This week’s question is from Hazel,
“How do I react and respond when my child is biting me and other family members when he gets upset? Sometimes he hits or pinches us really hard. It’s typically when he’s been told no, or when something doesn’t go the way he wants it to go. We’re new to all of this, and I feel like we have no idea what to do. Help.”
In this episode, I will address what to do when your child is hitting, biting, or pinching when they’re upset. I will provide you with strategies on how to divert and redirect this negative behavior, how to keep yourself calm, and ways to structure your caregiving methods to build positive self-regulating skills.
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Why biting and physical aggression happens
- Physical aggression like biting, pinching, or hitting happens when kids haven’t yet learned better ways to handle uncomfortable feelings
- Common in young children, or kids with neurodevelopmental, executive function, or mental health issues
- Kids preschool and younger are still developing self-regulation skills; the ability to stop themselves, handle physical or emotional discomfort, think ahead, or anticipate outcomes
- Aggression is the “tool” they feel they have/can use at that moment
- The aggression likely doesn’t have anything to do with how your child feels about you
Be the “calm in their storm”
- Anchor them with your calm
- The more we escalate in our emotions, the more it escalates our child’s emotions/behaviors
- Kids need a lot of trust-building experiences with parents; so they know you are going to do what you say, and what is best for them, even if it’s not what they want at that moment
- This consistency builds their skill set and nervous system to feel safe and regulate appropriately
Potential underlying causes to ongoing aggression outbursts
- Ongoing aggression may be because the child isn’t clear as to how the “authority” is going to respond, i.e. if a parent is wishy-washy, it is confusing for kids.
- A caregiver that is inconsistent with boundaries or their own regulation, is scary and anxiety-provoking for a child
- If this is happening with one but not both parents, or only with a specific caregiver, it may be an opportunity for the adult to work on staying grounded and learn communication in a way that makes the child feel secure and sure about boundaries, etc.
Proactively reacting before aggression
- Set and enforce consistent boundaries around behaviors. It’s not being mean or lacking empathy towards what the child is dealing with. You are doing things in a way that’s going to help them to develop the regulation capabilities that they need
- Focus on keeping yourself calm, use an internal mantra that works best to regulate yourself such as “it’s not about me”
- If you see the agitation building, try to stop them before they engage in the behavior; let them know “It’s okay to be upset, but I won’t let you bite me”
- This “pause” in behavior helps them develop self-regulation skills
- You can’t always anticipate, but acknowledge the child’s feelings while maintaining firm boundaries
- Remember, their feelings are welcome, fine, and appropriate, but their behaviors are not.
- As the caregiver, it’s your job to help them not engage in something that’s inappropriate
- Remember, their feelings are welcome, fine, and appropriate, but their behaviors are not.
Handling aggression in the moment
- Do not immediately launch into them about the actual behavior
- Stay firm, calm, and physically contain the situation (i.e. remove/reduce the stimulation) to help their nervous system settle
- Most kids recognize right after the aggression, or shortly after, that that was not a good thing, and now their anxiety and distress is even higher because they’re distressed about what they’ve done
- If possible, stay with the child and bring them to a quiet, smaller space (big spaces or crowds are overwhelming)
- It is appropriate to hold your young child firmly, if needed, to prevent them from harming or continuing to harm, whether it’s stopping before the harm has happened, “I won’t let you hit or bite me”, and firmly holding your child facing away from you; maybe on your lap in a basket hold with your arms.
- If it’s an older child, you may need to stay in the space and keep some distance or wait outside the room if they’re being really aggressive or trying to come at you. Safety first.
- Any type of physical holding to prevent from harming MUST be done in a calm, supportive, and firm, but non-punitive/aggressive way.
