The Explosive Child

by Ross W. Greene, PhD

  When Kia needed to let her parents and teachers know there was a problem, or when she began exhibiting signs of frustration, the adults would ask her to point to the picture that best communicated what was frustrating her. When Kia pointed to a picture, her caregivers would verbally confirm the problem (e.g., “Ah, you’re hungry”). Whenever Kia encountered a problem that wasn’t depicted in pictures, new pictures were added to the “problem card.” After the basic menu of problems was established, a second laminated card was created that depicted potential solutions corresponding to each unsolved problem (this is described in the next section). The long-term goal was for Kia to begin using words rather than pointing, and in the meantime her frustration over having difficulty communicating diminished.

  When a kid has significant communication challenges or other cognitive impairments it is crucial to give serious consideration to the words or concepts that are the absolute highest priority and that need to be taught first. The words or concepts needed for pinpointing unsolved problems or concerns, solving problems, and handling frustration should be a very high priority, because not having these words causes the kids’ most concerning moments and impedes their ability to learn much else. While a vocabulary for feelings (happy, sad, mad) may seem important, such a vocabulary actually may not be a high priority because it’s more important for her to communicate about the problems that are causing her to be sad, mad, or frustrated than to simply express that she is sad, mad, or frustrated. Communicating the cause of her feelings will give you a faster track to resolving the problem.

  IDENTIFYING AND SELECTING SOLUTIONS

  The same strategies that are useful for identifying unsolved problems can be applied to identifying and choosing solutions to those problems. Kia’s parents created a problem-solving binder filled with laminated cards depicting in pictures potential solutions for each of the problems depicted on her “problem card.” Here are some representations of what that looked like:

  When she signaled that she was hungry, she would turn to the card in the binder containing pictures of potential solutions to that problem. If it became apparent that additional solutions were needed, pictures of additional solutions were added. Thus, the rudimentary binder system helped Kia participate in the process of communicating not only about problems but also about potential solutions.

  It’s the last element—participating in the process—that is perhaps the most important for kids like Kia. Often it’s assumed that kids with limited communication skills cannot participate in the process of solving problems, but this typically isn’t the case. If adults automatically assume that such kids can’t participate, then the kids are relegated to the sidelines as decisions are made about how their problems are to be solved. Many can, in fact, participate in Plan B, and doing so opens the door to enhanced relationships and communication with important people in their lives. Sometimes it just takes a little extra creativity and perhaps some additional resources to get Plan B rolling.

  By the way, the problem-solving binder can be just as useful with kids whose communication skills are not compromised but who benefit from having a system in place to organize problems, concerns, and solutions.

  A few other points before we move on. Because some solutions are applicable only to certain problems (for example, a hot dog would make good sense for the problem of being hungry but wouldn’t be a great solution for most other problems), sometimes it’s a good idea to teach a more general set of solutions. A high percentage of the solutions to problems encountered by human beings fall into one of three general categories: (1) ask for help, (2) meet halfway or give a little, and (3) do it a different way/change the plan. These categories can simplify things for kids whose communication skills are compromised and who may benefit from having the three possibilities depicted in pictures, as well as for kids whose communication skills are generally intact but who become easily overwhelmed by the universe of potential solutions. These three categories can be used to guide and structure the consideration of possible solutions.

  First, you’ll want to introduce the categories to your child at an opportune moment. Then, when you’re trying to generate solutions using Plan B, use the categories as the framework for considering solutions. As with the previous examples, verbalize the words that correspond to each picture (“Ah, do it a different way”) to confirm the kid’s idea and encourage the use of words. Then the universe of ways in which things could be “done a different way” in order to solve the problem can be explored. Let’s see what that might look like with a speaking child:

  PARENT (Empathy step, using Proactive Plan B): I’ve noticed that you’ve been having difficulty going to gymnastics lately. What’s up?

  CHILD: I don’t like my new coach.

  ADULT: You don’t like your new coach. You mean Ginny? How come?

  CHILD: It’s boring. All she has us do is stretch. That’s boring.

  ADULT: OK, let me make sure I’ve got this straight. You haven’t wanted to go to gymnastics lately because it’s boring, just a bunch of stretching.

  CHILD: Right.

  ADULT: Is that the only reason you haven’t wanted to go to gymnastics lately?

  CHILD: Uh-huh.

  ADULT (Define Adult Concerns step): I can understand that. The thing is, you usually really like gymnastics, and you’re really good at it, so I’d hate to see you give it up.

  CHILD: I don’t care.

  ADULT: You don’t care?

  CHILD: Not if it’s just going to be a bunch of stretching.

  ADULT (Invitation step): Well, I wonder if there’s a way for us to do something about your not liking all that stretching without you having to give up gymnastics completely. Do you have any ideas?

  CHILD: Ginny’s not going to change the way she does her class.

  ADULT: You might be right about that. But let’s think about our problem-solving options. I don’t know if “asking for help” will solve this problem. And I can’t think of how we would “meet halfway” or “give a little” on this one, especially if you think Ginny isn’t going to change the way she does her class. I’m thinking this is one where we’d “try to do it a different way.” What do you think?

