[MUSIC PLAYING] We are the Association for Child and Adolescent Mental Health or ACAMH for short. And this is ACAMH Learn. Welcome to Mind the Kids. I'm Dr. Jane Gilmour, honorary consultant, clinical psychologist, and child development programme director at UCL. And I'm Umar Toseeb, a professor of psychology at the University of York, focusing on children and young people's mental health and special educational needs. In each episode, we select a topic from the research literature and, in conversation with invited authors, sift through the data, dilemmas, and debates to leave you with our takeaways for academics and practitioners. Today, we'll be discussing when emotional expression causes a problem. This episode is called The Lowdown on Meltdowns. Let's talk meltdowns. So my understanding of a meltdown, based on the very little reading that I've done around this topic-- and I've never really explicitly researched meltdowns. So everything that I know has come from the reading that I've done for this particular episode. My understanding is when your feelings become so intense that you can't cope anymore. And so all of the emotional regulation strategies that you might be familiar with, that you might have used in the past fail. And it manifests as tears, tantrums, maybe even physical violence. Is that what you think too, Jane? Yeah. I mean, it's interesting you were saying about the literature because there's a variety of different ways of describing it. But the phraseology is quite different depending on the age of the child. So you might see here tantrums, meltdowns, anger episodes, or rages in older kids. So we're thinking, developmentally, you have to be aware that the phraseology changes, probably to reflect the expectation that there is a developmental stage where these meltdowns are to be expected as compared to more of an anomaly in older kids. But what I think is really interesting-- and I certainly wouldn't say I'm an expert in this area. We have a guest here today who's going to help us unpack lots of aspects of this literature-- is that the literature that does exist really doesn't look at the quality of the emotion. So an out-of-control negative emotion might be one way of talking about a meltdown. But actually, what's happening in that ball of emotion-- there is one exception to this. And this is a model that I often use clinically. And it's the anger-distress model, Potegal and Davidson. And they describe a meltdown having a high burst of anger followed by a prolonged period of distress, a little bit like a sort of comet where there's a nuclear of hot anger and then a long tail of sadness. But what is interesting is the pool part of those two different negative emotions, I think, is highly informative and a good way to start to help parents and any adult supporting a young person to think about what's going on there. So yeah, it's a huge literature. But it's somewhat patchy in terms of looking at some aspects of emotion, I think, from my understanding of it. And my understanding based on the reading-- and I think what you've just said as well, although I'm not sure-- is a meltdown feels very outwardly rather than inwardly. So I wouldn't associate a meltdown with having really intense feelings about something, feeling overwhelmed, and then internalising that I would attribute or I would associate a meltdown with feeling very intense about something, not being able to manage those feelings, and then externalising in a way that it's apparent to other people. Or even if there's not people around, it's apparent that there's a meltdown happening. Is that what you see as well, Jane? Yeah. And it's certainly overt. So there's no debate that we can all spot one when we see one. But I think it's interesting what you're saying about the internalising and externalising definition because there is some emerging data. And I certainly wouldn't suggest that it's well established in the literature. But there might be, if we look at any given meltdown, the proportion let's say, sadness as compared to anger that we just talked about earlier, where there is a young person that has proportionately more anger in their outburst, they may go on if there is going to be a difficulty to have externalising problems. And those young children who have more sadness in their outbursts proportionately may go on to have internalising problems. And I think that would be very interesting if that were well established to explore that a little bit further because it might imply that at a very early age, we could have some clear predictors about A, what may be on the horizon, but B, how to support these young children and their families. It was a few episodes ago. I think it was the aggression episode where minor regression, major impacts. I think it is where I was throwing out various hypotheses. And then some of them were correct. And some of them were just completely wrong. So I thought I would do the same in this episode and maybe suggest some hypotheses and think about some predictions. And then when we bring the guest in, maybe the guest can tell me whether the data supports what I'm predicting or not. So should we go through some of those? Yeah. I think be brave. I love audacious hypothesis. Let's have some predictions. So I would guess that meltdowns are more common in younger children than they are in older children, whatever that looks like, because I would hypothesise that as children grow