- Stay quiet: in voice volume and amount of talking
- Let them know that you’re going to continue to help them work through this
- These are “fight or flight mode” moments, their brain isn’t processing verbal and higher-level information well (or at all), so they are incapable of productively managing how they are feeling physically or emotionally
- Once in the “rational brain”/ calm, which may take a few moments or substantially longer, simply acknowledge that they are feeling better and move on
- This is not the time to make a big deal out of it or teach a lesson, they are still too sensitive
- With older kids, if appropriate/needed, review or discuss the situation at a later time/day
- Ask them how they are feeling about it and do some problem solving with them
Tips for building self-regulation skills
- Practice calming/soothing activities outside of their dysregulation
- Stick to what you say: be consistent with boundaries across the board in all areas of parenting
- Look for patterns that trigger aggression and mitigate; whether it’s a person, environment, or situation
- If you are having a lot of intense moments with a child regularly, try setting aside time daily to do activities together that go well for them/positive time to build your relationship
- This is helpful for both child and parents
- Don’t forget to care for yourself during challenging developmental phases to proactively support your nervous system regulation/ take time “to fill your own cup”
Role of Nutrition and Sleep in Aggression
- Chronic low distress tolerance often creates underlying physiological or lifestyle issues:
- Low nutrients such as low iron, zinc, magnesium, etc.
- Food allergies or sensitivities such as dairy, gluten, dyes, chemicals
- Blood sugar dysregulation; too much sugar and not enough protein and fiber
- Sleep: consider quality or sleep time
- Remember, regardless of any underlying physiological issues, all the skills discussed are foundational to help kids develop the regulation skills that they need to manage uncomfortable feelings
Episode Intro … 00:00:30
Listeners question … 00:00:50
Why Physical Aggression Happens … 00:01:30
Be the Calm in Their Storm … 00:05:00
Troubleshooting Aggression … 00:06:50
Proactively React to Aggression … 00:10:15
How to handle aggression … 00:13:15
Tips for Building Self-regulation Skills … 18:26
Nutrition & Sleep affect Aggression … 00:22:27
Episode Wrap up … 00:25:05
Hey everyone, welcome to the show. I am Dr. Nicole, and on today’s episode, I am answering a question from a listener. I get lots of questions each week, and this is a great way to provide answers that many of you might find helpful. If you have a question you’d like me to consider answering on a future episode, email it to firstname.lastname@example.org and you just might hear it on an upcoming show. Now on to today’s question from Hazel, who writes: “How do I react and respond when my child is biting me and other family members when he gets upset? Sometimes he hits or pinches us really hard. It’s typically when he’s been told no, or when something doesn’t go the way he wants it to go. We’re new to all of this, and I feel like we have no idea what to do. Help.”
Well, Hazel, this is something that a lot of families deal with, and I know that many of you listening have either been there with your kids at various points, or maybe are dealing with this now. So let me give you some big picture ideas that will be helpful, as well as some in the moment strategies. The important thing to remember is that when kids act out in this way, when they are biting or hitting or pinching, or being physically aggressive, when they’re distressed about something, this is about them struggling to manage their uncomfortable feelings. They’re having big feelings that they don’t know what to do with. They haven’t yet learned other ways to handle those kinds of uncomfortable feelings, and so they’re acting out in that way. It’s important to know that from a developmental perspective, this is actually quite common in young children, and even in older kids who have neurodevelopmental or executive function or mental health kinds of issues. So just to normalize that a bit: I’m not sure exactly how old Hazel’s son is. It sounds like he’s a young child, but for any of you who are dealing with this, just know that this can be typical behavior, depending on the developmental stage of your child and other needs that they have going on. So let’s think about some other big picture things. It’s important to know that the aggression has nothing to do with you. We tend to take this very personally as parents or family members or adults, but actually it’s not about us. This is about a child who is distressed and doesn’t know how to soothe himself, so he’s lashing out. That’s the tool that he has or that he feels like he can use in that moment. So it’s important that we depersonalize it. When we take it personally, and we allow our feelings to get in the way, feelings of maybe hurt or “My child doesn’t like me”, or feeling offended that our child would act like this towards us, or feeling anxious about “Why are they doing this to me?”, when we let our feelings get in the way, it actually creates a bigger problem, and makes it more difficult for us to handle it in a helpful and supportive way. So it’s really important that in the midst of these kinds of behaviors and moments, that we are focusing on staying calm and regulated ourselves, reminding ourselves that this doesn’t have anything to do with how my child feels about me.
