Reactive, Aggressive, and Withdrawn Kids: A Complete Guide to Transforming Extreme Dysregulation and Challenging Behaviors

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Tere Bowen-Irish, OTR/L Related seminars and products

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Tere Bowen-Irish, OTR/L, has over 45 years of experience as an occupational therapist, specializing in psychiatry and pediatrics across hospital, school-based, and private practice settings. Through her practice, All the Possibilities, she provides consultation, evaluation, treatment, and education to support the functional and emotional well-being of children of all abilities. Tere has delivered continuing education nationally for over two decades, sharing practical, strengths-based strategies with therapists, educators, health professionals, and parents. She is also a certified YogaKids instructor and Mindful Schools Educator. Her publications include the Drive thru Menu Suite of Exercises, Yoga and Me, Come Be a Tree, and My Mindful Music (coauthored with Maryann Harman). Currently, she offers therapy and mindfulness instruction – often with the help of two canine companions – at a therapeutic school serving students unable to attend public school.

 

Speaker Disclosures:
Financial: Tere Bowen-Irish is the owner of All the Possibilities, LLC., and has an employment relationship with Seacoast Learning Collaborative. She receives royalties as a published author. Tere Bowen-Irish receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Tere Bowen-Irish is a member of AOTA.

Additional Info

Program Information

Access never expires for this product.

For a more detailed outline that includes times or durations of time, if needed, please contact cepesi@pesi.com. 

Objectives

1. Identify the neurological and sensory-based origins of extreme dysregulation in children and adolescents.
2. Identify behavioral outbursts as communication of unmet developmental, emotional, or safety needs.
3. Choose polyvagal- and sensory-informed strategies to support nervous system regulation and resilience.
4. Develop individualized prevention and intervention plans using structured tracking and observation tools.
5. Identify in-the-moment responses to acute behaviors such as elopement, aggression, shutdowns, and self-injury.
6. Utilize relational safety, co-regulation, and recovery rituals to rebuild trust and promote long-term emotional growth.

Outline

Getting the Root of Behavior

Communication, Not Defiance

• Unmet developmental, sensory, cognitive, and social-emotional needs
• Environmental contributors: schedule, demands, transitions, overstimulation
• Emerging diagnoses (ASD, ADHD, PDA & more)
• Gaps in functional skills
• Behavioral patterns across settings: home, school, community
• Relational dynamics: peers, adults, authority
• Sensory processing challenges and common environmental triggers
• Structured behavior tracking and data collection tools

The Role of the Brain & Nervous System

Trauma, Stress and the Developing Brain

• The impact of chronic dysregulation on learning, participation, and relationships
• Brain pruning in the early teen years: Behavioral implications
• Nervous system states explained through Polyvagal Theory
• Differentiating shutdown, fight/flight, and functional freeze responses
• Recognize how your own nervous system impacts responses to dysregulation
• Supporting executive functioning skills: inhibition, flexibility, planning, and self-monitoring
• Limitations of the research and potential risks

Preventative Interventions

Setting the Stage for Success

• Neurodiversity-affirming, sensory-safe environments
• Daily mindfulness practice to build self-awareness
• 20+ movement strategies for use throughout the day:
  • Heavy work to support emotional regulation
  • Vestibular input to facilitate focus
  • Bilateral coordination tasks to facilitate cognitive flexibility
• Visuals, timers, and cues for transitions and predictability
• Go-to menus of coping tools and regulation strategies
• Point-of-performance coaching to build skills in real time
• Choice, autonomy, and refusal as communication
• Play, humor, and connection
• Use-anywhere tools for emotional literacy
• Consistency across home, school, and therapy settings

Acute Interventions

Responding in the Moment

• Meltdown vs. shutdown vs. escalation
• Crisis response team: Trusted adults, not just available staff
• Cues and precursors to acute behavior
• Verbal de-escalation scripts and visual cues
• Structrued exits, alternative escape routes, and break plans
• Elopement, self-harm, or aggression: Safety and regulation as the goal
• Connection during refusal or withdrawal
• “Bounce-Back” systems post-incident to rebuild trust and resilience
• Neuroaffirming incident documentation: No blame-based language

The Human Element in Intervention

• Embedding relational safety as a core strategy
• Co-regulation opportunities
• Consideration of an embodied approach
• Student voice and nervous system signals
• Emotional recovery and re-engagement
• Predictable rituals for repair and reconnection
• Intentional relationship-building

Target Audience

• Occupational Therapists
• Social Workers
• Counsellors
• Educators and School Administrators
• School Nurses
• Psychologists
• Speech-Language Pathologists
• Physical Therapists
• Physicians