by Mary Abreu

It’s not unusual for special needs children to have occasional behavior problems, whether they resist doing homework or act out at the grocery store. Parents of children with attention deficit hyperactivity disorder, autism and a host of other disorders, however, often find that they are in for a long, arduous journey through a host of behavior issues, from willful disobedience to outright aggressive and destructive behaviors. It’s a problem that creates friction between parents who may disagree on approaches to managing the behavior issues as well as limits quality family time since so much time and energy are spent dealing with the difficult child.

A growing number of parents are finding success through behavior management, which gives parents the tools and strategies not only to cope with their child’s less-than-ideal behavior but actually change it.

Who can benefit

Behavior management programs can help nearly every parent, says Brad Bezilla, May South’s director of home-based services. “It’s not just limited to children with autism or developmental disabilities.”

In fact, any child who has an ongoing problem following the rules, no matter how small, can benefit, says Michael M. Mueller, director of behavioral services for Southern Behavioral Group Inc. “It could be self injury, aggression, property destruction, or more routine kinds of child problems like not doing what they’re told, not cleaning their room, not having good routines, not doing homework.”

They are particularly a must for children who exhibit destructive and dangerous behaviors, say the experts. Mueller says this is where professional programs can be especially helpful.

“Once compliance is taken care of, if the child is still exhibiting the behaviors, we have to get more specific,” he says. “The behavior management strategies need to be matched to the reasons why kids are doing something.”

For example, if a child like Dylan gets aggressive or angry about doing his homework and is sent to timeout, he has accomplished his objective – not doing his homework – via the punishment. “Letting the child out of what he already wants out of is making it worse,” Mueller says. The alternative might be to break up the homework session into smaller chunks of time and provide a tangible reward for completing each time block. Over time, the parents can increase the length of each homework mini-session.

“We need to highly reinforce appropriate behaviors so they spend less time being inappropriate,” says Bezilla.

Children as young as 2 can benefit from behavior management, says Mueller. Because autism is diagnosed between ages 2 and 3, behavior management experts often see autistic children earlier. The experts usually help children with ADHD between the ages of 7 and 14.

Early intervention yields the best results, he says, because children learn quickly how they can use behavior to get what they want. That doesn’t mean throwing in the towel if you have an older child. “There’s no age at which you can’t change behavior,” says Mueller. However, if a child has a communication problem, it’s better to begin the process earlier rather than later because it’s much easier to teach formal language systems before age 10.

Of course, it’s important for parents to be committed to the process, which can be challenging, at best. “I think if a parent thinks that they’re going to do therapy and all of a sudden are taught something that will be as easy as hearing it and they’ll just change it,” they are setting themselves up for failure, says Dr. Thomas G. Burns, director of neuropsychology at Children’s Healthcare of Atlanta. “If a child exhibits aggressive behavior, deep down it’s because the child is angry or has agitated aggression. You have to put time in and work at trying different strategies.”

He suggests looking at a lot of different forms of therapy and finding a therapist who will be a good fit for the family. “Part of it is being able to trust and have confidence in the person that you’re going to.” Other parents who have been through similar experiences can be a resource for finding a therapist.

A psychologist suggested Jill Prussack of East Cobb try giving son Jake, 10, negative consequences when he displayed unacceptable behavior. She quickly found it didn’t work. “We tried that and he was so belligerent and obstinate,” she says. “It just hasn’t worked for us.”

Prussack researched other behavior management methods to try to find something that would work for their family and help Jake, who has ADHD.

“What worked the best overall was [the book] 1-2-3 Magic,” says Prussack. “I think positive reinforcement probably has had the most success for us.”

Since implementing the strategies in the book, Prussack says she and her husband have learned how to communicate to Jake their expectations for his behavior, as well as to recognize his limits. They also reward Jake for achieving the goals they set for him.

“We’ve revised it over time, because you learn as you go,” she says. “We do more immediate rewards now. And if the behavior disintegrates, we start back.”

