It is difficult to stabilize the state of children at the emotional, social, and behavioral levels without stabilizing the emotional, behavioral, and social state of their parents. Children pick up on the emotional state of their parents. The sooner parents can stabilize their own condition, the more chances children have to adapt to the new reality and change. Therefore, it is important to model/demonstrate adaptive behaviors that children can copy and apply in their everyday life. 

Therefore we want to emphasize again how important it is to provide self-care first. Look at the recommendations for adults and caregivers for some ideas that might help you. Try to be that calm person the child can lean upon. Parents often experience the same fears as their children. But if parents can remain calm when a child panics, it will help calm them down. If the parents panics, it will make the child feel even more scared. It is important to reduce ongoing exposure to stressors to prevent development of secondary traumas.

There are many actions parents can take to help children deal with fears they might experience.You are probably already doing everything you can. We hope that these recommendations will give you more ideas on how to stabilize your child or children. Keep in mind that everyone’s situation is different and you might need to adapt the recommendations to better suit your individual circumstances. Though none of these recommendations will completely eliminate fear, they can help a child navigate through a scary world.

Given the unpredictable nature of the military events, is it expected to see an explosion of sensory behaviors. Forbidding and suppressing these natural reactions to what is happening around might worsen the emotional burden. Think about how you can still let the child engage in self-stimulating activities but in a more socially acceptable way. Can you find alternative behaviors? The child may be overly active, run, scream, destroy, break everything, the child may show aggression. How can you still let your child express all these emotions, but in a more acceptable way? What are the alternatives that best fit your child?

In case of persistent auto-stimulations (hitting objects, intense movements such as swinging or extreme vocalizations, etc.) you might find it helpful to redirect children towards other sensory activities instead of trying to stop the current self-stimulating behaviors. For example, vocalizations can disappear with singing or listening to music; hitting objects is reduced when hands are busy with other sensory toys; or is there a way to find something appropriate to hit? 

In order to reduce anxiety and socially unacceptable behavior, you can incorporate sensory toys and games in your routine. Can you include anything from below into your child’s activities?

• kinetic sand, ready playdough or salty dough/corn dough (can be made at home and does not contain gluten) 

• any games with water (playing with objects in a pan, pouring water)

• games with grains (looking for hidden treasures in buckwheat, lentils, rice or measuring grains and pouring them from one container into another)

• any games with respiration (breath to make object move and fall from a surface)

• wrinkle and tear off paper (for example, old newspapers), throwing them into a bin

• making a tent with blankets to let a child hide himself in case of sensory overwhelming 

• putting a child in a blanket/shit/towels...and make deep massage to all body parts, especially feet and legs

• listening to classical music

• taking soothing baths or showers

There might be things or activities that you might want to reduce exposure to. For example: 

• exposure to excessive noise (is there a way to use earplugs?) 

• some songs (are there songs that increase anxiety in your child?)

• excessive time spent on gadgets 

Sensory toys and activities should give the child opportunities to explore and better understand their body and express emotions. Engaging in sensory activities and playing with sensory toys is often a normal human need in stressful situations which helps to reduce feelings of stress.

Read more about healthy diet and progressive muscle relaxation in the recommendations for adults here. 

Teach children to take frequent breaks. Taking frequent breaks can help you to return to harmony. Integrate 10-second breaks into any activity you are engaging in at the moment. You do not need to push yourself to succeed or achieve your goal at the expense of your body. You can practice 10-second breaks during any activity, be it teaching in a classroom, working on documents, working with a child on something together. Even if you have to focus on a very difficult task it is still important to take these very short breaks. It might help to take them together with other people since they might need a short break too. Pauses serve a structural function that adds predictability in life and therefore some stability. Otherwise you might deplete your resources and your body will force you to take a pause but in a maladaptive form (sometimes in a form of excessive distress, irritation, apathy, disease, burnout, etc.).

Taking pauses should  also be reflected in your speech. Make pauses when you talk to other people or yourself. Sometimes our thoughts race at a speed we cannot follow or comprehend which might be stressful. Taking pauses will help you slow your thoughts down and therefore tone down and level down stress and anxieties we sometimes experience. Speaking more slowly with pauses will also make your speech easier to comprehend for your listener(s) because pauses structure your syntax and it helps to emphasize main ideas of the speech. Therefore teach children to make pauses in their speech. They do not need to rush when they are talking.

