Post on 27-Dec-2015
Behavior Problems in Young Children
Linda Grossman, MD
Developmental-Behavioral Pediatrician and Director, Clinical Services
Baltimore County Department of Health
Key points
Young children (ages 3 to 5) - different developmental stage than school age
Need more active, child initiated learning experiences
Affected more by external factors than older children
“Imprinting” of behaviors has major impact
Case #1 - - Refusal to join activity Sarah just turned 4 and is enrolled in a
pre-K program She refuses to join the group for circle
time despite multiple efforts by her teacher to get her to join the group
Possible role for developmental issues Erik Erikson –
– School age – age of industry– Pre-school age – age of initiative
Selma Fraiberg - “The Magic Years” – development of imagination and mastery of imagination
More on pre-school development
Child initiated learning Multi-sensory and active Interest in peer interactions - need to
develop social skills to foster peer interactions
Input from key adults besides parents is very important but not as much so as for school age
Potential strategies
Invite to join group but avoid pressuring Set limits about staying in classroom and
playing quietly Feel free remind that she needs to be
thoughtful and not be too noisy so the other children can’t hear the story
Then ignore child totally or include comments referring to child but not directed at child– “Let’s read our story and maybe Sarah will join us later”– “Boy this sure is fun, I hope Sarah joins us tomorrow”
Usual outcome
Sarah usually will gradually move closer to listen to story or group interaction
She may call out an answer – if this happens, you can re-invite her to join in or tell her you are glad she was listening (don’t criticize her behavior or actively exclude her)
Eventually she will join in – welcome her but don’t give her too much attention linked to joining the group
Case #2 – Aggressive youngster
Thomas is a large youngster in the pre-school He just turned four but looks much older He is playing with a group on the floor with
blocks and trucks He knocks over another boy’s tower and
grabs his car This behavior seems to happen often but
especially on Mondays
Factors
Physical appearance and developmental level out of sync – people’s expectations are too high for him
Crowded conditions Inadequate supervision Stresses out of school
Stresses and other factors out of school Basic needs
– Not enough sleep– No breakfast– Inappropriate food (sugar, caffeine)
Family stresses – Financial – Work schedules or overscheduled child – Divorced parents - weekend visitation
More out of school factors
Exposure to violence– Family violence– TV and other media
Parenting style– Authoritarian parents – Indulgent/permissive parents– High level of parent conflict over child
rearing
Emotional disorders
Possible ADHD – but less than 40% of 4 year olds who are given ADHD dx still have that diagnosis at age 7
Possible ODD – usually more related to home and school management
Possible language disability – lack of language skills to manage social interactions
Possible autism spectrum disorder
Possible management strategies
More space between children – less crowding
More supervision – adult proximity and positive input for pro-social play
Duplicate toys
More on management – talk with parents about Importance of sufficient sleep Value of good role models for conflict
resolution Having opportunities for physical activity
each day Limiting exposure to media – especially
media with violent themes
Most important component of management Supervise and intervene before misbehavior
occurs Provide positive feedback for pro-social
behavior Anticipate and redirect (if don’t tell child why
redirecting, child will not develop habit of misbehavior to get attention)
Prevention and reinforcement of positive behavior patterns is most valuable thing you can do for a youngster like this
If misbehavior has occurred
Correct behavior but keep any punishment to a very small amount
Consider “reframing” – tell boys that you are sure Thomas did not mean to knock over the tower (that helps reinforce that he is not a bad kid) but encourage him to say he is sorry and help build it back again
Encourage use of words – “Thomas, please use your words when you would like a turn with the truck – say ‘may I have a turn? Or “my turn, please’”
Case #3 – Eloping
Gordon is a four year old new to your school
He has run out of his classroom three times since school started
One time he headed out the door, saying that he was going to walk home
Possible ideas
Previous experiences – including minimal experience with limit setting
Feels like he has no opportunity for choices in classroom and/or lesson plans are very teacher directed
Feeling overwhelmed School is not fun for him
– Nothing of interest– High demands in areas of relative weakness
Management
Set clear limits on staying in classroom Give more active role in lesson and provide
more supervision at the same time Provide more flexibility for him within
classroom if he is feeling overwhelmed Provide more choices for him among
acceptable alternatives Consider his interests in planning day
Summary
Pre-school is a different developmental stage than school age– Need child directed learning– Need more active and more multi-sensory
learning– Need help in developing social skills– May have trouble with confusing
imagination and reality
Summary continued
Pre-schoolers affected more by external factors– Less ability to process external things– Less coping skills– Imagination may lead to misinterpretations of input
Best thing can do is to build positive experiences for child – anticipate and redirect from misbehavior whenever possible and verbally reinforce positives
For more information The Incredible years: A Troubleshooting Guide for
Parents of Children Aged 3-8. By Carolyn Webster-Stratton, Umbrella Press, Toronto, Ontario, 2005
Young Children’s Behavior: Practical Approaches for Caregivers and Teachers. Louise Porter, MacLennan and Petty Pty Limited, Sydney, Australia, 2008 (3rd Edition)
Toddlers and Preschoolers. Lawrence Kutner, William Morrow and Co, New York, NY, 1994
1, 2, 3 Magic: Effective Discipline for Children 2-12. Thomas Phelan, Parent Manage, Inc., Glen Ellyn, IL, 2010.