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Aggression in Children and How to Handle it

Aggression- how to decrease behaviors

By Patience Domowski, LCSW

Aggression in children is really difficult. From yelling to hitting, its very disruptive and sometimes even dangerous. Especially as the child gets older it becomes more of a safety concern. A 3 yr old hitting a parent is not that big of a problem, but a 13 yr old could really hurt someone.

To solve this problem we need to figure out why it is happening. Here are some possible causes:

-Child cannot manage their emotions (needs coping strategies), gets easily angry, anxious, frustrated, etc

-Child cannot effectively communicate (hasn't developed full speech due to age or speech delay, or autism)

-Child has a mental health diagnosis (autism, bipolar, ODD, …)

-Child has observed and copied aggression from older siblings, parents, violent TV

-Child is very impulsive (can’t stop and control themselves)

-Child has discovered that this gets them what they want from others  (example: if they hit then people leave them alone, if they yell then dad gives in, etc)

-Child gets attention from their behavior (even though it is negative, some children still want this attention).

-Other reasons…

For some children there may be a combination of reasons. Sometimes the reason is easy to discover but other times it may be more complicated. Collecting data (writing down the behaviors and what happened before and after) and doing an FBA (Functional Behavior Analysis) can be helpful. Ask your child’s teacher or behavioral therapist about how to do one if it is difficult to figure out the ‘why’ for the behaviors.

To correct the behavior we want to teach the child a combination of better coping strategies and a more effective way to get what they want.

For example: if they get angry easily when their sibling takes their toy we want to teach them to calm down, and also the skill of asking for the toy nicely, or asking a parent for help. If the child wants attention then teaching the child a more appropriate way such as saying “Mom, play with me!” instead of hitting would be helpful. Also the parent should ignore the inappropriate behavior until the child does the expected response.

If the child is copying others aggressive behavior- whether in person or on TV shows/games/ etc it is important to limit this exposure. If the parents are showing aggression such as yelling and hitting children, then it's likely the child will copy this as well. If the parents can try to be more patient and handle their frustrations in a more appropriate coping way, this can greatly help the child. Parents may want to seek therapy on their own, or try anger management groups, or even medication to help, if they are really struggling with depression for example. If older siblings are exhibiting aggression it is helpful to try to get them some more help and teaching the younger child to not copy those behaviors. If the child is watching violent TV shows, movies, video games, eliminate or at least reduce the frequency the child is exposed to that. If the child resists, explain that if they reduce their aggression they can slowly return to those games/shows etc. Pay attention to the ratings on games and shows however and the child’s age.

For cursing- if it’s in conjunction with anger and aggression, use same strategies already listed to teaching better coping behaviors, but besides that mostly ignore it, or teach a silly replacement word “peanut butter jelly sticks!” The more attention you give the curse word, the more powerful they become. You can tell them not to say that word and maybe even why, and if necessary punish for it, but if you make a huge deal about it (such as yelling and lecturing) it will likely make it worse. Also make sure parents and older siblings are refraining from using those words completely. Even if parents tell child not to say a word, if they are saying it themselves, the child will still learn it and repeat it. With any behavior, parents need to model good behavior and not to do anything they would not want their child to do (for the most part). Sometimes an old fashioned ‘swear jar’ is helpful. The person that says the bad word is ‘fined’ and has to pay real money into the jar.When the jar is full some families will use it for a fun activity, sometimes the money would go to the non-swearing person, or maybe the family would donate it to a charity.

Make sure the child’s aggressive behavior is not getting them what they want. If they are hitting their sibling to get them to leave them alone, and its effective, that is going to maintain the behavior. Try to teach the sibling to respond better and quicker and teach the aggressive child to request space in a better way. If the aggressive behavior is getting them the attention or item they want from parents, parents need to try hard to not give in. Even though it makes the screaming stop now, it will just make the behavior worse the next time if you give in.

If the child has not developed appropriate speech, due to age or delays, it maybe be helpful to teach a simple hand gesture/sign language to use to communicate. Maybe a clap means ‘Can I have it?’ or a hand tap means ‘I need help’. Ask your child’s speech therapist for some ideas to figure out what will work best for your child’s speech needs.