older, they develop more emotional regulation strategies or more adaptive emotion regulation strategies. So I know that we've had a bit of a chat. And we've said maybe these meltdowns look differently depending on developmental stage. I would hypothesise that the frequency of meltdowns would reduce with age, irrespective of what they look like. Well, yeah, I'm taking that one. I'm interested in the development-- you're implying there's a sort of spontaneous developmental process-- as compared to the learning process because I think there might be two going on. But let's come on to that one. Go on. Give me another. The other one is I would hypothesise that when meltdowns are rare, it's quite a typical response. So if you occasionally have a meltdown, that's quite typical, I would guess. But if you start having regular meltdowns, then it becomes atypical. So I think it touches upon something that we discuss often in this podcast, which is the behaviour itself or the characteristic or the feature might not be problematic if it happens occasionally. But when the frequency reaches a certain amount, then it becomes problematic. And I would guess that meltdowns is the same. I'm going to guess and say that when we get our guest on, they will confirm that it's probably normal to have a meltdown every now and again for everyone. And then it becomes problematic if it's a lot. Yeah. And I think that will depend very much on age. So in the UK, we use the phrase terrible twos, which has lots of negative connotations. But the idea of these emotional meltdowns being a developmentally expected thing to do in the preschool years-- and we know about 85% of preschoolers will have that experience at one point or another. But that is a really interesting hypothesis. I'm also really interested-- because I always want to get in and fix it. I want to get in amongst it and see what we can do from a clinical point of view. So I'm also really interested in the idea of learning emotional competence and emotional literacy. So how do adults talk about emotions around young people? Do they describe a meltdown as is bad behaviour? And if so, how would those vulnerable children learn about what's happening? And how do parents or adults describe their own emotions, especially the tricky ones, like being jealous and so on? Because I think that emotional context will be really interesting about helping those vulnerable young people who may have a problematic pattern beyond the developmentally expected ones. I have a final hypothesis before we bring the guest in, which is I would predict that children with certain neurodevelopmental conditions will be more at risk or more likely to experience meltdowns. And I'm thinking specifically of autistic children who, for example, if they have sensory overload, that might lead to a meltdown. So yeah, that would be my prediction. Children with no developmental conditions would be more at risk of experiencing meltdowns. Yeah. And I think that that sensitivity to the world, in particular conditions and thinking particularly about autism but also perhaps not having the words to express the sensation and the overwhelm, there are two aspects to that might create a perfect storm, as it were. We've got lots to ask. And we've got lots to do. I wonder [INAUDIBLE]. Let's bring the guest in. So today, we're joined by Professor Erin Gonzalez from the University of Washington School of Medicine. Erin will be hosting the ACAMH webinar Mastering meltdowns, managing big feelings in kids, which is due to take place on the 5th of March 2020. Thank you so much for having me. It's great to join you today. Absolute pleasure. So let's start with the definition. We've been discussing what we think meltdowns are. But what is the definition of a meltdown that you're working with? So what is a meltdown? Yeah. As I think your discussion really nicely represents that this means a lot of different things to different people, there's probably as many definitions as there are people out there. My work is really on the behavioural end of working with families whose kids are in crisis due to their meltdowns, due to explosive behaviour and aggressive behaviour. So we are really going to work with what the family is seeing, what the context is around this in defining these episodes with families. So you mentioned that we think of meltdowns as being a set of externalising behaviours. And I think that is classically how we work with this. And I loved, Umar, what you said about it's a failure of our coping strategies to regulate our emotional system. We know this all begins in the brain and in the body. Our brains may have some hardwiring in how they assess threat, how quickly we get a cortisol or an adrenal response to something. And then we also have, psychologically, how we may be wired with our temperament to be more sensitive to certain things. Maybe it's a sensory issue. Maybe it's just interpersonal sensitivity, a large variety of different components that would play in there, as well as our ability to take perspective and problem solve things and be flexible when things aren't quite how we expected. So we pull that into the picture. And then we really, have the behavioural piece of, how do I react to my internal body sensations when I am out of strategies to self-regulate? So we tend to see, especially with the families that we work with at Seattle Children's Hospital, they're coming in because of behaviours