Dr Gemma Fisk — “How to Support Your Child with Emotion Regulation”

In this Q&A with Dr Gemma Fisk, a Clinical Psychologist, I ask about emotion regulation — what it is, and how parents can support their children with this complex task.

Read on to pick up Gemma’s fantastic tips and resources to help parents think about and support their child’s emotional development.

First off, thank you so much, Gemma, for meeting with me to do this Q&A. Can you introduce yourself and tell us a bit about your work?

I completed a British Psychological Society–accredited undergraduate degree at Loughborough University, a Master’s in Clinical Forensic Psychology at the Institute of Psychiatry, followed by a three-year full-time professional training course leading to a Doctorate in Clinical Psychology at the University of Surrey. I am a registered psychologist with the Health and Care Professions Council (HCPC) as well as a member of the British Psychological Society.

I have worked for many years with children, young people and their families — initially in the NHS, then for a Social Enterprise, and for the last six years I have been working in private practice. I have experience working with a range of mental-health presentations and work therapeutically with clients, as well as offering consultation and training to other professionals on various areas related to mental health.

I specialise in the assessment of neurodevelopmental conditions including ADHD and Autism in both children and adults, and in supporting clients who are neurodivergent. I am neurodivergent myself and a mum to two neurodivergent boys, so I also have a lot of lived experience in this area.

Emotion regulation is an essential part of human development. Can you explain what emotion regulation is?

Emotional regulation is the ability to recognise our emotions and to manage them in adaptive ways. It usually encompasses strategies which maintain, intensify, or decrease our emotional responses. Emotional regulation is a skill that develops with age but can also be a lifelong learning process.

Our ability to develop emotional-regulation skills depends on a range of factors, including our personality, environment, and experiences. The strategies we use to achieve emotional regulation can adapt and evolve over time.

Can you explain the important role parents play in helping children learn about their emotions?

Parents play a really important role both in modelling to their children how to talk about emotions and in demonstrating how to regulate them. In our household, no emotions are ‘bad’ or ‘negative’; instead, we talk about what we do with those emotions as being important.

It is okay to feel sad, worried, angry, disappointed, etc., and it’s important that we are able to sit with those feelings before trying to problem-solve or rush to get rid of them. We all need that experience of being ‘heard’ before we are helped.

There are lots of really good resources out there as a starting point for what we as psychologists refer to as ‘emotional literacy’, which is building understanding of the many different layers of feelings. Using emotion flip-books as a visual prompt for younger children can be helpful, and they’re easy to place around the house to open up conversations about emotions.

There are also lots of great books aimed at primary-school children. Usborne publishes a brilliant collection about feelings, including Lift-the-Flap Questions and Answers About Feelings. The Colour Monster and My Body Sends a Signal by Natalia Maguire are both firm favourites for me — professionally and as a mum.

Using different animals to represent different feelings can also be a fun and engaging way to explore emotions with younger children.

As parents, we know our children best, and yet we will all have our blind spots — things that we overlook or miss. This can be anxiety-provoking when you’re not sure what is going on for your child. If a parent has a hunch that something is troubling their child, should they watch and wait or intervene by seeking advice and support from a professional?

If parents are concerned about their child, early intervention is best, particularly if they are worried about their child’s emotional wellbeing. Having open conversations with your child about their emotions is important.

Children need to know that the adults around them can listen to their emotional world and provide a safe and contained way of helping them make sense of their emotions. When our children share their emotions with us, we need to give them the message that we can hold space for those emotions — no matter how overwhelming they may feel — and give the emotion back to our child in a way that feels safe and manageable.

This is co-regulation, and it’s a fundamental stepping stone to self-regulation. The earlier we can support children, the more opportunity there is for a positive outcome.

Who should a parent contact if they’re concerned about their child’s emotional or behavioural development?

The first port of call is usually your GP, who can then signpost you to more targeted services where appropriate.

Within West Sussex, there is also the Single Point of Access for children aged 4 to 18, where parents can make a direct request for support if they are concerned about their child’s emotional wellbeing.

There are also helpful websites that provide advice around emotional wellbeing for children and families, including Young Minds and Barnardo’s.

