Basic behavior management

Think about helping a child learn about finger paint. Let's imagine these children had never seen finger paint before. Hardly any caregiver would ever think of just putting out lots of paint in front of this group of young children without some guidance.

A top-notch caregiver might talk about finger paint, show the children its consistency, and probably demonstrate how to use it on paper. The caregiver probably would give the children a few cautions about not throwing or slopping the paint or not dumping the entire jar of paint on the paper. No caregiver would simply put out the open finger paint jars and go do something else. She would watch carefully, making appropriate and encouraging comments about what the children are doing.

Every one of you, if you were in this situation, would be patient, and would not yell if the child accidentally dropped some paint on the floor. You'd calmly tell the child to get a paper towel and wipe it up. You would realize the child is learning, and that the child is a beginner in this business of using finger paints.
Helping a child learn what is acceptable behavior is much like helping a child learn about finger painting. It takes patience, it takes repeating, and it takes firmness. In our example, if the child deliberately turns the jar upside-down and dumps the paint onto the floor, you would talk with the child and probably end the finger painting activity. But you would do it calmly, and you would understand that the child is not ready, at least today, to do finger painting.

So it is with behavior. The one big difference is that behavior is occurring all the time. Unlike finger painting, you can't tell the children, "Now we are going to behave!" Why? Because they are behaving all the time. You meet new situations all the time. So do they. They don't always know or remember how to act. Because you are an adult, you developed some skills that will enable you to deal with most of the situations you run into. Remember, children are beginners. They don't have much experience. Most situations children face are new.

Many caregivers come to the pediatrician or other family physician with complaints about their children's behavior. These complaints are particularly common during toddlerhood, when children begin to assert themselves and their wills. Basic behavior management is most useful when started at this time. It becomes increasingly more difficult and less successful as children age. The following guidelines can assist caregivers who are motivated to make changes in their children's behavior.

Changing a child's behavior is an adult's work
It is important for caregivers to understand that managing behavior will require a significant amount of work on their part. They must be willing to make changes and spend time and energy. To do it occasionally, to start then stop or to give in too quickly is a waste of their time and confusing to the child. However, energy invested now will reap benefits for years to come.

Keep it simple, keep it quick, keep it coming
Caregivers should begin with reasonable expectations for their child, considering his or her age, developmental level and any health concerns particular to the child. Caregivers must be precise about what they want the child to do. "Listen better" is the most common request, but it is vague at best. Children usually listen to what a caregiver says, but choose to disobey. "When mom says stop, you stop," is much clearer to the child. He or she knows exactly what is expected. The more simple and specific the request, the more likely the child will comply.

Pick the right place to start
Once caregivers have identified the behaviors they want to change, they must choose which one to work on first. Chances for success are increased if caregivers work on one behavior at a time. Start with a behavior the child can change, but not the one that is the most common. 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 a child is successful, he or she is more motivated to continue working.

Provide immediate feedback
Responses to behaviors, both positive and negative, must occur quickly. Children have short attention spans and their memories still are developing. For young children (age 4 and younger), waiting seven days (while they collect enough stars or stickers or "good days") is not effective. They need more frequent acknowledgement of their efforts. They also require more reminders of what they are trying to change. Several times a day a caregiver can say, "Remember you are working on not hitting." Preventing an undesirable behavior is better than having to provide a consequence after it has occurred. If a child has trouble every time he and his brother play with cars on the floor, saying, "Remember, you are working on not hitting," may help the child to find another way to manage the difficulty. Suggesting another way to handle the situation is even better.

Increase the chances for success
Avoiding situations where the child is likely to have trouble is another basic element. If the child cannot manage being in the grocery store without crying for a candy bar, he or she is not ready for the store. If a chocoholic mother is dieting, a good spouse does not bring home a chocolate cake and set it on the table in plain sight. As much as possible, caregivers must assist their children in the same way by reducing circumstances in which their children are likely to fail.

Be prepared to be consistent
Consistency is the most important part of managing behavior. If a caregiver gives a time-out for hitting sometimes but not every time, the child often will think it is worth a try. If the child doesn't know for sure, he or she doesn't know change is necessary. Keep in mind that children don't wait to challenge until their caregivers are well rested, full of energy and have all the time in the world. Children challenge when their caregivers are tired, preoccupied, sick, pressured, on the phone, with company, in the car, in the store, in the restaurant. Being prepared to leave the shopping cart in the middle of the aisle and remove the child from the store is difficult, but this sends a strong message that changing this behavior is so important that the caregiver is willing to forego something he or she wants in order to achieve it.

When good, simple, quick, consistent attempts to change behavior fail, it may be time for professional help. If caregivers are struggling with serious behavior problems on a daily basis and tips like these don't help, pediatricians and other primary care physicians can assist by referring families to pediatric behavior management specialists.


Funding for this program provided by the Department of Health and Human Services