that are causing a big environmental disturbance. Aggression. We see a lot of kids where elopement or running away from the situation is an issue. Sometimes, it's more instrumental aggression or saying things that are threatening or shocking or upsetting. I would say, though, I think that meltdowns can certainly be driven often-- actually, Jane, you touched on this-- by internalising issues. We see a lot of families where we come to understand it's anxiety driving these behaviours. And often, they look like the fight part of fight or flight. So the aggression. But sometimes, you have kids where it can be a total shutdown of systems. I have a family member that calls that vapour lock, just like almost frozen and unable to respond to anybody who's trying to help and coach and support them in that moment. So we've got a lot of different-- it's not always totally explosive. Sometimes, it shows up as a shutdown or an inability to communicate or move on or transition or things like that. And I would say we see some kids where there's some positive valence to the meltdown-- hysterical laughter, shrieking, leaping around-- not because they're necessarily enjoying that moment. But that's where it's landed in terms of a behavioural spiral they've gotten pulled into in their dysregulation. So we can look at how the literature defines it. But it's really important to how this shows up for that family and what impact those sets of behaviours are having on the family system and the child's daily life. I sense a bit that maybe you're a bit hesitant to say what it's defined as in the literature. Or maybe you're not. But I think the reason I want to know is because at the beginning of the episode, I was like, oh, I haven't really researched this. But I wonder, what is the kind of terminology-- if people are interested to look at the research on this, how big a research field is this? And what kind of terminology is used in the literature? Because maybe I have researched meltdowns. I just don't know it, because it was called externalising problems or dysregulation or something like that. Absolutely. That's part of the issue here, is that there's so many different terms that we're using. And Jane mentioned developmentally, we might call it a tantrum in a younger child. But in a teenager, it's an aggressive episode. We're going to change the terminology. So we can point to how certain researchers have chosen to define this, maybe for the purposes of their research, that we're looking at duration of intense emotion. We're looking for a set of externalising behaviours and defining it so that we can study it. But where my practise really comes in is, as a clinical psychologist, we can define these things in terms of mental health and pathology. That's often what's done in my particular field. I really find it most useful to meet the family where they are in their real-world experience of it. That's why you hear me pulling in lots of different language. But for example, on the higher end of externalising disorders and behaviours in kids, we have disruptive mood dysregulation disorder, for example, where meltdowns are part of the definition of this disorder, having three or more episodes that we define developmentally as having an intensity and a duration that is outside of a typical range for that child's chronological age and their developmental level. So we're also defining it developmentally as well as behaviorally. So you're right, Umar. I struggle with that. To give you one definition, I don't want to exclude the very real experiences people have with this that doesn't match maybe how researchers defined it. Erin, it's such an-- and I love the way you're saying that it is important to have definitions so we can all look at it and describe it and so on. But the impact on family life is point number one. And it's really interesting because I work a lot with young people who have tics and Tourette's. And the tics are not necessarily the issue that is concerning the families. It is the anger and the rage attacks in inverted commas. So that's how it's described in tics. That is not part of the criteria. But it's the one that bothers the families most. That's what impacts their day-to-day functioning. So it's really interesting but what really struck me very carefully about that. You made a comment about that developmental issue, which I think is interesting because you might miss parts of the literature if you use one search term across an age group. Is it valid? So can you comment on the differences and similarities in terms of a toddler meltdown as compared to an older child? Can we just talk about it as developmentally inappropriate? Or are there other aspects that we might think about in terms of how those meltdowns are differentiated? So how we might differentiate an 18-month-old or a three-year-old's meltdown from an adolescent meltdown, for example. And I am mostly in our hospital setting. We are working more with school-age and teenagers than we are, partly because of this issue of impact. In the DSM, when we define a mental health disorder, a key part of the criteria is that it is causing functional impairment. And that's where I think developmentally you see a big difference. Most of us who've had young kids are accustomed to dealing with what we might call meltdowns and some pretty explosive and even very aggressive behaviour that maybe doesn't necessarily impair our child's ability to