By: Laura Petix, MS OTR/LEPISODE 22

Laura: What your definition of meltdown is vs. tantrum?

Dr. Lockhart: When I look at tantrums, I see tantrums as something that’s very healthy and developmentally appropriate. It can happen at any stage or age, but typically we hear about it most happening in the toddler stage, because they are still learning how to balance themselves. 

They’re still learning how to control their impulses. They have words and a voice and more autonomy than they’ve ever had, compared to when they’re a baby. They can say “no”, they can refuse, they can hit, spit and kick. It’s very common because they’re learning to express themselves and have autonomy. 

Tantrums are a way to communicate a need or a want. Once the need is met, the behavior stops. Eg. “I want more tv” or “I want more chocolate”. Then when you give in, it stops. SO it’s a clear want or need that’s met. 

A meltdown is usually related to sensory overload (overtired, over thirsty, too cold, etc) and the child is reacting to being overwhelmed. There is a trigger that’s like “I need to feel safe” and have a release to feel safe. So, kids aren’t having meltdowns because they have a demand or request. They’re having meltdowns because their central nervous system is panicked, and they’re trying to regulate and survive. 

Sometimes that screaming and crying, rolling helps them regulate, and we’re standing there with our hands on our hips like “This is ridiculous, you got what you wanted.”, when it wasn’t about what they wanted, it was about their body needing to balance out. 

Laura: Yes, they can also look the same. But tantrums have a very clear need that they want, so whether it’s a cookie or more time with a toy or tv. But if you give in then tantrums give in, and tears end. 

Usually, it’s a lot less duration. I haven’t seen it in the literature, though, but it seems less duration.

Dr. Lockhart: I’ve seen that as well, typically 10-15 minutes. If it lasts longer than that, then it’s more of a problem than a tantrum.

Laura: I also feel like meltdowns, in our house, can also step from not getting the cookie or not going to the park. However, it’s not BECAUSE of not getting the cookie or not going to the park. It’s because my child is already dysregulated from not enough sleep or from school that day or from anxiety. 

The antecedent before a meltdown can make it look like a tantrum. But when I give in to “what she wants”, it’s never what she wants. 

She’ll complain about the chair being too far, so I’ll scoot it in, then it was too close, then too far again. I went down the line of things but nothing I did was right. She was completely dysregulated.

So, sometimes people call them sensory meltdowns. But meltdowns can just encompass really big emotions, especially anxiety. People often forget that a part of sensory is your interoception (heart rate, body temperature), and you can have a hard time noticing it but it can trigger your emotions and can come out as a meltdown.

A lot of my daughter’s meltdowns start from something that looks like a tantrum. 

I always say, you could even have a split screen of the exact same scene playing out, identical, but what’s going on underneath can be very different. 

I think the whole thing that makes it hard to differentiate is that there is no clear definition of meltdown or tantrum. 

But something I’ve noticed with my daughter and in my practice is that tantrum emotions are usually associated with feelings like anger or frustration, maybe even sadness. It feels like meltdowns are triggered by sensory triggers related to overwhelm, anxiety, shock, startle or fear. I see those feelings much more in my daughter with her meltdowns. 

I also want to tack on how you mention that tantrums are very healthy for development. Even neurodivergent kids can experience tantrums, and neurotypical kids can experience meltdowns. I just think neurodivergent kids are more prone to meltdowns than tantrums. 

Dr. Lockhart: I agree. I agree with that and also what you said about the split screen. The same behavior can be observed, that’s why when parents are like, “What should I do when they’re stomping around and screaming?” and I say, “Well I don’t know, because it depends why they’re doing it.”

It’s the same as when it’s the middle of the night, and they’re screaming at the top of their lungs. Maybe they wet the bed, maybe they had a night terror, or nightmare. Maybe they want to sleep in your bed. Maybe they heard something outside. 

You can’t have the same strategy for the behavior that looks the same in the surface because then you’re missing what drove the behavior to begin with. So if you say “oh just sleep in my bed” now you have a kid who’s peeing in your bed because the reason they were waking up was because they needed to pee, not because they wanted to be in your bed”.

I think when we’re looking at tantrums and meltdowns, we can’t speak about them interchangeably, because then we’re going to use a strategy that anybody can google, and you’ll miss the whole point of why it happened to begin with. 

