Tag Archives: Behavior problems

Growing the Attachment Strategies of Preschool Children

Important Note: The image in this post and in all the previous ones are not images of the children discussed in the posting. They are simply children whose photos I have collected throughout my travels. 

I am going to offer several ways of doing this, with the understanding that I will continue to think about it and add more later.

The first option is to intervene in the school setting with the help of teachers and other school professionals. The second is consultation to the parents, for example, video feedback. The third is dyadic or family psychotherapy. The fourth is individual psychotherapy for the child; this would necessarily include meetings with the parents. These options are offered in order of increasing intensity of intervention with the idea that if parents choose an intervention of lesser intensity that proves ineffective, they may then choose a more intensive alternative.

Intervention in the school setting is predicated on the assumption that school is a safe environment; that means that the child is adequately compliant with the teachers’ directives, follows the school routine, can access the school curriculum, and can relate to peers relatively well. If the school is safe for the child, the teacher and parent can prepare him or her for appropriate behavior at pickup by breaking up the transition into manageable steps, previewing the experience, and having a teacher available to coach the child and parent through the reunion.

The parent should follow up afterwards with behavior designed to consolidate the positive reunion by encouraging the child to talk about her day and giving the child comforting feedback for difficulties and positive recognition for achievements. This is the tricky part, because the pattern that gets established when the child makes a fuss about pickup generates stress in both parent and child, so that warm, responsive communication at pickup time is usually contaminated with anxiety. Even when the pickup is successful, both parent and child are anticipating some negative experience. Also, there is an unconscious pull back into the problem pattern. That is because it is a habit, well practiced and therefore “simpler”, taking less energy in the short run, though more in the long run.

The parent can try to make declarative statements instead of direct questions that put the child on the spot – starting the comment with “I’ll bet” or “I wonder if” or “I’m thinking that”, for example, “I’ll bet that you liked the cooking activity today,” or “I wonder if it was sad for you that Martha was absent from school today.” If the child gives monosyllabic responses, just tell her that you guess she needs to rest after a long day and maybe you can talk about it later.

The thinking behind this plan is not strictly behavioral. It draws on Attachment Theory and nonlinear systems theory (odd bedfellows, actually) in that it seeks to practice more adaptive interpersonal patterns – reunion – over and over again, with the input of support (“energy”) from the teachers. If a new strategy for reunion after a separation is more successful and is practiced enough to become a stable part of the parent-child relational repertoire, it can facilitate the child’s development in a more general sense.

I will discuss the other options in subsequent posts.

The Problem of “The Little Girl with a Curl”

Important Note: The image in this post and in all the previous ones are not images of the children discussed in the posting. They are simply children whose photos I have collected throughout my travels. 

A particular problem has come to my attention over the years consulting to a preschool – children behaving in controlling and sometimes aggressive ways to parents at school transitions. Teachers report that the child behaves badly with his or her parents at drop off and pick up. Often the teachers express amazement that the children who seems well behaved in school, can change dramatically when they are with their parents – boss them around, even push or hit them. Another behavior characteristic of this problem is the child running away from the parent or refusing to come with them at pick up time. It is difficult for even the most empathic teacher to avoid the suspicion that the parents are somehow allowing their child to mistreat them by not setting adequate limits for the child. Supportive evidence is sometimes found in parents restraining from disciplining their children in the school.

This situation reminds me of a Mother Goose rhyme that my parents read me when I was a young child about a “little girl with a curl”. The rhyme goes, “There was a little girl who had a little curl, right in the middle of her forehead. When she was good, she was very, very good. But when she was bad, she was horrid.” I always secretly worried that I might be that girl.

Perhaps partly for that reason, I have given this problem a good deal of thought. My conclusion is that the answer to the mystery of the “little girl with a curl” mystery is rather complicated. The reason I say this is that when I talk to the parents of these children, I get a wide variety of answers about their child’s behavior in different settings. Some children are relatively well behaved in most settings and become suddenly noncompliant and belligerent at pick up time. Other children are compliant when they are involved in activities but become disorganized and unhappy during unstructured time at home and in school. Some children are usually cooperative but have difficulty with all significant transitions – bedtime, getting up time, leaving an activity, etc. Other children are always a handful.

What ties together all the children who fuss at pick up time and behave defiantly with their parents but not necessarily with their teachers? All these children are expressing difficulty with finding a positive strategy for reuniting with their parent. The subject of reunion strategies falls into the domain of a theory that informs much current developmental research and that has now also become popular in the vernacular – Attachment Theory. I have talked about Attachment Theory in other blog postings, because of its importance in research. The essential feature of Attachment Theory is that it presents the infant’s essential motivation as staying close to the parent in order to feel safe and secure. If the infant achieves the capacity to feel secure in his relationship to his mother, then he is free to explore the world, knowing that he can easily return to the safety of that connection.

We know that an important but primitive response to threat is running away or aggression. Remember that the “fight or flight” response of the sympathetic nervous system is one of the main “bottom up” as opposed to “top down” responses of the stress regulation system. That means that we must feel confident in our capacity to achieve security in order to use our thinking brain to tell us what we should do in a threatening situation. Transitions are inherently threatening, even small ones, because they require us to disorganize ourselves on the way to a new organization. That is, we have to stop playing in the sandbox in order to join Mother, get into the car, stay still in the car seat, etc. Playing in the sandbox is a complex organization involving a cognitive plan (building a castle), a motor rhythm (dig, pour, pat; dig, pour, pat), an affective and physiological state (contented, calm); and maybe even a compelling interpersonal experience (collaboration or competition with a peer). That is a lot to take apart in order to get into the car. And the hardest part is the disorganization in between the sandbox play and the car seat, between one organized state and the other. How do children manage that transition? It starts in infancy with the regulatory aid of the parent.