function in the settings that are expected and to function within our family. So yes, we do see kids coming in at young ages with big meltdowns that are causing impairment. But certainly, a child who's doing the same things as a three-year-old at eight years old-- swiping everything off their desk in the classroom, screaming in the teacher's face, I hate you-- those are things that cause huge impairment when they're in another setting or when they're happening at an older age than in a young child. One of the hypotheses that I set out at the beginning of the episode was about children with neurodevelopmental conditions. So in your clinical practise, do you disproportionately see children with neurodevelopmental conditions or neurodiverse children coming with meltdowns than you do neurotypical children? Absolutely, yes. And it's not to necessarily pathologize. In fact, I really don't want to pathologize neurodivergent brains and ways of responding to the environment. But if you are a neurodivergent person in a world designed for a neurotypical brain and behavioural style, it makes sense that the environment is going to be less predictable to you, more overwhelming to you. And your ability to navigate that with your social skills, your perspective taking, and your internal body regulation skills is going to be more taxed. You're going to have more times when you feel you've lost control. And maybe visibly, you've lost control. So I would say the most common diagnoses we see are actually ADHD, which makes sense because of the prevalence. This is more prevalent than autism spectrum disorder or certainly mood disorders. So we know that ADHD comes with inherent difficulties of internally regulating your engine and filtering incoming stimuli. But we see that meltdowns happen often for kids on the spectrum. And we see, as I mentioned, a lot of our kids are coming in where anxiety is our primary conceptualization with or without neurodiversity. But anxiety puts us into a mental space of needing rapid action. And sometimes, the rapid action we choose when we're flooded is going to backfire or cause big problems. And you've mentioned rapid action there. Can you talk us through, if possible, like a case study scenario? So let's just put ourselves in a Big Brother type situation, where we're seeing a situation unfold in a home where you've got a parent and a child who's experiencing a meltdown. How does that pan out? The child's having a meltdown. What is a typical parent response? What kind of thing happens during that response? Are there co-regulation strategies? And then what kinds of responses from parents are maybe not as helpful that might lead to that situation escalating rather than de-escalating? So I wonder if you can just talk us through what we would see if we had a CCTV camera in someone's home whilst the child was having a meltdown, a typical one. Oh, yes. OK, great. So we've talked already a bit about the biological, the psychological components. And now, we have the social components that contribute to externalising behaviour and meltdown specifically. So what do children learn from their environment? And we adults are key, if not the key, factors in their environment that help them learn which behaviours to do more of and which ones didn't get the desired outcome or any desired outcome at all. So let me walk you through an example I use with families a lot that involves screen time because I think our literature and our research is lagging in bringing the role of screens into our clinical understanding of things. And that's 21st century parenting right there. This is the world we're raising kids in now. And almost every kid out there has some screen exposure. So we know that screens are a dopamine flood to the brain. It's all the most exciting things to our brain. It's instant gratification. It's novelty. Every time we use it, it's a different experience. It's colourful. It's fast paced. So let's say I've given my child some time on a screen. And her brain is awash in all this dopamine. She's really enjoying herself. And then I come in. And environmentally, there's an antecedent often that kicks off an episode of escalation. So I say, all right, time to turn off the game and go get ready for bed. So I take the screen away. And my child explodes, screaming, throwing things. We see commonly as kids get older, we're seeing threats or kids-- because their ability to use language under threat is still in development, they're going to use whatever words are the maddest words they can think of in that moment. And sometimes, it's I hate you. You're the worst mum in the world. Sometimes, it's scarier things for young kids. We'll hear, like, I'm going to chop your head off, or things that just scare the daylights out of parents. And even for older kids, we hear threats and stuff like that. So as that gets whipped up into a frenzy, caregivers get pulled right into the chaos often because our fight or flight system is now activated. And as a parent, all I want is make this stop immediately, make my child not have a feeling at all right now. Yes, I want them to go to bed, but even more, just chill out and stop freaking out. And when that puts me into a place of urgency and my frontal lobe is flooded and I've got cortisol and adrenaline pumping, I feel that pressure for rapid action of just do whatever it takes, whatever the first thing that comes to mind is. And so we'll see two different