For kids who don’t have good coping strategies have them write up a list (or draw) several things they can do when they are angry and then hang the list in a well-trafficked area in the home (living room or kitchen is usually good). The list should be visible because when someone is angry they are not going to go searching for a paper in a drawer to figure out what to do. The strategies can include deep breathing, walking away/ignoring, asking parents for help, doing something fun to distract yourself, and remembering to ask nicely for things. There are many coping strategy lists that can be found online. The key is to find which ones work best for your child and to have your child identify these as well. The more the child is involved in identifying the strategies the more likely the child will use them.  Also have the child act out the appropriate coping strategy when they are in a good mood, as a role play, or after they made a poor choice to reenact making a better choice.

Try giving a reward to the child for using a strategy. For example if the child takes a deep breath instead of hitting mom, or stops screaming by deciding to go chill out in their room, give them a piece of candy, access to a special toy, or extra ipad time for making a good choice. Praise your child for calming down, whether it took 10 seconds or 1 hour, immediately praise them when they are calm so they associate positive attention with calming down.

Try behavioral charts. Children are often not motivated to make a better choice internally - it’s easier for them, or not big deal for them to yell and hit versus breathe and ask nicely. But if you sweeten the deal by offering candy, toys, extra time, other privileges then they are more likely to make the better choice. Some kids will need the reinforcement reward immediately and some can wait until the end of the day or week. Think about your child’s needs and personality to figure out the immediacy of rewards. If you aren't sure how to do this seek out a behavioral therapist who is experienced in this and can help you. Once your child learns the strategies to handle their feelings more appropriately they are likely to reduce aggression and you can fade out the behavior chart, or use the rewards to target another behavior.

Sometimes if the child is so out of control and aggressive they have to be restrained. Parents can learn appropriate ways to restrain their children (ask the school, doctor, or a therapist). If the child is in danger to themselves or others it is okay to restrain them until they are calm and in control again. The police and mental health crisis workers can also be helpful in these situations. If aggression is a regular occurrence, behavioral interventions are not effective, and the behaviors are fairly severe, medication may be necessary. Talk to your child’s doctor or seek a child psychiatrist for help.

Helpful Links:

Swear Jar: https://en.wikipedia.org/wiki/Swear_jar

Child Restraining: https://www.k-state.edu/wwparent/courses/rd/toolbox/rdtool-37.html

Causes of Aggression:

https://childmind.org/article/aggression-in-children-causes/

Handling aggressive behavior:

https://www.empoweringparents.com/article/how-to-manage-aggressive-child-behavior/

Taming Aggression and Coping for parents:

http://www.parentingscience.com/aggression-in-children.html

Anger Strategies (Other helpful blog articles)

I hate you!

When your kid says “I hate you!”
by, Patience Domowski, LCSW

When your kid says “I hate you!” and how to handle it…

1)      Remember you’re not alone. Many kids say this at some point to their parents.

2)      Recognize they usually don’t mean it. Knowing they don’t mean it and it’s not personal can help parents feel better about themselves and also not overreact. Instead of getting hurt or angry, recognize that your child is really trying to communicate something.

3)      Realize it’s a lack of skill. They don’t know how to express their frustration properly. Teach them by modeling the correct feelings words, giving them space to calm down and later discussing with them how they could’ve handled that situation differently.

Usually when kids say “I hate you” or similar mean things like “I want a different family!”, “You’re the worst parent”, etc… they are really trying to say “I don’t like the answer you gave me”, “I’m upset I'm not getting what I want”, or “I’m mad/frustrated/etc”.

Instead of saying “We don’t say Hate” or “You don’t mean that” or “You’re hurting my feelings” etc try saying this instead: “Sounds like you’re frustrated. Can you say “I’m really mad!” or “I don’t like that!” Model it for your child and hopefully they will copy you in the moment and then remember next time how to handle it.

4)      Teach empathy. Talk to them later about how they would feel if someone said “I hate you” to them when they really didn’t mean it. Even if they apologized later. Explain how it makes parents feel. Talk to the child about their feelings and teach them to identify some better coping strategies.

