How Can We Help Kids with Self-Regulation?
Some kids need help learning to control their emotions, and resist impulsive behavior
Clinical Expert: Matthew H. Rouse, PhD
EN ESPAÑOL
If you’re a parent, chances are you’ve witnessed a tantrum or two in your day. We expect them in two-year-olds. But if your child reaches school age and meltdowns and outbursts are still frequent, it may be a sign that they have difficulty with emotional self-regulation.
Simply put, self-regulation is the difference between a two-year-old and a five-year-old who is more able to control their emotions. Helping kids who haven’t developed self-regulation skills at the typical age is the goal of parent training programs. And many older children, even if they’re beyond tantrums, continue to struggle with impulsive and inappropriate behavior.
What is self-regulation?
Self-regulation is the ability to manage your emotions and behavior in accordance with the demands of the situation. It includes being able to resist highly emotional reactions to upsetting stimuli, to calm yourself down when you get upset, to adjust to a change in expectations, and to handle frustration without an outburst. It is a set of skills that enables children, as they mature, to direct their own behavior towards a goal, despite the unpredictability of the world and our own feelings.
What does emotional dysregulation look like?
Problems with self-regulation manifest in different ways depending on the child, says Matthew Rouse, PhD, a clinical psychologist. “Some kids are instantaneous — they have a huge, strong reaction and there’s no lead-in or build-up,” he says. “They can’t inhibit that immediate behavior response.”
For other kids, he notes, distress seems to build up and they can only take it for so long. Eventually it leads to some sort of behavioral outburst. “You can see them going down the wrong path, but you don’t know how to stop it.”
The key for both kinds of kids is to learn to handle those strong reactions and find ways to express their emotions that are more effective (and less disruptive) than having a meltdown.
Why do some kids struggle with self-regulation?
Dr. Rouse sees emotional control issues as a combination of temperament and learned behavior.
“A child’s innate capacities for self-regulation are temperament and personality-based,” he explains. Some babies have trouble self-soothing, he adds, and get very distressed when you’re trying to bathe them or put on clothes. Those kids may be more likely to experience trouble with emotional self-regulation when they’re older.
But the environment plays a role as well. When parents give in to tantrums or work overtime to soothe their children when they get upset and act out, kids have a hard time developing self-discipline. “In those situations, the child is basically looking to the parents to be external self-regulators,” Dr. Rouse says. “If that’s a pattern that happens again and again, and a child is able to ‘outsource’ self-regulation, then that’s something that might develop as a habit.”
Children with ADHD or anxiety may find it particularly challenging to manage their emotions and need more help to develop emotional regulation skills.
How do we teach self-regulation skills?
Scott Bezsylko, the executive director of the Winston Prep schools for children with learning differences, says that acting out is essentially an ineffective response to a stimulus. The parent or teacher needs to help the child slow down and more carefully choose an effective response instead of being impulsive.
“We approach self-regulation skills in the same way we approach other skills, academic or social: isolate that skill and provide practice,” Bezsylko explains. “When you think of it as a skill to be taught — rather than, say, just bad behavior — it changes the tone and content of the feedback you give kids. ”
The key to learning self-regulation skills, says Dr. Rouse, is not to avoid situations that are difficult for kids to handle, but to coach kids through them and provide a supportive framework — clinicians call it “scaffolding” the behavior you want to encourage — until they can handle these challenges on their own.
Imagine a situation that can produce strong negative emotions, like a frustrating math homework assignment. If a parent hovers too much, they risk taking over the regulation role. “Instead of the child recognizing that the work is frustrating and figuring out how to handle it,” Dr. Rouse explains, “what they feel is that the parent is frustrating them by making them do it.”
Scaffolding in this situation might be helping the child with one problem, and then expecting them to try the rest. If they feel frustrated, they might get up and get a drink. They might use a timer to give themselves periodic breaks. The parent would check in on them at intervals and offer praise for their efforts.
If a child is prone to melting down when they’re asked to stop playing a video game, scaffolding might be practicing transitioning away from the game. “You’d want to practice with a game in which they’re not overly invested — you don’t want to begin with high-stakes,” Dr. Rouse explains. “Have them practice playing for two or three minutes and then handing you the game. They get points towards something they want every time they do it.”