The Process

A professional parent-training program typically begins with a comprehensive assessment of the child and may include an evaluation of basic language and learning skills. There also may be a functional behavioral assessment done. Depending on the therapist, the testing may take as long as 15 hours, although it’s typically done in shorter sessions lasting up to two hours.

The psychologist or counselor will discuss the results with the family and identify specific goals for the child. Families then can consider which training and treatment options work best for them.

“We use a methodology called applied behavior analysis. This method uses a scientific approach to socially specific behaviors: aberrant, inappropriate, self-injurious, aggression, social skills, adaptive living skills,” says Bezilla. “We’re trying to teach parents to look at all aspects of the behavior: What occurs before the behavior and what is the … behavior consequence. We train parents to look at that continuum. Eighty percent of behavior management is changing our own behavior.”

Bezilla gives this example: When a child of 2 or 3 has a tantrum, it may be because he doesn’t want to clean up his toys, as his mother suggested. Perhaps he has learned that when he throws a tantrum, he will get attention from his parents. It’s up to the parents, then, to change the way they react to their child’s tantrums as a means of decreasing their frequency and duration.

The secret to success, says Mueller, lies in the parents’ abilities to provide consistency in dealing with their child’s behavior. “If parents are consistent with what they are doing, it makes the child’s behavior easier to control. A child’s behavior changes more easily if they are used to consistency versus inconsistency, because the child learns what to expect in any given situation.”

The Challenges

Parents should be aware that implementing behavior management strategies often means enforcing unfamiliar and uncomfortable routines in the home.

“Parents have to be willing to be involved,” says Burns. “It’s very difficult to tell the child they need structure without the parent modeling it for them or helping them.” It can be time-consuming and may not always yield the expected results.
“It just takes a ton of work,” says Prussack. In her already-busy household, implementing the tips from 1-2-3 Magic meant creating more work for Prussack and her husband, who both work outside the home.

Children may not always be the most willing participants, either.

Parents “sometimes feel like they’re not being very supportive of their child. The child will act out more as you become more adept at identifying those functions of those behaviors,” says Bezilla.

Bezilla calls this a “behavior burst,” the result of a child not getting what she wants when she acts out. “For parents and teachers, it’s really difficult to see the escalation of behavior,” he says. “It is part of the process.”

Being prepared for “behavior bursts” can help parents maintain consistency in managing behaviors until the child gets into the routine and starts responding in a more desirable manner.

A parent’s emotions also can interfere with a program’s efficacy. “They are so caught up in the middle of it, they can’t be very objective,” Bezilla says. “A lot of times, we’ll pull the parents off to the side and a light bulb comes on.”

In those situations, it often is helpful to have a professional who can help take emotions out of the equation and return the parents’ focus.

Expectations

Parents who explore behavior-management programs can expect to gain “the skills necessary to identify future behaviors in the child,” Bezilla says. “They also will look at the positives in the child’s life and strengthen those positives.”

How quickly parents see results depends on a number of factors: the severity of the problem, how easy it is to identify and how consistent the parents are. “It can be immediate or it can take weeks,” says Mueller.

Mueller says behavior management really focuses on changing the parents’ behavior. Sometimes this means changing parent behavior for the short term to help change things for the long term.
For example, a parent might devote more time each night to helping her child with homework to establish the new routine. Over time, that parental involvement will gradually decrease as the child becomes more compliant with the homework routine.

With time, patience and consistency, parents can hope to see an improvement in their child’s behavior both at school and at home, say the experts. The degree of success depends on many factors, not the least of which is the child’s own potential – and that may be limited by the severity of any underlying disorders, such as autism or ADHD.

Prussack says she and her husband sometimes find maintaining their system of positive reinforcement can be challenging, especially the time commitment it involves. It does, however, yield the desired results.

“Telling your child what to expect and consistently applying it eliminates shouting matches,” she says. “Sometimes, even if I can do it for a couple of weeks, it helps him get back on track.”