"Why should I?" (Child Defiance)

Parents and teachers make many requests of children. These requests are assumed to be reasonable (by the adult), but children may refuse to comply. Children may have many reasons for refusing to comply with a request, and understanding the reasons is usually helpful in getting compliance.

Can't do or won't do?
The first question we should ask is if a child is refusing to do the task because they "can't do" or if they simply"won't do?" If a child is incapable or believes that she is incapable of doing the task, then it is a "can't do" problem. We usually address this by teaching and practicing with the child to make it easier. Teaching and practicing a task that the child is refusing to do, however, can be difficult. Having some kind of a reward as an incentive can encourage them to put forth the effort and "give it a try." Giving them feedback as they get better can help them become more motivated and more confident (which makes it easier to get compliance in the future).

A "won't do" problem means that the child is able to do the task, but it is unpleasant for them or they would rather do something else. It's very common for children to want to do something else (for example, playing or watching TV), and a task like "clean your room" is naturally not appealing. One approach for getting compliance in this case is to allow the child to do what they want to do after they finish what you've asked them to do. When needed, you can also offer bigger rewards (for bigger tasks). This is essentially like paying your child for doing the task, which is not necessarily a bad thing (they will learn about that in the future anyway). Many parents are afraid that their child will come to expect a reward for "every little thing", but this rarely appears to happen and we can always reduce how often they get the rewards in the future. It is important to not think of it as "bribing" the child, though, because bribes are given for unethical or inappropriate activities, whereas rewards are given for appropriate activities.

Avoiding direct conflict (aka "opposition")
There are many things we cannot make a child do, and children will eventually discover this during direct conflicts with a parent. It does not help to get into a "power struggle" with a child because we 1) give them something they can oppose, and 2) they will sometimes win. By setting up choices for a child, we reduce the opportunity for them to directly oppose a parent, and essentially leave it up to them. If they want to play a favorite game, then they need to first complete their chore. If they refuse to complete their chore, then they simply do not get to play their favorite game. This is less about fighting with the parent (though expect the child to whine and nag; see Tantrums) and allows the child to make the decision for herself.

Providing multiple choices can be helpful at times as well. We may tell a child that she can choose which chore she wants to do and give her two or three options. It is usually not recommended to give too many options (which can be overwhelming). When a child selects one of the options, then she may be more willing because it was "her choice" (even though you set the options).

Why should I?
Always keep in mind that it is a fair question for the child to ask, "why should I?" when you ask them to do something. Just because it's a "fair question" doesn't necessarily mean that you have to engage them in some kind of debate or negotiation. However, acknowledging to yourself or anticipating this question can make it easier to understand the child's resistance and how to best overcome that resistance. There is further discussion about working with resistance and defiance in this post about "making concessions."

The last point I would like to make is: try to remain calm and patient. Defiance can be extremely frustrating, but becoming angry is not a good long-term solution even if it gets an immediate response. Your child watches and learns from how you handle these situations.

Importance of Silver Linings

"Bad behavior" is frustrating, common, and can quickly drive a parent to the end of their patience. Whatever we expect to see is what we are more likely to notice, regardless of how often it is really happening.  We are quick to notice when a child is engaging in bad behavior and before long it can become all we notice. In the same way, a child who has a tendency to get in trouble a lot quickly begins to expect to get in trouble. The process can become an unpleasant cycle and can put a strain on a parent's relationship with their child.

In a similar way, there is an effect referred to as "behavioral momentum." It is called "momentum" because the tendency is for an individual to continue behaving in the same manner when they start behaving in a certain way. This is commonly used by effective sales-people to convince customers to agree to things they probably would not have if simply asked upfront. In the case of a child, we can begin to prime a child's behavior to get more good behavior simply by getting the child to change their direction and praising them for it.

These two concepts (the first paragraph and the second paragraph) can be important for parents. When a child begins misbehaving, parents are quick to point it out, which begins to frustrate the child after it has happened a few times. The child quickly gets into a pattern of misbehavior, and the parent quickly gets into a pattern of scolding the child. More scolding is not likely to improve things; indeed, if the parent is having to scold many times, it has already been shown to not work at that time. It can take a tremendous effort, but if the parent deliberately changes direction and begins praising the child for doing relatively simple things correctly, then the child may begin to get into a more positive direction with their behavior too.

