{"id":8353,"date":"2014-07-09T16:06:57","date_gmt":"2014-07-09T23:06:57","guid":{"rendered":"http:\/\/www.speechbuddy.com\/blog\/?p=8353"},"modified":"2018-05-15T12:27:37","modified_gmt":"2018-05-15T19:27:37","slug":"4-tips-managing-difficult-child-behaviors","status":"publish","type":"post","link":"https:\/\/www.speechbuddy.com\/blog\/speech-therapist\/4-tips-managing-difficult-child-behaviors\/","title":{"rendered":"4 Tips for Managing Difficult Behaviors in Children"},"content":{"rendered":"

As SLPs, we have all dealt with\u00a0our share of difficult behavior. I\u2019ve certainly found myself at a loss for how to approach a client that has\u00a0trouble with focus, motivation, or simply\u00a0keeping \u201cin line.\u201d \u00a0After all, we work with children, so this should\u00a0be expected to a certain degree. However, challenging behaviors can get in the way of our work, and we must do everything we can to avoid them. When they do occur, we must be prepared\u00a0with\u00a0reliable strategies to minimize their negative impact on the session at hand, and ultimately, on our entire therapeutic interaction with that client. The four strategies described below will provide you with a plan for\u00a0managing\u00a0difficult child\u00a0behaviors as\u00a0they arise, and getting you back on track with your therapy.
\n<\/p>\n

Take Initial Rapport Very Seriously<\/h3>\n

\"establishing-rapport\"Whenever I get a new case, I make sure to ask the client\u2019s parent three core questions:<\/p>\n

    \n
  1. How does your child relate\u00a0to new people, especially new adults?<\/li>\n
  2. How well can your child sustain his attention on\u00a0a task?<\/li>\n
  3. How does he react to frustration?<\/li>\n<\/ol>\n

    Directly asking whether I should expect\u00a0any\u00a0“challenging behaviors” can\u00a0seem like an affront to parents,\u00a0but\u00a0the answers to these questions give me a good sense of a child\u2019s behavior in school and other learning situations. If a client\u2019s parent suggests that her child takes some time to warm to new adults, may have trouble sustaining their attention to task, or gets overly emotional or withdrawn when frustrated, this is a sign that I should\u00a0take extra time to establish rapport. Remember that rapport establishment is a therapist\u2019s and child\u2019s mutual first impression. It is crucial to take extra care establishing rapport with a client that you suspect may be\u00a0more behaviorally challenging.<\/p>\n

    Focusing on rapport\u00a0initially will go a long way toward reducing the frequency of challenging behaviors during our therapy experience.<\/p>\n

    Ignore and Distract<\/h3>\n

    \"TheInevitably,\u00a0challenging behaviors do arise.\u00a0My cardinal rule when dealing with a difficult or disruptive outburst is simply to \u201cnot get into it with the child.\u201d In other words, don\u2019t take the outburst or sudden onset of a difficult behavior in any way personally, or too seriously, and never<\/em> escalate it. Taking outbursts\u00a0personally could poison the therapeutic relationship, and escalating them\u00a0only gratifies the child\u2019s impetus to use outbursts inappropriately — to vent frustration or avoid a difficult task. Of course we want to be sensitive to a child\u2019s frustrations with improving speech —\u00a0after all, this is often a very tall order! But we don\u2019t want the child to feel rewarded by the outburst or challenging behavior.\u00a0Instead, ignore the behavior and distract the child with, for example, a reminder of the number of items left before a fun break.<\/p>\n

    Only five more words till we can play a quick game!<\/p><\/blockquote>\n

    Also try\u00a0an on-the-spot modification of the task at hand. For example you, the therapist, could do the next few items and have\u00a0the child judge for accuracy, or perhaps record the child\u2019s productions and listen to them together. Either way, it\u2019s important that we don\u2019t interrupt our work for a challenging outburst. We should ignore the outburst itself, distract the client by acknowledging and validating their frustration,\u00a0and\u00a0then make a slight modification to the activity at hand or reassure him that a break is on the horizon.<\/p>\n