  CHILD: I don’t know what a different way would be.

  ADULT: Well, Ginny’s not the only one who teaches that level. The main reason we picked Ginny’s class is because the other class that’s your level is the same time as your karate lesson. But maybe we could change karate to a different time. Then you could be in the other gymnastics class. What do you think?

  Naturally, this Plan B discussion would continue until a realistic and mutually satisfactory solution has been agreed on. Not only would the problem get solved, but Plan B would help the child begin using the solution categories as a framework for generating solutions.

  By the way, if your child has difficulties with language processing, a talented speech-and-language pathologist can take you much farther than the information provided here. Something worth looking into, if you haven’t already.

  * * *

  Monday morning, Debbie was in the kitchen, having coffee and thinking about what had happened to Sandra the night before. Did Frankie come home? If he did, what happened then?

  Jennifer came into the kitchen. “Good morning,” said Debbie.

  Jennifer did not respond—Debbie knew that she wouldn’t—but set about the task of toasting her waffles. When the waffles were ready, Jennifer sat down to eat.

  “Did Riley like my idea?” Jennifer asked suddenly.

  “Sorry, what honey?” said Debbie.

  “Did Riley like my idea?”

  “Oh, you mean the idea about the TV schedule? I spoke with him very briefly about it last night. He seemed OK with the idea. He wasn’t too sure what the schedule should be, but we didn’t talk about it for very long.”

  “The schedule should be that I get to watch the TV when my two shows are on and he can watch before or after.”

  “Well, I can certainly
mention that idea to him. Would you prefer that we discuss this all together or do you want me to discuss it with you separately?”

  “Separately.”

  “I’m picking him up at hockey practice tonight, so I can mention your idea to him then.”

  “Did he have any ideas?”

  “Not that I’m aware of.”

  “Because I thought of another one, just in case.”

  Debbie tried to hide her surprise. “You did?”

  “That’s what I just said!” Jennifer said impatiently.

  “Sorry, I just wanted to make sure I heard you right. What was your other idea?”

  “I could record my shows, just in case he wanted to watch sometimes while my shows are on.”

  “That’s a great idea, Jennifer. Shall I run that one by him, too?”

  “Yes, but I like the first idea better.”

  “I’ll be sure to let him know that.”

  Jennifer’s focus returned to her waffles. Debbie went back to her coffee, glancing occasionally at her daughter, in slight disbelief. Jennifer had revisited the discussion! She’d come up with more than one solution! She wanted to know if her brother was OK with her idea! Debbie couldn’t resist the temptation . . . she got up and gave Jennifer a quick hug.

  This did not go over well. “Why’d you do that?!” shouted Jennifer, immediately pushing Debbie away and stalking off to her room with her waffles. But Debbie thought she noticed the slightest hint of a smile on Jennifer’s face as she departed.

  “My partner,” Debbie whispered when Jennifer was gone. “My problem-solving partner.”

  * * *

  That night, Debbie was growing increasingly concerned that Sandra wasn’t answering her phone. Sandra finally called at around 9:30 pm, sounding harried. Frankie hadn’t come home all night, and Sandra had paged Matt, the new home-based mental health counselor. He’d come over and encouraged Sandra to call the police to help find Frankie. Just as she was about to, Frankie walked in. Sandra was sure Frankie would go ballistic when he saw Matt in the apartment, but he didn’t. “He saw my lip and got really remorseful,” said Sandra.

  “I guess that’s good,” said Debbie.

  Sandra related that Matt was able to get Frankie to start talking, and that Frankie told him that he was sorry he’d hit her, and that he hates his new program at school, and that the staff in the program are mean and the kids are way more screwed up than he is, and that his new medicine is making him feel really jittery.

  “And Frankie told Matt that he’s really sick of being in trouble all the time and that he’s been smoking a lot of weed at his friend Tyler’s—that’s where he was last night—because that’s the only thing that makes him feel better . . . and that he’s really scared.”

  “Scared?” asked Debbie.

  “Yeah, scared. He said he feels out of control . . . and like there’s no one who can help him.”

  “Geez.”

  “That’s what I’m sitting there thinking. I mean, the kid hasn’t talked this much for like five years.”

  Sandra further related that Frankie had nodded when Matt asked if he was thinking about hurting himself. Then Frankie said he didn’t want to talk anymore in front of Sandra, so Sandra sat in her bedroom while Matt and Frankie talked. About ten minutes later, Matt came and said he thought Frankie needed to be in the hospital.

  “Oh, no,” said Debbie.

  “That’s what I’m thinking!” said Sandra. “But Matt says Frankie’s on board with the idea because there’s an inpatient unit over in Amberville where they don’t restrain kids or throw them in seclusion rooms. So, me and Matt and Frankie get in Matt’s car and we drive over to the inpatient unit and that’s where Frankie is now.” Sandra paused, wincing at the pain in her lip. “Sorry, it hurts to talk.”

  “So, he’s still there?”

  “Yeah, he might be there for a week.”

  “I’m so sorry you had to go through all that,” Debbie said. “Are you OK?”