This may mean trying to identify the things the child has done right, creating easy requests for the child to make an opportunity to do something right, and trying to focus on the many things the child does right while not focusing on the little things that are done wrong. This process is not simple, but it can make a world of difference for a frustrated parent and child.

Another strategy (the Penny in a Pocket technique) for changing a child's behavior and our own behavior as parents is provided here.

Asking for Help is Successful Parenting

I see lots of frustrated and stressed out parents. There are a number of phrases that I hear so often I'm considering making a poster for my wall so parents know they're not alone. These phrases are what it may sound like when parents are calling for help:

Top 10 Parent Sayings
(that may indicate a need for a new plan)

1. It worked for a little while.
2. I’ve tried everything. 
3. Time-out doesn’t work.
4. I’ve tried explaining things. 
5. He should do it because he’s expected to.
6. I feel like I have to ask 100 times. 
7. Everything is a battle.
8. It’s like pulling teeth. 
9. He doesn’t care about getting spanked.
10. I have to call him down all the time. 

If you are a frustrated, confused, and stressed out parent, don't feel like it reflects poorly on you in any way to go ask for help. Asking for help when needed is the most responsible thing you can do as a parent. You are concerned about your child's welfare, you want to have a good relationship with them, and you want them to be successful. Asking for help may simply be a part of achieving that. Refusing to seek help because of pride can further increase your stress and may cause you to do something you would regret. 

When working with parents, a psychologist does not judge them and certainly doesn't think less of them. I have seen amazing parents and wonderful people come in for help. They have incredible patience and love for their children, but they have simply run out of ideas. I have tremendous respect for these parents because they have realized that they need to get some outside input and are taking action. When we are frustrated, it is hardest to think about things logically and realize what we need to do (as opposed to what we feel like doing). As an outsider, the psychologist has the luxury of not being directly affected by the child's behavior, not being as frustrated, and not being so personally invested that they lose the ability to be objective. 

Parenting is a hard job, but it can be the most rewarding experience as well. However, parents must take care of themselves so they can take care of their child. When you reach your limit, take a step back and consider if you might need to get a little help. Know that if you decide you do, it's not a failure, but a success.

Making Concessions

When we are trying to change a child's behavior, it is partly about identifying the behavior we want to see, but also about getting the child to actually engage in the behavior. Getting their cooperation can be very challenging. It may be a matter of identifying a good reward for the behavior, but it also may be a matter of managing inconvenience to the child. Naturally, if something is highly inconvenient, then we are reluctant to do it. Why should we expect it to be any different for children? We can develop an elaborate and brilliant behavior plan, but if the child will not actually do the behavior, then the plan has zero effectiveness.

So how do we address inconvenience? We consider what we are asking the child to give up. Whatever the child's problem behavior is, the child continues to do it for a reason. Identifying that reason is a good first step. We are also asking for a certain amount of time and effort for the new behavior. If we can reduce this demand, then we also improve the child's willingness to do the new behavior. When all else fails, we can ramp up the reward to make it "worthwhile."

Let's consider a common problem: Doing Homework
A child isn't doing his homework, instead he gets home, fights about homework, procrastinates, and maybe will do a little bit of it after a lot of nagging. This is frustrating and a pretty common situation. On the one hand, the child should do his homework (it's the right thing, everyone has to do it, and he is expected to), but the fact of the matter is he isn't doing it.

Let's consider why he isn't doing it. Is it because it is too hard? Is it because it takes too long? Is it because he likes to fight about it? Is it because his favorite show is on? We can consider many reasons, but ultimately the first one is a problem of ability (he can't do it, so he resists it) and must be addressed with instruction and practice. That's a legitimate problem and he needs some help. The other reasons have more to do with resistance because homework isn't fun and he would rather do things that are fun. That's behavior, and that's something that can be addressed.

We have a lot of options that are designed to make it feel like homework doesn't take "forever." We can set timers, we can have planned breaks, and we can break up the homework task into chunks (rather than 50 problems, it's just 5 sets of 10 problems with a break after each set). That can make a big task seem shorter. Now we work on the incentive to increase compliance. "Complete homework before the timer runs out and you get a reward (maybe some videogame or TV time)." Or maybe offer a small reward for each set of problems completed.