Now, some other ideas about the big picture of development. Kids in the toddler and preschool years are still developing what we call self-regulation skills. Those are things like the ability to stop themselves, the ability to handle discomfort, both physical and emotional discomfort, or the ability to think ahead and anticipate outcomes. Those are some examples that fall in the category of self-regulation. So we might think about, “Well, my child is upset and he’s lashing out. I want him to be able to communicate to me how he’s feeling and maybe manage that in a better way.” That’s great, but that requires a lot of self-regulation skills that many kids, either with neurodevelopmental differences, a history of significant trauma, behavior challenges, they’re just developmentally at a younger stage and they’re not able to self-regulate yet. So it’s not reasonable to expect young kids or even older kids with these kinds of challenges to do this on their own. They need our support to develop these self-regulation capabilities.
So we need to be the calm in their storm. That’s how I like to think about it. When kids are suddenly really distressed, really escalated, and managing their heightened emotions by biting, pinching, and acting out like that, we need to be an anchor for them. We need to be the calm in their storm. Stay as nonchalant about it as possible. I get that that’s difficult, but the more we escalate in our emotions, the more it’s going to escalate our child’s emotions and behaviors. They need us to anchor them with our calm. So you want to think about it as, “Okay, yup. This is what’s happening. I expect this because you’re a young child, you don’t know how to handle this differently yet”, or even for an older child, “I get it. You haven’t yet learned other tools for this”, and to remind ourselves, “I can handle this. My child isn’t handling this, but I can handle this. I’m an adult.” Remember too, that kids need a lot of experiences with trusting that as a parent, you are always going to do what you say and what is best for them, even if it’s not what they want in the moment. They need to know that we are going to stick to appropriate boundaries, that we’re going to follow through, if we say something is going to happen, or we’re going to handle something in a certain way that we follow through with that. That’s how they build trust in us, and that trust is super important, not only for the big picture of our relationship, but also for them learning these regulation kinds of skills and developing the ability, even in their nervous system, to feel safe and to regulate in these kinds of situations.
So when kids have a lot of ongoing issues with these kinds of aggressive acting out behavior, so it’s not getting better over time or you’ve tried some things, but they’re still consistently getting dysregulated and lashing out physically, typically what I find in those cases is that the child isn’t clear about how the parent is going to respond. They sense some ambivalence on the part of the parent. Maybe one or both parents are being sort of wishy-washy about how they handle these situations, or sometimes the parents are flying off the handle and reacting one way and other times trying to stay calm and reacting another, that’s really confusing for kids. When kids sense that the parent or the adult is ambivalent or distressed, and maybe even out of control themselves, in relation to the child’s behavior, that can really create anxiety and perpetuate this kind of behavior. Kids need to clearly know that the adults with them in these moments can handle it, that you, as the adult, will not lose yourself in the process of this and that you are in control, because it’s very scary for kids to feel like they’re out of control and they need to look to us and see that we’ve got this, and when they sense ambivalence or distress or a high amount of anxiety in our part, that tends to continue this kind of cycle, and the kids will continue to test and be easily distressed until they feel more confident in our ability to set and consistently enforce boundaries, and to manage this in an appropriate way. A good clue of whether this is maybe something that’s going on between you and your child is if this kind of behavior is happening with one parent in particular, or maybe it’s happening at home with parents, but it’s not happening, for example, at daycare or at school, that can be a clue that maybe there are some things happening on the parents side of it or the adult side of it, in terms of how they’re approaching it that may be confusing for the child, or may not be as consistent as it needs to be. I don’t say that to blame any parent if that’s what’s going on for you, but it’s just an indication that the child isn’t feeling secure and sure about the boundaries and about the parent’s ability to stay grounded and in control. So it’s an opportunity to work on that.
