Ask Dr. Susan

What types of behavior problems are common among children?

There are two basic categories of misbehavior: willful and non-willful. Willful misbehavior is when a child does something he knows he shouldn’t do, but does it anyway. Examples are physical assaults (e.g. hitting, kicking, etc) and verbal disrespect (e.g. screaming, arguing, refusing, and name calling). Non-willful misbehavior is when a child fails to do something he knows he should, or has agreed to do. Although done unintentionally or without thinking, it annoys, frustrates, and angers others. Examples are agreeing to complete a task and taking too long because of distractions or not doing the task at all because of “forgetting”. Both willful and non-willful behaviors provoke negative responses, but only willful misbehavior is intended to do this.

Why do children misbehave?

Willful misbehavior is often committed by strong willed, overly rigid, or aggressive children. They are done to annoy, punish, provoke a reaction, seek revenge, obtain a desired object, or avoid an undesired task. The child often feels angry, may not be remorseful, and may claim, “It’s your fault!”  Non-willful behaviors are done unconsciously and tend to occur in children who are impulsive and easily distracted. The child typically feels frustrated when they are punished because they meant to follow through but failed. Their self esteem can suffer and they may begin to perceive themselves as “stupid” or say “I can never do anything right.”

What is the best way to handle willful misbehavior?

Clear rules are needed to specify what behaviors are expected and what consequences will occur if the rules are broken. For example, a typical home rule might be “no hitting/hurting” and “no rude talk”. A typical consequence for breaking the rule is a brief time out (about a minute per year of age). Ideally, you would warn the child of the consequence when the rule-breaking behavior begins to escalate. It would also help to coach the child regarding an alternative good choice he or she could make to deal with the situation more appropriately. If the child insists on challenging you or breaks the rule, you need to implement the consequence swiftly and without further discussion. Use a normal tone of voice and stay as calm as possible to avoid further emotional escalation.

What if the child refuses to comply with the consequence?

Younger children may have to be physically escorted to the time out area and then firmly told “stay here until I tell you to get out.” Return them to the time out area if they bolt, but avoid further discussion. Actions really do speak louder than words! Avoid physical confrontation with older children. Instead, inform them that until they comply with the consequence, all of their privileges are revoked – including TV, computer, phone, friends, etc. If they complain, use the broken record technique to remind them, “I’ll be glad to reinstate your privileges as soon as you comply.” Other logical consequences, such as chores and longer privilege removal are options for older children and teens for disrespect, curfew violation, lying, and other forms of acting out.

What is the best way to handle non-willful misbehavior?

Punishment is not very effective and can even escalate the situation if the child’s misbehavior was not purposeful. Structure and rewards work best to improve compliance. Develop a plan to address the specific problems, like not getting ready on time in the morning, or not doing homework or chores. Break the task down into simple steps and encourage the child by noticing any effort they are making to comply. It is critical to pay attention to the positives rather than focusing on shortcomings and failures. Give them lots of hugs, “wow”s, and “atta-boy’s as incentives to change. Young children can earn stickers, stamps, small toys, and enjoyable activities. Teens can earn car, phone/computer privileges or needed cash. It isn’t necessary to use material rewards, but it makes sense to encourage children to “earn” desired objects rather than spoiling them with too many free things. It also helps teach kids to prioritize their wants and needs and appreciate the value of a dollar.

What can parents do if these basic techniques don’t work?

Consult a behavior specialist. Your child may have a specific condition that needs to be addressed. For example, attention or learning problems, sensory integration dysfunction, a mood or anxiety disorder, etc. A thorough exam, proper diagnosis, and specialized behavior modification plans are needed to address these issues. Don’t be afraid or embarrassed to ask for help!

Dr. Susan Istre, LPC-S has been in private practice in Dallas for over 20 years. She is the Founder and Director of the Center For Social Success, with offices in Dallas and the Shelton School. Dr. Istre and her  staff therapists provide a broad range of services to children, adolescents, and adults. They often help parents develop positive home behavior plans. Call for more information.  They can help!

Why do some children have problems making and keeping friends?

Children at risk for peer problems are typically either shy and withdrawn or loud and aggressive. They may under or overreact to others because of their basic personality style, or because they have a tendency to be anxious, moody, or impulsive. Children with language delays, attention, and learning problems are particularly at risk because they more often miss or misinterpret social cues and lack specific social skills.

How can parents and teachers help?

Children with peer problems need coaching and support to learn new skills, become more self aware, effectively communicate feelings, and solve problems. Adults can serve as good role models and give step-by-step advice and a lot of positive reinforcement for appropriate behavior.

When should a child be referred to a therapist for help?

When a child continues to be socially isolated or socially rejected and parents have been unsuccessful in their attempts to help, a child needs to see a specialist. Therapists trained in this area can conduct an assessment to determine specific skill deficits and determine if other evaluations are needed to rule out attention and learning problems, language and motor delays, and mood and anxiety disorders.

What is the most effective treatment for social skills problems?

Group therapy is needed to teach children specific skills and give them real-life opportunities to play and interact successfully with other children. Therapists use techniques such as direct teaching, role modeling, role play, real play, and feedback to teach and practice social skills.

How long does social skills training take?

Changing social behavior takes time. Most groups meet for one hour one time a week for several months. Children learn specific skills each week and then have a chance to practice the skills between sessions.

Are parents involved in the social skills training?

Parents definitely need to know what the children are being taught in group so they can reinforce positive changes in the child’s behavior. Monthly parent meetings are ideal to review training techniques and get feedback on progress and problems at home and school.

How much does social skills training cost?

Group therapy is typically about one half the cost of individual therapy. It is also much more realistic and effective than individual therapy to treat social interaction problems.

Where can I go to get help for my child?

Call your school counselor or ask your family doctor for the counseling center nearest you that does social skills training.

Dr. Susan Istre, LPC-S has been in private practice in Dallas for over 20 years. She is the Founder and Director of the Center For Social Success, with offices in Dallas and the Shelton School. Dr. Istre and her staff therapists provide a broad range of services to children, adolescents, and adults. Social skills training is one area of specialization.  Call today for more information.  We can help!