5)      Train kids to change their thoughts from Negative to Positive. Instead of seeing the bad sides to situations, help the child identify the positive sides of the situation. Over time they will better be able to handle disappointments.

Here's a link to a list of great responses!

Getting on the Same Page, even if you're not in the same book!

The Same Page: Helping Parents Agree on Discipline
by Patience Domowski, LCSW

Many parents struggle to be on the “same page” with parenting. This is totally normal because both mom and dad have their own different personalities, upbringing, thoughts, and ideas that they bring into the relationship. But it can be so frustrating when the parents cannot agree on the same strategies or level of enforcement for discipline at home. Some parents are not only not on the same page, they aren’t even in the same book! Mom might be really strict with the kids because she’s home all day and needs them to listen to her, and dad feels bad he’s not around much so gives in all the time. Or maybe mom’s the nice soft pushover and dad’s the strict one the kids know they can’t get away with anything around him. There does not have to be a “strict parent” and a “fun parent” or a “good cop”/”bad cop” in a parenting couple- there can be the a balance for each parent. It’s really important to try to figure this out so that there is less arguing between the parents, a more cohesive family, and the children aren’t playing parents against each other.

Here are some ways to try to get on the same page with your spouse or co-parent.

1)     Agree on something!  Try to find even something small you agree on – even if it’s just the outcome like you want your children to be “good people” for example. (Then later define what that means and how to get there!)

2)      Decide on an outcome. Do we want our children to be happy, balanced, independent, highly educated, etc. Then work on what’s the most important to focus on for our family (Such as school/education, life skills (like learning how to cook, do chores, etc), sports/activities , being social, being creative, future independence, just being “happy”, spiritual/faith based, being healthy, etc) Do the kids need to work on improving their grades? Or are we worried they will live with parents forever because they won’t do chores and get a job? Do we just want them to be happy, we don’t care what they do for the most part?

Parents should decide what they’d like to see in the future so they know what they are working towards. It doesn’t have to be super specific like “my child will be a doctor” or “my kid will never eat red meat” or “I really want them to be married or they won’t be happy”. Outcomes can be more general like “I want my child to be independent” or “I want my child to be as healthy as possible” (if child has health concerns, this might be a goal, for example).

3)     Discuss both parents’ backgrounds and where they come from. Where her parents strict and his super passive? Was she a “child of the ‘60s”, and he from a super conservative family? Discuss child rearing of the parents, how did the grandparents discipline them, what do you want to do the same and what do you want to do differently. Even discuss where they grew up (urban, rural), cultural backgrounds, even socioeconomic status, etc. (Especially if you don’t already know this, or it wasn’t covered in your pre-marital counseling- for married parents).

4)     Try to find a compromise somewhere. The plan doesn’t have to be all mom’s way or all dad’s way. In fact- it really shouldn’t be that one sided. (Because then the other parent will be upset, or one will undermine the other).

5)     Eachparent make a list of what is important to you- then compare and see which things are the same/almost the same.

6)     Decide which behaviors we’re going to “let go” and which we will make a big deal about. Not everyone will agree on what needs to be focused on and that’s okay. [If you can’t decide, see my other article on hierarchy of behavior for my suggestions.]

7)     Even if parents are split and kids go between homes it would be better to still be on same page at both homes for consistency for the children (if this is possible).

8)     Make a plan! Specific behaviors to target, discipline techniques, etc. Write it down and even post it in the house so everyone knows and remembers what to follow. Look online for templates or ideas for making House Rules, chore charts, behavior charts, etc.

9)     Consult with a therapist if needed. A couples/marriage counselor can help get parents to be on the same page, and a child behavioral therapist can help parents come up with specific behavior interventions for their children.

10)Try to get grandparents, babysitters, etc on the same page with the parents for consistency. If the kids know grandma will say yes if mom says no, or the babysitter allows kid to do this and dad would not, it’s going to be difficult to maintain the level of control and discipline you may want in the home. So try to get everyone on board, if possible.