I think, again, it’s super important to remember that it’s actually very scary and anxiety-provoking for a child to not have the security of firm, consistent boundaries from caregivers. Sometimes parents feel like they’re being mean by setting and enforcing consistent boundaries, or by being firm with kids around certain behaviors or certain expectations, but actually kids really need us to guide them in that way, because when they feel out of control, they need to clearly sense that we are in control and they need to know that those boundaries and the way that we’re handling things are going to be consistent. So just know that actually, by setting and enforcing consistent boundaries around these kinds of behaviors, you’re not being mean, you’re not lacking empathy towards what they’re dealing with. You are doing things in a way that’s going to help them to develop the regulation capabilities that they need.
Okay. So let’s talk about, in the moment, what you do. So your child is getting worked up, maybe starting to get aggressive. Number one, focus on keeping yourself calm. Find a mantra that works for you. It might be something like “It’s not about me”, or “He’s not in control of himself”, or “He’s a good kid who is having a tough time right now.” Whatever that mantra needs to be for you, latch onto that and remind yourself of that. That will help you stay calm in these moments. Now, if you see this dysregulation building, if you are aware of what’s going on with the child, if you’re able to, in the moment, and you notice the emotions starting to build, the agitation starting to build, and you see the signs of that, it’s great if you can intervene and physically stop your child, or support them before they engage in the aggressive or harming behavior. Often, especially as a parent, you get to know your child’s patterns. You can anticipate environments or situations where the biting, the hitting, the pinching might happen. You can stay close by and be really aware, so you can quickly stop their arm before they hit. “Well, you’re upset, I won’t let you hit your sister”, or “It’s okay to be upset, I won’t let you bite me.” You’re stopping them before they can engage in that behavior. So if you can anticipate, that’s a great thing to do in that moment. And in stopping them, you’re actually helping to strengthen those brain connections, and build those brain connections needed for some of those self-regulation skills, like stopping myself before acting on something. You’re helping them develop that by putting a pause in there by physically stopping, holding their hand back or moving their body back so they can’t bite you, something like that.
Now you can’t always anticipate. Maybe this is something that spirals to that level before you realize, or it’s a situation that you didn’t anticipate would happen, and then you responding immediately after the fact, but it’s important to know that you want to acknowledge the child’s feelings and also set a boundary. So that can sound something like, “I know you’re angry. I won’t let you hit me.” “You’re sad that I said, no, I won’t let you bite your brother.” Those are simple ways to talk about that, that lets them know that you see and acknowledge how they’re feeling. Their feelings are welcome and fine and appropriate, and their behaviors are not, and so you’re going to help them not engage in something that’s inappropriate. That’s the boundary part of it. So it’s this acknowledgement of the underlying feeling and the setting of the boundary. Let’s say that your child has now bitten, pinch, hit, whatever. Instead of immediately launching into something like ”You can’t do that!” or “Ow that hurt!”, or “We’ve talked about this, that’s not okay!”, or really responding to the actual behavior that’s just happened, you want to stay much more calm and firm, and physically contain the situation as much as possible and help them settle, because when they’re that worked up, especially now, if they’ve hit or bit or something like that, most kids recognize right after doing that or shortly after it, that that was not a good thing, and now their anxiety and distress is even higher because they’re distressed about what they’ve done. So we need to stay really calm, but really firm in our approach. Bring the child to a quiet, smaller space to stay with them if it’s possible, because big spaces, lots of activity and people, that’s overwhelming. That’s going to take longer for the child to regulate. So you want to think about containment at that point. How can I reduce the stimulation that’s going on and help my child’s nervous system to settle? So if you can somehow create containment, move to a quiet area, if you are somewhere in public, maybe even go to the car, if you’re in the house, bring them to a quiet, more contained space. For a young child, a small child, you can pick them up and bring them. For an older child, you can guide them to an area that’s going to be better to manage this. If they are resistive and not going, then you just work on clearing out the area where you are, asking siblings or other family members to give some space and to move to another area so that this child can calm down. It’s also appropriate to hold your child firmly, if needed, to prevent him from harming, from continuing to harm, whether it’s stopping before the harm has happened, “I won’t let you hit or bite me”, and firmly holding your child facing away from you, maybe on your lap, kind of in a basket hold with your arms. If it’s an older child, you may need to stay in the space and keep some distance, you may need to wait outside the room if they’re being really aggressive or trying to come at you. Safety first. But for younger, smaller kids, it’s very helpful to firmly contain them. Give them that structure of physically holding them to prevent them from harming, and that’s not in a punitive aggressive way. It’s in a calm, but firm and supportive way, that they need help to regulate their nervous system at that point.
