Top Ten Strategies for Emotional Meltdowns in Public

March 9, 2011

Behavioral meltdowns are difficult enough when they happen in the safe confines of our homes, but when they occur in public they can be scary, overwhelming and embarrassing. These incidents are more common than you may think for children diagnosed with PWS. If this happens to you, understand that you are not alone and many, many parents have suffered through the same experiences. Here is what to do if it happens.

10. This is “normal.” Those diagnosed with Prader-Willi Syndrome are more susceptible to increased anxiety, emotional dysregulation and the inability to manage all stress in effective ways. It is important to remember that this is not your individual child acting out because they are bad, but rather may be more symptomatic of the syndrome. They are doing the best they can.  Also, much of this behavior can be fairly typical for all children. Pre-teens and adolescents are not known for their charm and easy dispositions so don’t forget to account for this. When a child has maturational stress- think of how stressful your adolescence was- combined with some common symptoms of PWS the chances of a meltdown is increased.

9.  Don’t be embarrassed. It is easy for us to write that and much more difficult for you to remain composed when you have strangers stopping to stare at you when your child is screaming bloody murder in the middle of the mall. Do your best to focus on moving through the meltdown and try not to let other people add to your level of stress. All parents feel like they sometimes don’t have what it takes to parent and when your child has special needs this feeling is amplified even more. YOU ARE THE BEST PARENT FOR YOUR CHILD. There is no one better than you and don’t give in to the judgment of others.

8. Perform a risk assessment. There are too many possibilities to advise on, but in general, anything that occurs in the community is risky. It is important that you quickly evaluate what is happening and evaluate the potential risks to you and your child. If you see a risk that seems large you must ask yourself if you can handle the situation on your own. There are many unknowns when you are in public and you need to ensure that you are supported.

7. Take a breath and step back.  You must literally do this because it accomplishes two very important things. One, taking a breath will help you to stay at baseline so you can effectively act in this situation. Crisis can cause you to react, but you must act against that and remain thoughtful. Stepping back provides space and gives room for everyone to breath. Your child will need you to ground them and it is imperative that you are actively focused on what needs to be done in the moment. Breath, collect your thoughts and then act. You want to de-escalate the situation not make it worse.

6. Stay calm, look neutral and stay present. In times of crisis, a significantly large percentage- over 90%- of communication is non-verbal. How you look and how you sound is far more important than what you say. Think of when you are personally really angry or upset, do you hear specific words someone says? Your instinct may be to raise your voice, give a command or get angry. What you must do is relax your face, even your tone and appear unaffected. You do not want to add to the stress of the situation because this will only make it worse. You must be the grounding force for your child at this time.

5. Avoid “no” and “can’t.” Redirect when possible. In times of crisis, you must be focused on reducing stress and stimulation. Have you ever been in an argument with someone and in the midst you are just hoping that they give you a reason to argue more? What happens when you are in an argument with someone and they suddenly grow calm and begin to appease what you are saying? This is an example of reducing stimulation. It is very difficult to stay in an argument by yourself. We are not recommending that you encourage bad behavior to continue, but you need to be thoughtful in how you respond to a person in crisis. Being direct and oppositional fuels the crisis and is not the most effective way to handle the situation. For example:
Child: (screaming) I want to ride the carousel.
Parent: (calmly) Once you are calm then you can focus on what we are doing next.
Child: (screaming) Let me ride it.
Parent: (calmly) I see you are still upset. Once you can take some deep breaths we are going to discuss what we will do next. Take a breath with me. . .

4. Give a simple direction and then time and space. Although it isn’t always easy, often the only thing parents/caregivers can do in situations like this is ride it out. What we want to stop from doing is adding extra stress into an incident. Especially if your child has cognitive and/or language processing delays, time for things to sink in sometimes takes longer than we want to wait. This is even truer in times of crisis when rational thought is not at the forefront. What you can do is come up with a simple direction- sit on the bench, take a deep breath, walk with me- and say this in a neutral, calming, yet assertive tone. Then try to just be quiet. The less you say in times of crisis the better. There are times this might be difficult to do in public depending on the crisis and your surroundings, but it is the ideal to shoot for.

3. Let it go. Once the episode is over it is over. Typically, it is not effective to bring the incident back up and discuss it. You may change your future plans or where you go with your child, but that doesn’t have to be told to your child. Chances are what you were involved in was a result of emotional over flooding. This is a skills deficit that your child needs help in building up. Discussing how bad they behaved typically is not useful to lessening the future possibility of a similar even occurring and only serves to create more stress and anxiety.

2. Debrief. Talk to someone who understands the trials and tribulations that PWS brings and who can ground you ASAP. If you do not already have this person then find them by involving yourself in the PWS community either through your local chapter or on-line. It is crucial that you talk to someone who really, truly understands your experience because most do not. If you do not debrief, then it is easy to build walls up against your own child and blame them. When you talk to others and involve yourself in the community you will feel much better.

1. Take care of yourself. If your tank is not recharged you will be of absolutely no use to anyone else. You must take time to laugh, cry and be quiet. If you are saying you don’t have the time, you must make the time and it must be your first priority. This can be down in small bits and does not require a huge commitment of time. Even a 15 minute walk by yourself at night or a regular bath routine can do wonders. Carve out time for self-care and guard it ferociously.

For more information about PWS and/or Latham Centers, Inc. please go to: www.lathamcenters.org . If you have ideas for future Top Ten lists that you would like to see, please email Tim Vaughan at tvaughan@lathamcenters.org. Any reproduction of this list must contain the following:

Latham Centers
1646 Route 6A
Brewster, MA 02631
Tel: 508-896-5776
www.lathamcenters.org


“Take rest; a field that has rested gives a bountiful crop.” 
~Ovid

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