What Is Emotional Dysregulation in Children?

We’ve all been there. Making a mountain out of a molehill—or in our case, scream-crying over a basket of unfolded laundry. But when our children act like this, frequently and unexpectedly, something else may be at play: emotional dysregulation. We asked occupational therapist Judy Katz, OTR/L, who specializes in treating children with sensory processing and behavioral regulation issues, what exactly emotional dysregulation is, how to spot it and how to deal with it. Here’s what she told us.

Emotional dysregulation, according to Katz, refers to a person’s consistent inability to regulate their responses to certain stimuli. Think: extreme reactions to small triggers. Katz explains, “While you probably experience lots of emotional responses internally—perhaps you found out an ex is dating a new person, or a coworker copied your outfit—you (hopefully) don’t wail and pound your fists on your desk.”

So yeah, if you’re like me, you’ve been temporarily emotionally dysregulated before. Hey, you’re only human. But, according to Katz, “frequent, lengthy and intense meltdowns are probably a sign of something else going on.” 

According to Katz, “Emotional regulation is a core part of the development of the personality and contributes to a sense of safety and comfort in the world, which leads to a sense of confidence and competence in life.” So, uh, yeah, that seems important. Untreated sensory processing issues—i.e., being too sensitive to noise, under or over sensitive to touch—can lead to unceasing dysregulation, which can make a child uncomfortable in their own body. “This in turn can lead to things like impulsivity, anxiety, rigid thinking patterns, difficulties understanding what is said to them and difficulties understanding unwritten social rules of engagement.” Hence: wailing and pounding those fists over spilled milk…a lot and with intensity. 

Katz says, “The difference between a normal hiccup or a lasting problem can often come down to the number of events per day/month, duration, consistency (i.e., long vs. short), intensity (i.e., physical aggression) and ability to recover. My rule of thumb is to always evaluate if the child’s tantrums are disruptive to the family’s well-being, and if so, then some intervention is needed.” More specifically, be on the lookout for “episodes” that occur more than five time a week at school, more than 20 to 30 times at home in a month, aggression and self-harm.  

An occupational therapist herself, Katz says that pediatric O.T.s can help parents and teachers to understand the difference between typical behaviors—being upset after losing four square; crying because someone hit him; not liking to share a stuffed animal—and extreme behaviors: a child who locks themselves in the bathroom rather than head to gym class; hangs onto the teacher’s leg at recess; tantrums every day after school. And they can also start devising a comprehensive plan, perhaps with a social worker and/or psychologist, to calm whatever’s causing the dysregulation.