Understanding and Supporting Children with Challenging Behaviors

Every child experiences moments of frustration, anger, sadness, or confusion. These emotions are part of growing up and learning to navigate the world. However, when these emotions consistently lead to disruptive or challenging behaviors, they can create stress for both the child and those who care for them.

A Complete Guide for Parents, Caregivers, and Educators

As occupational therapists, we look beyond the behavior itself. We ask why the behavior is happening. We explore the child’s sensory experiences, emotional regulation skills, environment, and developmental readiness.

This guide is written to help caregivers, educators, and professionals better understand the underlying causes of challenging behaviors, identify strategies to support emotional regulation, and build stronger, more trusting relationships with children.

Understanding the Root Causes of Challenging Behavior

Children rarely act out “just because.” Their behaviors are forms of communication, such as messages about what they need, what they are feeling, or what is overwhelming them. In order to support them, we must first uncover what is driving these reactions.

1. Sensory Processing Difficulties

Every child’s nervous system interprets information from the senses differently. Some children are more sensitive to light, sound, texture, or movement. Others may crave more sensory input to feel calm and alert.

A child who covers their ears during group time, avoids messy play, or melts down in crowded areas may be overwhelmed by sensory input. Conversely, a child who is constantly running, spinning, or crashing into things may be seeking more input to regulate their body.

Occupational therapy helps identify these sensory processing differences and uses sensory-based strategies, including deep pressure, movement breaks, or calming sensory tools to help children achieve balance.

2. Emotional Regulation Challenges

Emotional regulation refers to the ability to manage and respond to feelings in a socially appropriate way. Many children with challenging behaviors have not yet developed the tools to recognize and control strong emotions.

This may look like:

• Crying or yelling when plans change

• Shutting down when overwhelmed

• Hitting or throwing objects during frustration

• Avoiding tasks that feel difficult or unpredictable

Children do not misbehave because they want to; they do it because they are struggling to manage internal stress. Occupational therapists teach emotional literacy by helping children name and understand their feelings and use practical tools to calm the body and mind.

3. Communication Barriers

A child who cannot express what he or she wants or needs may resort to physical or disruptive behaviors. This is especially true for children with speech or language delays, autism spectrum disorder, or selective mutism.

Teaching children alternative ways to communicate, such as gestures, visual aids, or assistive technology, can reduce frustration and build confidence. When children feel understood, the frequency and intensity of challenging behaviors often decrease.

4. Cognitive and Executive Functioning Difficulties

Executive functions are the mental skills that help with organization, impulse control, and planning. When a child struggles in this area, tasks like cleaning up, waiting for a turn, or completing homework can feel overwhelming.

Instead of seeing these as willful refusals, it is important to recognize that the child may need external supports, such as visual checklists, timers, and routines to succeed.

5. Anxiety and Emotional Overload

Children experience anxiety for many reasons, such as fear of failure, separation from caregivers, sensory overload, or unpredictability in their day. Anxiety often appears as aggression, avoidance, or controlling behaviors. The child is not trying to manipulate; they are trying to cope.

Recognizing anxiety as the root cause allows caregivers to shift from punishment to support by providing reassurance, predictability, and emotional safety.

6. Environmental and Social Stressors

Home, school, and community environments all influence a child’s behavior. Noise, transitions, peer relationships, and family stress can heighten a child’s emotional sensitivity.

Creating calm, structured environments that promote success rather than confrontation helps reduce these triggers.

Effective Strategies for Emotional Regulation

Supporting a child’s ability to regulate emotions is one of the most powerful ways to reduce challenging behaviors. Occupational therapy emphasizes hands-on strategies that integrate the mind and body.

1. Teaching Emotional Awareness

Children cannot manage what they cannot identify. Begin by helping them name emotions through visual charts, picture books, or feelings games. Instead of labeling behavior as “good” or “bad,” use descriptive language like “I see you are feeling frustrated” or “It looks like you are worried about that.”

Modeling emotional vocabulary gives children permission to express their inner world safely.