So I agree, I see it’s a lot of the emotion and need and desire for a tantrum, but for the meltdowns it’s trying to get myself back in balance and I don’t know how else to do it. 

Laura: It’s important to differentiate, I agree. But I think the part where parents get stuck on is there’s already so much narrative “what should I do, what should I say” going on, and then on top this also having to wonder “is this a meltdown, is this a tantrum?” what am I going to pull out of it what should I do. It’s so much for parents to worry about.

So when I first start working with parents, just to be safe, I usually tell them “you’re safest best to make sure that you’re holding more space for your child and creating more of a supportive environment… if you’re not sure, treat it like a meltdown. Because it’s safer that way than treating a meltdown like a tantrum.”

You see a lot of tips out there to validate the emotions and narrate, but if you did that in the middle of a meltdown, your child will hit you more or scream louder because they’re already overwhelmed.

So if you’re not sure, I would just, at the very least, try to stay with them, but not add extra auditory input during the meltdown. 

Parents also worry about feeling like they’re ignoring their child if they stay there but don’t say anything. 

I always say it’s not really ignoring. It’s so hard to describe that dance of being present but silent. 

How do you usually tell parents to act if they don’t know if it’s a tantrum or meltdown? 

Dr. Lockhart: 

I think a big thing, which is what I learned early on with my son… because my daughter used to have tantrums that lasted a minute for like a month at the most. My son had meltdowns and tantrums that lasted like six years.

For me, the biggest thing that helped me and helped him (he’s now 9 and extremely regulated), was just remaining present and keeping my thought process and my narrative in check. 

Because what often happens when our kid is having a ridiculous meltdown for the 10th time in a row, we’re like, “What in the world is wrong with him now?” “What are people thinking about me as a parent? I must be a horrible mom that my kid is having this meltdown again.” All these things that we’re thinking.

So what’s happening is we’re actually feeding that emotion in our kid because although we may not know exactly what they’re reading from us, they’re picking up on something. 

They see you roll your eyes. They see your energy. They can sense when you have an attitude too.

Our mindset and our personal parent narrative needs to be in check in that moment. 

For example, when my son was 2 or 3 he was having many what I thought were tantrums at the time. He would be screaming and throwing himself on me, on my lap and on the bed. He’d scream and scream. I’d sit there, criss cross applesauce, slow breaths, close my eyes, and tell myself 

“This is normal. This is normal. It will not last forever. My calm presence is what he needs”.

Did I want to scream and cry and shout? Yes.

Did I sometimes? Heck ya I did.

Because it’s frustrating, it’s irritating and there’s only so much patience tha you have.

Especially on a long day and it’s not the way you thought parenting would be.

But for me, just staying calm and present helped so much.

I remember, he was verbal very early. He would just hug me and saying “Thanks for staying with me Mama”.

I didn’t want to stay I didn’t want to be there, I’d rather go off, go watch Netflix, go to Target, I’d rather be anywhere else but here. But that escape for me was not what he needed.

He needed my presence and my calm. And it was hard to do. 

But that for me was the most important thing for me to do, whether it’s a meltdown, tantrum, or dysregulation. You staying calm and using that narrative makes such a difference because they pick up on that.

Laura: Yeah. I think that narrative is where it really gets to my anxiety. One of my themes of anxiety is going through a checklist of what I have to do that day. If she has a meltdown that happens at 7 AM then I’m just mentally going like “okay, now I can’t do this till tomorrow, can’t do that” And I’m like counting, watching the clock, and it comes out on my face. 

Now that I know most of her patterns for meltdowns, I know most of her triggers (that aren’t avoidable), I feel like I’m mentally prepared for them.

I wake up earlier and basically build in time for a meltdown because I know if I have more time in the morning then I know I’m going to respond calmer and be able to be present and spend time hugging her vs. rushing through the meltdown because we have to go to school. 

Dr. Lockhart: One of the things that helps parents a lot (I guide parents a lot through this in parent coaching), is anticipating the trigger and knowing the trigger so you can address it before it occurs. 

For example, my son, who’s a highly sensitive kid is very in tune with his environment. So when he’s tired, he’s the most tired and when the tag is bothering him, it’s the worst tag ever. Everything is so big.

