Tag Archives: oppositional behavior

Want Better Self-Regulation in Young Children? Help Them Manage Aggression

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You might think as a pediatric OTR, I would be writing a post about sensory-based treatment for self-regulation.  And I have in the past.  Not today.

But I have been an OTR for decades, and what I know about today’s children is that agitated and dysregulated kids often need help managing aggressive impulses and negative emotions first, in order for me to assess whether or not their behaviors have a sensory basis.

That’s right:  a young agitated child cannot be assumed to have sensory processing difficulties if they haven’t learned any self-management tools.  It is too easy to assign them a label, and I refuse to do that.  But I can and will use effective techniques to manage aggression before I jump in with all the bells and whistles from my sensory processing treatment bag.

What works for me?

I get a lot of mileage out of Dr. Harvey Karp’s Happiest Toddler on the Block strategies.  Once I learned these simple techniques, I applied them to every situation in which a young child was oppositional, aggressive, defiant, or threatening/delivering a tantrum.   That could be every session!  Toddlers aren’t known for their easy-going ways.

His Patience Stretching, Fast Food Rule, and Time-Ins are my three-legged stool that supports my therapy sessions.  Read Use The Fast Food Rule For Better Attunement With Your Child and Stretch Your Toddler’s Patience, Starting Today!  Kids aren’t born with the ability to handle frustration and manage impulses.  Adults teach them how to deal with their feelings.  When they aren’t taught what to do when they are disappointed, when they want attention, or when they are angry, things can get pretty unpleasant.  The good news is that learning can begin around their first birthday.

Job number one should never be unclear to anyone, but as time has gone on, fewer and fewer parents seem to communicate it clearly:  physical violence from anyone isn’t acceptable at any time.

Are parents committing violence against their child?  No.  It is the child that is biting, hitting, or damaging items.   “We don’t hurt people or animals in this house” isn’t always communicated clearly to a child.  I never hear a parent say that they like being smacked across the face by their child, but they also seem to struggle to clearly communicate that this behavior is unacceptable.  Resorting to responding with violence is not helpful.  Teaching how to manage aggression can be done without spanking a child or even raising their voice.  Changing their tone of voice and rapidly putting the child out of arm’s reach will make it clear to their child that they have crossed a line.  But so many parents seem hesitant to set limits, and some seem to worry that being firm will harm their child or hurt their feelings.  This is coming from,  remember, the same child that just smacked them in the face or bit them.  By not reacting clearly, parents are in fact communicating that aggression toward others isn’t a problem.

I try hard to teach parents that it is kind and loving to teach children that they can have their feelings but they cannot express them with aggression.  There are limits in the wider world, and if they act this way with people that don’t love them, the consequences aren’t going to be good.  Learning to hear “no” from someone that loves you is a lot easier.

Young children need to learn the vocabulary of negative emotions like anger, disappointment, frustration and sadness.  They need to practice waiting and need to be spoken to in a way that makes it clear that they are understood but may not get their way all the time.  Negotiation and appreciation go hand in hand.  Dr. Karp’s techniques really work for me, and they aren’t difficult to learn or use.  I wish every parent would try even one and see how easy they can be incorporated into daily life with young children!

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Young Children, Sensory Modulation, and the Automatic “NO!”

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Kids as young as 18 months can express their sensory processing issues with one word: “NO!!”  What appears to be a budding attitude issue or even oppositional defiant disorder can be a sensory modulation issue instead.

How could you possibly tell?

Well, if your child has already been diagnosed with sensory sensitivity or sensory modulation problems, you know that these issues won’t just make it harder to wear clothes with seams or touch Play-Doh.  These issues affect all aspects of daily living and create emotional regulation and biological over-activation issues as well.  Young children are learning how to express their opinions and separate physically and emotionally from their caregivers.  Saying “NO!” isn’t unusual for young kids (and a lot of older ones too!).  But refusals that make no sense can have a different origin.

So what is the giveaway?

When a child has an almost immediate “NO”, perhaps even before you have finished your sentence, and the reaction is to something you know they have liked or almost certainly would like, you have to suspect that sensory modulation is at play.  You usually sense when your child is trying to get your attention or get you activated.  This should feel different.

What do I do next?

You also need to respond in a specific way to test your theory that sensory issues are the root of the ‘tude.  Your response should be as vocally neutral and emotionally curious as you can manage.   “Oh, really….you said no…” is a good template.  Whether it is “no” to their fave food, show, toy or an activity.  You remove all criticism and encouragement from your voice.  You don’t want to fuel the refusal fire; you want to shut it off and see what is left in the embers of “NO”.

