Written by Julie Higginbotham, Senior Case Coordinator, Mecklenburg County CDSA
Here in Mecklenburg County, NC, we have completed our first monthly roundtable discussion for our early interventionists to discuss issues surrounding behaviors during visits with families. Elizabeth Sweet, MA CCC-SLP, and Lindsey Moss, LCSWA, were great facilitators, and it was a wonderful forum for folks to get together and support each other around this sensitive topic – we all know that addressing behaviors with families can be a tough one to approach because each family is different, their priorities and values are different, and we all have our own ideas about what is and is not an appropriate response when children act out. For those of you who weren’t able to make it, or if you were there and want to see the recap, here is a summary of key points that the group discussed….
- Leave your “stuff” behind. A common theme in the group was acknowledging that we all have our own ideas about addressing behaviors in children. For those of us who are parents, we have our own experiences to draw from when we are helping to support children and families, but those thoughts often don’t match families’ priorities and ideas of how they want to address behavior issues with their own children. Each family has their own history, culture, experiences, and thoughts about what might and might not work, as well as what they can and cannot do. Our job is not to go in with the right and wrong things to do – our job is to meet the family where they are, learn about where they stand and what they feel might work, and move forward from there.
- Find out what seems to trigger the child when the behavior is occurring. There are a lot of different reasons for behaviors that we see in children. Maybe the child isn’t talking and is getting frustrated when he or she wants something. Perhaps there is a medical issue and the child doesn’t feel well. Sensory issues can look like behaviors when children hit, bite, jump off of furniture, or throw toys, but what they really want is to get impact and input. For some families, there could have been some trauma causing a behavioral problem. We can ask questions, such as “What happens before you see Timmy bite his brother?” or “Have you noticed that certain things seem to make the behavior better or worse?” When you are in a visit and notice the behavior, stop what you are doing and coach the family through figuring out what the child needs and how to make it through to the other side. This is a great opportunity to help the family troubleshoot and come to some conclusions on their own, and you can discuss ways the family can use those strategies during the week when you aren’t there.
- It’s hard to admit when there’s a problem and to address it with professionals. Parents don’t want to hear that they aren’t doing a good job or that they need help with something. Who does? Early Intervention is built on the premise that everyone has strengths, so that’s where we need to start. Pointing out things that parents are doing right can help build their confidence in themselves and their trust in you, and being empathetic is key in building this relationship so you can be as supportive as possible. Just because someone doesn’t know what to do doesn’t make he or she a bad parent, it creates opportunities for everyone to learn together in a supportive setting.
- Help families understand that some tough behavioral issues are typical for this age group. This one can be hard because no one wants to hear, “Sorry, but this is normal” in any situation that is difficult. On the other hand, we don’t want to give the impression that everything can be “fixed,” either. This is where being empathetic is important again, and just because something is typical, it doesn’t mean that we can’t find ways to help make it smoother for the family. Talking to families about making their routines more successful for everyone not only will better support the family, but it should also be reflected in outcomes on the IFSP.
- Know that some families just don’t want to address it. When we notice behavioral concerns during visits, some families are very open to discussing it. Others might not be ready to talk about what’s going on, or they may not see it as being a problem. What we see as a problem might not be on the radar for the family, and that’s OK. Remember that our priorities are not their priorities, and if they don’t want to bring us into that process, it’s their right not to do so. That being said, keep these next two thoughts in mind…..
- We are mandated reporters. We come across a wide variety of cultures as we are working with children and families. Some families find it to be perfectly acceptable to discipline their children in certain ways that, to others coming into the home, may be seen as crossing the line. In particular, the group provided some great feedback about families who are not native to the United States. When families move here, they sometimes are unaware of what the law says and get an unexpected visit from social services because they didn’t know that the rules aren’t the same. This can hold true for any family – educating families is very important, but sometimes, that’s not enough. If you see something during a visit that constitutes abuse and/or neglect, we are mandated by law to report these issues. Find out who you should contact in your area and what the law says in your area to ensure the safety of the children in the home.
- Set your own boundaries. Maybe a parent doesn’t think that their children hitting them in the face is a problem, but you don’t want them to do that to you. Your tolerance level may be different from the family’s, and while we are in their home, there are some lines that we don’t want crossed for ourselves. You can explore the parent’s position on the matter by asking “What do you do if/when he hits you like this?” If they say that the child doesn’t do that to them, or if you get the impression that they aren’t bothered by it, let the family know that you would prefer that the child not hit you or throw things at you. You can ask whether the family minds if you say “No, thank you” to redirect the child or put your hand up to stop the hit or block the toy so you don’t cross any boundaries that the family feels are important. You may even need to adjust where you sit so the child doesn’t have access to hitting you or throwing things at you. We want to be respectful with families, but we also want to respect ourselves in the process.
This is just a taste of the wonderful information that was shared during the Table Talk Wednesday event here in Mecklenburg County. What are some things that you’ve noticed when helping families address behavioral concerns, and how did you deal with it (Remember, please be constructive and confidential in your responses)? Here are some additional resources that you may find helpful as you are coaching families through behavioral issues….
http://www.askdrsears.com/topics/discipline-behavior/10-techniques-shape-childrens-behavior http://www.parenting.com/article/5-tantrum-stoppers-that-work http://www.babycenter.com/302_behavior_1516044.bc http://kids.lovetoknow.com/wiki/Child_Behavior_Problems
For the next Table Talk Wednesday on September 18th, we will be talking about “What Routine?” and opportunities for learning and coaching throughout day-to-day routines. Join us for another great conversation and opportunity for networking and support!