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Supporting communication in emotionally dysregulated children and young people

What does emotionally dysregulated mean?

confused faceBeing emotionally regulated means that you are ‘emotionally available’ to interact and learn.

When we are emotionally dysregulated we might feel cross, anxious, stressed, upset, distracted and this makes it hard to be ‘emotionally available’ to interact and learn.

It is normal for everyone to become emotionally dysregulated at some point, however some children and young people are at more risk of this for lots of different reasons.

Our communication skills help us to be emotionally available. For example, we can use our communication skills to help us to manage difficult situations as well as helping us to talk to and get along with others.

When we are emotionally dysregulated our communication skills weaken. For example, we struggle to think straight and reason, we find it hard to take in spoken information and to say what we need to say so we find it hard to solve problems through talking. This puts us at risk of communication breakdown.

Increased anxiety and worry lead to normal communication skills being disrupted…

Scales showing communication skills Emotion regulation scale tipping

Fight or flight

People talking and listening with a red line through

Sometimes children and young people are in ‘fight or flight’ mode, this makes it hard for them to be emotionally available and to use their communication skills.

They may find it hard to:

  • focus
  • ignore distractions
  • stay still
  • be motivated to interact with other children and adults
  • be able to build and maintain friendships
  • feel able to follow another person’s agenda
  • know how they feel and be able to communicate and manage this
  • ‘read’ people to predict what they are thinking or feeling or expecting the child or young person to do

Worried and sad faceThese things can cause more anxiety and agitation and weaken communication and thinking skills even more. Being in ‘fight or flight’ mode is exhausting and makes it hard for the child or young person to do all these things.

Children and young people who find it hard to be emotionally available will benefit from strategies to support them to communicate (understanding others as well as expressing themselves).

Make things predictable

Smiling face with a thought bubble containing a tick

Help the child or young person to know what to expect, for example:

  • what is going to happen
  • where they will go
  • who they will see
  • what they will do
  • what type of activity it is
  • how long something will last
  • how they might feel (particularly in a less familiar situation)
  • how they will be able to manage the feeling (if they are worried they can have time out, speak to X).

Eyes with arrows looking downVisually supporting these conversations through daily and task timetables, social stories, comic strip conversations and emotion monitoring tools, for example, 5 point scales or emotion cards will help the child or young person to take in the information and is something they can refer back to.

Help the child or young person to ‘read’ other people and therefore avoid misinterpreting a situation – provide a running commentary to help them understand what the child’s communication partner may be thinking, feeling or expecting.

Think about your talking

Red speech bubble showing what not to ask and green speech bubble showing better ways to ask a child what has happened

  • avoid overloading the child or young person by using lots of language.
  • simplify your talking
  • give information in short sentences, avoid complicated language such as, “If you do x then would y happen?”
  • give instructions in order
  • repeat key pieces of information
  • allow processing time before repeating or moving onto the next bit
  • avoid complicated, open ended questions that require the child or young person to summarise, retell and reason for example: “why…?” “how…?” “would, could or should…?” “if…”

Visually support communication

A pencil drawing a shape

When talking to a child or young person try to draw the situation as you talk. This helps to slow the pace of the conversation, simplify questions, show the child or young person what you are saying and understanding, get the order of events right and explore complicated ideas like ‘feelings’. See the Comic Strip Conversations strategy sheet for more information.

Make following another person’s agenda feel safe

Offer choices so that the CYP can feel like they are maintaining some control.

Acknowledge the feeling the CYP may be experiencing when they are expected to follow someone else’s agenda and why, for example, “I know you’re worried to do what Miss is saying because you don’t know what might happen/you’re not sure if you’ll be able to do it/you don’t like maths ”.

Motivate the CYP to follow another person’s agenda by making the activity desirable, such as, theming an activity to their interest or skills.

Be indirect with the way you phrase instructions and invite the CYP to collaborate rather than directly instructing them.

Ensure the situation is predictable! (see above)

Consider the CYP’s emotional regulation needs

what to do emotional cards

Find out what helps the CYP to stay calm/emotionally available as this will enable them to be more able to use their communication skills. Some CYP need to move around, sit in particular positions, have regular movement breaks some have particular sensory preferences, for example, light, sound, touch, smell.

Consider making visual tools to help the CYP to understand and communicate what will help them to ‘feel ok’ again if they become emotionally dysregulated see the ‘suggestions for scaling & regulating emotions and behaviours’ & ‘suggestions for using emotion monitoring cards’ strategy sheets.

Consider that often CYP who experience lots of emotional dysregulation can have limited use and understanding of words for feelings – ‘developing your child’s ability to talk about, manage and understand feelings’ strategy sheet to find out about the importance of modelling and coaching these skills.

Consider that CYP who are emotionally dysregulated may behave in an angry way but this may be because they are experiencing a different emotion such as, worried, scared, upset.

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Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: SL55

Resource Type: Article

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