Divorced Co Parenting Tips (and Worksheet for Kids)

Divorce tips to co-parent better - because it’s really all about the kids
by Patience Domowski, LCSW

1)Don’t try to ‘get back’ at your ex via the kids such as trying to take the kids away, limit visits, get the kids to not like them, etc

2) Try not to always have your way or the control. It’s about what’s best for the kids, not you. If you and your ex both think your opposing ways are the best for the child and you can’t agree- meet with a mediator or therapist.

3) Don’t use your kids as “spies” asking what their other parent is doing or who they are dating (there’s social media for that)

4) Don’t let your kids get stuck in the middle. They shouldn’t have to hear both sides and make a choice whom to believe. Don’t make them feel like they have to take sides.

5) Don’t bad mouth your ex to the children. Even if its completely true. Try to find something nice to say or don’t say anything.

6) Don’t try to get your child to not like your ex or their new stepparent (if applicable). It’s okay for them to love mom, dad, stepmom, stepdad, new sibs, etc all at once.

7) If the kids ask why the divorce occurred and it’s a complicated or “adult” reason, don’t tell the children exactly what happened, instead explain that ‘mom and dad just couldn’t work things out’ reassure the child you still love them and that won’t change and that the child is not at fault at all. Be careful about saying you don’t love the ex anymore because sometimes children worry that because parents don’t love each other anymore they might not love their children anymore at some point too.

8) If you have to argue with your ex, try not to let the children hear. Use a professional or unofficial mediator if needed. Try not to respond in anger to texts, emails, etc. Wait until you’ve cooled off before replying.

9) Spend quality time together, especially if you don’t have a lot of time together. Do fun things together, talk, bond. Sometimes do things one on one with the kids (without your new spouse or other children if possible) so they get some alone time. Encourage them to talk by being open and not judging or criticizing.

10) Allow your child to take favorite toys and comforting transitional objects, and call their other parent if they miss them. It doesn’t mean they don’t like you because they miss their other parent or ask for them. Try to help ease the transitions.

11) If your child seems distressed about the divorce, arrangement, etc have them go to therapy. If parents aren’t handling it well go to therapy and handle your stress yourself, don’t dump/vent to the kids. 

Printable version of this article

Worksheet for your child to fill out to see how they feel about the divorce

Communication with children and teens

Communication between parents and children/teens

by, Patience Domowski, LCSW

Isn’t it so frustrating when your child/teen won’t talk to you? Especially if they seem to talk better to their other parent, stepparent, friends, teachers, etc. Communication with your child/teen is so important as it builds your relationship together, and prevents some risk factors as well (like drug abuse, for example). Here are some ways to work on this.

If your child won’t talk to you…

·         Initiate/ask about their day. Don’t accept shrugs/”fine” answers, press a little more and then back off a little and wait for them to answer. (Riding in the car is the best time to talk usually).

·         Try being more approachable- Don’t expect your child to talk to you every time you try to initiate a conversation but be open and ready when they bring something up/start to talk. If it’s really not a good time tell them that what they have to say is really important to you and tell them when a better time is- and then stick to that time/make sure to come back and discuss it later.  

·         Don’t overreact- Even if your child tells you some shocking things- please act cool or he/she will automatically shut down and refuse to tell you what’s going on. It’s better to know what they are thinking and doing than not so be open minded to hearing what they have to say.

·         Don’t respond with shut downs like “you shouldn’t feel that way” or “don’t do that!” or “you have to do…” but instead just listen to their feelings and give advice if they want it without telling them no or shutting them down.

·         Be nice- don’t make fun of them or say something demeaning or insulting, try not to yell, don’t make a big deal about small things, don’t punish constantly for small problems, try to listen and not just talk. Compliment them when they make good choices or you are proud of them. Tell them specifically what you liked about their behavior/choices/etc.

·         Ask your child how to make things better and try to take their suggestion if possible- If you realize there is a problem but don’t know what it is exactly that is causing your child to pull away or not want to be around you, ask them what the problem is and then try to take their input and see if its fixable.

·         Try to fix the problem – If your child says what the problem is or you realize what it is try to fix it! Be open to changing and don’t just expect your child to change but parents to adjust too. Be willing to compromise.

