Book Excerpt: How to Discipline a Defiant Child

The treatment did not make any attempt to get at a root cause of behavior — to determine, say, the ultimate cause of Sharon's rages. We proceeded upon the idea that if you can help the child in the short term to change her behavior, over time you will change the child. The research tells us that building up a better response to replace tantrums, if the new behavior is repeated often enough, will in effect rewire that child's brain so she doesn't jump to rage as the default coping strategy for difficult situations.

Sharon's was an extreme clinical case, but I also wanted to bring the research to bear on the more everyday behavior problems that all parents have to deal with. I was appalled by the unending stream of bad "expert" advice to often desperate parents, who understandably snatched at anything that looked like a tool and rarely had the training to tell what was based on good science and what was not. So I began conducting parenting classes in which we discussed and practiced techniques for changing behavior that parents could use at home. Often the behaviors we addressed were utterly normal ones, like getting a child to eat certain foods, using the toilet, getting ready for school, doing homework, practicing a musical instrument, playing nicely with a sibling, respecting property, and not teasing or hurting a pet. The programs did not always succeed, especially at first, but we constantly evaluated whether change was happening and whether it was happening fast enough. We would adjust the program, measure our progress, and adjust again.

I also began working with schools, and when I moved from Chicago to take a job at Pennsylvania State University, I applied what I had learned to help children in local schools there. There were many challenges — such as a memorable five-year-old girl who would self-induce vomiting whenever she was mad, thoroughly disrupting the class every time she did it. (She actually turned out to be an easy case.) But as the research on behavior made the leap from the laboratory to meaningful application to the lives of real people, and as the body of that research built up, we had more equipment with which to face those challenges. The accumulating studies began to show conclusively that what many of us do as parents — from harsh punishment to endlessly explaining to a child why his behavior is wrong — may not work at all and can even make our children's behavior problems worse by giving attention to them.

We began teaching parents to "catch their children being good," instead of unwittingly reinforcing unwanted behaviors by shouting, hitting, explaining, or otherwise attending to them. And the developing body of scientific research began to show conclusively that small, temporary changes in what parents do at home have large, lasting effects in changing children's behavior at home and at school.

After a decade at Penn State, I moved to the University of Pittsburgh School of Medicine, where, in addition to continuing my research and directing an inpatient service, I continued training parents to change their children's behavior at home over the long term. My colleagues and I also used federal grants to study the techniques we taught, refining them and making them more effective.

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