2. Using the Zones of Regulation Framework

The Zones of Regulation is a common occupational therapy approach that categorizes emotions into four color-coded zones:

• Blue Zone: Sad, tired, or bored

• Green Zone: Calm, focused, and ready to learn

• Yellow Zone: Excited, anxious, or silly

• Red Zone: Angry, scared, or out of control

Teaching children to recognize which zone they are in helps them pause and use appropriate coping tools, such as breathing exercises, stretching, or sensory play.

3. Sensory Regulation Tools

Sensory-based strategies can help children find calm and focus. Examples include:

• Weighted lap pads or blankets

• Fidget tools for tactile input

• Movement breaks like jumping, wall pushups, or yoga poses

• Listening to calming music or using noise-reducing headphones

Every child’s sensory profile is unique. What calms one may energize another. Occupational therapists work with families to identify the right balance.

4. Breathing and Mindfulness Exercises

Teaching simple mindfulness practices can empower children to take control of their emotions. For example:

• “Smell the flower, blow the candle” breathing technique

• Bubble breathing (watching bubbles rise and fall to match breath)

• Guided imagery (imagining a safe or happy place)

These strategies help shift the body from a “fight or flight” response to a state of calm awareness.

5. Co-Regulation Before Self-Regulation

Children learn regulation by being regulated with a calm adult. When a child is upset, they need connection, not correction. Sitting nearby, maintaining a soft voice, and offering empathy helps the child borrow your calm until they can find their own.

Phrases like “I’m here with you” or “Let’s take a deep breath together” communicate safety and understanding.

Guidance for Caregivers

Parenting or teaching a child with challenging behaviors can be exhausting and emotional. Caregivers often feel guilt or frustration, especially when strategies seem to fail. Understanding that behavioral change takes time and consistency is essential.

1. Shift from Punishment to Connection

Challenging behaviors often arise when children feel misunderstood, unsafe, or overwhelmed. Instead of punishing, we can guide and connect. Although punishment may stop a behavior temporarily, it does not teach new skills. Instead of focusing on what the child did wrong, focus on what they need. Ask yourself: What is the message behind this behavior?

For example:

• Instead of “Stop yelling,” try “I can see you are upset. Let’s find a way to solve this together.”: 

Punitive Response:“Stop crying. There’s no reason to be upset.”Connection-Based Response:“I can tell this is really upsetting for you. I’m here, and I’ll help you work through it.”Why It Works:Dismissing emotions teaches suppression, not control. Acknowledging feelings validates the child’s experience and promotes emotional intelligence.

• Instead of “You lost screen time,” try “Let’s talk about what happened”

Punitive Response:“You yelled at your sister, so no TV tonight.”Connection-Based Response:“I noticed you were angry at your sister. Let’s talk about what made you feel that way and what we can do differently next time.”Why It Works:Consequences are replaced with reflection. The goal shifts from obedience to understanding and problem-solving.

• Instead of “You never listen,” try “It Seems Hard for You to Focus Right Now”

Punitive Response:“You never listen to me! Why do I have to repeat myself?”Connection-Based Response:“It looks like it’s hard for you to focus right now. What can we do to make this easier?”Why It Works:Instead of labeling the child as defiant, it identifies a barrier and invites collaboration, reducing power struggles.

Below are more examples that show how small language changes create big shifts in emotional growth and cooperation:

Punishment-Based Response	Connection-Based Response	Why It Works
“Go to your room until you calm down.”	“I see you’re having a hard time. Let’s take a break together until we both feel calm.”	Promotes co-regulation. The adult models calm and teaches emotional safety instead of isolation.
“Stop crying. There’s nothing to be upset about.”	“I can tell this is really upsetting for you. I’m here, and I’ll help you through it.”	Validates feelings and teaches emotional awareness instead of suppression.
“You yelled at your sister, so no TV tonight.”	“I noticed you were angry at your sister. Let’s talk about what made you feel that way and what we can do next time.”	Shifts from punishment to problem-solving and builds emotional literacy.
“You never listen to me!”	“It looks like it’s hard for you to focus right now. What can we do to make this easier?”	Reframes frustration into empathy and collaboration, reducing power struggles.
“That’s it, go to your room until you behave.”	“It’s okay to feel angry, but I won’t let you hurt anyone. Let’s find a safe way to calm your body.”	Sets firm yet compassionate boundaries and builds trust.
“If you don’t stop throwing, I’m taking that toy away.”	“It looks like your hands want to throw. Let’s find something safe you can throw instead.”	Redirects behavior instead of threatening, teaching safe alternatives.
“Don’t talk to me like that!”	“I can see you’re frustrated. Let’s try saying that again in a respectful way.”	Models respectful communication and teaches social-emotional skills.
“I’ve had enough! Go away.”	“I’m feeling frustrated too. Let’s both take a moment to calm down.”	Demonstrates emotional regulation and empathy, turning conflict into connection.
“You’re doing it because I said so.”	“This rule helps keep everyone safe. When we understand why, it’s easier to follow.”	Builds understanding and internal motivation instead of fear.
“You broke the rule. You’re in trouble.”	“You made a mistake, but we can fix it together. I’m on your team.”	Encourages accountability without shame, fostering a growth mindset.

How Connection Changes Behavior?

When adults respond with empathy, presence, and guidance rather than punishment, children begin to:

• Feel emotionally safe and understood

• Develop trust and a stronger attachment

• Learn problem-solving and communication skills

• Build self-regulation instead of fear-based compliance

• View adults as allies, not opponents

At A Touch of Hope OT, we help families replace reactive patterns with relational strategies that support long-term success and emotional wellness.

2. Consistency and Predictability

Children thrive when they know what to expect. Establish daily routines for meals, playtime, and bedtime. Use clear visual schedules and consistent rules. Predictability gives children a sense of safety and reduces anxiety-driven behaviors.

3. Positive Reinforcement

Acknowledging and rewarding positive behavior encourages repetition. Simple verbal praise like “I love how gently you spoke to your brother” is often more powerful than material rewards.

When children feel seen and appreciated for small successes, they develop motivation from within.

4. Avoid Power Struggles

Challenging behaviors often escalate when both adult and child try to control the situation. Instead of insisting on immediate compliance, offer limited choices:

• “Do you want to brush your teeth before or after putting on pajamas?”

• “Would you like to start homework at the table or on the floor mat?”

Choices give children a sense of control while maintaining boundaries.

5. Practice Self-Compassion

Caring for a child with emotional or behavioral challenges is not easy. Caregivers need support, rest, and understanding, too. Seeking help from occupational therapists, psychologists, or parent support groups can prevent burnout and create a stronger family system.

Enhancing Relationships with Children

Strong relationships are the foundation of behavioral success. Children are more likely to cooperate when they feel safe, valued, and connected.

1. Build Trust Through Attunement

Attunement means being emotionally in tune with your child by reading their cues, noticing changes in tone or posture, and responding with empathy. This nonverbal communication tells the child, “I see you, I understand you.”

2. Create Quality One-on-One Time

Even ten minutes of undistracted play or conversation each day can make a difference. Follow your child’s lead during play, narrate what you see, and express joy in their company. This strengthens the connection and decreases the need for attention-seeking behaviors.

3. Use Gentle, Respectful Language

Language shapes behavior. Replace commands with collaboration:

• Instead of “Don’t run,” try “Let’s use walking feet inside.”

• Instead of “You’re being bad,” try “That was a tough choice. What can we try differently next time?”

Respectful communication models emotional maturity and problem-solving.

4. Focus on Repair After Conflict

Conflict is part of every relationship. The key is how we repair it. After a meltdown, calmly revisit what happened:“I saw how upset you were when it was time to leave the park. I understand that leaving was hard. Next time, let’s try setting a timer before we go.”

Repair restores connection and teaches children that relationships can survive hard moments.

Environmental Modifications

The environment plays a major role in shaping behavior. Simple adjustments at home or school can dramatically improve a child’s ability to self-regulate and participate successfully.

