Tips to Manage DMDD in the Classroom and Beyond

Managing disruptive mood dysregulation disorder (DMDD) in the classroom isn't as simple as knowing how to prevent DMDD behaviors. Yet parents of children with DMDD are often expected to have immediate solutions for teachers and caregivers in our children's lives. Symptoms of DMDD are tough for even parents to handle, and immediate solutions don't exist, but there are doable small steps that can help manage DMDD in the classroom.

Managing Caregiver Expectations for DMDD in the Classroom

My son recently got suspended (again) from his after-school program. I can’t quite describe the helplessness of having a provider hand me an incident report and ask, "How can we prevent this from happening again?"

The hardest part of DMDD is that we simply can't know what will trigger an outburst, and I think that's hard for other caregivers to understand. It's hard for me to understand sometimes. My son was probably bored when he had the most recent after-school incident. I can't prevent boredom. The only things that seem to have alleviated his symptoms so far are:

1. Managing his negativity
2. Finding positive behaviors to reinforce

DMDD in the Classroom and Negative Self-Statements

Managing negative self-statements was a goal on my son’s early individualized education plans (IEPs). He was constantly declaring himself "stupid" or “bad,” resulting in disruptive or dangerous behaviors.

Teachers needed to be aware of the negative thoughts so they could help my son replace them. They'd redirect him and help him develop more positive statements. He'd get stickers on a chart as a reward for every hour without negative self-statements.

The repetitive reinforcement helped him make a habit of pausing the negative thoughts. At home, for instance, he used to go into huge outbursts during which he’d scream, “This is the worst day ever!”

We could’ve spent the whole day at Disney Land, and if we then asked him to brush his teeth before bed, it was suddenly the “worst day ever" followed by a major outburst.

Thanks to the focus of his teachers at school dealing with DMDD in the classroom, and our persistence at home, the “worst day ever” shrank over time. It became the “worst night ever” then the “worst bedtime ever.” Now, when asked to do something he doesn't like, he doesn't always equate it with ruining his entire day, meaning fewer outbursts and better management of DMDD in the classroom.

It may seem small, but in a house with DMDD, it's amazing.

DMDD in the Classroom and Rewarding Positive Behaviors

Typical children may respond to punishment, but children with DMDD tend to have oppositional streaks. Punishment makes them dig in their heels. Rewards, however, they remember.

For instance, my son has a swearing problem. This isn’t unusual for kids with DMDD or oppositional defiant disorder (ODD) because they know that swearing pushes our parenting buttons. There are still repercussions for poor behavior in our house, but we do add statements like, "but thank you for not swearing when you were angry."

We may make the punishment smaller if he avoided certain behaviors. His after-school providers have done this, too and slowly, we've seen a change. In the midst of an outburst, there are moments when impulse-control kicks in enough to remind him to limit the swearing or remove it entirely. Any sign of impulse-control is worth celebrating when it comes to DMDD in the classroom and beyond.

The Classroom with DMDD and Celebrating Small Steps

We may often feel embarrassed, angry, or confused when our children with DMDD don't act like "typical" children. It makes sense that other caregivers may also be confused when trying to manage DMDD in the classroom. It's hard to explain to someone who isn't used to seeing intense outbursts why we might praise a child for certain behaviors that did or didn't happen during that outburst.

That's the biggest lesson we can give others, though. Be impressed by the small things. Don't demand the world from our children if they haven't even been outside the neighborhood yet. Think more short-term, and maybe we'll see more success than we realized.