Summary
We would like for children to do "the right thing" because they should, but this expectation is not always reasonable (and sometimes it just doesn't matter). If we insist on it, we can get a lot of push back and lose a lot of time and patience. It's often helpful to consider why the child is resisting the task and accept that their reason, though perhaps ridiculous to you, is actually perfectly reasonable in their mind. Then focus on the problem rather than on your frustration and consider what you're asking them to give up. If you can adjust that a bit, you may suddenly get much less resistance and frustration (for everybody).

Sleep Routines

"Sleep problems" aren't really my main focus, but I've seen quite a few parents having problems with their child's sleep habits. The problems include the child not falling asleep in a reasonable amount of time, repeatedly getting out of bed, loudly complaining and refusing to go to bed, wanting to sleep in their parents' bed, or just being afraid of the dark. There are many things that can produce problems with sleep and there are many ways to deal with them. I always ask parents this same set of questions:

• What times does ____ usually go to bed (not necessarily asleep)?
• How long does it take for ____ to go to sleep?
• What time does ____ usually wake up in the morning?
• How easy is it for ____ to wake up?
• What is their mood when they wake up and do they seem tired the next day? 

I ask these questions for sleep problems and for a wide variety of behavior problems. Sleep is critical for a child (and for adults).  It is important for a child's physical and mental development, and it greatly affects their behavior and their ability to learn effectively in school. If a child hasn't gotten enough sleep, then the brain is less ready to learn and the child is less able to handle the frustration necessary for learning new things. We see more behavior problems because the child's tolerance for frustration is so low and their ability to control their behavior is simply not as good.

Though a child may try to insist otherwise, children really need sleep routines. They should be going to bed at basically the same time every night and waking up at about the same time every morning. By maintaining this, the child's body gets into the habit and they will naturally begin to feel more tired and ready for sleep at around the same time each day. This makes it much easier for them to go to sleep. As a quick note: I strongly discourage allowing children to fall asleep with the TV on. TV's are designed to be naturally stimulating and attention-grabbing.

It can also help to use a familiar routine of activities every night to prepare for bedtime. That might include taking a shower, putting on pajamas, brushing teeth, laying in bed, listening to a story, and getting tucked in. The routine activities help prepare the brain for going to sleep. It is sort of like when you see a bunch of familiar landmarks on the way home. You know where you're going because you see all of the same things and you know what to expect at the end of it. It's the same way with these activities, but naturally you want your child's bedtime routine to include activities that are less exciting and stimulating for them so they can "wind down."


The first major step in helping your child with their sleep problems is to establish a routine and stick to it. Be consistent and they'll get the hang of it (if we keep changing it, they'll just be confused). We cannot make a child sleep (which they'll point out to you if they're fighting it), but we can help them be more successful at it. We can use a routine, we can require them to stay in their room, and we can remove a lot of the distractions they may use to keep from sleeping (toys, TV, video games...). Beyond that, we need a large amount of patience as they begin to learn how to sleep well.

Tourette's Syndrome

Tourette's Syndrome is a spectacular disorder full of profanity, if Hollywood actually portrayed it correctly. In truth, Tourette's is a neurological disorder that produces involuntary behaviors (very rarely profanity). These behaviors are called "tics", and include motor tics (movements of the body) and vocal tics (which typically produce sounds with the mouth or nose). The severity of the disorder can range from fairly small behaviors that are hard to notice, to very complex or forceful behaviors that can be physically harmful to the person with the disorder. Tourette's is not easy to understand and parents may be alarmed and frustrated by the child's behavior, or may simply try to ignore it and explain it as "something they'll grow out of."

In truth, some individuals do grow out of Tourette's (as they enter adulthood), but many others continue to have tics throughout their life. The tics in Tourette's come and go, increase and decrease in severity, and change over time (sometimes they are said to "move" from one area to another). In addition to tics, children with Tourette's may have obsessive-compulsive behaviors, difficulty controlling their emotional responses, and have more frequent behavior problems. I have had the opportunity to work with many individuals with Tourette's or related disorders, and have Tourette's myself. I wish to share a little bit about this commonly misunderstood disorder.

