stress from many sources such as social anxiety, overwhelming demands or learning challenges in school. Your son’s sensory issues are probably contributing to his stress levels – he may be agitated by many things around him. Take time to explore with your son the different stresses and agitations he experiences in his day and see which ones you can address or reduce. Often just naming what is going on makes a big difference.
When your son says he is sorry after an outburst, try to be compassionate and understanding. You might say “thanks for saying you’re sorry ... lets try to figure out together what is stressing you so I can help”. Over time, you want your son to develop self-awareness and to be able to articulate what he needs: “I get agitated if ...” or “I freak out when ...” or “when I’m getting stressed I need to take a break by ...”
Address underlying stresses
Take steps to address underlying stresses for your son. Consider how his needs can be better met during the day and how changes to family routines might suit him better. Consider also the school day and how this might be affecting him. Explore with his teacher how he is doing in school and how his needs are being met as an autistic/ADHD child. Many neurodivergent children find the school day very stressful even though this is not immediately apparent. A common pattern is for stressed children to appear “quiet” in school. They might be just about holding it together in school and then have a meltdown at home where they feel safe to let off steam.
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Make a co-regulation plan
Think through a step-by-step plan as to how you will get through the next outburst. You want to find a plan that both supports your son to regulate and relax and which helps you remain calm and emotionally intact. Different regulation strategies work for different children. Some children might respond to soothing words and some need their parent to be more silent. Some might respond to touch such as placing a hand on their back and some might need space from their parent. In your situation, it is significant that your son panics when you leave him in the height of a meltdown. Even though he is directing anger towards you, he is also attached to you and needs your support to regulate. Unfortunately this is a common pattern in human relationships – stress causes us to take out our frustration on those closest to us.
Try to find a middle ground in how you respond. You might pull back a little to interrupt the negative communication and stay close enough to your son that he feels secure and safe.
Try to get in early to notice your son’s rising stress so you can divert him before he gets into a full-blown meltdown. Agree in advance with your son what strategies might help. Some parents I work with do up a “when I feel frustrated chart” with their child whereby they create a visual list of strategies such as “going to my room for a minute”, “using the trampoline”, “saying how I feel”, “watching my favourite show”, “rocking to music on the bean bag” or whatever else particularly works for their individual child.
Get support
Do seek more support for you and your son. Many therapists such as OTs (occupational therapists) work with parents and children to help children understand their sensory needs and to learn to self-regulate and manage big emotions.
Do seek out a therapist who understands the needs of autistic and ADHD children.
- John Sharry is clinical director of the Parents Plus Charity and an adjunct professor at the UCD School of Psychology. He is running workshops on motivating ADHD children and managing anxiety and stress. See www.solutiontalk.ie.
