By: Rachel Gilgoff, MD, FAAP & Devika Bhushan, MD, FAAP
Particularly after stressful events, babies, children and teens often communicate their needs to us through their behaviors. That's because they don't yet have the language or tools to tell us exactly what is going on inside.
If your child is "acting out" or unusually irritable, there is a good chance that they:
When emotions take control: "flipping a lid"
To help kids better understand and manage their emotions, clinicians sometimes use a hand brain model. The fingers, folded over the thumb, represent the prefrontal cortex, the upper or thinking part of the brain. The thumb represents the amygdala or "emotional brain," which controls the freeze or flight-or-flight survival responses. When activated by something stressful, threatening or dangerous, the emotional brain can flip the thinking brain out of the way and take over.
"Acting out"—"spacing" out, freezing, ignoring, temper tantrums, crying, screaming, slamming doors, hitting, kicking, storming off or just being excessively irritable—is actually often our children "flipping their lid" after experiencing something stressful. (Adults do this, too.)
Helping your child learn to manage the stress response
Kids can bring their thinking brain back in control if they have the skills to manage their situation and calm their stress response. But many don't. Teaching them how to manage their stress will help them to adopt healthy, adaptive responses to stress, both in the moment and in the future.
Learning takes practice
Like anything we need to do without thinking, we need to practice. Rescue and medical teams practice responding in traumatic situations. So, when times are stressful and they can't access their higher "thinking" brains, the skills they need are automatic. Kids need this kind of practice, too, including for stress-related behaviors. We need to look at what is going on behind the behaviors they display, which show us what skills our kids may still need to learn. And then we can help them do so.
Take a look at your child's environment to see what may be causing the stress. Problem-solve with them, anticipate stressful events, and take action to lower your child's stress response. This can take a lot of exploration, practice, and time. Coping with scary or upsetting events is more doable with a supportive and caring person who has our back. In fact, reaching out to others for support during stressful times is one of the most important ways we can teach our children to cope with stress. Finding support means that we don't have to resort to freeze and fight-or-flight.
Strategies and skills to tame the stress response
While every child is different, there are several strategies you can use to help them calm down and turn off their stress response.
The brain processes information from the bottom up—from the most basic functions to more complex. This means that the regulatory (instincts and automatic functions such as heart rate) and relational parts of a child's brain will be the first parts to process and respond to what we do and say.
To most effectively reach a stressed child (or adult), you can use child psychiatrist and neuroscientist Dr. Bruce Perry's 3 Rs: "Regulate, Relate, Reason."
regulate ourselves and co-regulate our children. Help them feel safe and calm, reducing their stress responses.
relate to their emotions. Help them feel understood and connected.
Once your child feels safe and understood, engage them to process what happened through
First, REGULATE: Calm the stress response
Safety first—both physical and emotional
reassure your child that they are safe. Try to be the calm your child needs. If we start feeling panicked or start yelling, it may make the situation worse. This can be incredibly hard to do in the moment. If you are upset, use the strategies below for yourself, too, before you engage with your child.
Use calming, non-verbal cues
Put down your phone
Pay full attention
Be at the same height or lower
Use a soothing, calm voice
Show a concerned or curious facial expression (rather than anger or impatience)
Keep a non-threatening and open posture (like uncrossing your arms)
Try these grounding mindfulness practices
Feel your feet on the floor, your back on a wall, your arm on a chair rest.
Use your five senses: Notice 5 things you can see, notice 4 things you hear, notice 3 things you touch, notice 2 things you smell, notice 1 thing you taste
Use breathing techniques
Slow, long exhalations slow our heart rate down and calm our stress response. Try:
Explore sensory techniques
These rhythmic and sensory activities can soothe our stress systems:
Try some movement
Moving our bodies can help release the stress energy that may be causing the current outburst. It can also help rev up a system that may be depressed or down. Consider
Walking or jogging
Stretching or yoga
Look for parallel activities
Ever notice how kids seem more relaxed and are more talkative in the back seat of the car or when you are walking side-by-side? Eye contact or face-to-face interactions can sometimes be stressful when we are already feeling activated. Consider positioning yourself to their side or lower than them to decrease their stress. Also consider "parallel" activities that you can do together to calm the stress response, such as:
Plan ahead. When your child is calm, identify a person, place, thing or memory that makes them feel calm, strong or happy. Help them practice visualizing that person, place, thing or memory. Then, when your child has a rough day or emotional moment, you can help them connect with that resource either in their mind through their imagination or if possible, in real life.
Then, RELATE: Connect
"Connect then redirect"
When your child is struggling, connect with them first. Listen to their full story, empathize with their situation, be curious, ask questions. Once they know you are listening and attuned to their needs, they are more likely to feel safe and calm. Then, if needed, you can redirect the conversation to discussing what to do next, such as safety planning, building coping skills, and making healthy choices.
"Name it to tame it"
Helping children name their emotions can help them recognize what they are feeling and feel more in control. You can say, "you seem really frustrated or angry right now, is that right?" This works for all ages—toddlers to adults!
Finally, REASON: Process and plan
Once your child feels safe and understood, you can work with them to problem-solve and build longer-term skills to cope with stress.
What were the triggers that led to the stress behavior?
What are your child's strengths that they could draw from next time to help them cope?
What supports might they need to feel safe in the future?
What skills might they want to learn to feel more in control and better able to cope with that trigger or stressful experience next time?
About Dr. Gilgoff
Rachel Gilgoff, MD, FAAP is an integrative medicine specialist, child abuse pediatrician, researcher, science writer, and mother of two amazing kiddos. She is dedicated to improving care for stress-related health issues and promoting lifelong health and wellness.
About Dr. Bhushan
Devika Bhushan, MD, FAAP is an equity- and resilience-focused pediatrician, public health leader, parent, and Indian-American immigrant who served as California’s Acting Surgeon General in 2022. She leads a community focused on resilience and well-being at