Stroke can lead to emotional and behavioural difficulties, which you might notice at home or in childcare or education. There is plenty you can do to help, whatever stage your child is at.
How can stroke affect emotions and behaviour?
Stroke can affect how a child or young person feels or behaves in two ways:
Directly
Stroke may affect parts of the brain that control your child's ability to manage their emotions, communicate and understand body language. It may also make them more or less sensitive to noises, touch or other stimuli.
Indirectly
Stroke can affect your child's life in many other ways. Any of these changes may cause emotional distress. This in turn, can lead to a change in behaviour. For example:
Fatigue may make it harder to cope with daily challenges or to join in with social activities.
Mobility problems might affect their self-image and they might feel different from their friends.
Talk to people who understand what you're going through.
Parent
What are the signs of emotional or behavioural issues?
Many parents tell us that their child has emotional or behavioural difficulties after stroke, and it can affect children and young people at any age.
Emotional difficulties may include:
Anxiety.
Low mood.
Stress.
Anger and frustration.
Feeling different.
Sometimes there are no obvious signs, and your child may not talk about their feelings. But you might spot changes in their diet, activity levels or sleep. Your child may seem different from their usual self. If this happens, just be aware this is a natural response.
Behavioural difficulties may include lashing out, avoiding situations, or seeming to shut down. A child or young person might refuse to do chores or homework, become disruptive or take part in risky behaviours.
What impact can emotional or behavioural issues have on my child and me?
Emotional or behavioural difficulties can affect every aspect of a child or young person's life. Poor emotional wellbeing can make it difficult to join in with friends or family, to play an active role in therapy and to manage the demands of daily life and school.
Try to work out if there are communication, sensory, fatigue or other issues that might be behind behaviour changes.
Check your child has been tested recently for hearing, eyesight, reading and writing problems. Problems can emerge a long time after a stroke.
For you, seeing your child struggle may also trigger strong emotions. You may be grieving for what you have lost and the life your child might have had, or you may feel angry or jealous of others. These feelings are completely normal. They may never go away but they will feel less raw over time as you gradually adjust. Seek out people who understand, and consider counselling. You can only be strong for your child by meeting your own needs too.
Let your child talk about how they feel. Listen and try to understand how you might feel in their situation.
Parent
Useful tips and techniques
Every child is unique and they will face individual challenges. Sometimes it helps a child to learn about their stroke and about other children who had similar experiences. This should be at the child's pace and may help them feel less alone.
Here are some situations parents have asked us about, with some practical tips.
Child lashing out
Some children and young people may develop behaviours such as lashing out verbally or physically. This needs to be addressed, for the safety of the child and those around them. If the behaviour stems from your child's distress, it may not respond to traditional parenting methods such as rewards or consequences. Instead, they need help to feel safe and find new ways to express and manage their feelings.
Try to be understanding. The saying 'All behaviour is communication' reminds us that any difficult behaviour is a sign that the child is struggling.
While you may need to be flexible you do need to set standards for behaviour. Try to reward good and ignore bad as much as possible.
Try to field things for your child so they only deal with what they need to and are not overloaded. Try to keep a family routine, especially in the early stages
Addressing this situation can take time, but it is possible, with the right help and support. Talk to their school or nursery, the school Special Educational Needs Coordinator (SENCO) or additional support needs teacher, and find out what help is available.
Although it's difficult when you're exhausted too, let the child feel like you have listened to them and empathise.
Parent
Teenager showing behaviour changes
A teenager will be experiencing hormonal changes and could be anxious about schoolwork or feeling pressure to fit in with peers. The behaviour issues could be due to stroke or a separate condition that hasn't yet been identified.
Consider if they are having problems with sleep, fatigue or diet.
Try to notice what seems to trigger their behaviours. For example, are you seeing the behaviours after they've been with friends, or while doing homework?
Ask them about what they are going through, such as their feelings about the stroke as well as their school and social life.
Talk to their medical team to understand if the behaviour could be directly related to the stroke.
Check the basics, such as hearing and sight tests. Ask the school to consider an assessment for learning difficulties and problems with comprehension, memory and attention.
They might find it helpful to talk to other young people who have had a stroke, or to view the videos of other young people in our "I am a young person" resource.
Your approach to parenting changes as your teen becomes more independent. You may move to a more consultative, negotiation-based approach. Keep an open mind and look for support for yourself.
'...since our child had a stroke we would ask 'is this him acting out, or is this the stroke?' and this was from the age of 4, so not just when they hit the teenage years.
Parent
Child losing interest in doing things
A stroke is a major life event which is likely to have an impact on family life, for all of you. Your child could be struggling with fatigue, or might be anxious about trying new things. Try not to focus on what they do, and instead, look for anything that will help build a warm connection between you.
This type of withdrawal response is an expected emotional response to stroke. But you should keep an eye out for signs of low mood, like poor sleep and appetite, and speak to the school or GP if you are worried.
Comment on your child's strengths when she does things ('That was really kind,' 'You're such a good listener').
If she does show an interest in anything, run with the idea. Try inviting one trusted school friend over and enlist their parents' help.
Ask your child's nursery or school how to use the technique called 'zones of regulation' to open up conversations in your family about how everyone is feeling. This simple tool allocates a colour to different feelings. It helps children become more aware of how they feel and to understand that emotions come and go throughout the day.
This is used by teachers but can also be used at home. It is a way to help children understand and regulate their emotions, using colours to help them visualise emotion. Find out more on The Zones of Regulation website.
Young child becoming disruptive in class after stroke as a baby
It is possible that your child's difficulties may be related to the stroke, or there could be a separate issue. Work with their nursery or school to understand what is going on, and agree a joint approach. Teachers might need to arrange assessments to find out what is causing the problem.