TIP of the WEEK: Avoiding Outbursts

June 20, 2014

Although it is not always possible to avoid outbursts, with a little planning and appreciation for the thought process of a person with PWS many incidents can be thwarted.

1. Try to understand where the stress is coming from. It may appear as though there was no antecedent, that the behavior came out of nowhere. This is rarely the case. Even switching a non- preferred activity for a preferred one can cause anxiety. For example, a trip to the dentist may be low on their list of fun things to do but if historically that appointment ends with a prize or reward then missing it will cause disappointment and stress. It is not always easy to determine what causes upset; by putting yourself in their shoes and trying to see the world through their eyes will usually give you the answer.

2. Teach coping skills every day. The best way to learn to manage feelings of frustration is to practice often while at baseline. Over time these skills will sink in well enough to be used during times of escalation. Some effective skills are: deep breathing, taking space away from others, asking for stress relief objects like sensory balls or music, and the most effective skill- the ability to communicate your feelings. It will likely take some time to be able to use these skills when distressed however with enough practice they will be able to use them.

3. Strategize. If you know that a stressful event is coming up, don’t wait until the behavior occurs. Have a back-up available to help you contain the situation; a safe place to go to spare your child from being the center of a scene (the embarrassment of exploding in front of a group can have an adverse effect on self esteem).

4. If an incident is unavoidable try to remain empathetic. Shame, judgement, and guilt will only add to the negative feelings. Threats and bribery don’t work and will just exasperate the situation. Remain calm and offer kind and caring words when the person starts to decompress.

Always remember that escalated emotions and behavioral outbursts are not intentional and in most cases the person is not in control. What the person needs more than anything is a face saving way out and support to get back to baseline. Tantrums, outbursts, and acts of aggression are not choices that the person with PWS would make if they were able to think clearly in the moment. Teaching skills and being supportive are the best ways to avoid these behaviors over time.

Submitted by: Patrice Carroll Manager PWS Services