There are many practitioners like myself who run private mental-health clinics, and often the waiting times for these are shorter than seeking support through the NHS. If parents have private healthcare, they can speak to their insurance provider to see if they can access a consultation or assessment through their policy.

For parents of children with Special Educational Needs, talking to other SEN parents can also provide an invaluable source of advice and support.

What factors impact a child’s ability to manage their own emotions (self-regulate)?

Self-regulation is a skill that can be tricky even for adults. There can be a lot of pressure put on children to self-regulate, particularly in the school environment, when they may not yet have the developmental skills to do so. In my experience, children are often expected to self-regulate much younger than they are actually able to.

A large part of my work with parents focuses on educating them about brain development and the importance of co-regulation as a stepping stone towards self-regulation. The Whole Brain Child by Daniel Siegel is a really insightful and helpful resource for parents who want to understand more about brain development.

Children learn from those around them, as evidenced by Social Learning Theory. If children have grown up in an environment where emotions are not openly talked about and helpful ways of regulating are not modelled, this can impact a child’s ability to self-regulate.

In our household all feelings are valid and there are no ‘bad’ or ‘negative’ emotions; it is what we do with our emotions that is important.

Our emotional and sensory systems are intertwined, and for neurodivergent children who have sensory sensitivities as part of their profile, self-regulation can be more challenging — particularly if they are in contexts where their sensory system is being overstimulated.

A lot of people who are neurodivergent experience a condition called alexithymia. This is a condition whereby people have significant challenges in recognising, locating (in the body), and describing emotions. For people who experience this, managing emotions can be very difficult if they struggle to recognise and describe them.

There is a helpful guide here: Alexithymia & Autism Guide | Embrace Autism for those who want to understand more, and The Hidden 20% podcast episode E80: Cathy Wassell (Part 2) explores the impact of alexithymia.

Maslow’s Hierarchy of Needs suggests that lower-level needs such as physiological and safety needs must be satisfied before higher-level needs can become motivators. Just like adults, if a child is feeling hungry, thirsty, tired, physically unwell, in pain, too cold or too hot, and/or does not have access to shelter and safety, it is going to be much harder for them to self-regulate.

In my work with clients we often talk about the ‘Stress Jug/Bucket’ and try to spot all the things contributing to the jug filling up over the course of the day, week, or month. If our jug is too full, it starts to overflow and it becomes much harder to regulate our emotions. Finding ways to empty the jug as we go along — and talking with children about what this can look like — is really important. For example, this can mean parents having difficult conversations with school about relaxing homework expectations, allowing additional snacks in school, or reducing after-school clubs.

Can you give some examples of tools that have helped the children you work with regulate their emotions so they can better manage change?

Visual timetables can be very helpful for a lot of children. These help to map out visually what is happening over the course of the day or week and can be personalised. In our house we have printed pictures of places we go to regularly, places we go to sometimes, people we see regularly and infrequently, as well as events such as school discos, playdates, and parties. My laminator and sticky Velcro strips are a godsend!

Using Social Stories can also be helpful in supporting children to understand their emotions and prepare for events. Social Stories can talk a child through planned events, describing what they can expect, what may be expected of them, and what they can expect from others. This can help reduce a child’s anxiety, which in turn can make transitions easier. A useful resource to explore Social Stories further is What is a Social Story? by Carol Gray.

In my work with children we often develop a visual feeling scale to help them identify different levels of their feelings and think about things they can do to regulate themselves, as well as things other people can do to co-regulate them. We also include things that others should avoid saying or doing, as these can escalate situations. Representing feelings using colours, animals, or even pop stars or footballers can help engage children in the process.

This visual scale can then be used across home and school to provide a shared language for communicating emotions. The Incredible 5 Point Scale by Kari Dunn Buron and Mitzi Curtis provides a helpful template for those who want to explore this further.

The concept of Energy Accounting is a really helpful framework for parents and educators supporting neurodivergent children, particularly when thinking about barriers to self-regulation. It’s worth spending time identifying which daily activities deplete and replenish your child’s physical and emotional energy. This is also a valuable exercise for caregivers themselves. There is an informative resource from the National Autistic Society available to learn more about Energy Accounting in their Know Yourself series.

Is there any practical advice about routines you could give parents of school-age children who struggle with separation anxiety?