These interpersonal regulatory patterns that start in infancy gain power and stability as parent and child repeat them over and over again during the course of daily life. One pattern, that Attachment Theory would call “secure”, is demonstrated by the parent-child dyad who are able to support the child in managing all these disorganizing (and therefore threatening) experiences of – letting go his plan of building the castle, discontinuing the motor rhythm, interrupting the calm and contentment, and giving up the competition or collaboration – and maintaining adequate regulation and sense of security until the new car seat organization is established. I say “parent-child dyad” because I do not see this activity of facilitation transition as emanating exclusively from the parent. Although sophisticated advocates of Attachment Theory would probably agree with me, Attachment Theory largely tends to place the responsibility squarely on the mother, who carries attachment patterns within her even before her child is born, according to the AAI.

I will tell you how I use these thoughts about Attachment Theory in my search for answers to the “girl with a curl” problem in my next posting.

“A Healing Place”: Part II

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I continued with the workshop, referring to Bruce Perry (as I so often do) as I addressed what Rachel had described to me as the caregivers’ discouragement. I told them that the parts of the brain that influence this problem behavior “have been shaped over many years with hundreds and thousands of repetitions”, and that traditional therapies that typically take place in 45 or 50 minute sessions at a frequency of once a week cannot be expected to reverse years and years of traumatizing experiences (Perry & Hambrick, 2008, p. 39). I wanted to talk about changing the brain in healthy directions and how that improves behavior, but mindful of the role of consultant and the necessity of staying close to the caregivers’ stated concerns, I addressed the need to respond to problem behavior “right now”.

Changing Behavior Right Now: Think Ahead

(1) Know the child. (2) Make realistic expectations. (3) Anticipate problems. (4) Prepare for transitions. (5) Be predictable, but not too predictable. (6) If something is not working, stop and try something else. (7) Resolve conflict. (8) Give rewards and consequences.

I will go into detail in the first point in this posting and continue with the subsequent ones in the following postings.

Know the child:

It is important to keep in mind the child’s strengths and weaknesses, and also to remember the child’s story of pain. The role of the child’s traumatic background is easy to forget when you are dealing with his problem behavior, but it is important to bring it to mind now and then, because it can help you with how to respond. First of all, remembering the child’s story of pain can refresh your empathy for the child. Second, it can help you identify “triggers” or special challenges for this individual child. For example, a child who has been sexually abused will often be triggered (have a traumatic reaction) to certain kinds of touch or to intrusive behavior (someone putting his or her face too close to the child’s face, or looming over him or her). Remember what I said about children on the autistic spectrum. Often these children will also react violently to someone coming in too close.

Again, channeling Bruce Perry, I emphasized the importance of special relationships – For traumatized children, “The relational environment of the child is the mediator of therapeutic experiences.” (Perry & Hambrick, 2008, p. 43) In fact, in the fortunate case that there are multiple good caregivers available, such as is true at Love and Hope, the child may choose one person who can help him feel calm, another whom the child can rely on to be firm, and another who can help him have active, rough housing kind of fun. This is not so different from what happens in families, especially big families.

We know that it is also important for the relationships that partners make with each other – such as adult partners or even close friends at any time in life – to include a mix of these functions. That is, we would not choose a partner or close friend for whom we could not rely on both for fun and also for comfort. Yet these children may require time to put it altogether, and a “family” environment in which these relationship functions are offered by different people is often a first step.

Reclaiming children and youth www.reclaiming.com

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Threat of Loss and Change

Conversation Between “S” of the Home and Sarah Measures

 

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9-9-2011

Sarah spoke to S on Friday about the two ten-year-old twin brothers. Recently the boys have been acting up more at school, but not at home. Behavior issues include: not listening, swearing, disrespect of other children. Although the boys are in different classes, the behavior seemed to begin with one boy, F. and spread to K. At home they continue to do their homework quite well and are able to complete it independently, once they get started. When asked about these behaviors the boys tend to become defensive and say that other people instigate it.

Both boys are skilled and passionate about soccer. They have trained and played in a local team at the park for the past year. K wanted to switch to the school team, but logistically this was not possible for the home. They also like to play computer games. They are less interested than other children in the home in other activities such as going to the park or skating. 

There is a correlation between the timing of these behaviors and children beginning to leave the home. Two girls, M and N, are scheduled to leave in a month. The boys are particularly close to N, a slightly older girl.   The boys are unlikely to leave the home themselves because their placement was the result of court action. When asked about the increase of visiting days to twice instead of once a month the boys appeared neutral. 

S and Sarah discussed talking with them about their feeling around the changes going on in the home, and the departure of their friends. In addition to the emotional loss this embodies, they may also be feeling anxious about their own futures. This may also be discussed within a small group of children.

S plans to talk further to the boys’ two teachers concerning:

a) Their existing strengths, interests and connections and how to foster them. 

b) Possible reasons why the twins may be more troubled than usual at the moment. 

S might then follow this conversation by offering the teachers contact and brainstorming opportunities with me by e-mail or phone. (The boys have two teachers, one English speaking, the other Spanish speaking. This is likely to be useful to the English speaker.)

An intervention, might begin by understanding the root of their feelings, the reasons for their actions, and then helping them to understand their feelings and replace their negative behavior with more positive, self affirming actions. Eventually, after gathering more information about causes and supporting success we could discuss some positive behavioral strategies.

 

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