Practice runs
Dry runs are another way to scaffold self-regulation. For instance, if you’ve had trouble with a child reacting impulsively or having a tantrum in a store, make a short visit when you don’t need to do serious shopping. Have them practice walking with you, keeping their hands to themselves. They get points towards some goal every time they are successful.
Dr. Rouse says that often parents get discouraged when things don’t go well the first time they try skill-building, but consistency and starting at a level that is appropriate for your child are key. Rather than giving up, try paring down the activity so it is more doable, and slowly give your child more and more independence to handle it.
For instance, if brushing their teeth is a problem for your child, you might start by focusing just on putting toothpaste on the brush, and respond with positive feedback and rewards when they do it. Once they’ve practiced that a few times, add the next step in the chain.
Similarly, if getting out the door in the morning is causing meltdowns, target one step at a time. First, say, getting dressed by 7:15. Once they’ve mastered that, set a target time for breakfast, and add that. Breaking the chain into small steps allows them to build self-regulation skills in manageable increments.
Help kids become self-reflective
Bezsylko stresses that when parents or teachers approach impulsive, inappropriate behavior calmly and give them time, kids can learn to choose better ways to respond to that situation. The feedback kids need is non-judgmental and non-emotional: what went wrong, and why, and how they can fix it next time.
“When kids are part of an environment that’s reflective and analytic as opposed to emotional and fast-paced,” Bezsylko explains, “they can learn to make better choices.” Slowing down allows children to become more thoughtful, reflective and self-aware. “We need to slow down and model self-reflection and self-awareness and self-regulation for our kids,” he notes, “but it’s also helpful and good for us, too.”
Bezsylko notes that mindfulness and meditation are good for everyone, but especially for children with self-regulation challenges. And Dr. Rouse mentions the many parent training programs available to help them become better coaches for their kids. For older kids, dialectical behavior therapy (DBT) is also an option, as it focuses on distress tolerance and emotion regulation.
At the end of the day, though, nothing can replace the work of the parent. “It seems to me,” says Dr. Rouse, “that the family environment is the most important piece.”
Dear parents,
For this week I want to share an article on Artificial Intelligence and its possible application for mental health. In this case, for Suicide Prevention.
As psychologist I have observed how suicide attempts are increasing and how people tend to not talk about mental health struggles. Young people tend to share more about themselves in social media than they would share with adults or even peers. There is a potential use of Artificial Intelligence for tracking digital footprint and determine risk before it’s too late.
It’s important to let kids know that it is ok not to be ok, and encourage them to talk with someone they trust, with confidentiality and without feeling there is embarrassment in doing so.
Kind Regards,
Ms. Mora
9th-12th grade Guidance Counselor
A high school senior's science project could use AI to prevent suicides by Abē R. Levine
Text messages, Instagram posts and TikTok profiles. Parents often caution their kids against sharing too much information online, weary about how all that data gets used. But one Texas high schooler wants to use that digital footprint to save lives.
Siddhu Pachipala is a senior at The Woodlands College Park High School, in a suburb outside Houston. He’s been thinking about psychology since seventh grade, when he read Thinking, Fast and Slow by psychologist Daniel Kahneman.
Concerned about teen suicide, Pachipala saw a role for artificial intelligence in detecting risk before it’s too late. In his view, it takes too long to get kids help when they’re suffering.
Early warning signs of suicide, like persistent feelings of hopelessness, changes in mood and sleep patterns, are often missed by loved ones. “So it’s hard to get people spotted,” says Pachipala.
For a local science fair, he designed an app that uses AI to scan text for signs of suicide risk. He thinks it could, someday, help replace outdated methods of diagnosis.
“Our writing patterns can reflect what we’re thinking, but it hasn’t really been extended to this extent,” he said.
The app won him national recognition, a trip to D.C., and a speech on behalf of his peers. It’s one of many efforts under way to use AI to help young people with their mental health and to better identify when they’re at risk.
Experts point out that this kind of AI, called natural language processing, has been around since the mid-1990s. And, it’s not a panacea. “Machine learning is helping us get better. As we get more and more data, we’re able to improve the system,” says Matt Nock, a professor of psychology at Harvard University, who studies self-harm in young people. “But chat bots aren’t going to be the silver bullet.”
