Psychiatry and Behavioral Medicine Center - Articles

Basic behavior management

Many parents come to the pediatrician or another family physician with complaints about their children's behavior. This is especially common among parents of toddlers, when they begin to assert themselves and their wills. Now is the time to start basic behavior management because it becomes more difficult and less successful as children get older. The following guidelines can help parents make changes in their children's behavior.

Changing a child's behavior is an adult's work
It's important to understand that managing behavior requires a lot of work on the parent's part. To do something occasionally or to give up too quickly is a waste of your time and is confusing to your child. The time and energy invested now will provide many benefits for years to come.

Keep it simple, keep it quick, keep it coming
Begin with reasonable expectations for your child, considering his or her age, developmental level and any health concerns particular to the child. Be very specific about what you want your child to do. "My child doesn't listen" is the most common parental complaint, but it is unclear. Children usually listen to what their parents say, but choose to disobey. Try saying, "When mom says stop, you stop." This is much more clear to your child. He or she knows exactly what is expected. The more simple and specific the request, such as "No hitting," the more likely your child will obey.

Pick the right place to start
Choose one behavior to work on first. Chances for success are better if you focus on one at a time. Start with a behavior your child can change, but not the one that happens most often. Choosing a behavior that happens every day but not many times a day offers a better opportunity to reward good behavior and provide consequences for undesirable behavior. When your child is successful, he or she is more motivated to continue working.

Provide immediate feedback
Responses to behaviors, both positive and negative, must happen quickly. Children have short attention spans and their memories are still developing. Children age 4 and younger need acknowledgement of their efforts more frequently. They also need more reminders of what they are trying to change. It's OK for you to say, "Remember you are working on not hitting," several times a day. Preventing an undesirable behavior is better than providing a consequence after it has occurred. It also may help your child find another way to manage the difficulty. Suggesting another way to handle the situation is even better.

Increase the chances for success
Help your child as much as possible by keeping him or her out of situations in which he or she is likely to fail. If your child cannot be in the grocery store without crying for a candy bar, then he or she is not ready for the store.

Be consistent
Consistency is the most important part of managing behavior. If you give a time-out for hitting sometimes, but not every time, your child will think it's worth a try. If your child doesn't know for sure, then he or she doesn't know change is necessary. Remember, your child will challenge you when youÍre tired, sick, on the phone, with company, in the car, in a restaurant or at the grocery store. Being prepared to leave the shopping cart in the middle of the aisle and leaving with your child is difficult, but it sends a strong message: Changing this behavior is so important that youÍre willing to forego something you are doing in order to achieve it.

When simple, quick and consistent attempts to change behavior fail, it may be time for professional help. If you're struggling with serious behavior problems on a daily basis and tips like these don't help, your pediatrician and other primary care doctors can help by referring your family to pediatric behavior management specialists.

The Temper Tantrum Clinic is part of the Child and Adolescent Psychiatry and Behavioral Medicine Center at Children's Hospital of Wisconsin. It serves parents and their children ages fiveæand younger who have severe behavior problems, which we see in their temper tantrums. Visit www.chw.org for more information.

By Kimberly Gerlach, LCSW, CTS, Child and Adolescent Psychiatry and Behavioral Medicine Center, Children's Hospital of Wisconsin