1. Visual Supports

Visuals help children process information more effectively than words alone. Examples include:

• Picture schedules for daily routines

• Visual timers to show how much time remains

• Choice boards for activities or snacks

• Emotion charts to identify feelings

Visual supports reduce uncertainty and promote independence.

2. Establishing Routines

Routines provide structure and predictability. Begin and end each day with consistent rituals, such as morning greetings, snack times, and bedtime stories. Over time, these routines anchor the child’s sense of safety and stability.

3. Creating Calm Spaces

Designate a “calm corner” where the child can retreat when overwhelmed. Equip it with soft lighting, weighted items, books, or sensory tools. This is not a punishment zone but a safe space for self-regulation!

4. Reducing Overstimulation

Limit clutter, reduce background noise, and use natural lighting whenever possible. Overly stimulating environments can heighten anxiety and distractibility.

5. Collaboration Between Home and School

When strategies are consistent across settings, children learn faster. Share sensory profiles, calming tools, and visual supports with teachers and caregivers. Occupational therapists can help design school-based accommodations for success.

Implementing Positive Reinforcement

Positive reinforcement focuses on recognizing desired behaviors rather than punishing unwanted ones. It builds self-esteem, strengthens relationships, and motivates change.

1. Catch the Good Moments

Children crave attention. When they receive more attention for positive actions than negative ones, the frequency of those actions increases. Comment on every effort toward improvement, even small steps.

2. Use Specific Praise

Instead of general statements like “Good job,” be specific:“I love how you waited for your turn.”“You worked so hard to stay calm even though it was hard.”

Specific feedback helps children understand exactly what behavior was appreciated.

3. Visual Reward Systems

Sticker charts or token boards can make progress tangible for younger children. Ensure that the goals are realistic and rewards are immediate.

4. Gradual Fading of Rewards

Over time, external rewards should give way to intrinsic motivation. The ultimate goal is for the child to feel proud and satisfied internally for making positive choices.

Case Studies and Testimonials

Case Study 1: Daniel, Age 4 – Sensory Overload at Pre-school

Daniel’s teacher reported frequent meltdowns during transitions. He often covered his ears and refused to participate in group activities.

After evaluation, we discovered that Daniel had auditory sensitivity and difficulty processing loud environments. His occupational therapy plan included:

• Scheduled sensory breaks

• Use of noise-reducing headphones

• Visual schedule for transitions

Within two months, Daniel was able to participate in group circle time with minimal distress. His teacher shared, “He smiles more and asks to help lead activities. The difference is remarkable.”

Case Study 2: Maya, Age 6 – Emotional Regulation and Anxiety

Maya struggled with perfectionism and anxiety about making mistakes. Homework time often led to tears and yelling. Through occupational therapy, we implemented:

• Deep breathing and grounding exercises

• Positive self-talk statements

• Gradual exposure to challenging tasks

Her parents learned to reinforce effort instead of outcome, praising courage over perfection. After several weeks, Maya proudly said, “I can try again even if I make a mistake.”

Case Study 3: Liam, Age 3.5 – Impulsivity and Social Challenges

Liam had difficulty waiting for turns and was often in trouble for pushing peers during play. Therapy focused on impulse control through games, movement activities, and visual rules. Teachers and parents collaborated to provide a consistent structure and positive reinforcement.

After six months, Liam’s preschool report noted, “He is learning to pause before acting and uses his ‘stop and think’ strategy. His friendships are growing.”

Parent Testimonial

“Before therapy, I felt lost. My son’s tantrums controlled our home. A Touch of Hope OT gave us tools that actually work, such as visual routines, calming strategies, and confidence that we can handle the tough moments. Now our evenings are peaceful, and he feels proud of himself.” – Parent of a 7-year-old

Final Thoughts

Challenging behaviors are not signs of bad children or bad parenting. They are signals that a child is struggling and needs support to manage overwhelming emotions or sensory experiences.

At A Touch of Hope OT, we believe in understanding the whole child: mind, body, and environment. Through compassionate assessment and evidence-based intervention, we guide children and families toward balance, confidence, and joy.

Every child deserves to feel successful. Every caregiver deserves to feel hopeful. With the right support, progress is always possible.