·         Do fun things together- Find something you have in common to do together or at least something your child enjoys even if you don’t. Go out to eat, go shopping, mini golf, bowling, make crafts/build something together at home

Some writing prompts could work really well as conversation prompts. Check these out. 

"If I have to tell you one more time!"

“If I have to tell you one more time!”

Reducing frequency of prompting

An Explanation of 123 Magic and Supernanny’s “warnings” techniques

by Patience Domowski, LCSW

Do you find yourself telling your child to do something (or stop doing something) a million times and they don’t listen? Do they ignore you until you really start to lose it and scream at them? Do you find yourself threatening things but nothing seems to work? Or are you always arguing with your child? Well here’s the secret solution!

To reduce telling children a “million” times to do something you need to have a specific consequence tied in as a result for not listening. So if the child isn’t doing what you’ve asked right away they learn they get something taken away and then they start learning to listen right away. The power is in the consequence. They might not care that you are frustrated, but they sure do care when you take away that ipad!

You may have heard of 123 Magic but don’t have time to read the book. I thought I’d summarize the strategy here. (Okay I’ll admit I haven’t read the book either, but I know the strategy!). Remember the “Magic” is in the consequence, not the words!

To use 123 Magic you give the direction and say “That’s One” to the child to let them know you told them what to do once. Wait a few seconds/minutes and if the child doesn’t comply you give the directive again and add “That’s Two”. After a minute if the child still refuses to comply then you say “That’s Three” and give them a consequence. Important note- 123 Magic is NOT counting to three. So it’s not “Pick up that toy, 1. 2. 3. Okay you’re in trouble now,” but rather giving the direction 3 times after 3 occasions of refusals.

Now before you start this you should prepare your child by explaining how it works (during a calm time, not in a moment of noncompliance). You should also have a go-to ideas of consequences in your head that you can use. It doesn’t always have to be the same consequence but it needs to be something the child cares about, and something that you are able to enforce/follow through with. Also don’t use a consequence that will punish yourself. Like taking away TV time when you know that’s the only time you can actually shower, for example!

Here’s how you can explain the new program to your child “Mom and Dad are tired of telling you MANY times to do things. It’s frustrating for us and then we yell at scream at you. I'm sure you don’t like when that happens either. So we’re going to use a new strategy. It’s called “123 Magic”. Isn’t that a cool name? Basically we will only tell you THREE times to do something and then you get a consequence. The consequence will be ____ (examples: lose a toy/go to room/loss of privilege/etc). So when we ask you to do something we will tell you “That’s one” so you know we told you the first time. If you don’t listen right away then we’ll remind you “that’s two” so you know this is the second time we asked you to do something. If we get to the third time we will see “that’s three” and you will have the consequence right away. You still have to do what we told you to do but you also get a consequence. If you do it before we get the Three then you don’t get the consequence.” Then practice it with something easy like throwing trash in the trash can or putting a toy in a box so the child gets in the habit of listening right away and understands how it works during a calm time/teaching time, not just waiting for a problem time.

After you’ve used this strategy a few times the child learns that they do not want to get to Three. They know you MEAN IT and you don’t have to scream at them. You just have to say “That’s three. Now you’ve lost ipad time tonight” in a calm tone. [Ignore any resulting screaming/crying and still insist the child completes the direction you gave them].

When you FIRST start using 123 Magic you might want to remind them of what they are going to lose. Here is an example for when you FIRST start using this system with a child who is refusing to follow directions.

Example “Pick up your jacket and hang it up. That’s one.” (wait a few seconds). “Remember if we get to 3 you don’t get to go out for ice cream with us tonight.” (wait a few seconds). “Pick up your jacket and hang it up. That’s two. If we get to three, you lose ice cream tonight.” (wait for compliance). “Okay this is 3. You lose ice cream tonight. You still need to pick up your jacket.”

After that there should be no more explanations. No more pleading. Nothing else. Just “That’s one” “That’s Two” “That’s Three”. You should NOT be saying “If I have to tell you again…” or “I’ve already told you x times” or explain why they need to listen, etc. Just give a simple direction with the numbers. Because they will know what the consequence is. Then take away the privilege or whatever the consequence is calmly and quietly.