paths often diverge here in parent responses. We see what we call the parent externalising response, where I go into fight mode of, can I get louder than them? Can I shock them out of their funk? Can I threaten? For some parents, this can get physical. People may think, this is how I was parented. I won't stand for this. This is unacceptable. And we try to overpower the child in that situation to make them-- I would say, shock them into stopping and trying to regulate themselves. Or we have an internalising parent pathway, which is often that we blame ourselves. And we feel helpless in that moment. And we go, how have I screwed up my child like this? How are they ever going to be successful adults in life when they behave this way and they can't even turn off a screen for bedtime? And we may placate. We may do what's popular in Seattle, what we call a gentle parenting approach in social media. Let me try to do time in right now and talk them down and talk it through and ask them how they're feeling about this and see if I can de-escalate that way. And sometimes, that can come with, fine, you know what, you can finish the level of your game. Go ahead. Just wrap that up. You have five more minutes. And then we'll transition. So in both cases, I've kicked off a pattern of learning for my child that is counteradaptive to learning self-regulation. I've taught them that their meltdown is scary and overwhelming to me and that it works to get me to give up boundaries. Or they've learned that their feelings are unsafe and cannot be tolerated and are out of control by my big anger reaction. Is as a parent doing nothing in that moment a usual response? So you've described two situations, one where you try and overpower, one where you try and talk the child down. The third option that I can think of is just thinking, this situation is way too escalated. I'm just going to not do anything right now. [INAUDIBLE] for everyone to calm down, give it some time, and maybe pick that up in a few days time or the next day or something. Is that an option that you see? Yeah. I think part of the parent internalising pattern is often not feeling able to interact at all. We work with parents who go barricade themselves in their bedroom and just like, I can't deal with them right now. And often, the kids run amok during that time or come after them. And it gets more escalated. Or parents just give in. Fine take the screen to your bed with you tonight. Don't brush your teeth, whatever. Feel like they throw in the towel. But there's a middle path that I think you're touching on, Umar, of non-escalation. If we cannot de-escalate a child whose frontal lobe is in complete chaos, we can at least have control over non-escalation of the environment and of the situation in that moment. So our interventions, when we work with high-intensity, aggressive behaviour, first and foremost have to do with parents regulating themselves and orienting themselves to their parenting values and their game plan, which often involves going low stimulation in those moments. Now is not the time for a learning moment of lecturing on why bedtime has to be this time, because the school bus comes at-- x, y, z. And there's no learning that's going to happen cognitively at that moment for our children. Really, what we want to get to is parents giving the mental and physical space for everybody's frontal lobes to unflood to get to a point where it can become a learning experience, where we can co-regulate alongside our child. And maybe we can have a conversation then. I'm with you, Umar. I think usually the conversation needs to wait. But it is an option to be a calm presence and do what we call co-regulation, where I'm going to focus on me, the caregiver, getting through this moment and creating a regulated environment for my dysregulated child to learn in. So that is where I think we want to head with parents. Do less. Do less. Fewer words, I think that's-- but I also think that there might even be a fourth option about a cycling between the internal response and the external response and maybe not even a predictability about the response, which is sometimes an expression of desperation often in the families. They may just not know quite what to do. And I think that description of going further, the third way, is exactly-- it's beautifully described. We can be alongside. We can give minimal comfort. But our physical presence, particularly for young children, is quite an important way of regulating emotion. And that's not about talking about, we're going to give you more screen time. And oh, yes, of course, you can have your screen. But literally being there and showing that calm. I will say it's a bit like physics. If you can share the energy and pass some of that brain activity over to me, I can deal with that. I'm the grown up. And then we can calm down. And as you say, we can have a look we can have a discussion in that moment. But nobody's listening. It's a waste of energy. So I think that's brilliantly described. That's a very evocatively described scenario. It really rings true. Absolutely. What predicts parent responses in that situation? So you touched upon one, which was, this is how I was brought up. So this is what I'm going to replicate. What are some of the other ones that might predict how a parent responds in that situation? Yeah, that is such an important part of intervention here, is unpacking for us where our emotional