Really important during these moments to stay quiet, both in your voice volume, and also in terms of not doing a lot of talking. Kids in these moments are in fight or flight mode, and their brain isn’t processing a lot of verbal and higher-level information. So if you’re trying to talk to them about what’s going on, “Tell me how you’re feeling”, or kind of reprimanding them or trying to talk through what they should be doing instead, you’re probably just going to escalate the situation more. It’s going to take longer for them to settle. So stay quiet in your voice volume, say only what you need to say, and don’t keep talking. You want to stay calm and let him know that you’re going to continue to help him. That’s important. “I know you’re upset. I’m here. We’re going to work through this. I’m going to help you”, and then stay really calm and quiet. Our sole focus in these moments is to help their nervous system calm and regulate again. Their nervous system has gotten really escalated, they’re beyond the point where their brain now is capable of managing how they’re feeling physically and emotionally in a productive way, so we’re helping their system to calm so their rational brain, their thinking brain can come back online again and we can move on from that. Once they are calm — and for some kids that just takes a few moments, for some kids that can take significantly longer, depending on the circumstances. Once they’re calm, you want to just move on to whatever is next. You want to avoid, the second you notice that they’re calm, making a big deal out of it or trying to teach a lesson. You just want to acknowledge that. “Oh, it seems like you’re feeling better now,” or “Oh, I’m noticing that you’re calm”, or “It seems like you’re feeling like you can manage things again.” For little kids, “Oh. Seems like your brain and body are feeling better. Let’s go make lunch”, or “Let’s go outside”, or whatever it is that’s next. You don’t want to make a huge deal out of it because you run the risk of sending them right back into escalation again. With older kids, you can review or discuss the situation at a later time if it’s needed. Again, I wouldn’t do that right then, because you’re likely to push them right over the edge, back into dysregulation, but you can wait until a later time. Maybe later that day, maybe the next day and say, “Hey, I wanted to talk about what happened. I wonder how you’re feeling about that. I want to think about how we could handle that differently next time”, and you can do some problem solving with them. So that’s how to handle that in the moment.
Now, the longer term here. It can often be beneficial to practice with some calming and soothing strategies when the child is not in the midst of feeling completely dysregulated and distressed. So that might look like introducing some basic belly breathing, it might be some mindfulness strategies, might be having them practice with squeezing a stress ball or finding a weighted blanket or going in the hammock or crawling underneath their blankets and all of their pillows. Finding some things that are calming and soothing for them and practicing with that when they’re not in the midst of falling apart. Then that can be helpful to direct them towards that, or eventually they can even seek those things out before they become aggressive, but that takes a lot of practice and a lot of exposure to those kinds of things outside of the moments when they’re feeling really worked up. Also important in the longer term that you, as the parents are focusing on being consistent with boundaries across the board, not just in the moments where they’re really dysregulated and being aggressive, but that you are practicing being consistent with setting and sticking to boundaries across the board, whether it’s in terms of things that you say yes or no to, or routines, the way that you’re handling things in general. That builds that trust and connection. That really is helpful when those difficult moments happen.
