By Ray Levy, Ph.D.
"Doo-doo diaper-head!" That was the name Michael, age 5, called me in my first interview with his mother and him. Frustrated, and not wanting to be in a psychologist's office, Michael was angry and showed it the only way he knew how. Embarrassed, his mother calmly scolded him, "Don't say that, Michael. That's not nice." Not knowing what else to do with her misbehaving son, she soon directed her attention back to me.
As a psychologist, I want to see the behavior in my office that parents often have trouble with at home. While Michael's outburst was helpful for me to see, I knew that his mother was disturbed by it. During the third session, Michael again became upset, but instead of resorting to calling me names, he took on a sour face, stared for a moment at me, turned abruptly away from me, and faced the window. "Michael, that's rude! Now turn around and stop that pouting." Again his mother was upset by his inappropriate behavior.
"I know you get frustrated with him, Mom," I responded, "but he's showing better behavior and doing a child's version of a self-imposed timeout. Actually, it's better than calling me names."
"I guess so," his mother replied hesitantly, "but he can be so rude. How do I stop him from being so rude and mean?"
While Michael's mother is at a loss about how to handle her difficult child, she is also somewhat hesitant to reinforce a small but positive change in his behavior. "But it's still inappropriate," his mother commented when I noted the change from the first to the third session.
Children and adolescents with learning disabilities (LD) and Attention-Deficit/Hyperactivity Disorder (AD/HD) often have social and behavior problems along with their learning and attention problems. Rarely do their difficulties occur in isolation of other manifestations. Many parents, teachers, and therapists try rewards or punishments to change much of their defiance or inappropriate behavior. All too often we excuse these children because we believe the myth that they "can't" behave and that it is not within their capabilities. As a result, many grow up thinking the world will tolerate their unruly or just plain "rude" behavior.
As children grow, most children "get it" or seem to incorporate the subtle nuances of our social dance. They understand that when another child rolls his eyes, it is usually a sign that he has had enough of your behavior, or that a sigh means move on to another topic. While these subtleties are often naturally intuited, when a child doesn't easily pick up on them, we often become frustrated and try to teach these skills with our endless lecturing, scolding, and comparison to another sibling or another child. All of our attempts usually fall on deaf ears. Our children's "deaf ears" are not out of defiance, although it often looks like that, but due to a disability. These disabilities are similar to a math or a reading disability and should be handled accordingly. The problem with our approach is two-fold: first, we don't reinforce small changes, and second, we tend not to teach skills but use punishment instead. This article will deal with the first problem.
When students fail a subject, say math, we don't expect them to immediately make an A. Instead, we look for slight improvements like a D- with our tutoring. This signifies they are moving in the right direction. From a D we look for them to improve their grade up to a C and so forth. If I asked any teachers of a student who was failing what the first sign of change would be, they would all indicate a D or thereabouts. Yet when it comes to behavior, we expect children and adolescents who misbehave to immediately right their wrongs and exhibit perfect behavior, hence, go from an F to an A.
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