You probably have heard a lot about deep breathing. Deep breathing helps the body to slow down and rest from fast pacing activities. Teach a child to do a deep breath exercise. You can do it together. Here is an example on how to breathe:       

1. Find a comfortable position and do body check 

2. Let your breath flow through your nose and out through your mouth

3. Try to breath gently and regularly

4. Sometimes it helps to count as you breathe in and breathe out (count from 1 to 5 when you breathe in and breathe out). 

You might wonder if breathing is helpful at all. Does it affect the brain? Research has shown that deep breathing helps to stabilize brain functioning. It stimulates the vagus nerve that runs from the brain to the abdomen. It is the exact nerve that is responsible for the fight or flight reflex. Deep breathing helps to balance the parasympathetic and the sympathetic nervous system and therefore calm down.  

Another way to take a break (pause) is to listen to music that you like and the one that does not antagonize you. Signing, humming, chanting, and gargling might also activate the vagus nerve and balance the heart rate and regulate oneself. Thus, integrating music into a child's life can help them to self-regulate.

You can teach children (and yourself) the following self-helping activities after intense leaning: 

• Deep rest for the body 

• Breathing practice during pauses 

• Meditation/mindfulness upon availability

• Progressive muscle relaxation

Using these pictures can be very comforting for children with special needs. These pictograms can be organized into a visual schedule or be used for one activity only. In this case we can also use any visual scheme “First + picture, then + picture” of the desired reward or next activity to motivate the child to do something. Such images are often used for “do and don’t” rules posters in order to enhance socially desired behavior and are used as constant visual prompts in various settings. You can use them with reinforcement for every step or for following all the rules or. With time, when implemented correctly, following these rules might become reinforcing.

For example, you can create a visual schedule. It can be drawn by hand and verbalized to your child out loud. If it is not possible to create a visual schedule, say it out loud and give prompts (physical, gestural, modeling) to help your child to execute the planned activities.

The schedule and prompts should be easy to understand and easy to follow. It is important not only to show the child a visual schedule but also to verbalize it to him/her. 

Let's look at the example of quenching thirst, where a child needs to pour herself/himself water from a bottle.

1. Take a mug (or another object that can act as a mug)

2. Place it on a safe surface (table)

3. Take a bottle

4. Carry the bottle to the mug

5. Flip the bottle towards the mug

6. Pour water without spilling over the rim of the mug

7. Place the bottle on a safe surface

8. Close the bottle

9. Drink water

1. a child puts on pajamas;

2. takes dirty clothes to the dirty laundry bin;

3. brushes their teeth;

4. washes their face;

5. goes to bed;

6. hugs mom

7. listens to a story read aloud by mom.

Rituals have an important function in a child's life - they form certain habits, daily routines, or the order in which certain actions are performed. There is one more important function that rituals can serve - trauma prevention. Rituals give a child with ASD peace of mind because he/she  knows in advance what is going to happen next and what he/she should do. 

It is the predictability piece that helps people to feel that they can handle life. You should not make everything predictable and robotic but some predictability helps. At the end of the day it is too time consuming and that is why it is exhausting for the brain to constantly evaluate the surroundings and create new plans of action all the time. We need to give our brain some time to take a break, where the brain does not need to constantly recalculate the course of action but can work in an autopilot mode on something enjoyable or relaxing.

In a situation when you are not at home due to martial law, but in a bomb shelter or in a temporary residence, try to support the typical schedule of the child's day and their rituals as much as possible

Including your child in a daily routine (set a table, clean a table, throw out trash, load a washing machine, water flowers, etc.) might also help you and them to shift attention from the war atrocities to something more manageable and still very important. The repetitive nature of rituals creates a sense of predictability and therefore might serve as a coping strategy with stress. Not every child is able to perform these tasks on their own. In this case the job of an adult is to provide the help (prompts) to the child to learn to perform different tasks. 

Teaching your child a chore is also a way to create one more opportunity to spend time together in a healthy way. So, stay positive and supportive for your child. Focus on practicing 1-2 chores at a time in a structured environment and do not force your child. Try to create conditions where the steps in each behavior chain (activity or chore) are easily achievable and enjoyable. Provide a lot of praise and other types of positive reinforcement. Help them to feel successful and valued. Please do not include activities that your child might find aversive or do not turn chores and rituals into something aversive and therefore traumatizing for both you and your child. 

