When Mina’s parents first reached out to me, they weren’t in crisis mode, but they were definitely carrying the weight of months (maybe years) of trying to “figure it out” on their own. I know firsthand how jolting it can feel when you look up one day and realize you’ve been in survival mode for longer than you can remember.
They weren't necessarily worried about her development, but they were exhausted and ready for change. Especially when it comes to navigating meltdowns in unfamiliar environments — or getting through even simple transitions like getting out of bed in the morning.
Her mom reached out with the following concerns with hopes to start getting ahead of things before the next rough patch:
-
Difficulty transitioning from one task to another (e.g., waking up, getting dressed, getting in the car, bedtime)
-
Extreme dysregulation and meltdowns during travel, despite enjoying the destination
-
Intense meltdowns at home, including screaming, kicking, unreasonable requests
-
Sensitivity around clothing textures and fit
-
Strong aversion to cold, which made morning transitions (getting dressed, walking on the cold floor, sitting on a toilet seat) even more challenging
At just 3 years old, Mina runs a tight ship, knowing exactly what she wants (and doesn’t want). She has a very specific way she likes to get dressed, with just the right amount of layers, sitting on her arms and legs in just the right way she likes them. Mina has her go-to swings and floor dots she likes to hop and play on at home. She loves the structure and routine of going to school everyday, seeing her friends, teachers, and reading and learning.
At home, they’ve figured out how to meet her sensory needs. There’s a system, a rhythm, a shared language that works (mostly). They’ve got headphones. A visual chart. A cozy swing. An early morning wakeup to schedule in time for the meltdowns. The routine is dialed in.
But the moment the routine shifts—whether it’s a tiny shift like a schedule change or a bigger change like a vacation—things get hard again, real quick. Mina gets stuck in loops of what I call unreasonable requests, a classic sign of dysregulation that’s often overlooked (“I’m cold. No,I don’t want a jacket. I want the air to be warmer.”) and starts spiraling into loud, long, often physical meltdowns.
My initial thoughts
Honestly? My initial thoughts were that Mina sounds a lot like my daughter was at that age. Extremely dependent on sameness and routine; very particular, vocal and sensitive about the way her clothes fit her; and long, intense meltdowns preceded by warning signs by asking for unreasonable things.
I felt like jumping through the screen and giving Mina’s parents the biggest hug and rub on the back to tell them it gets better. But I remember hearing those same words at that part of our journey and rolling my eyes thinking, when? Because I can’t handle this another day!
So I knew that my work with them needed to be riddled with quick wins to make daily life feel less like gasping for air.
Coming up
Mina’s parents were already doing so many things “right” — they just wanted to understand more behind her behavior. Is any of this part of the threenager stage? Are there any other strategies worth trying? Is it worth finding an OT in person?
In this four-part series, I’ll share all the insights and strategies we discussed to help Mina’s parents catch their breath. We’ll talk about:
-
Why traveling (even if it’s fun!) can be so dysregulating, and how to best prepare for this with a neurodivergent child
-
Supporting clothing sensitivities
-
Managing morning routines
Next week, I’ll walk you through the part of their day that was the biggest challenge: mornings. From cold floors to clothes that “don’t feel right,” we looked at why even getting dressed was a full-body stressor for Mina — and what we could do about it.
Disclaimer: These case studies are inspired by real-life clients I have worked with, with permission from their parents to share. Some aspects of the case are authentic, and other details are added to include more variability for our discussions. None of the strategies and advice here substitutes medical advice, diagnosis or intervention with an Occupational Therapist.
Continue learning from me:
Responses