Supernanny has a similar system where she calls it “Warnings”. It’s really the same thing. You can do it that way too. For example “Stop hitting your sister. That’s the First warning”. (behavior continues) “Stop hitting your sister. This is the 2nd warning.” (behavior continues). “This is the 3rd warning.” (wait briefly, if behavior continues then) “Okay that was 3 warnings- now no more computer time tonight.”

The “magic” is that there is no more arguing and parents don’t have to repeat themselves many times. Children soon learn to comply within 1-2 prompts instead of 20!

Check out the 123 Magic books program and read some articles by Supernanny as there are some great strategies there. Links are below. 

Also see my "resources" page for links to more articles. 

Reference:

http://www.123magic.com/1-2-3-magic 

http://csgreeley.org/sites/default/files/files/1-2-3-magic.pdf 

http://www.supernanny.co.uk/Advice/-/Parenting-Skills/-/Routine-and-Teamwork/Parent-child-power-struggles.aspx

http://www.supernanny.co.uk/Advice/-/Parenting-Skills/-/Discipline-and-Reward/Punishment-or-positive-discipline.aspx

You're job as mom (or dad)- for stay at home parents

Your job as mom

So you’re a stay at home mom. It’s your “job” to clean the house, do the laundry, cook meals, etc, right? Well yes… but it’s even more important to teach your child how to do these things and teach them responsibility or they won’t be successfully independent. Your job as mom (and dad!) is not to make your kids dependent on you- it should be to work yourself out of a job (not that your kids will never need you! Even as adults we still need our parents, right?!). “Working yourself out of a job” means you train your children to do the things they need to learn as life skills so they can be on their own one day. It’s more than just teaching your daughter how to use the washing machine or your son how to vacuum, but also requiring and expecting them to help out around the house, do their chores, and care for their things. When they go to college or move out they might be shocked there’s no magical mom-fairy that picks up their stuff, washes their laundry, etc! They need to learn these things now as children so they will be ready for their future. Start as young as possible, and expect more as they grow up. Older teens should be able to do pretty much everything around the house that the parents can do. Younger children may need help but can do more than you might think! It’s definitely harder to teach than to just do it for them but in the long run its better for your child, and it’s less work for you as they can start taking over more responsibility as they get older and there’s less for you to do. Life skills are sometimes even more important than academic skills as everyone needs these for daily living in any future living situation they may find themselves in. So remember don’t do everything for your child but teach them out to do for themselves! 

[see also article on chores by age] 

You're not a bad mom

You’re not a “Bad Mom” ~ by, Patience Domowski, LCSW

You’re not a bad mom if…

·       you can’t breastfeed/choose not to

·       your baby/kids aren’t on a perfect sleep schedule

·       you want a break from your kids sometimes

·       you don’t want to be a stay-at-home-mom (or can’t)

·       you don’t’ do “Pinterest” crafts

·       your home doesn’t look like a catalog/clean and decorated

·       you have to ask for help in caring for yourself/your family

·       you aren’t up with all the current trends in parenting

·       sometimes you don’t like your children

·       you have to put your kids in daycare/hire a sitter

You’re a good mom if…

·       you love your kids with all your heart

·       you try to do everything you can to care for your family

·       you admit when you need help (and ask for help!)

·       you play with your kids

·       you let the kids make messes sometimes

·       you teach your children to love others and care about people

·       you take a break when you need to in order to save your sanity

·       you try to have a good marriage/get along with your child’s father as best as possible for sake of the children

What if the baby isn't healthy?

What if the baby isn’t healthy?

By Patience Domowski, LCSW

When you find out you’re having a baby, you are usually scared and excited all at once! Whether the baby is expected or not it’s scary but exciting to become a new mom/dad. You start to think about what that child will be like as a baby, growing up, and even what their future might be like when they are an adult. Sometimes you really want a girl or a boy but often people say “I don’t care if it’s a boy or a girl, I just want it to be healthy!” Sometimes they are lying- they secretly want a boy. Or a girl. But usually they really do mean they want the baby to be healthy. No one wants an unhealthy child. But what if the child is “unhealthy”? What if the child is not “normal”? Then what?