For example: draw at the table, sort household items or learn new words. Be sure to include walks outside into your child’s daily activities; a trip to playgrounds (if possible) where the child can be among peers. Incorporate a few rituals into your daily routine. An example can be feeding birds outside. Before the walk, pour grains into a jar or bag together with your child, look for places where birds can be and feed them. Drink hot chocolate or juice on a bench before returning home, etc. Feel free to come up with those rituals that suit your family most. Just remember that the purpose of the rituals is to bring comfort and joy. So, try to include those activities into your rituals that promote a sense of hope, safety, comfort, and happiness.

Changing a child's activities from one to another in a stressful situation can serve as a behavioral coping strategy. Refocusing the brain from one activity to another, in this case from the traumatic situation by some pleasant activity, can help distract the child from the traumatic situation. If possible, create a space where your child can stay alone by themself if they do not want to be bothered or with you nearby. The space can be a relaxation zone with the child’s favorite toys and sensory toys for emotional discharge.

When I accepted the developmental age of my child, I lifted so many demands. My behavior mathed his developmental age. That helped to feel happy together. I allowed him to be who he is and it in turn helped him to develop and grow despite the fact the ongoing war. He finally started cooing and watching very simple cartoons for very young children. I started allowing myself to behave and respond to him as if he is very little even though he does not look like this at all. He started getting what he needed to get. 

Absence of punishment for unachievable developmentally inappropriate goals, focus on play, and acknowledgement of his developmental age helped him and me to regulate his behavior and emotions better. For example, he started to put away his toys when he is done playing or giving a basket to me with toys. He started showing attachment to people. For example, he ran to greet and hug my friend he had not seen for a month and a half when she visited us. He was not used to doing that before. He started showing more positive emotions and his relationships with people improved in general. He is more interested in people now. 

It was not easy to accept my son’s developmental age at all. It was not easy to lift demands from him. I had to change my whole perception of him, our communication, relationship. I needed to go back and look at the pictures when he was much younger, when his sister was much tougher to remind myself of how they used to behave and I how I used to see them. I started watching videos of children play, children who match his developmental age. I watched what they are interested in, what toys they like, how they played with them, how they and adults in the videos talked to each other, what voice intonations they used. All these helped to change my attitude towards our communication, find appropriate toys for him, my tone of voice, and meet him where he is. 

When possible, try to follow these tips when working on your relationship with your child (children):

1. Determine your child’s developmental age and find what is appropriate for this age.

2. Don't ask your child for more than they can handle (perform).

3. Simplify instructions to the child’s developmental age.

4. Provide more prompts to help them feel more successful. This does not mean providing excessive prompts which might make the child prompt dependent.

5. Praise your child often for completing instructions, both independently and with help

6. Do not take things that your child can perform for granted. Find space to celebrate small achievements.

7. Avoid sending double messages. Do not speak in veiled phrases. Phrases should be clear, short and mean exactly what you are saying. If you ask to “give me a cup”, you should understand that the child will give you any cup, and not, for example, a blue one, which you might have wanted, but you did not communicate that to the child. 

8. Address the child only when you are sure that they are not busy with something else. Attract their attention and only then give instructions.

9. Feeling happy or enjoying simple things might help as well. Sometimes I wake up in the morning and run outside, drink warm tea, hear birds singing, and look at the sun. I am glad that I am alive, my children are alive. During the war, I learned to appreciate what I have at the moment. This attitude might help to notice small good things in your child (children’s) behavior. Try to verbally acknowledge it to your child (children) or show it any other way they can understand. 

Social stories might be a good accessible way to prepare your child about any changes in their daily routine. For example, if you know in a day that you will be moving from one place of residence to another, draw by hand (on a napkin, paper) in the form of a comic strip, with a short text, a plot in which you describe all the actions in stages. 

Here is a sample text for a social story:

1. Mom and Sasha pack things into a suitcase.

2. Mom and Sasha carry their belongings to a car/bus.

3. Mom and Sasha get into a vehicle and go to a new house.

4. On the road, Sasha watches cartoons/plays games/looks out the window.

5. Mom and Sasha arrive at the new house.

6. Mom is very happy that Sasha arrived calmly and stayed in a good mood.

7. Mom hugs and praises Sasha.

Social Stories are one of the ways to reduce the child's anxiety associated with change. Social stories have the most effect when they are supported by video examples, verbal explanations, frequent repetition, and matching what is drawn in the picture with what is happening around. Doing so is more efficient than just following a static image. 