Now you need to wait for them to neurologically calm down.  Little brains are like old computers.  They take a while to reboot.  Look at the floor, wipe your hands, etc and wait a minimum of 15 seconds, probably 30, then ask again if they want a cookie, want to go out, want to play, to eat, or whatever.  The child who needed the primitive defensive part of their brain to go offline to allow them to use their budding frontal lobes may sweetly ask for what they just refused, or respond to your exactly identical request with a cheery “YES”.

Please try to have compassion for them.

It can seem maddening to do this all day long, and in truth, if you are, you need to learn how to work with an occupational therapist in order to learn powerful sensory treatment strategies that can get your child out of this pattern.  But your child isn’t jerking your chain when their behavior fits this pattern.  They are more likely a captive of their brain wiring.   Don’t let yourself react as if they are intentionally being difficult.  That day will come…..13 is just around the corner!

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Defiant Kids Can Change With Dr. Kazdin’s Simple Plans

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Dr. Alan Kazdin wrote “The Kazdin Method for Parenting the Defiant Child” in 2008. His follow-up book, “The Everyday Parent Toolkit” came later.   He is the director of the Yale Parenting Center, and he has seen some hardcore kids.  You do not get the feeling that he has treated a lot of children younger than 2, and based on the techniques he uses, it seems like a child would need more cognition and language than a young toddler to respond well without adaptations.   Not a problem: Dr. Karp created the Happiest Toddler on the Block, and he has done a great job dealing with defiant 18-month-olds.   Read Why Telling Your Child “It’s OK” Doesn’t Calm Him Down (And What To Do Instead) and  Toddler Demands? Give it in Fantasy! for some good strategies that work.  if you r preschool child has already lobbed some hateful statements at you, read What To Say When Your Child Says “I Hate You!” .  But if your kindergartener refuses to go to bed or your teenager won’t do her homework, this Kazdin guy has really helpful ideas for you!

Dr. Alan Kazdin’s books can change the dynamic for families that feel their life is one battle after another.  If you have embraced the idea that you can target defiance through behavioral science, then he is already preaching to your choir. If not, you might be wary. The funny thing is, when you are using the program, it doesn’t feel that much like science.  You feel like you are connecting with your child’s better nature.  He has crafted strategies that really work.  The biggest drawback is that if you make too many beginner mistakes it will seem as if it is never going to work.  I recommend that parents actually read the books and understand the principles he is using to change a child’s behavior.  This is one of those techniques that you can’t learn in a 900-word article in a magazine.  You might be inspired in a short article, but you won’t learn enough to “take it on the road” and really use it.

Bonus:  understanding a child’s behavior helps us understand the impact of rewards and consequences on our bosses, our mates and on ourselves!

I liked his first book, but I don’t think it took off in parenting circles.   I am going to guess that his first book was a little intimidating for some parents, as it does a very thorough job of explaining how behavioral plans work.  Not every parent wants to think of their star chart in terms like “positive reinforcers” and letting go of the chart as “extinction of reinforcers with intermittent rewards”.  His second book, “The Everyday Parent Toolkit” is a little more user-friendly, but still gets his message across.  The truth is that all of our interactions can be viewed through a behavioral lens.  When a child is refusing to do their homework, telling you that you are the worst parent ever, and then breaking the lamp, it might be time to explore a strategy that takes out some of the drama and focuses on how you really want your evening to go.

Dr. Kazdin is very focused on positive interactions and warm exchanges. He is aware that adult stressors make reacting calmly to a screaming child harder, and screaming children create stress for adults.  He has sympathy for everyone, but sees parents as the agent of change in this situation.  He is like the white-coated scientist with a “Mr. Rogers” sweater on underneath!

My suggestion:  read both books and think about how to start out small.  Attack a small problem behavior first, then refine your approach as you address some of the bigger defiant behaviors.  And consider reading “The Happiest Toddler on the Block” if your child has a cognitive age of less than 6.  Many of those techniques will be even easier to implement and work very well to smooth out the waters so that Kazdin’s techniques work better and faster!

Not sure you want to do this alone?  Visit my website tranquil babies and purchase a consultation session.  I do phone sessions with parents to help them craft a plan and provide support along the way.  Being able to ask questions and tell your story can make such a difference in how you see your child and yourself!

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