One thing that has really stood out to me is how often Tourette's goes undiagnosed and untreated. It may be because parents don't know that the child is showing tics or it may be because they do not wish to consider the possibility that their child has Tourette's. There is no "cure" for Tourette's, but there are good treatment options these days, including behavioral therapy ("CBIT" - Comprehensive Behavioral Intervention for Tics) and medication. Medication is usually used for more severe tics that risk producing medical harm, but behavioral therapy is a fairly quick (perhaps 12 sessions) and efficient approach to reducing the severity and frequency of tics. Tourette's is certainly nothing to be ashamed of because it is simply an impulse created by the brain (like blinking or breathing), but many people may feel embarrassed by their tics because they look unusual.

I have written up a short guide for parents discussing Tourette's and trying to answer some common questions (such as, "does my child have Tourette's?").

Tourette's Syndrome

Psychological Sticker Shock

The cost of psychological services can be surprising to some parents, and usually not in a good way. On the one hand, the cost of services for one's child and the benefits of those services should be easily justifiable (for example, consider how much we might spend on maintenance for something as comparatively unimportant as a car). On the other hand, that doesn't necessarily mean it's easy to afford. Insurance coverage for psychological services varies a great deal, and even when insurance does offer to cover psychological services, some psychologists will not accept insurance.

Perhaps the most immediate comfort that can be offered is that psychologists have an ethical obligation (as required by the American Psychological Association) to not exploit patients, to seek to do good and aid the public, and to ensure that they do not harm others. Although the rates charged for service may vary, they should generally be fair. I've written up a guide in an effort to help increase parents' understanding about the cost of services and what those services might include. This guide is by no means perfect and it does not cover all services that might be provided, but it may help parents to make a little more sense out of what goes on in a clinic.

One rule that should always be remembered though: When not sure about something, feel free to ask. 

Cost of Services

Incoming Resources

I had planned to write up a short explanation about the costs associated with psychological services to help parents understand the costs and not suffer as much sticker shock, but I found that this is a larger project than I expected. I am still working on this and will post it when I am done, but there is a lot of information that goes into explaining evaluation, consultation, and intervention services (and that is just within my particular approach: behavioral and academic).

I ask for some patience while I prepare these resources!

Happy Biting

"We were playing and having fun, why did he bite me?!"

When children are biting it's not fun for anyone. Their ability to bite is often surprisingly strong, and sometimes their desire to do so is equally strong! It's common for children to go through phases where they bite, but it can become a real problem as they get older. I've worked with quite a few parents who reported a biting problem of some sort. It's often a problem that the child bites when angry, and we can kind of understand why the child is biting at those times. We tend to think of biting as an aggressive action (after all, it hurts!), but children may bite for a variety of reasons, and not always because of anger or aggression. In this case, we're talking about "happy biting."

To best help a child who bites, we need to understand a bit about why the child is biting and then how we should respond to it. Naturally a child may bite out of anger, but it often surprises parents that a child may also bite out of happiness. This seems strange, right? We need to understand that emotional reasoning takes time to develop and if a child is "worked up", then certain behaviors (like biting) are more likely. Being "worked up" can include being mad, being scared, or being very excited and happy. In all cases, the child is "in a state of high arousal."

High arousal has a bunch of behaviors associated with it, including things like laughing, jumping, clapping, screaming, spinning, biting, hitting/kicking, grabbing, and hugging. Most of those sound fine, and maybe even fun. But some of those we tend to associate with being angry. For a child who is 2 to 4 years old, they've not had a lot of time to understand the differences between these different types of "high arousal" states and may produce any of those behaviors during any of those emotions (such as biting or hitting when happy). As they get older, they'll learn to tell the difference and their behavior will become more specific (hugging is not part of being mad, hitting is not part of being happy, and so forth). They learn to tell the difference, however, based on the reactions of others and by observing your behaviors (they'll imitate you). It takes time, but patiently helping the child learn what is "ok" and what is not, and giving other cues to show how they maybe should be feeling will help them learn to tell these emotions apart.

Information on how to respond to and stop biting can be found here: Biting

Psychobabble and Jargon (quick reference)

There is a lot of lingo and jargon in psychology and education. Sometimes I relax into my jargon when talking with parents and eventually notice the look of confusion on their faces. It can take effort to be aware of what we're saying and make sure we use terms that make sense. Unfortunately, when parents go to a meeting at the school they often hear lots of jargon and get confused. School personnel may not realize that they're using a bunch of jargon (after all, they use it everyday when talking to each other) or that the terms are unfamiliar to parents. I saw a very helpful post on another blog recently, where the author collected a bunch of terms used in schools and special education and provided nice explanations for them. I'm posting a link to that here and highly recommend reading through it to learn a bit about terms used in schools and special education.

Education Lingo Every Parent Should Know

What's the Big Deal with a Diagnostic Label?

Diagnostic labels can bring relief, sadness, confusion, or anger. Often they produce all of these emotions at the same time. When I meet with parents to talk about the results of an evaluation, I wish I had an hour to go over the main results, a couple of hours for them to leave and think about it, and then another hour to talk about their questions and what to do next. I usually end up spending an hour or two with them talking about the results and coming up with some kind of immediate plan. Then we make another appointment after they've had time to think about everything and come up with new questions.

Labels can be scary because we don't want our kid to have "that label", for other people to say things or judge them, and sometimes because we don't want to accept that label. A lot of work goes into reducing the "stigma" (the negative thoughts associated with a label), but that work is never-ending because a label means "something unusual" has happened. We may also think that if there is a label, then it will never get better. While it may be true that there are some challenges that will always be there, it is wrong to think things will never get better.

On the other hand, labels can be useful. One of the main purposes of a label is so that we can work toward making things better. With a label a child may get access to services he previously couldn't. We may understand a bit more about why the child does the things he does, or maybe why he doesn't do some things he should. As a result, we might become more patient with our child once we know "what's going on." We can also start using lots of research to find better ways of helping the child.

Labels often seem to create more questions than they answer, but we can start asking better questions. We're no longer trying to find our way through a large, open field. We have clearly marked paths, and can start exploring them. Finding the approach that is best for your child may begin with an evaluation and a label, but it continues with problem-solving and working together.


I have two documents that discuss evaluations and labels in more detail:

Diagnosis - more information about the process of making a diagnosis

Understanding Diagnostic Results - written with one of my colleagues, this one is about questions that often come up after the diagnosis

"Remorseless Children"

Parents and teachers want children to "do the right thing" because of a moral compass. Really, this compass is almost a magical device. We kind of expect it to happen without really thinking about what it takes to develop moral reasoning. There's a lot of research out there about moral reasoning, and a couple of my favorite points are that two things are very important for its development: 1) the ability to think about and understand things, and 2) experiences that challenge the child's current moral beliefs. I like those ideas. They're neat, they make sense (intuitively), and they're very appealing (maybe because they don't put all of the responsibility on parents). The problem is they don't give us any comfort when a child is engaging in aggressive behavior and doesn't appear to feel guilty.

I've heard from parents, teachers, and daycare providers that some children are "remorseless" or even take pleasure in the suffering of their peers. That seems scary and is likely to make us think of criminals, murderers, and so forth. Maybe there is a biological risk of a child having a natural tendency to become a criminal, but it does not do any good to assume a child is "bad" or destined to become the next Jack the Ripper (or Hamburgler). If we assumed that it was the child's fate, then at the worst we abandon all efforts to change the child, and at best we begin thinking from the perspective that this child is "bad." It's better to think of the child's behavior and what we want them to do instead of their current behavior.

"But he smiles and laughs after hitting his classmate/taking something from his classmate!"

We're thinking from our own perspective in that situation. We don't actually know why he is smiling or laughing, though, and we're making a pretty big assumption: that the child is thinking like an adult or feeling emotions like an adult. It's also not a well-supported assumption. Children have only had a limited amount of time to learn how the world works, and that includes their "internal world" (emotions, thoughts, and body sensations). Consider the following questions:

- When an infant smiles or laughs, what kind of reaction does that get from other people?
- If a child is feeling nervous, worried, or confused, what kind of reaction do you expect from them?
- What do you think the child is expecting after hitting his classmate?
- What does "remorse" look like? How do you really know it's happened?

I'm oversimplifying here, but when young children feel worried, sad, upset, frustrated, irritated, angry, anxious, confused, or nervous, what they're really feeling is "Upset." It's one category for them and all of those emotions fit in there. They aren't that good at telling the difference yet, nor are they very good at controlling their behavior when they suddenly get a strong feeling. It takes a lot of time to understand the difference between frustrated and irritated, or worried and nervous. If you ask a child what those emotions feel like, they'll probably tell you that they feel "bad" and that's about it (note: I've asked many children and gotten the same responses). It also takes a lot of time and practice to get good at not immediately responding to how one feels. Indeed, many adults still can't stop themselves from acting immediately in response to a strong emotion. It's just how humans are wired; it helps a lot in certain situations, but the classroom is not one of those situations.

So we should consider that this child is not "remorseless" (which really isn't even a "thing" for young children yet), but that he/she doesn't know how to respond to the worry they're feeling about getting in trouble (which they know is coming). We shouldn't pay as much attention to what we see on their face at that time. We need to focus on what we want them to do differently, give them every incentive and advantage in being able to do that, and then letting them know when they've done the right thing instead of the wrong thing. Try to take ourselves out of the situation and instead focus on the behavior and the child. It's hard to do because we don't naturally think that way, but it is more helpful than assuming the child is seeing things the same way we do.

"Poop Candy" (overcoming toilet fear)

Here's another of my favorite stories about using behavior modification to solve a common problem in early childhood: toilet training.

I had a parent come into my office because of a number of different behavior problems that a child was experiencing, but one of them had a pretty fast solution (we were kind of lucky it was this easy). The child refused to sit on the toilet. In fact, the child was so afraid, that he would not tell his mother when he needed to go to the toilet. As a result, there was a lot of soiling of clothing ("pooping the pants"). We needed a way to get the child to be willing to even sit on the toilet first. Then we needed to get him to sit on it for longer periods of time (so he could actually do his business).

Our solution turned out to be pretty simple. We identified his absolute favorite candy, and he would get a piece of it every time he sat on the toilet. We started calling it "poop candy" in our meetings, though I'm not sure what the mother told the child it was called. Here's the important key to this though: it didn't matter if he needed to use the toilet, it didn't matter if he actually did anything, and at first it didn't matter if he took his pants off. If he put his bottom on the toilet, he got the candy. Basically, we were giving him a button to push to get candy whenever he wanted it. Naturally, he took advantage of the situation some, but that's fine, he's still sitting on the toilet. After a little while, the problems stopped entirely. He was willing to sit on the toilet, he actually used it, and the fights were over (and fewer dirty clothes). As time passed, his mother could reduce how often he got the candy: not every time he sits on it, but sometimes; not for just sitting on it, but taking pants off, and so on...

Like I said, this turned out to be a pretty simple problem and solution. We were lucky that it was just a fear of sitting on the toilet (the same approach can be used with a child who is afraid of entering the bathroom). If the child didn't have language to indicate when he needed to use the toilet, that would have to be addressed, such as teaching some way for the child to communicate it. If the child wasn't aware of when he needed to go, that would also have to be addressed, which can be challenging (there are good techniques for that too though).

There are many problems that come up in toilet training. Naturally, there are many different solutions as a result. However, a common problem I've heard is a child developing a fear of the toilet. This can take many forms, including refusing to sit on the toilet, running from the toilet when it is flushed, and refusing to enter the bathroom at all. The way we handled the anxiety in the story above is "counter-conditioning." In counter-conditioning we provide something desirable and enjoyable (a "reinforcer") to counter the fear. This can be done with many different fears or even things the child simply doesn't like (for example, school). We have to match the reinforcer to the aversion (fear or dislike). If the child is extremely afraid of something, then the reinforcer must be extremely desirable to the child. We want to start off by making the reinforcer available every time the child encounters the aversion. Eventually we don't have to make it available every time; we can start to reduce it and make it inconsistent (maybe available once, but not until two or three times later). This is called "fading" and it is a common technique so the child does not become dependent on the reinforcer.

There are some other recommendations for toilet training here: Toilet Training

"It worked for a little while..."