urges come from in that moment and really how we see our child in that moment. The very same behaviour, we could have totally different takes on it depending on the lenses we bring to the situation. So we can't ignore our own biology. We are going to be hardwired. Our fight or flight response is going to tend more toward one or the other. Our limbic system may be more or less reactive. We've got our own temperamental factors at play in terms of how quickly we escalate our own ability to think flexibly, our own ability to self-regulate. But we certainly have our own learning histories not only from how we were raised-- that's probably the most powerful-- but the communities that were part of, the social systems, whether it's your neighbourhood, whether it's a cultural or religious community you're part of, your extended family and how they talk about expectations for kids and behaviour. Social media-- what social media are you following? Gosh. And I see this. It breaks my heart so much that parents of kids with maybe a behavioural diagnosis are following influencers, gentle influencers with gentle children, and feeling like they should be doing that parenting with a child that it was not intended for. And of course, it's not evidence-based either. So I think our media is increasingly impactful on our parenting lenses. But then we have what we bring to the table that day. I mean, my goodness, we're navigating our own adult lives and work stress and partner stress and fatigue and our own nutrition and physical health too. So many factors that are, in one instant, converging on a fast response to try to get us out of this crisis moment that-- very often, most of us, very first emotional impulse is generally not going to be so helpful. Even as a psychologist, my first parenting impulse is often one that comes from my history. And I know once I can get my head on straight that that's not going to help us in this situation. A lot of the conversation that we've had is around meltdown potentially being a negative thing. But is the absence of a meltdown for a child-- so if you have a child who's never had a meltdown and really seems to be coping quite well, is that problematic? I think there are some unicorn kids out there whose nervous system maybe has a little bit more stability and regularity to it. I know a few. They're not my kids. But I know a few out there who really have a very mellow and regulated response to threat. And actually, the research does not show that those kids become more explosive later. We tend to see that these are traits that are genetically biologically brain-based, related to self-regulation. We see early self-regulation and explosive behaviour problems predicting those later. They do get better for most people. But there's stability in that presentation. So I wouldn't go so far as to say that's unhealthy. But where I do want to take that question is to the area of what kids learn from meltdowns and what parents learned too because our instinct is, make it stop. This is terrible. What's wrong? My kid has something seriously wrong with them. But we can actually take those moments as a connection opportunity and a learning opportunity for them. And that's where I want to emphasise-- that's where I want to go in. In the webinar, is to talk about how we can view that as an opportunity. And it's where our kids learn to self-regulate-- they co-regulate alongside us, as Jane mentioned. We know that. Baby mammals in nature need an adult to help them in moments of threat and overwhelm. And humans are, of course, the same. But it's also an opportunity for us to use emotion coaching and some clinical strategies with our kids to help them connect language to their internal overwhelming experience and, with time, be able to clue us in earlier and maybe use language in place of some of the more shocking or explosive behaviours. So I hope that we can all move toward a place of connection around the meltdown rather than panic and fear of the meltdown, though we can't control the fact that that is our instant reaction. We can bring in new ways of seeing and new ways of responding as parents. So when we have a meltdown, we are expressing in an action how we feel. So our ultimate goal-- you're talking about being able to have perhaps feeling a sense of frustration to the nth degree. But instead of lying on the floor and beating our fists, we say, I'm extremely frustrated. So we move that idea that we use it as a learning opportunity to say, oh, look, that was a meltdown. I can see why that happened after the moment has passed, and allow the young toddler or child to get to an emotional competence. And that can only happen, as you say, with a connection. So would you say that timeout would do more harm than good? I know it's provocative. But you know what I mean. Given that it is a learning opportunity and there is an instinct to erase it, but actually we need to connect with it, how would you consider a timeout? Well, it may be controversial. But I disagree with the statement that timeout does more harm than good. There's been a lot of debate in the popular media about this topic. But American Psychological Association, for one, has consistently come back to the research on timeout and consistently confirmed with all available data that the most effective thing to do in the moment, in the middle of the crisis, is, again, to do less-- so to not double down on convincing