  “I’m glad he’s safe,” said Sandra. “So I’m kind of relieved.” She paused. “But I’m really sad that he was going through all of that and couldn’t tell me. I wish . . .” Sandra couldn’t continue.

  “Maybe this will be what gets things on track,” said Debbie.

  Sandra tried to collect herself. “I’m not getting my hopes up. We’ve been through this before. We’ll probably be right back at square one when he gets out.”

  “Maybe this time it’ll be different.”

  When the conversation ended, Debbie sat quietly by the phone. She felt like crying, but wasn’t quite able to figure out why. She couldn’t decide whether to feel hopeful or helpless. How did Sandra find the strength to deal with everything she had on her plate? Why hadn’t she just thrown in the towel a long time ago? Then she answered her own question. “Because it’s her kid,” she whispered quietly. “When it’s your kid, you keep going.” It was good that Frankie was finally talking to someone. She hoped the people at the hospital knew what they were doing.

  She wondered about the things that were going on in Jennifer’s head, things she knew nothing about. Still, after so many years of worrying and arguing and screaming, she felt the slightest glimmer of hope that she was finally getting to know that prickly, closed-book daughter of hers. She sighed. “Why does this have to be so hard?”

  Debbie stood up and began walking toward her computer but then she did an abrupt about-face, bumping into Kevin, who was headed toward the refrigerator.

  “Where you going?” Kevin asked.

  “I was just thinking of going to see if your daughter wants me to tuck her in to bed.”

  “She hasn’t wanted you to tuck her in for years.”

  “I know,” said Debbie. “I think that’s because I’ve been so caught up in who she isn’t that I’ve been blowing right past who she is. I’ve let that get in the way of the most important parts of being her mother. And I don’t want it to be that way anymore.”

  10

  Your Family

  Every family has its challenges. Siblings don’t always get along, parents don’t always see eye to eye on things, everyone’s too busy, kids are stressed about school or grades or friends, adults are stressed about work or money or trying to carve out time for themselves. Add a kid with concerning behaviors to the mix, and many families and marriages will be pushed to the brink.

  Then add grandparents who remember the way they would’ve done things in the “good old days” and soccer or hockey coaches who are delighted to tell you how they’d handle your kid. Also add a pandemic, with the unrelenting togetherness and dramatically increased parental responsibility for academics. Life is now much more interesting than most people bargained for. Small annoyances turn into big issues, minor disagreements and stressors become major upheavals, and communication problems that might never have been noticed become glaring roadblocks.

  Now add a child whose concerning behaviors are extremely aggressive and unsafe and who is highly volatile, reactive, and unstable, and “concerning behaviors” has taken on new meaning. In such cases, you’ve entered much more urgent territory, and safety and stability need to be your top immediate priorities. Stabilizing things often requires considering medications, as discussed in chapter 9, and always involves a lot of Plan C. (While Plan B may also play a role in creating greater stability, some kids simply aren’t available for Plan B until they’re more stable.) You want to do whatever you can to prevent those aggressive and unsafe outbursts, and that means taking the fuel (unsolved problems) out of the equation, at least until things have settled down a bit. Those outbursts are far more damaging to family life than almost any unmet expectation.

  SIBLINGS

  A child with concerning behaviors can make run-of-the-mill sibling rivalry look like a walk in the park. It’s not uncommon for “ordinary” siblings to direct their greatest hostility and most savage acts toward each other. And it’s not unusual for “ordinary” siblings to complain about preferentia
l treatment and disparities in parental attention and expectations. But these issues can be magnified in families with a kid with concerning behaviors, because they may require such a disproportionate share of the parents’ resources.

  There are a few important themes that can help govern sibling interactions when a child with concerning behaviors is in the mix:

  All family members need to feel safe. As you just read, if your child with concerning behaviors is so volatile, reactive, and unstable that siblings feel unsafe, then stability and safety are your top priorities.

  All kids (and adults) have lagging skills and unsolved problems, some more than others. In other words, we’re all working on something.

  All concerning behaviors tell us that a child is having difficulty meeting certain expectations.

  If a family member has unsolved problems, our job is to help solve those problems, collaboratively and proactively.

  Fair does not mean equal. As parents, we’re going to do everything possible to make sure that each child gets what they need, which will be different for each child. Some kids need more than others.

  We know how hard it can be to have a sibling with concerning behaviors, and we’re doing everything we possibly can to make things better.

  If they are old enough, it is often useful to help brothers and sisters understand lagging skills and unsolved problems, how you’re going about working on them, and why Plan A hasn’t made things better. However, this understanding doesn’t always keep kids from complaining about an apparent double standard between themselves and their sibling with concerning behaviors. Fortunately, parental attention is never distributed with 100 percent parity in any family, and parental priorities are never exactly the same for each child in any family. In your family, everyone gets what they need, which is different for everyone. In your family, you may be doing things differently for the child who needs extra help in the areas of flexibility, frustration tolerance, and problem solving, but you’re also doing things differently for the other children, who have unsolved problems of their own. When siblings complain about disparities in parental expectations, it’s an excellent opportunity to empathize and educate.