    Use Positive Reinforcement and Praise<\/h3>\n

    \"happy-family-drawing\"This can be a tricky one for therapists because frequent outbursts are\u00a0indeed frustrating. It may\u00a0be instinct to punish these outbursts, even with a seemingly innocent comment like,<\/p>\n

    \u201cwe can\u2019t do our game until we finish these five words,\u201d or, \u201cI am going to have to tell your mom that you\u2019ve been rude to me today.\u201d<\/p><\/blockquote>\n

    But I much prefer, from the above examples,<\/p>\n

    \u201cwe\u2019re almost there. You\u2019re doing a great job. Five more and we can play or game,\u201d or \u201cI really want to be able to tell your mom you did a great job in speech today.\u201d<\/p><\/blockquote>\n

    I admit that I have resorted to the first, more “punishing” responses, but this doesn’t tend to help.\u00a0Rather it detracted from\u00a0my overall mission to\u00a0improve the client\u2019s speech. But we also don\u2019t want to coddle our clients. Our high expectations and insistence on their best work are what really help them.\u00a0The evidence in child development literature for positive reinforcement, rather than punitive or negative reinforcement, is strong and I think you will see a big difference in how your clients respond.<\/p>\n

    Similarly, don\u2019t be stingy with praise. It’s obvious to\u00a0praise exceptional behavior or a learning breakthrough, but a child who has successfully managed an outburst, or a child who struggles to\u00a0stay attentive should be praised for “little” victories.\u00a0And we should be quick to heap them\u00a0on.<\/p>\n

    Be Consistent with Rules and Expectations<\/h3>\n

    It can be very confusing for a client to deal with shifting rules or expectations. Set your rules and disclose them to your client in a friendly, non-threatening manner during the rapport establishment phase of therapy\u00a0—\u00a0and stick to them! If your rule is\u00a0“you have to finish a set of 20 stimulus items before playing a quick game,” then make sure you finish all 20. Don\u2019t do fewer than 20 or the client may\u00a0use that occasion to “negotiate” or\u00a0refuse\u00a0to cooperate in the future; don\u2019t do more than 20 items or the client could become exasperated and lose trust.<\/p>\n

    It\u2019s key to remember that challenging behaviors are, generally, unrelated to the way we conduct therapy. However, as therapists, it is part of our job to do the best we can to manage challenging behaviors (i.e. not to throw our hands in the air!) even if we were not specifically trained to address them.<\/p>\n

    Best of luck in your work and I hope these tips were helpful to you.<\/p>\n

     <\/p>\n

    Gordy Rogers, M.S. CCC-SLP, is co-founder and Chief Scientific Officer of Speech Buddies, Inc. the makers of\u00a0Speech Buddies Tools<\/a>, as well as the owner of\u00a0Brooklyn Speech Solutions, PLLC, a private practice in Brooklyn, New York.<\/p>\n \n \n \n \"Parents'<\/a>\n <\/span>\n <\/span>\n \n","protected":false},"excerpt":{"rendered":"

    As SLPs, we have all dealt with\u00a0our share of difficult behavior. I\u2019ve certainly found myself at a loss for how to approach a client that has\u00a0trouble with focus, motivation, or simply\u00a0keeping \u201cin line.\u201d \u00a0After all, we work with children, so this should\u00a0be expected to a certain degree. However, challenging behaviors can get in the way […]<\/p>\n","protected":false},"author":4,"featured_media":8397,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[3,15],"tags":[1669,1329,1014,6,5,149,1668,16,22],"class_list":["post-8353","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-speech-therapist","category-speech-therapy-techniques","tag-difficult-behavior-in-children","tag-parents-corner-2","tag-slp","tag-speech-therapist-2","tag-speech-therapy","tag-speech-therapy-activities","tag-speech-therapy-strategies","tag-speech-therapy-techniques-2","tag-speech-therapy-tips"],"jetpack_featured_media_url":"https:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2014\/07\/managing-difficult-child-behaviors.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/posts\/8353","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/comments?post=8353"}],"version-history":[{"count":14,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/posts\/8353\/revisions"}],"predecessor-version":[{"id":11481,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/posts\/8353\/revisions\/11481"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/media\/8397"}],"wp:attachment":[{"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/media?parent=8353"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/categories?post=8353"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/tags?post=8353"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}