them, threatening them, punishing them, but giving our frontal lobe enough space to come on board and help us choose some better strategies. And that's the goal of timeout. It's not that I want to isolate my child or make them feel sorry or then make them conform to wrongdoings in order to get out of timeout. That's not what it is. To me and to the practitioners I work with, it's a timeout to cool down. And I'm going to put out there. We parents need it as much as our kids do in that moment. We're going to be ineffective. If we are dysregulated, we cannot regulate them. So removing kids from the immediate trigger is part of time out. If we're at a birthday party and things are going off the rails, we need to step out of that setting in order to be able to use our skills. And we need to not interact in an active way during those moments. We can be there. In fact, we discourage parents from putting kids in their bedroom for timeouts. I think timeout and the way I've done it with my kids is right there-- they can be sitting right here at the edge, at the periphery of the situation for a couple of minutes. But I can't let you continue to be hitting your sister. So I do need to remove you from the fray. And we want kids to learn this actually as a coping strategy as they get older to step back rather than double down on a conflict. And this becomes a cooldown that helps us bring online our skills. So what you're talking about is removing the social noise and reinforcement around that as well. And so the idea of the old fashioned timeout might be a social exclusion and, probably, in my clinical experience, can have a lot of negative attention around it in order to enforce it. Actually, we're just dialling down the attention and maintaining our connection. But we're dialling down all of the social noise. So that's really helpful to describe it in that way. I think we should wrap up there. But before we let you go, Erin, as I mentioned at the beginning of this episode, you'll be hosting a webinar on Mastering meltdowns, managing big feelings in kids. So who should sign up for that? And what else is to come in that webinar? Yes. Although my background is research and academia, my passion is trying to make academic concepts just into usable language and strategies that everybody can use. You don't even need a full course of therapy to immediately try some different things with your child. So I'm hoping that people will come to this webinar for the very accessible and, I hope, relatable ways of looking at some of these strategies. So certainly, I'm planning to use the language that I hope parents can really work with and use. But clinicians, I think, sometimes, we need to focus too on stepping away from the academic perspective sometimes and just being very real and actionable with our strategies. I hope that clinicians may also be interested in learning some of the ways I talk about these skills with families and from some real examples that we'll talk about too. Thank you. Well, we'll add a link to the description. So people who are interested in signing up to the webinar can just click on the link in the description of this episode. And that'll take them to the page that they need to be at to sign up. But all that's left now is to say thank you so much, Erin. That's been a really nice conversation. I really enjoyed some of the practical things that we talked about and was just insightful. So thank you. That was fantastic. Thank you, Erin. My pleasure. Great to be here. And I am a parent. And I do have some very high-strung kids myself and get to humble myself daily by trying to put things I study and learn about into action at home. And that's part of this, I think, is trying to bring that perspective, that walking the talk is hard and is a never-ending learning curve for me as well. Thank you. Let's think, Umar, what reflections did you have following that discussion? It was really good. And as you said, I think, with Erin, there was a lot of practical and very tangible content to that discussion, which was really useful. I agree. I think that we usually have a really nice conversation on these episodes, which is very data heavy research, heavy research terminology, research jargon. And we try to make it as accessible as possible. But this was very different because Erin made a conscious effort to think about not just what meltdowns are in the academic literature but trying to make those very accessible and relatable to people who aren't researchers, people who are parents who don't have a background in this. And I think that really came across when I was really trying to get Erin to say, well, what are the words that are used in papers, in the academic literature, in the scientific literature? And it was just really nice and refreshing that Erin was like, well, actually, this is what it looks like in practise in homes. And these behaviours might not correspond neatly to the concepts that we think about in academic literature, because I think it's broadly externalising behaviours but not necessarily. It's a specific type of externalising behaviour, which is why there was confusion for me at the beginning, where I was like, oh, I might have I done this. Have I not looked at this? Have I just looked at this and not called it a meltdown? But I really liked that about this episode, where Erin was very focused on everyday use of the word meltdown and what it looks like in people's lived