How can you still let a child express all these emotions but in a more acceptable way? In applied behavior analysis, we call it “Response Interruption and Redirection”.  For example, vocalizations can disappear with singing or listening to music; hitting objects is reduced when hands are busy with other sensory toys. You can also use kinetic sand, any games with water and seeds, respiration practices. When he wants to break something, tear off paper and throw them into a bin and so on. Once again, try to implement play elements and stabilize the body by making deep massages and providing sensory activities. 

One of the best solutions to help a child feel accepted and thus reduce this challenging behavior is commenting on what he/she is doing by describing his actions and giving a positive feedback of his activities. This promotes the feeling of being accepted and understood and helps to establish a better rapport with the therapist and other team members. These are some examples of such commenting that reinforces positive behavior.

By showing reflective listening, or commenting on a child's behavior, emotions, and their experiences without judgment and evaluations you provide them with psychological support they need in stressful situations. Being attentive and recognizing verbally how the child feels and behaves might help you alleviate your child’s emotional stress and resolve emerging conflicts, reach mutual understanding and feel mutual acceptance, build a healthier relationship between parents and children. By doing so you communicate the child a message that you are listening and hearing them and trying to understand and show support. Here are some examples:

• It sounds like you were really scared

• I wonder if you felt sad

• I can see that something is going on

• How can I help?

Reflective listening helps you understand the true message that the child (or any other interlocutor) wants to convey to you. In the process of communication, refrain from:

• interruptions;

• hasty conclusions;

• hasty questions and moralizing.

For example, you can start your sentence by saying “It sounds like you are saying ….”

Rules for reflective listening:

1. Take the correct posture. Sit next to or across from the child (squat down with the child / hold them in your lap), so that your eyes are at the same level;

2. Do not be scared of pauses. After each child's answer, do not rush to comment and express your thoughts on the issue of the discussion. Take a short pause before saying something. This time is necessary so that the child can comprehend their experiences and feel that you are with them even more;

3. Paraphrase and repeat what the child said in the same emotional state the child did. This will allow you to clarify whether you understood the child correctly, and the child will understand that you heard them. 

For example, a child comes to you and says "I don't want to be friends with my brother." Repeat what you heard expressing the same emotion your child showed to you: “you don’t want to play with your brother”.

4. Let the child know that you know about their experience/state by verbalizing the feeling that the child is most likely experiencing at the moment. Do not ask questions, your comments must be statements. It is hard to show empathy with questions.

For example, a child comes to you and says "I don't want to be friends with my brother." You can ask them questions like “What happened?”, “Are you offended by him?”. However, at this point you will not give the child an opportunity to reflect on their emotions, feelings, experiences. Instead the child will be in the position of the respondent rather than equal contributor and leader of the conversation.

Try to say: “You don’t want to play with him. You must be feeling hurt”

Another example can be where a child cries and says they want to go home. Try to say “you are very upset, you want to go home” first instead of asking “why do you want to go home?”

Commenting on the child’s behavior also helps the child understand that you are nearby, you are interested in what they are doing, this is important for you, and at the same time you don’t want to impose your own rules, opinions on the child, you don’t want to moralize, you are a close adult who can be trusted, who hears, understands and accepts the child. Also, an adult's commentary speech allows the child to better focus on what they are doing and associate the actions with the right vocabulary. This is also a way to model to the child how to describe things which eventually will help them to speak about themselves, things, events, and other people around them on a more advanced level.

For example, a child wants to find something in a suitcase.

The child opens the suitcase. You say: “you opened the suitcase”;

The child took clothes out of the suitcase and put them next to him. You can say: “you took the clothes out and put them aside. You don’t need them”;

The child found their toy in the suitcase, You can say: “you found the bear!”.

Not all children are the same developmental level. Some of them have reduced receptive and expressive language. In this case you can still work on reflective listening but try to use the length of the phrases your child understands. For example, one of my clients reported having a very tense relationship with her son. Every time she asked him to do something, he would show a tantrum to the point that she started feeling abusive. She was very sad that their relationship looks broken. According to her, he did not want to do anything she asked him to do. Instead, it looked like that she was a source of his tears, anger, and frustration. Reducing the number of instructions towards him and introducing commenting on his behavior and emotions helped them to mend their relationship. Whenever it was his leisure time she joined him by saying something like “it is a book”, “ you flipped the page”, “happy, you are looking happy”, “you are smiling”, “you are sad”, “elephant” (pointing to the elephant in a book), “you are sitting”, “you are watching TV”, “you are looking at me”. Only after a week of commenting on his behavior and emotions did she share very pleasant news with me. Her son started looking at her more often, he started establishing eye contact with her more often, he stopped walking away from her every time she joined him during his leisure activities, he started inviting her into his leisure. After two more weeks he started speaking one-two word phrases more often. He was more happy to see her. It became easier for them to negotiate their schedule. His tantrums have reduced. She started feeling happier.

