Q: My 8-year-old has had all her evaluations and is on medications that seem to be the right ones. How do I handle issues at her school’s after-care program in regards to when she does have her occasional meltdowns or misbehaviors? I’m struggling to keep my cool and address her in private.
A: I was recently listening to an interview on the radio in which a police captain was explaining the new mental-health-care training his officers were receiving. Apparently, a mentally ill woman had been taken into custody and died at the hands of the police. The police did not understand her mental illness, and the courts found that the police had used excessive force on a person who was not trying to cause them harm; she was having a mental breakdown.
The captain mentioned something that stuck with me: He said that mentally ill people and their families are in a great deal of crisis when they call the police, but that his officers are also afraid and don’t want to cause harm. They didn’t understand what they were seeing, he said, and it hurt them, too.
Everyone was suffering. The people who are off their medication (or never on medication to begin with) or having a substance-induced psychosis are the people we focus on. They are the victims, the ones in need. But the police were struggling, too. They wanted to serve and protect; they did not want to hurt people who needed help.
When I read your question, I thought of that scenario. No, of course the stories aren’t parallel, but I imagine that the after-care employees would love a heads-up when it comes to your daughter’s changing emotional landscape. Whatever she was struggling with was difficult enough to be diagnosed and medicated, but medication is not a magic wand. Yes, it can save children’s lives, but there is still a great deal of acclimation to the meds. While a child’s brain is changing, the child is still challenged. For instance, if your daughter has attention-deficit/hyperactivity disorder, she still has ADHD even while on meds. Medication doesn’t always fix problematic behavior, nor should we expect it to. Let’s add that even 8-year-old children without mental illness have occasional meltdowns. That is part of being a kid.
So you need to help the after-care professionals support your daughter while she is in their care. Write to the director and outline the basics of what is happening. “Adrienne is on medication for _____. She is doing exceptionally well, but sometimes after school, she is just too tired to regulate herself. You may see some explosions that look like _____ and sound like _____. This usually happens when _____, and then _____ happens. Here is a list of what does and doesn’t work: _____.” And in this section, you will explain how to help your child through these tantrums. For instance, if your child detests being touched, you might ask her caretakers to contain her for her safety but to avoid restraining her. Or maybe the tantrums are a sign of low blood sugar, and she needs juice, stat. Maybe she needs a quiet corner with a book and less stimulation. Maybe she needs to whirl in circles and run up and down the gym. You see? You are arming the professionals with the knowledge that “Hey, this is not a bad kid in front of you. She is struggling and needs help.”
If the after-care professionals are worth their salt, they will (like the aforementioned police) eat up the information. Most child-care professionals lack critical details that could help them support their young charges immensely, and when you help these professionals by being specific and clear, it makes their job easier. This information also protects the relationship between the after-care program and your child, and, most important, it prevents them from creating problems for your child.
A young child who is on medication does not need shame or separation-based techniques heaved upon her shoulders. She needs loving boundaries and compassionate support.
Important: Thank you for keeping your cool and addressing your child in private. There is nothing more humiliating (for a child or anyone, really) than being chastised in front of others.
Let’s switch up the “talking to her” about this behavior to instead letting her know that you understand she had a tough incident at school and that you and the after-care folks are working on it together. Let her know that everyone has tantrums here and there and that you know it can be hard for her. You can say: “Yes, after-care has to remove you from the room when you start screaming. But they don’t think you are a bad kid, and neither do I. I know you are doing your best.”
You may or may not believe this in your heart, but that doesn’t matter. Seriously. We have to solicit her best intentions and let her know that we are working on it and that there are better days ahead. Not to mention, once she has had a tantrum, what is she supposed to actually do about it? You don’t want to spend too much parenting time in the past. Focus on helping her smooth her future.
So include the after-care professionals in the care of your child. All boats rise when every caretaker has the same information and wants to know how to help her. Also, don’t shame your daughter for past events. Keep moving forward.