Firstly, it is important to try to unpick what is underpinning your child’s separation anxiety. Once parents understand what is making their child anxious about being apart, they can explore ways to support them.

Using a transitional object — something that reminds your child of you — can be a helpful strategy. This could be a favourite stuffed toy that smells of you, an item of clothing such as a scarf, a two-part keyring where you each keep one half, or a piece of jewellery you both wear. Transitional objects help a child feel safe and comforted, reassuring them that they are being kept in mind and will be reunited.

Gestures such as love hearts, stars, or smiley faces drawn on the arm — ‘powered up’ with love and strength just before separation — can also be helpful.

The Invisible String by Patrice Karst and Joanne Lew-Vriethoff is a lovely book exploring the normality of separation anxiety for younger children (ages 3–7). Similarly, What to Do When You Don’t Want to Be Apart by Dawn Kristen Lavallee and Silvia Schneider is an excellent CBT-based book for children aged 8–12.

For many neurodivergent children, anxiety about being away from parents stems from being separated from the people who understand them best. For these children, their parents are their safety and biggest advocates. My youngest son has struggled hugely with separation anxiety and is able to articulate that he doesn’t feel safe at school. This isn’t easily fixed with books or transitional objects alone. If a child is with people they feel safe with — who understand them and can make the accommodations they need — this can be a game changer.

With the families I support, we often discuss the need for schools to make reasonable adjustments to support children with separation anxiety and to be mindful that this is not always a quick fix.

Do you have any tips for parents of children with sensory-processing differences on how to make the home-to-school transition easier?

Using a sensory calming kit can be helpful for supporting transitions. This can be a small bag or box that’s portable and easy to take anywhere — even in the car. Spend some time with your child exploring the eight senses and identifying one or two calming items for each. Examples include a pleasant scent on a handkerchief, a fidget toy, a favourite snack (chewing gum or mints can be very regulating), and visual items such as photos or small toys. Update the kit regularly.

Sensory circuits can also be valuable. These involve a sequence of physical activities designed to alert, organise, and calm a child. The activities should be active, physical, and fun — tailored to what your child enjoys. Sensory circuits can help at the start of the day, during transitions into school, and throughout the school day to keep children regulated.

You can’t treat the symptoms without first identifying the reasons behind a child’s difficulties managing change. Can you explain why it’s important to understand what might be behind the young person’s struggles with emotion regulation?

As psychologists we believe that all behaviour is a form of communication and that challenging behaviour is often the result of an unmet need. This might be a mismatch between the person and their environment, a communication difficulty, or — returning to Maslow’s Hierarchy of Needs — an unmet basic need.

It’s vital to understand what this unmet need is so that we can intervene in the most helpful way. A child’s symptoms can also reflect an unmet need for their caregivers, so it’s equally important that caregivers access support when needed.

If there is unidentified neurodivergence underpinning differences in emotional regulation, it’s important that this is explored further, as strategies may need to be adapted both for the individual and within their wider support systems.

Reflecting with your child helps to build emotion-regulation skills. Do you have any tips on how parents can help their child develop the ability to reflect and learn from what went well or not so well?

This will be a very individual process; some children are naturally more reflective than others. I encourage parents to keep a written log of their child’s successes and achievements on a daily or weekly basis.

In our house, we all have a decorated plastic jar. At the end of the day, we each write on a post-it note something we’re proud of, something we did well, or something we tried hard at — no matter how small. At the end of the week, we share what we’ve written and celebrate each other’s successes. My kids get to practise their handwriting, which is a bonus, but they also take real ownership and even suggest ideas for other people’s jars.

Another helpful tool is Comic Strip Conversations, particularly for reflecting on social situations. In my clinical work, we often draw out a scenario that a child has found stressful, looking at what they said and did and how this impacted others. We also explore what they might have liked to say instead and the potential outcome. This gives children a visual script to help them practise assertiveness.

I work with many people with perfectionistic tendencies, and as someone who has been a perfectionist my entire life, learning to do things ‘good enough’ is a lifelong lesson. To help children reflect on the value of mistakes and build a growth mindset, Beautiful Oops by Barney Saltzberg and Ish by Peter Reynolds are lovely resources.

Dr Gemma Fisk has a practice based on the West Sussex/Surrey border and can be contacted through her website: www.drgemmafisk.co.uk