Children's challenging behavior is a sign of them struggling with understanding and regulating emotions. Therefore, they might need adults’ help. When adults connect to children’s emotions by providing empathic understanding, it has a calming effect, also called as co-regulation. This co-regulation allows children to learn skills in emotional competence. Very often behavior problems reduce or stop when humans feel emotional acceptance and that they are understood.

At home, play videos for your child with children or cartoon characters doing various exercises/dances/yoga. Video modeling will help the child to both continue developing cognitively and physically. It is not necessary to be near the child 24/7, give her/him time to be alone as well, to play on their own. At the same time it is important to teach your child how to spend time alone. Visual schedules and visual behavior chains might help them to do so. Parallel play, following your own visual schedule in parallel might be another option to help your child learn how to gradually spend time on their own. At the same time do not be too far from your child so they can find you easily when needed.

During play children not only try to understand and gain control over challenging situations but they also practice different ways to cope with such events and then regulate their emotions and behavior. This is also a space where they can improve their communication skills and continue building trusting relationships. Building (and constantly improving) positive and trusting communication and emotional context through play makes it possible for the child to achieve healing psychotherapeutic effects. Therapeutic play is a type of play where the mandatory rules are limited to safety. It is a play with freedom of action for a child and manifestation of various emotions without judgment. There are games with rules as well but the rules should be understandable for the child and the way they are introduced should be gentle. With the help of play as a therapeutic method, the child understands their importance, uniqueness and feels accepted as a person.

Case example. Girl A plays a story game. In her play she arranges toys on the floor and at the same time tells what is happening in the game. A therapist sits nearby, watches the course of the game and comments on the actions and statements of the girl. The girl builds an island (which has the same name as the area where her family summer house is) and a railway with a train. She puts a doll called Masha on the train and decides to go to this island. While still on the train, Masha realizes that she is beginning to freeze, and the girl begins to get nervous. The therapist offers different ways to help Masha warm up - find warm clothes or a blanket, turn on the heating, or drink warm tea. But the girl says that all this will not help Masha. So, the Masha doll reaches the island and hopes that it will be warm there, but no, the doll gets completely frozen. The girl gets upset, starts crying, she does not like any solutions that she offers by herself and the ones that the therapist offers. They cannot not solve the problem. The girl cannot calm down for a long time, because she does not know what can help Masha to warm up, because she is already very cold. After some time, the therapist asks the girl: “What can warm you up when you are cold?”. The girl thinks for a while and says “hugs”. Then the therapist and the girl hug the doll together. That is the right solution. The hug helps the doll to warm up very quickly.

Once in a safe environment, it is important for parents to foster a child's play routine. Parents can use all kinds of materials/resources that are available to them, starting from toys that they have taken with them (during evacuation) to improvised materials. If you have art supplies, draw with your child, sculpt (you can make dough by yourself), play drama, or be a supportive observer of your child’s play. It is also important to remember that any child’ play should be voluntary and not imposed. The play should be enjoyable both for the child and you or other participants.    

Development of play and interest in toys might help you during relocation or to spend time in a shelter. For example, one of my clients was working on developing play skills and interest in toys in her son before the military events in Ukraine started. In the beginning of the therapy his interests in toys were extremely limited. By the time military events started he had a variety of toys he wanted to play with. That helps them a lot when they need to go to a shelter. She gives him a list of things in a picture format that he can put in his backpack. He packs his backpack by himself now and takes his toys, books, drinks, and a blanket. Observing what he plays with in a shelter most helped her to create a visual list of things which are very desirable for him. These toys helped him to learn how to eat at the table, use a bathroom in a proper way, and develop new skills. For example, she showed him how his favorite doll uses a bathroom and he decided to use a bathroom. These accomplishments would have been hard to achieve without taking into consideration the child’s developmental age and developmental sequence of play. 

Refer to developmental sequence of play when playing with your child or children.