It’s also valuable to look for patterns: Are there certain people, environments, situations that may feel overwhelming or may more easily trigger this kind of dysregulation and aggression in your child? It’s helpful to look for those things. Maybe it’s the playground with other kids. Maybe it’s when grandma comes over. Maybe it’s when there are lots of people talking in a big space, lots of activity going on. You want to watch for those kinds of patterns because then you can work on making some adaptations. Things like how to support maybe less noise, fewer people. What can you do in those situations to proactively manage things so that it helps them not get to the point where they are now completely out of control and being aggressive?
Also look for a positive time to build relationship throughout the day. This allows for some counterbalance for these uncomfortable, dysregulated kinds of interactions, particularly if you have a child who’s acting out a lot, who’s getting aggressive very quickly, you’re having a lot of intense, challenging moments with them throughout the day, try to find some times where you can do things with them that go well, that they don’t get distressed and dysregulated about, where you can just build that positive relationship, that’s helpful for them, but it’s also helpful for you as the parent to just fill that cup of good feelings that you have for your child and about the relationship that you have with them.
Also important: If you have a child who’s going through a phase, developmentally, with sort of this aggressive acting out, or you have a child with some challenges who you’re dealing with this over the longer term, it’s important that you’re taking time to care for yourself, that you are finding opportunities to decompress and regulate your nervous system as needed because as we talked about, the number one most important thing you can do for your child with their dysregulation and their aggression is to stay calm and regulated yourself, but that’s really hard to do if we are completely depleted and fraying at the ends and our nervous system is not functioning in a very regulated way. So finding some time to maybe switch off between parents, to take turns managing things, or to just take some time for yourself to support your nervous system regulation. That’s really important.
The last two things that I want to share around this are related to nutrition and sleep. Just some other things to think about if you feel that this is more than just a developmental phase, or this has been really ongoing now for quite a long time, or you feel like the intensity of this stuff with your child is greater than maybe it should be for their developmental level, consider some things in the realm of nutrition. I often see that kids who have a super low distress tolerance and an inability to develop better regulation, often have some underlying nutrition-related issues, whether it’s specific nutrient levels that are low, iron, zinc, and magnesium can be big ones in that realm, food allergies and sensitivities can be big ones in this area, particularly things like dairy, gluten, dyes, chemicals, those kinds of things are the big ones that I see creating issues for kids who tend to be quite aggressive and dysregulated, and also blood sugar dysregulation. Kids who are having a lot of sugar at meals or snacks, and also are not having enough protein and fiber to balance that out, they’re on this blood sugar roller coaster all day long, that really can exacerbate their dysregulation and make it very difficult for them to develop those better self-regulation skills, can lead them to be much more impulsive with their reactions. So those are some things, nutritionally, to think about. I’ve done lots of other podcast episodes on those topics, and you can find a lot more information on my website and blog as well.
And then the other one is sleep. Kids, again, who have a chronically low distress tolerance, who sort of go from 0-100 with no warning and are becoming aggressive quite quickly, very reactive, are not improving in their self-regulation as they’re getting older, sleep can be a big culprit there. Kids either not getting enough sleep time or the quality of their sleep is not what it needs to be, and that can really lead to this kind of behavior during the day. So that’s another area to look at as well. Even in the cases where there are nutritional or sleep-related things, all of the strategies and the parent-focused things that I talked about in this episode, do form the foundation for how to manage these things, but then it’s also important if there are nutritional or sleep things going on to address those in addition. It’s the combination of those things that really helps kids develop the regulation skills that they need to manage uncomfortable feelings and distressing situations more appropriately.
So I hope this information is helpful for Hazel and any of the rest of you dealing with kids who bite, hit, pinch or become aggressive when they’re distressed. Remember, if you have a question you’d like answered on a future show, email it to email@example.com. You can put “Podcast Question” in the subject line to help us out. Thank you, as always, for listening, and I will catch you back here next time.