As a pediatrician, I frequently encounter families struggling with their children's challenging behaviors. One recent case perfectly illustrates how a seemingly intractable problem can often have a surprisingly simple solution.
This story involves a bright elementary school student who consistently experienced intense meltdowns after school. These 30-minute tantrums included flailing arms, and attempts to calm him often resulted in accidental (or perhaps purposeful?) hitting of his mother. The only thing that seemed to stop the tantrums was yelling, a solution his mother found both ineffective and upsetting. He refused chores, homework, and dinner, making afternoons incredibly difficult.
What was particularly striking was that this behavior only occurred after school; he was perfectly well-behaved at school. This immediately suggested that something was happening during the school day or immediately afterward.
During our consultation (without the child present – I always prefer to speak first with parents to avoid making the child feel like they are "bad"), we explored his daily routine: sleep patterns, mealtimes, activities, and even whether he fell asleep on car rides. This approach is rooted in the understanding that most behavioral issues stem from underlying struggles—often the same struggles adults experience: hunger, tiredness, or discomfort.
We discovered he was getting plenty of sleep (10 hours a night). However, his lunch was at 10:30 am, followed by a small, often uneaten snack at 1 pm, due to engaging with other children. By 4 pm, when he got home, he was likely ravenous! Critically, these meltdowns didn't happen on weekends or vacations, when lunch was later and snacks were readily available.
The solution was remarkably straightforward. Mom started giving him a small, healthy, protein-rich snack immediately upon arriving home from school, and also packed a small snack for his ride home. The change was immediate and dramatic. His afternoon behavior did a complete 180. Instead of yelling, she began approaching him with curiosity, asking, "Looks like you're struggling. Want to talk about it?" Sometimes he just needed a snack, sometimes a quiet moment in mom's lap. The key was shifting from seeing her son as the problem to looking for the problem he was experiencing.
This story highlights a crucial point: often, challenging behaviors aren't about "bad" kids; they're about unmet needs. By understanding the underlying causes—hunger, tiredness, discomfort—we can help children, and ourselves, navigate these challenges more effectively. It takes time and patience to figure out the “hows” and “whys,” but the rewards are immense.
I understand that many pediatricians don't have the time to delve into the complexities of parenting struggles and behavioral issues. At Blooming Bright Pediatrics, however, we prioritize addressing all parental concerns. Free from the constraints of insurance companies, we can dedicate an hour to discussing parenting techniques, observe behaviors firsthand, and help find solutions even when simple adjustments aren't enough. Working collaboratively with schools and other providers to ensure your child receives comprehensive support is always our highest priority.
If you're struggling to understand your child's behavior, please don't hesitate to reach out to Blooming Bright Pediatrics. We're here to help.
Here for you always,
~Dr. Chacko
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