Written by Mona Delahooke - July 30th, 2017
It was almost dinner- time, and little “Max” was hungry and tired. After a busy and active afternoon, he was in the midst of a lengthy home session with his behavior therapist when his mother stepped in the door from work.
Smiling with delight, the boy instinctively ran toward the door to offer a greeting, only to have the therapist instruct him to sit down and finish his task. When the boy tried again to reach his mother, the therapist stood in the way, blocking him. Frustrated, Max burst into tears, screaming and striking him in protest. It took him several long hours to calm himself down again.
The mistake? The therapist was focusing on behavioral goals without regard for the child’s social and emotional functioning. As a consulting child psychologist, I routinely observe this approach to treating children’s developmental delays and mental health challenges. Not only is it ineffective, it has the potential to cause unnecessary distress to our most vulnerable children, teens, and their families.
As the psychologist Ross Greene has written, children do well when they can. When a child doesn’t consistently comply with what we ask of him, we should understand that the child is probably not making a deliberate choice to misbehave, but rather adapting to an immature social-emotional system that is still developing. The first step to fix this problem: stop trying to manage and control a child’s behaviors before the child has the developed the capacity for self-control.
Too often, adults react to problematic behaviors—whether in the form of language, physical actions, or emotional outbursts—by issuing consequences for this “choice.” But that approach assumes the child can choose to behave otherwise, that she has the capacity for “executive function.” But many vulnerable children, teens—and even young adults—require years of experience to acquire that capability.
Max certainly hadn’t. His interventionist’s demand to sit still exceeded Max’s developmental ability to comply. Not only that, he should have praised his enthusiasm for greeting his mother, which reflected the kind of human connection that should be be a primary goal of all his therapies. Such supportive relationships form the foundation that is essential to building brain connections and, in turn, the future capacity for behavioral control and executive function.
Of course, there’s nothing wrong with helping children develop skills, tolerate delayed gratification or strive for more advanced capacities. But here is the primary problem I see in education and behavior therapy: when we insist that vulnerable children control their behavior before they’re able to, there’s a potential to do more harm than good to their mental health and social-emotional development.
We can shift the paradigm by using developmental approaches that are informed by neuroscience and based in compassionate best-practice principles. The first step: pay attention to what the child is showing us in his/her body.
Look for these indications of physiological stress:
Physical responses such as crying, protesting, increased heart-rate, wide-open eyes, trying to escape, hitting, or otherwise striking out
Signs of disengagement, including flat, still or frozen facial features; lack of interest or reaching out to others; monotone or flat vocal tone; lack of exploration; or slow or decreased body movement
If you observe a child exhibiting stress responses, make these your priorities:
Before anything else, give the child cues that he or she is physically and emotionally safe.
Understand the behavior as a stress response: what we are asking of the child exceeds his ability to carry out the task.
Be flexible about changing plans and immediate treatment goals to prioritize warmth, engagement and understanding when a child exhibits stress responses.
In short, paying attention to what the child is showing us in his body—rather than how well he complies with requests—is the best way to determine whether the child is ready to learn or acquire a new skill.
When we prioritize a child’s emotional life, behaviors will improve organically over time as the child experiences safety in mind and body. All of us who work in the mental-health and developmental disabilities fields should understand the central importance of this solid foundation for children and families. A child’s relationships and emotional stability are the best markers for treatment goals and serve as the best foundation for future growth.