Monday, July 18, 2016

Challenging Behavior are a Source of Confusion and Stress

Parents usually ask me what to do with their kids when they are rigid and their tantrums are frequent and intense (lasting for long periods of time and being violent). Often times these kids have to be restrained to prevent them from kicking/punching holes in the walls and hitting others. A parent recently shared with me that her son becomes so aggressive that “his sisters run away from him and hide in the corner because they are scared of him.”  

Some of my recommendations include providing these kids with alternative things to hit and tell them that they can scream as loud as they want but inside their room. These strategies work, sometimes. But kids often refuse them.  So more intrusive strategies have to be implemented. I encourage parents to use distracting techniques. For example, redirecting their children to a coping kit: a box of sensory stuff to play with, such as squishy balls, hand pump, musical instruments, etc. It might take some time but eventually it helps to distract and calming them down.  

I’m not naïve. I know it gets confusing to decide what to do during the “eye” of the storm when the tantrum is at its peak and kids are at their most violent. Challenging behaviors are indeed a source of confusion and stress.

Parents can’t allow kids to bang on the walls/doors, or hit people in the house so sometimes they feel the only thing they can do is restrain them.  On those situations bear hugging them from behind is a good idea.     

Although restraining, distracting and redirecting to alternative activities are the right thing to do, they are not enough. I highly recommend to combine those strategies with highly motivating rewards when kids are not tantrumming and distracting them at the first signs (precursors) of distress to prevent the “storm” all together.  

Talking about their feelings is great. The more verbal communication the less "behavioral" communication. Teach them how to appropriately express wants and needs. And listen to them.

When possible make a plan together with your kids about the schedule of activities. Let's give him some control because otherwise they’ll “fight” for it.   

As difficult as they may seem, kids who seek control and communicate their feelings (even when the communication is through challenging behaviors) have a lot of potential and respond very well to the consistent implementation of effective behavior management strategies. When you withhold rewards contingent on problematic behaviors and consistently reward the non-occurrence of those behaviors they quickly understand that they are missing "the fun."

It is also important in those difficult situations to give them a "do-over" possibility. That way they regain control. Being angry and punishing for the rest of the... (session, day, outing, etc.) will only make the situation worse. The "as soon as you calm down you can play, let me know when you are ready" approach is very powerful.

And remember, tantrums are the best opportunity to teach kids they won't work.   

Daniel Adatto, BCBA