experiences. Yeah. And I think the idea that families really do-- of all the kind of options in terms of presentation that might cause concern, meltdowns are very much up there. And so I think the idea of taking the family's definitions and descriptions from first principles is absolutely-- and it also means it makes more sense to the families, that the language that they use and the behaviours and the descriptors are exactly as you would expect. And also-- I know this is a bit odd because we're slightly changing position. You're thinking clinically. And I'm thinking theoretically. Because also, I do think there is something about us as an academic community being able to describe these behaviours so that we can draw these parallels because I do think, I guess, there's a frustration in terms of the literature not being particularly subtle in its exploration. It's a little bit of a blunt instrument. Because actually, what we do know-- and I think Erin used some really wonderful phrases about that emotional reactivity. So your brain is flooded. And you've got that biological propensity to feel overwhelmed by your environment. And that is a sort of temperamental aspect. And maybe it's the way you're delivered and less amenable to change. But also, we know that those emotionally reactive kids are less likely to be emotionally competent. So they're less able to use the word to describe their feeling. And when that emotional competence and reactivity come together, those are the kids that are most likely to have meltdowns and persistent and frequent meltdowns. If they're longer in length, they're more unpredictable in their triggers. Those are the kids we know are going to have difficulties in the future. There is something that we can do. And Erin's webinar is going to be-- it's going to be an excellent evidence-based way of showing these are the things you can do to change the quality of life in a family. But I think there is also that theoretical idea that we can teach emotional competence. And if you have better emotional competence, even if you are an emotionally reactive kid, you're much less likely to have meltdowns. So we can make that shift. There is a lever to push. But it's sometimes misunderstood, I think, that learning emotional competence is somewhat not very valid. Actually, it's got enormous power. So I do think there's a theoretical thing in there as well as that the really wonderful and tangible clinical content that she was describing. What is your takeaway for clinical practise? OK. So my takeaway is quite a clear one. And it's really what Erin was coming to in terms of the capacity to connect. So emotional competence is a teachable skill-- so the capacity to identify and manage emotions. And we know for children with that high reactivity, who feel overwhelmed by their environment, that emotional competence is particularly important. So my argument is always that emotional literacy should be considered as fundamental to learning as word literacy. So we want to produce young people who can read a book and read the room. For me, it's the terminology issue. So the terminology that we use as academic researchers does not neatly correspond to the terminology that people use in their homes and families. And clinicians are even like, I don't know. And that's particularly important because when I'm trying to communicate research beyond other researchers, I often struggle with finding the right words that people who aren't researchers would use. And I think there was an example of that during this episode, where I was trying to find another word for externalising behaviours. And externalising behaviours is what we say in the research literature and what we talk about in work. But a parent wouldn't use externalising behaviours, I don't think. I've definitely not heard my parents use externalising behaviours or people around me. Oh, Umar, [INAUDIBLE]. So I think it's thinking about the correspondence of the terminology that we use in academia and in research papers and being mindful that that's not what parents use. Necessarily, they might do. But that's not necessarily what they use in trying to think about other ways to communicate those concepts. And the other way around as well. When we do research which involves co-production with parents or listening to parents' experiences, they might use words that don't neatly correspond to the concepts that we think of in academia, like externalising behaviours. Like, someone might mention a behaviour. And that might not be your definition of internalising problems or externalising problems or emotional reactivity or whatever. But maybe that's what they're trying to get at. Yeah. I think the terminology is really interesting. And in fact, when I'm working with kids, even the very little ones, I always encourage the families to use the word that the child uses because that's the beginning of emotional competency. So if they say-- they call it something. And sometimes, we would personalise it. So make the rage. Call it a name because being able to recognise that emotional state and giving it whatever word they use is step number one. But the sheer terminology is always so important. And we don't want to disconnect those literatures or disconnect from the family. So it's a really good point. Let's wrap up there. Join us again next week when we'll be speaking to Professor Francisco Musich on autism and co-occurring conditions. [MUSIC PLAYING]