Often parents don’t find out their child has special needs until months or year after he or she is born. Sometimes parents find out while pregnant, however, such as if the baby’s condition shows up on a test or ultrasound. Sometime parents find out when the baby is born with some defect right away. Whenever you find out about a “difference” about your child you were probably not expecting it. Whether you find out there is something “different” about your child sooner rather than later, it’s still usually surprising, and often devastating. New parents aren’t expecting any problems usually, and when they find out their precious new baby is going to not be healthy or normal, they are usually very disappointed. Which makes sense, considering it’s not the ideal and it’s usually quite unexpected.

However, many people might not expect to go through all the stages of grief and loss like you would if you lost a baby to miscarriage or stillbirth, or infant due to SIDS, etc, however often the reactions and feelings are quite similar to someone’s who lost a child. Parents might be shocked and confused why they are feeling such loss when their baby didn’t pass away, and they might feel bad knowing other people have lost their children but they at least have one even if the child has special needs. You might feel guilty because you know you love your child, yet by being upset about their condition you feel like you are denying him/her to an extent. Parents go through grief because the loss is not of a child, but of an expectation. They feel their child may never live up to the parent’s expectation of their potential that they had hoped for, and that is why they must grieve. Grieving is important, so we can get to Acceptance and Hope.

The Kubler-Ross stages of grief and loss, so often noted for bereavement, can be applied to this situation as well. The stages include Denial and Isolation, Anger, Bargaining, Depression, and finally Acceptance. Often parents don’t believe the child’s condition- whether it be mental health, cognitive, developmental delays, medical fragility, sickness, deformity, genetic conditions, etc to be real at first. They might want to see several doctors, they might try to get all the information they can online or from specialists to try to explain it away or find a way to change the situation. Parents often isolate themselves, feeling no one understands my child or what I’m going through, or it’s too hard to explain why my child looks or acts different. They might feel shame that their baby is not “beautiful” in the expected ways of the world or that their child is not “normal”. Parents might feel jealous and upset seeing everyone else’s “perfect” children and so keep themselves isolated so as not to feel that way by seeing other babies. Often parents will be angry- perhaps at God- why did you do this to me?, to my baby? Or at the doctors- why didn’t they tell me? Or why didn’t they do anything? Or even at themselves- I should’ve taken more prenatal vitamins, I shouldn’t’ve rode that roller coaster while pregnant, etc.

The Bargaining stage might look like parents going after every kind of intervention and help their child can get such as taking the child to every doctor, specialist, early interventionist, treatment clinic, etc to try to make whatever is “abnormal” about the child go away.

Parents are often grieving which can cause some depression, and postpartum depression can play into this as well, and when they feel they should NOT be grieving, or that they are “bad parents” in some way, or blame themselves for situation, it just causes depression to worsen.

What we want is to get to Acceptance. And Hope. Whether child lives or dies, is healthy or unhealthy, is not up to the parents for most part. Parents can, and should, get as much help as possible for themselves such as mental health therapy, support groups, reaching out to family and friends. Parents should get help for their child as well such as Doctors, Early intervention, etc. too, however it’s important to not worry so much about getting that child to “normal” in comparison to peers, but rather to get that child to be as healthy or as functional as possible for him or her. Develop a “New Normal” or Adapted Expectations. What that will be for your baby will vary greatly from child to child. Everyone is different and everyone develops in their own pace. Some people develop faster and further than others. Children, especially babies, have so many milestones to reach, but instead of focusing on what they “should” be doing or what their peers are doing, if you have a special needs baby, just focus on being happy that you have that child, that you were blessed with someone who needs some extra love and help from you, and embrace the special needs parents identity and community that comes along with it. You will find that you will feel less grief and depression, but rather much hope and acceptance, and even get to the point where you will celebrate difference perhaps. Your child will be happier for it, and you will too. 

[this article was written for MainLineDoulas. Patience provides some postpartum doula services through Main Line Doulas]