So when he wakes up in the morning (his room is above mine) I can hear him wake up because he starts to stomp because he’s mad that this alarm has gone off, although we’ve been doing this forever. I’ll come in really gently, and say “good morning”. He’ll grunt.

I’ll say “It seems like you’re still tired. You can choose to wake up now or you can choose to sleep for 15 more minutes, you decide.”

He’ll say “I’ll sleep for 15 more minutes”

“Ok”

“How will I know to wake up?

“We can re-set your alarm, or I could wake you up.”

“You can wake me up”.

“Ok. Go back to sleep”

The funny thing is about 90% of the time he actually gets up and gets ready instead of going back to sleep. 

He wanted me to understand that he’s tired and that I could relate to it. 

Laura: I always recommend giving a choice, like this or that. Right now though, that’s our biggest trigger at home. If I give her a choice between 2 identical bags of Cheezits, she can’t make the choice it’s a meltdown. So I make choices for her.

What I notice, was at first, when I was changing my method of everything was a choice, when I switched to making the choice for her, she still wasn’t happy, but the more I was consistent and came back with “this is my choice for you”, it de-escalated all of the emotions, like she just needed to know I (mom) was in charge. 

I had way less of a battle that way than having her make the choice. Eventually I’d love for her to make choices. But, in anticipation of those things, on school mornings when I know choices are a trigger for a meltdown, I don’t let her make any choices in the morning because it’s guaranteed to be a meltdown, so I accommodate those triggers for her. 

On school days, school itself is a landmine of triggers for sensory kids, so on those mornings I like to take as much cognitive demand away from her so she can be as regulated as possible at school. But on weekends, we practice making choices as much as possible. 

It’s important for parents to know you don’t always have to avoid the meltdowns. You can try to alleviate them and even if you know a trigger or a pattern, it’s still important to work on them at other times, don’t avoid them every time. 

Dr. Lockhart: Absolutely. In the process as you do it, you start to equip yourself, because then you’re more regulated, then the child is learning the skills, and this also then de-sensitizes yourself from being so bothered by them. So it’s not always this big judgment thing you’re doing on yourself. And it doesn’t mean more than it is, it’s just my child is learning skills they haven’t acquired yet. 

I remember my husband and I did that when we had our first child. Her crying would be triggering for me, and I though “what if SIDS?” and we had to allow ourselves to say “It’s okay if she cries and she’s bothered by tummy time and she’s fussing. We don’t have to react to everything”.

Then it got us to the point where we’d say “Yeah, she’s fussy” It stopped being a big deal and we didn’t have to be so triggered by it. 

I think what happens for a lot of parents is that we get triggered by tantrums and meltdowns because our needs haven’t been met, or we feel disappointed with how parenting is going. I think that’s why sometimes it helps when you have more than one kid.

For me, my daughter was super agreeable, everything was smooth and I was like “I could have 10 more of these.” 

Then when my son came along 2 years later, I was like “what the heck?”

From 6-7:15 PM every night he screamed non-stop as a baby. Nothing worked. 

I was like “OMG why is it so hard?”

So I think at different stages we expect the next one to be easy. Typically, those kids who are more collicky as infants can also be hard as toddlers.

It’s tough, we have to give ourselves a break and be more compassionate.

Laura: I think it’s important what you said how when you have to just come to accept “it’s ok if my baby cries”. 

When we think about wanting to stop meltdowns, I preface it by saying first, no one wants to see your child hurt and upset and dysregulated. 

But aside from that, when we talk about wanting to stop meltdowns, it’s usually a “you” thing as parents, like it’s about yourself as a parent. 

Like I don’t want to hear her cry because I have things to do , because I just paid money for those pants that you won’t wear.

It always comes back to the parents. That’s where it’s not aligned in terms of me wanting to be a respectful parent and having this bond with my daughter. 

But also, it means “you can’t have feelings because it’s inconvenient for me when you meltdown”. That’s really what I feel like when I want to stop a meltdown.

But in the long term, we need to show our kids that we can tolerate their big feelings even if it is a sensory meltdown that lasts 90 minutes. 

There are days when I can’t do it, and I have to tag team with my husband which is not always fun because he’s not as good at co-regulating her as I am, but I can’t physically always do it. 

There are some days where I’m good at it. Those times, I hold on to those times like “ugh that was a good meltdown, we ended it nicely, she saw me tolerate it”. I hold on to those moments so much because even if that was the 8th meltdown of the week, I know that it’s building our relationship and her comfort and confidence and advocacy so she knows that she has big feelings and that it’s okay.

Dr. Lockhart: I agree. Parenting is not about them, it’s about is. 

Laura: Yes! It makes sense. I’m doing so much work with my therapist and about my childhood, and I’m always like wait a second isn’t this supposed to be about her (my daughter?) But it does end up relating to her because it’s how you see yourself in your child and how yo have things in your head of how you wished you would be as a parent.

Dr. Lockhart: Our parenting journey is about us. How we thought it would be like and wished it would be like, and about us tapping into our past, our history, our family of origin in terms of not being good enough or whatever.

When I do parent coaching, I always ask them “what are your goals”? And their goals are always about their child, I’m like, “well we can’t change your kid. We can’t make them do anything”. They have their own autonomy and free will.

What we can do is change your goals to be about you. So instead of “let’s make my child stop having tantrums” how but us working on anticipating where those tantrum triggered might be. 

Then, how do we respond in a regulated state with it, so as we anticipate it we can respond with choices, or logical “when-then”, or empowering them in other areas or having more fun, watching our tone and attitude. 

There’s other ways to address it but I think sometimes we miss it because we get so focused on “change this kid’s behavior” even though it’s been going on for 10 years. Like change them, and make them be a better kid. 

But no, it’s more about you. It doesn’t mean you’re a bad parent. 

It means that, we’re winging it. Even though I’m a professional, I’m still winging it.

When adults have a hard time understanding the logic behind it because it seems so ridiculous, is I equate it to a panic attack.

A panic attack is basically an adult meltdown.

You’re not having a panic attack because of a cookie, you’re having a panic attack because you’re overwhelmed, your system is overloaded and you feel unsafe in someway because the room is crowded or you’re having a flashback or a sensory/auditory trigger.

Laura: Yes, and sometimes panic attacks happen out of nowhere. Like you’re just watching TV then it happens. Something that’s just been waiting to come out.

Dr. Lockhart: Right. Your body’s just going in this dysregulated state, so it’s not exactly a meltdown but it can be this similar feeling for the grown up version of a meltdown when you feel out of control and you have this cry session and you feel like you’re hyperventilating and your body regulates itself. 

It doesn’t make sense, people are like “why was I anxious for no reason?”

Well you don’t need a reason to feel anxious when there’s a panic attack.

Laura: Yes. I agree. 

Typically, too, the meltdowns themselves, the crying and all of that can last long, but even if it stops,  you can usually notice there’s a little “hangover” with continued dysregulation.

It’s not like an on and off switch like tantrums.

I also get this question often, “Can a tantrum turn into a meltdown?”. 

Can something start as a tantrum and completely morph into a meltdown? 

Dr. Lockhart: Absolutely. Because, if you’re having a tantrum because you didn’t let me sleep longer, but now I’m screaming so long I’m getting a headache and my body’s hot and my system is overwhelmed, then I go into fight or flight meltdown. 

They triggered their own meltdown.

Laura: This happens for us a lot in the morning when she has a meltdown and she cries so long she misses breakfast so she’s starving then nothing sounds good and she won’t eat then it’s a bigger meltdown.

So I want to know what do you tell people when you tell them why they should care about the difference between tantrums and meltdowns?

Dr. Lockhart: When we understand things better, we can make better decisions about what we need and what our kids need.

If you have a child who has these behaviors and you’re wondering “is this normal for it to go on for 2 hours?” Then you think that it’s supposed to be normal for 10-15 minutes, everyone says that. 

Maybe the child doesn’t have tantrums or meltdowns, maybe they have disruptive mood dysregulation disorder, maybe ADHD is going on, maybe it’s impulse control disorder, maybe there’s physical ailment and pain.

I used to work in a military hospital with pediatric populations, where they came in for tantrums or meltdowns but it was related to pain, like migraines and they didn’t know how else to express that. Or kids with sickle cell and they we’re having pain crises, so their body was in a dysregulated state because of medical issues.

Like there’s so many other reasons (not to get paranoid) but there are certain behaviors that are typical and normal, and then it gets to a point where this needs further clinical or medical intervention so that I can make sure my child doesn’t habituate to regulating with this behavior.

I think a lot of times parents let these things go on and on and on and then the kids have a habit of responding this way and it goes beyond tantrums and meltdowns and it becomes a habit behavior.

Laura: 

Yes, and I feel like not knowing the difference between tantrums and meltdowns can deter a parent seeking professional support if they think it’s normal.

Because if everyone calls their 2 year old stomping their feet for 5 minute a meltdown, and we’re all sitting around with our mom friends and I hear other moms say this… and I’m the mom who has a kid who’s neurodivergent who has intense meltdowns, then I’m going to think it’s normal.

But what’s misunderstood is that my child’s meltdown lasted 45 minutes and their kids’ lasted 5 minutes, and mine continued throughout the day and it ruined our day, versus their meltdown which was technically a tantrum that’s just part of typical development. 

Then there’s a miscommunication and no one knows it. But the parent who doesn’t know there’s a difference then thinks this is normal and then won’t seek support, and they’re suffering in silence through 45 minute tantrums that are really meltdowns.

It’s normal for toddlers to have tantrums daily. But if your child is having sensory meltdowns daily, then I say seek help. 

Even at the pediatrician I was still not given the support I needed, because the pediatrician was saying 2 year old meltdowns are normal, but in her head she was thinking of tantrums, not differentiating it.

It goes back to the fact that some professionals think that if your child “isn’t Autistic” then there’s nothing wrong with them, it’s just your parenting style, these are normal tantrums, be a better parent.

That’s the message that parents are getting. 

Dr. Lockhart: This is the message parents have been getting for a century. Where these “refrigerator Moms” who made their kids Autistic, or parents who made their kids ADHD. It’s not about “bad parenting” it’s about the child needing help.

I think this is why parents delay getting services because they’re worried they’ll be blamed for being a bad parent. 

We have to stop giving that message.

Kids are autonomous, free will beings who need further support because their brain hasn’t fully developed to learn how to maneuver these things. 

And when our parents that we have in this world aren’t equipped with those tools, they’re going to respond in a dysregulated way, so when their kid dysregulates them (like through a tantrum), 

Then the parent says “leave me alone” and slams the door, and screaming to the kid over and over again, the kid finally stops, but then later they apologize. 

So parents think “I scared them into submission”

But really the parent just had an adult temper tantrum. So now they both learned that dysregulation creates connection, and now we (parent and child) have both made this habit of needing to scream.

It’s such a horrible cycle, but easy to get into. 

I think that’s where the shame needs to come out of the formula. It’s normal to feel frustrated when someone does something that’s frustrating.

I tell parents, if you had a friend that always insulted you and said something under their breath, you wouldn’t want them as a friend.

So when your kid is doing it, you’re not going to want to be around them. That’s normal to feel annoyed and irritated by your kid sometimes.

But now, they get this conditional response that feeds a lot of the behaviors over and over again, so we need to break the cycle to equip parents better.

Laura: I have some extra questions for you.

There were questions on how to handle a meltdown when it’s like right before school or somewhere you have to go, like when you don’t have time to sit there calm and present like if there are other siblings and no time. Sometimes I try to plan for it and something still happens.

What do you suggest parents do in those moments when they can’t fully do the response that’s “correct” for a meltdown?

Dr. Lockhart: For me, it’s really about anticipating and planning in advance and knowing what the trigger is and trying to find ways to get around that particular trigger.

For example, getting ready for school let’s say you don’t have time to create a safe space and sit with them. Maybe they love choices, so we can give them a choice on what to wear, how to walk to the car, what kind of meal they want etc. 

Like giving them control and mastery which can help. 

I would say if you know there’s certain triggers like getting ready for school can lead to meltdowns. A lot of parents just have their kids sleep in clothes they’re going to wear the next day, which can help a lot of that process.

So again, just finding ways to short cut those things where you can give the child feelings of control and eliminating some of the triggers.

To me it’s anticipating what the triggers are and trying to decrease/avoid them. 

Laura: Sometimes even when I set it up just like that, it still happens. Those are times in my head where I think to myself “this isn’t going to be one of my best parenting moments, I gotta move her through this and pick her up”.

I have to get to work some days and I will regulate with her in the car and talk about it later.

I think a lot of parents just want the permission to not be the perfect parent 100% of the time

Dr. Lockhart: Exactly.

Laura: I strive for like an 80% average. There are some times when I’m like this is going to be one of the 20% where I don’t follow through with a tip because I can’t do it right now. I think if you can strive to keep everyone safe, that’s all you can do.

Dr. Lockhart: I think parents are looking for strategies so often and I’m like OK you can google strategies, you can listen to podcasts, but the bottom line is that it still goes back to mindset.

Parents need to think “I can give my kid all these skills, but I have to remember not to take it personally and not think I’m failing because a strategy didn’t work.”

Like if I had just given up like “screw it I guess this is my lot in life” then when my son was 2 or 3 years old, I would have been miserable. But it took consistent practice, and 6 or 7 years later, now it’s amazing how regulated he can be with certain things because he learned it because I (as much as possible) stayed in a regulated state.

So he’ll do that even with watching youtube or TV. He’ll bring his clock and he’ll say “okay I’ve been watching for an hour, I’m going to take a break. How long should I take a break for?”

And I say, “You decide.”

When you’re setting these foundations, it doesn’t go unnoticed. You’re dropping little things in their piggy bank, and even though you don’t see the result, there is something happening. It really does build up and one day, like with my son who watches something he shouldn’t have, it scared him, he confessed it to me.

I said “Thank you for being honest.”

He said “I think I’m just going to not watch youtube for the rest of the week.” 

And I said, “That’s your decision.”

If I had demanded that five years ago, it would have made him have a tantrum. But over time you’re depositing these things into their piggy bank to the point that one day, they will just do it themselves.

Laura: I think parents also think it’s not working, but really they’re measuring the wrong thing to expect it to “work”. 

Like you are expecting there to be zero meltdowns, then of course this won’t work. I don’t know anyone in this world who can promise a magic pill of no meltdowns.

But there are other ways to measure progress, and one day it’ll really surprise you.

One last question. They want to know if there’s any guidance for handling meltdowns in older children and teens. If they have sensory and overload meltdowns, what do you suggest parents do to support through the meltdowns?

Dr. Lockhart: It’s the same thing. It’s about anticipating certain things. I think for me a lot of it is the preemptive strike. Educating parents and teens with the information so they can understand why they have these feelings and why they were cursing out their parents, because e.g. “I was tired from zoom”. 

If they can be equipped and educated about their bodies and why they react the way they do, sometimes this could be their stop gap.

What I do with parents and teens is I tell them that when something is happening, instead of lecturing or punishing, utilize the “pause” or “do-over”. So when things escalate, someone just jumps in and says “Okay, let’s take a break, this conversation isn’t going anywhere and I don’t like the way we’re both yelling Let’s take a break.” 

Remember that we’re building skills and developing habits. So, it’s not immediate. It’s like planting a seed in the ground. We’re not going to see the big beautiful tree right away. We have to plan little things. 

Know that our regulation and modeling is going to move into their life and realize “Okay, I can respond differently in that situation”. 

We can give them the space to do that without withdrawing our love and attention. 

I think it’s also the same kind of thing, we have to anticipate, give them the tools, educate them on these things. 

If your teen is having reactions that appear to be like toddler type meltdowns, then yes I think an evaluation needs to happen.

It can be immaturity, which happens in neurodivergent kids, especially with ADHD because they tend to be 2-3 years younger developmentally than their peers.

But maybe it’s also a psychological disorder going on that’s not being addressed, which is why they’re so dysregulated. So, I would say if they look and appear a lot as if they’re much younger, then get them evaluated by a neuropsychologist and a psychologist. 

Links:

Instagram: @TheOTButterfly www.instagram.com/theotbutterfly

Website/blog: www.theotbutterfly.com

Email: LauraPetix@TheOTButterfly.com

Work with me: www.theotbutterfly.com/parentconsult

More SPD parent resources: www.sensorywisesolutions.com 

Buy me a coffee & ask me a question for a future episode: www.theotbutterfly.com/coffee

Dr. Lockhart links: Instagram @dr.annlouise.lockhart 

Dr. Lockhart website: www.AnewdaySA.com

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Laura Petix, MS OTR/L

I’m an enneagram 6, so my brain is constantly moving. My OT lenses never turn off and I can’t “un-see” the sensory and other developmental skills that go in to literally every activity. I love taking what I see and breaking it down into simple terms so parents can understand what goes into their child’s behavior and skills.

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