Colorado-based psychologist Nathaan Demers, who oversees mental health websites and apps, says that personalized tools like Pachipala’s could help fill a void. “When you walk into CVS, there’s that blood pressure cuff,” Demers said. “And maybe that’s the first time that someone realizes, ‘Oh, I have high blood pressure. I had no idea.’ ”
He hasn’t seen Pachipala’s app but theorizes that innovations like his raise self-awareness about underlying mental health issues that might otherwise go unrecognized.
Building SuiSensor
Pachipala set himself to designing an app that someone could download to take a self-assessment of their suicide risk. They could use their results to advocate for their care needs and get connected with providers. After many late nights spent coding, he had SuiSensor.
Using sample data from a medical study, based on journal entries by adults, Pachipala said SuiSensor predicted suicide risk with 98% accuracy. Although it was only a prototype, the app could also generate a contact list of local clinicians.
In the fall of his senior year of high school, Pachipala entered his research into the Regeneron Science Talent Search, an 81-year-old national science and math competition.
There, panels of judges grilled him on his knowledge of psychology and general science with questions like: “Explain how pasta boils. … OK, now let’s say we brought that into space. What happens now?” Pachipala recalled. “You walked out of those panels and you were battered and bruised, but, like, better for it.”
He placed ninth overall at the competition and took home a $50,000 prize.
The judges found that, “His work suggests that the semantics in an individual’s writing could be correlated with their psychological health and risk of suicide.” While the app is not currently downloadable, Pachipala hopes that, as an undergraduate at MIT, he can continue working on it.
“I think we don’t do that enough: trying to address [suicide intervention] from an innovation perspective,” he said. “I think that we’ve stuck to the status quo for a long time.”
Current AI mental health applications
How does his invention fit into broader efforts to use AI in mental health? Experts note that there are many such efforts underway, and Matt Nock, for one, expressed concerns about false alarms. He applies machine learning to electronic health records to identify people who are at risk for suicide.
“The majority of our predictions are false positives,” he said. “Is there a cost there? Does it do harm to tell someone that they’re at risk of suicide when really they’re not?”
And data privacy expert Elizabeth Laird has concerns about implementing such approaches in schools in particular, given the lack of research. She directs the Equity in Civic Technology Project at the Center for Democracy & Technology (CDT).
While acknowledging that “we have a mental health crisis and we should be doing whatever we can to prevent students from harming themselves,” she remains skeptical about the lack of “independent evidence that these tools do that.”
All this attention on AI comes as youth suicide rates (and risk) are on the rise. Although there’s a lag in the data, the Centers for Disease Control and Prevention (CDC) reports that suicide is the second leading cause of death for youth and young adults ages 10 to 24 in the U.S.
Efforts like Pachipala’s fit into a broad range of AI-backed tools available to track youth mental health, accessible to clinicians and nonprofessionals alike. Some schools are using activity monitoring software that scans devices for warning signs of a student doing harm to themselves or others. One concern though, is that once these red flags surface, that information can be used to discipline students rather than support them, “and that that discipline falls along racial lines,” Laird said.
According to a survey Laird shared, 70% of teachers whose schools use data-tracking software said it was used to discipline students. Schools can stay within the bounds of student record privacy laws, but fail to implement safeguards that protect them from unintended consequences, Laird said.
“The conversation around privacy has shifted from just one of legal compliance to what is actually ethical and right,” she said. She points to survey data that shows nearly 1 in 3 LGBTQ+ students report they’ve been outed, or know someone who has been outed, as a consequence of activity monitoring software.
Matt Nock, the Harvard researcher, recognizes the place of AI in crunching numbers. He uses machine learning technology similar to Pachipala’s to analyze medical records. But he stresses that much more experimentation is needed to vet computational assessments.
“A lot of this work is really well-intended, trying to use machine learning, artificial intelligence to improve people’s mental health … but unless we do the research, we’re not going to know if this is the right solution,” he said.
More students and families are turning to schools for mental health support. Software that scans young peoples’ words, and by extension thoughts, is one approach to taking the pulse on youth mental health. But, it can’t take the place of human interaction, Nock said.
“Technology is going to help us, we hope, get better at knowing who is at risk and knowing when,” he said. “But people want to see humans; they want to talk to humans.”
Copyright 2023 NPR. To see more, visit https://www.npr.org.
I hope you found this article interesting. In Costa Rica we have the following emergency free lines for suicide prevention/ risk:
