Worried about your child’s behaviour? Find out what you can do.

“Human behaviour is incredibly pliable and plastic”-Philip Zimbardo. And I cannot agree more with this quote. Hence, stay hopeful that your child’s current problem behaviour can be resolved. As they say, for anything to change, someone has to start acting differently. And I’m afraid that change should start with you first when it comes to changing your child’s behaviour. Every human behaviour serves a purpose and has a function. And that purpose is usually to meet an ‘unmet’ need. Once you appreciate this, you are on your way to solving your child’s problem behaviour.

In this article, I have discussed the causes of the problem behaviours, the consequences of not addressing these, along with information about who can help you and what they could do to help you. I have also listed dozens of simple strategies to enable you to start tackling your child’s problem behaviour. As always, at the end of the article, I have listed some useful books, support groups and helpful websites, where you could get further information, support and advice.

What are the types of behavioural difficulties?

Behavioural difficulties or problem behaviours can manifest in several ways and in varied settings and situations. In my clinical practice, it is common for me to come across the following forms of problem behaviours:

• Child hurting others or displaying some form of aggression towards others
• Self-injury
• Destruction of toys, or equipment
• Emotional meltdowns
• Temper tantrums
• Eating inedible objects
• Spitting
• Swearing
• Running off
• Demand avoidance and non-compliance with the requests made
• Missing school
• Lying
• Stealing
• Saying hurtful things on purpose
• Sleeping difficulties
• Not eating or using food as a bargaining tool, etc.

All the above can have significant impact on the harmonious functioning of your family, and friendships. Problem behaviours can also have serious impact on your child’s self-esteem, emotional well-being, learning, including their participation in activities both inside and outside of school. Behaviour experts report that many of the above behaviours become established or become ‘learnt behaviours’, as child resorts to these to get what they want. And many (well-intentioned) parents comply and give-in to stop whatever is causing the problem behaviour, thus contributing unwittingly to sustain the problem behaviour.

What causes problem behaviours?

Imagine if you can’t speak? Imagine if you could not convey or communicate what you need? And imagine if you cannot let someone know how you feel? What would you respond then? It is important to spend few moments thinking about these questions to understand why your child behaves the way he or she does, and how they must be feeling. Lack of ability to communicate how one is feeling is the most common reason behind many of your child’s problem behaviour.

Moreover, your child is likely to have not yet developed the ability to control their impulse, manage their anger, regulate their emotional state, negotiate, or even understand what is expected of them. All these factors could be contributing towards the presentation and or perpetuation of their problem behaviours.

Additionally, children with neurodevelopmental disorders, such as Autism/ASD (Autism Spectrum Disorder), ADHD (Attention Deficit Hyperactivity Disorder), Developmental Delay, Learning Disability (LD), Specific Learning Disability (such as Dyslexia, Dyspraxia), Anxiety, sensory impairments such as hearing loss, vision impairment, rarely an undiagnosed medical problem such as muscle spasms, subluxation of hip joint, etc, are more likely to present with problem behaviours, because of the above reasons. Problem behaviours can also result from mental health conditions such as Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), etc, and on rare occasions they could be secondary to neurological conditions such as epilepsy.

Behaviours are often seen as problems or challenges to parents, professionals and services, rather than the problems a child is living with. The services commonly label any behaviour as ‘challenging’ if it is, ‘culturally abnormal behaviour of such intensity, frequency or duration that the physical safety of the child or others around them is likely to be placed in serious jeopardy or a given child and/or his family is denied access to ordinary community facilities’.

Why it is important to address and resolve your child’s problem behaviour?

Behaviour difficulties can interfere with the learning of new skills. Behaviours that are problematic commonly result in some form of exclusion from the routine activities and/or learning opportunities such as in an educational setting. Moreover, behavioural difficulties can place significant stress on the individual manifesting them. They also have a considerable impact on the emotional and mental wellbeing of people around them i.e., their siblings, parental relationships, friendships and peer relationships. Unresolved and persistent behavioural difficulties can alter the course of your child’s learning and may possibly change the trajectory of your child’s ability to fulfil their potential. Eventually, all this could result in suboptimal education, employment and even career outcomes.

Who can help address your child’s problem behaviour?

Whilst this is not an exhaustive list, but many of the below mentioned professionals are likely to come across problem behaviours in children, regularly, in their day-to-day work. As a result, you can benefit from their skills, experience and expertise.

• Professionals who you can approach for help would be:
• Health Visitor (HV)
• Class Teacher/SENCO Coordinator
• General Practitioner (GP)
• Speech and Language Therapist (SLT)
• Behavioural Therapist
• Clinical Psychologist (CP)
• Occupational Therapist (OT)
• Educational Psychologist (EP)
• Social Worker (SW)
• Learning Disability (LD) Nurse
• CAMHS Service
• Child Psychiatrist, and a
• Neurodevelopmental Paediatrician

 

What can professionals do to help?

‘Understanding your child’s behaviour guides the intervention’. Hence the above professionals could do one or more of the following things based on their scope of practice, expertise, analysis and understanding of your child’s behaviour:

• Undertake ABC Analysis of your child’s behaviour:
  • A = Antecedents i.e., what triggers the given behaviour?
  • B = the problem Behaviour-its nature, frequency, severity, duration etc.
  • C = Consequence i.e., what happens after the behaviour? How is it managed?
  • Undertaking ABC analysis of parent’s history will help them formulate a ‘behavioural plan’.
•  Give you strategies to increase the number of desirable behaviours.
• Offer you strategies to reduce undesirable behaviours.
• A clinical psychologist or a behavioural specialist would be able to undertake a ‘functional assessment’ to look at what is causing these behaviours.
• A clinical psychologist or behaviour therapist would also be able to give you strategies to help develop your child’s ability to: communicate their needs, control their impulse, delay their gratification, manage their anger, negotiate their wants and problem solve.
• An Occupational Therapist (OT) or Health Visitor (HV) could offer you specialist equipment and advice on safety adaptations, where necessary.
• A SENCO or your child’s class teacher would be able to assess your child’s educational needs and consider their placement in a suitable educational environment that can meet their needs.
• A SENCO coordinator could also undertake an assessment as part of Education, Health and Care Plan (EHCP) process.
• Your GP, HV or Social Worker could offer you family support.
• Many of the above professionals could put you in touch with local and or national support groups and carers support group.
• The Social Services could offer you short breaks in the form of day-off, residential short breaks, and other ‘flexible options’.
• Could sensory difficulties be contributing to your child’s behavioural difficulties? If so, a paediatric OT would be able to carry out a ‘sensory assessment’ to help prevent sensory overload. They could also help them process sensory experiences that your child experiences.
• A speech and language therapist could carry out a ‘communication assessment’ to help identify specific difficulties in your child’s understanding of language ability and use of language ability. Accordingly, they can give you most appropriate method(s) of communication with your child.
• Medication: This should often be a last resort. And generally, medications are used in conjunction with the behavioural, educational and environmental measures. A neurodevelopmental paediatrician would be able to trial the use of anti-ADHD medication for ADHD or use Melatonin for sleep difficulties.
• A child psychiatrist would be able to consider the use of Risperidone for aggression or conduct disorder. This is usually undertaken under expert supervision/CAMHS service.

 

What can you do?

There is plenty you could do as a parent. I frequently explain to parents that every behaviour, any living organism exhibits, has a reason or a function. Moreover, a given behaviour either persists or resolves, depending on how we deal with it i.e., consequence. I frequently encourage them to think of problem behaviour in the form of ABC analysis, as detailed above. Taking time to understand the cause of your child’s behaviour and appreciating the factors that precipitate or worsen their behaviours, is an important exercise to undertake. Such an understanding will help you resolve these behaviours satisfactorily and for the long term.

Nevertheless, some of the strategies you could implement to tackle your child’s problem behaviour, are as follows:

• Keep your language simple. Use simple and short sentences.
• Use developmentally appropriate language. Avoid too much language for them to process.
• Give one instruction at a time.
• Wait for them to give a response.
• Teach them new words or phrases, to help them communicate their needs and feelings.
• Avoid abstracts and minimise negatives in your speech, such as the use of “not” and “don’t”.
• Avoid or minimise the use of time concepts such as “yesterday” and “tomorrow” if your child finds it hard to follow.
• Avoid sarcasm.
• Consider using objects, pictures, and symbols, to help them understand what you wish them to do or what you are saying.
• Try to use multisensory forms of communication, such as, use of emotional faces, traffic lights, thumbs up or thumbs down.
• Use visual forms of tools, such as, visual timetable and visual calendar.
• Consistency and routine helps.
• Plan for ‘transitions’, through use of countdowns, advanced warning, visual charts, social stories, etc.
• Avoid or modify situations that bring on your child’s problem behaviour.
• You can reduce the undesired behaviours and increase the desired behaviours, by doing the following:
  •  Remain calm
  • Speak minimal and in calm voice, especially when they are upset.
  • Ideally, speak to them only after they have calmed down
  • Resist the temptation to give-in to their demands.
  • Try and not show your irritation.
  • Maintain consistency in your approach.
  • Consistency between parents is important.
  • Say only what you mean and mean what you say.
  • Ignore minor behaviours where you can
  • Instead, try and catch them when they are good, e.g., say, ‘it’s so good when you are playing quietly’, ‘well done for asking politely’, ‘it’s wonderful to see you play and share with your sister’, etc.
  • Think ‘situations’ that bring out problem behaviours, e.g., taking your child to the park rather than staying all day indoors.
  • Think and give them a ‘choice’, wherever possible.
  • Identify and act on ‘triggers’ e.g., hunger, fatigue, boredom, anxiety, sensory overload, etc.
  • Apply remedial measures such as ‘time-out’, countdown, loss of privilege such as screen- time, consistently, calmly and proportionately.
  • Keep punishments and loss of privileges to minimum.
  • Reward them more often., e.g., sticker chart, a small treat, special 1:1 time with a parent on a regular/daily basis, extra screen time as a reward, etc.
  • Rewards should be given as soon as possible after the desired behaviour.
  • Listen, when they speak. You don’t have to agree, but actively listen.
• Take some ‘me’ time. Take some quality time to walk, go out for a cup of coffee, etc. This can recalibrate your mood, give you perspective, refresh and reenergise you. As Dalai Lama said, ‘don’t let others behaviour destroy your inner peace’. Some ‘me’ time helps enormously.
• The impact unhealthy lifestyle behaviours can have on your child’s behaviour is massively underestimated. For this reason, promote and encourage outdoor/physical activities, offer good diet consisting of fruits, vegetables, dairy and wholegrains, and help them have the recommended amount of sleep.
• Deal with one behaviour at a time.
• Believe in your abilities as a parent.
• Attend a parenting programme. This can be very positive and helpful.
• Network. Speak to other parents.
• Speak to any of the above professionals, who could either give specific advice or direct you to the correct professional who can help.
• Read further resources or contact support groups, mentioned below.
• Lastly, keep hope and stay positive.

 

Conclusions:

As they say, ‘the moon moves slowly, but it crosses the town’. Do not be discouraged if you do not see rapid resolution of your child’s problem behaviour. An understanding the above principles and calm and consistent application of the above techniques will help you solve the problem behaviour in your child. The use of above strategies would also nurture and help build strong bond with your child, for the long term.

Further Resources and Sources of Support:

1. S Gada, Oxford Specialist Handbook of Neurodisability and Community Child Health, Oxford University Press, ISBN 978-0-19-885191-2. https://www.amazon.co.uk/Neurodisability-Community-Specialist-Handbooks-Paediatrics/dp/019885191X
2. Incredible years website: http://www.incredibleyears.com/ParentResources/
3. Family and parenting institute: http://www.familyandparenting.org/
4. Family Lives website, https://www.familylives.org.uk/advice/primary/behaviour/challenging-behaviour
5. Young Minds Parents Helpline (offers information and professional advice), Tel: 0808 802 5544, Web: http://www.youngminds.org.uk/
6. MindEd for Families, parenting tips and managing common issues. https://mindedforfamilies.org.uk/young-people/
7. NSPCC website, https://www.nspcc.org.uk/keeping-children-safe/support-for-parents/cope-with-tantrums
8. A good book: How to talk so kids will listen & listen so Kids will talk, by A Faber & E Mazlish
9. Challenging behaviour foundation: charity for children and adults with severe learning disabilities. Information sheets for managing behaviour at: http://www.thecbf.org.uk/
10. The explosive child, by W Greene.
11. Child Mind Institute – Complete Guide to Managing Behaviour Problems. https://childmind.org/guide/parents-guide-to-problem-behavior/#block_64cbd9b5b5eea
12. Young Minds-fighting for young people’s mental health. https://www.youngminds.org.uk/parent/parents-a-z-mental-health-guide/