This story is really about two behavioral concepts that often surprise and frustrate parents: the "Extinction Burst" and "Spontaneous Recovery." First off, when a child is continually engaging in misbehavior, we know that we must change our response if we want the behavior to change. After all, why would behavior change if it seems to be working for the child? So we develop a plan (a "behavior modification plan" or a "behavior improvement plan"), start applying it, see a change in the child's behavior, pat ourselves on the back, and then become shocked and discouraged when the behavior comes back worse than ever before. These events are frustrating, but they are also typical and expected.

An extinction burst is what happens when a behavior the child used to do reduces in severity for a while, but then comes back worse than it was before. There are a lot of ways to think about how and why this happens, but one of my favorites is to consider what people do at elevators or crosswalks. If there is a button that can be pushed to activate the elevator or the "walk" sign, then we often see someone push it once. If the machine doesn't respond in the time we expect, we might push it again. If we're frustrated, we are likely to push it again many times and maybe even harder. This is similar to what is happening with the child. A good example of when this happens is with tantrums.

Initially the tantrums will often reduce as the child has noticed that the way you're responding has changed. We think, "Oh wow, it's gotten better already, that's great!" However, the child is responding to the change because it is new. Once the child has figured out that the change is long-term and gets used to it, the "new" has worn off. Now the child wants things to work the way they did before. She wants something, you say "no", she gets mad and is going to punish you for your behavior. The tantrum starts up and you don't respond. Knowing that tantrums worked before, she's going to go past what she has done before and make a more severe tantrum. The idea, essentially, is that if this worked before, then she just needs to push the button even harder to make it work again. What is critical is that you maintain the same response and plan as you have been doing. That is incredibly hard to do at times because a really severe tantrum is hard to ignore.

Spontaneous recovery is kind of like an extinction burst, except it occurs much later. In spontaneous recovery, we've managed to get a behavior to reduce and it has stayed that way for a long time. We feel pretty good, like we're out of the woods and the behavior is simply "better" now. Suddenly the behavior comes back without warning and we're surprised. It isn't necessarily as severe as an extinction burst, but it surprises us because it has been so long. What we have to remember is that a behavior is never truly completely gone. There is always a chance that it may occur, even if we've managed to reduce it to a very small chance. Just like with the extinction burst, we need to maintain our same response plan, exactly as we did before, and things will continue. It's hard to remember these things, especially if a child is going into a full tantrum and we're stressed out, embarrassed, or frustrated. If we can remember our plan and stick to it, though, we'll help the child learn the appropriate behavior and get things going in the direction we want.

(This is an excellent picture showing the typical pattern of Extinction Burst. It is from another blog, which also has good information about behavior! http://www.iloveaba.com/2011/12/extinction-procedures.html)

Planned "Together Time"

One of my favorite stories from my work is about a child who frequently had severe tantrums and disruptive behaviors at home. The problems weren't quite as bad at daycare, but when he was home after daycare, he would often seemed to suddenly engage in disruptive behavior (like screaming, slamming the door, hitting/kicking the wall or couch...) with little apparent reason. The mother and I brainstormed for a while trying to figure out what was setting him off. It's not rare for triggers to be things we don't notice, so we have to take time to really sit and think of all possibilities and rule them out.

In this case, the child was being raised by a single, working mother. She dropped him off at daycare in the morning and picked him up at about 5pm. Then she made dinner and let him play. After talking for a while, we noticed that whenever he would engage in these tantrums and disruptive behaviors, his mother would go over and talk to him to try to calm him down and find out what was bothering him. He would usually calm down after a bit, but then might start up again later. We thought that maybe it was in fact the mother's response (direct attention) that was maintaining the behavior. Essentially, he was acting up to get her attention.

We came up with a plan for this child that involved a planned period of "together time with mom" every day after daycare. They would simply sit down and enjoy an activity together. The activity isn't terribly important, and if it is TV, then that's fine (we'd rather it be something interactive, but TV is better than nothing!). The mother also taught the child a different way to ask for attention: he could come sit by her, tap her, or hug her. Any of those would start some "together time with mom." (Using words to ask for attention is fine too, but if the child doesn't have good language yet, then these alternatives are easy for them to do.)

Later, if his mother noticed the child getting upset, then instead of scolding him, she would happily call his name and ask him to come sit with her. This is preempting the behavior (catching it before it escalates) so that behavior doesn't get rewarded. To preempt a behavior we have to be especially observant to notice before it occurs. That can be hard to do, but if we can prevent the behavior from even occurring, then it is not rewarded, which is good!

