Managing Challenging Behaviours

Behaviour modification

When a child is born, it’s mind is like a tabula rasa i.e. a blank slate. Upon this are impressed early life experiences which as you can imagine form the basis of what this person may turn out to be like in the future.

An infant does not come with innate skills to communicate. The brain has much capacity to develop but at this stage the cognitive and language faculties are fledgling to say the least. It is not hard to comprehend why a child has to resort to crying, screaming, flailing its hands and legs, throwing objects around to draw the parents attention to its needs of hunger, sanitation and so on. The tantrum works, the parents attend and meet unmet needs.

As the child develops language and cognitive skills with the development and maturity of the frontal cortex, tantrums will recede (typically after age 4-5) but for some they do not and continue in to adolescent and adult strops. Why may such maladaptive behaviours continue?

  1. The tantrums worked and hence the behaviours are reinforced and continue unabated.
  2. Some parents fail to role model positive coping with stress and may in fact display adult tantrums in face of stress.
  3. In time the transaction or communication patterns get entrenched and one person cues the other, often inviting them to reenact a daily pattern over the most trivial matters.

Changing the patterns: Ignoring -

  1. Change the rules of transaction, if one person does, the other is forced to as well.
  2. Rather than allow the tantrum to draw your attention either positively by meeting the demands communicated or indeed reinforced negatively by way of attention albeit by entering a shouting screaming match - ignore the tantrum
  3. Learn some mindfulness and coping methods which allow you to accept the tantrum without reacting to it, stay calm , polite but firm, go about your business (house chores) while keeping an eye on the situation (you may intervene only if risk to life is posed at any stage).
  4. Ignoring is powerful, but you must sustain it. Remember the tantrum has worked in the past, so expect the tantrum to get worse for few weeks - the person will raise the stakes, seek to provoke you back in to your entrenched pattern and join a shouting match (negative attention) or give in to their demand (positive attention) - so if the tantrums are getting worse, congratulate yourself and stick with it, you are doing just fine.
  5. Sooner than later the penny drops - realisation that “a tantrum does not get me what I need…...why bother with it”. So you have a burst of tantrum (or any behaviour which is fast becoming useless) to raise stakes before it dies - psychologist call this extinction burst.

Ignoring needs to be combined with other strategies like a rewards programme.

  1. All that attention (positive and negative) that you have withdrawn by ignoring, use all that energy, invest it when the person is at their best behaviour.
  2. When a person exhausts the tantrum, they would calm down and become more civil.
  3. Find such moments to role model problem solving and use of language and cognitive skills to discuss and communicate needs differently.
  4. When the person has demonstrated the acceptable behaviour - reward immediately through praise.
  5. Praise - is not easy, try and make a list of adjectives one may use as praise may find the need to get a dictionary out to compile a list. Use this creatively but also make praise 'specific' - the person needs to what specific behaviour has drawn your worthy attention and praise is for same.
  6. Material rewards within reason supplement but do not substitute praise and non-material rewards (a stroll in the park or a game of footy in the backyard is more powerful than giving someone candy).
  7. Here is a typical rewards program sample and blank sheets for you to download.

Bribes and Punishments

  1. Rewards demanded and given prior to acceptable behaviour are bribes, do not succumb to this.
  2. Punishment follows an unacceptable behaviour but tends to be less effective, people oft get it wrong.
  3. If you have instituted the above rewards programme, as a rule avoid taking points earned (you don't lose the wages you earned for 20 days work put in if you din't show up one day, do you? Would you go to the job again if this was the case? Do this and in my experience invariably the young person loses interest in staying engaged with the negotiated rewards programme.
The above principles also apply with some differences to dealing with adult or adolescent difficult behaviour.
Difficult behaviour may be due to underlying medical / psychiatric causes - ADHD / learning disability, one needs to get expert help to assess and treat these conditions to allow the above to work in complementary manner.

Dr A Joglekar