The theory behind this solution:
When a child is engaging in a "bad behavior" to get something (tantrums in this case), it's often helpful to see if we can find an alternative behavior they can do to get the same thing. We want that behavior to be as easy or easier than the original target behavior. That's not always possible, and if it isn't, then we want to make the reward (the payoff) even better to compensate. Ideally, the child also won't have to do the new behavior for as long or with as much energy as the original (basically like just saying one word to get the reward as opposed to a whole conversation).

This story shows an example of addressing the "antecedent" (things that occur before the behavior and maybe cause the behavior to occur) and identifying the reinforcement (the reward that maintains the behavior). Additionally, there is a lot of value in promoting a close relationship with a child: the child listens better, pays more attention to the parent, values the parent's opinion, and the parent feels less stressed and more patient with the child.

Token Reward Systems

Also known as "Token Economies", a token reward system can be a very effective way of modifying a child's behavior, but setting one up and maintaining it is often more involved and more challenging than parents expect. The basic idea is fairly straightforward: Token systems are "money" for children.
However, they require many considerations, such as"

• How many tokens does a behavior earn?
• Should all behaviors earn tokens?
• Should tokens reset at the end of the week?
• How many tokens should the rewards cost?
• Do I need to provide a token every time?
• Can tokens be taken away? 

I've seen quite a few parents begin to implement a token system and run into unexpected difficulties, and I've seen quite a few parents come in and tell me, "we've tried token systems, they don't work!" I'll not say that token systems always work, but they can be used with many behaviors and produce excellent success, but parents need to plan and prepare.

I've written up a basic guide on implementing token reward systems. The guide is meant to provide some guidelines and help parents plan a token system. Token systems often look different depending on the family, the behavior, the child's age, and what the child likes. Parents should feel encouraged to modify these systems as suits them, and involving the child in planning the rewards is usually a good idea!

One last word of caution with a token system: Make it predictable and consistent. Stick to it. It can take a child a while to figure out how a new system works and that it is actually something that's going to be around for a while (and therefore is worth adjusting to). 

Basic Token Reward System Guide

Toilet-Training

The pattern in raising young children seems to be that we strive to help them learn new skills that inevitably make things more challenging for us as parents (crawling, walking, talking... eventually pushing the rules, questioning authority, and making their own decisions). It's all an effort to promote independence, which is good in the long-term, but a challenge in the short-term. Fortunately, toilet-training is one of those times when we're helping them develop a skill to make things easier on us.... eventually.

The process of toilet-training can be tiring and frustrating for the parent and the child. I've worked with a number of parents and children in developing toilet-training skills, including problems such as awareness training (so the child knows when he needs to go), following all of the steps, and overcoming the fear or reluctance to sit on the toilet. Fortunately these problems can usually be resolved with a combination of behavior planning and patience. I've written a general guide to help with toilet-training. The information is from a variety of excellent sources I've read as well as my own experiences in helping parents overcome the challenge of the porcelain throne.

Toilet Training

Why I made this blog...

I have created this blog to collect and present information to parents. I work with many parents and children with childhood disorders and behavior problems. In my experience I have found that parents often come to me with similar questions about their child's behavior, and I often end up saying the same thing. We aren't taught how to parent, as we are taught how to read or do math. It is something we learn through our experiences as children, observing other people, and trial and error. Naturally, we get confused, get overwhelmed, and make mistakes.

Parents also come to me with concerns about their child's development. They worry that their child may be falling far behind in development, failing to learn, or exhibiting abnormal behavior. In truth, there is a wide range of "normal" for children, but sometimes we are right to be concerned. I will also try to provide information to help parents figure out what may be "normal" and what may actually be a significant problem.

This blog is a place for me to collect and make available a variety of resources on how to identify and work with many of the problems that may come up during childhood and how parents might address those problems. I will be posting guides on certain problem behaviors, resources on how to identify potential problems, and tips on how to tell what is "normal" and what may need further evaluation. I will also occasionally post information about certain problems that have come up and how they were resolved; it can be comforting to see what we're not alone in our experiences, and seeing how someone else solved a problem can be very helpful.