1. 10/7/2010
1
Group Therapy for Parents of
Children With Difficult Behavior
1: Welcome /
Understanding Difficult Behavior (Part One)
Housekeeping
Introductions
Confidentiality Agreements
Billing Slips
Bathrooms
Questions
Other
2. 10/7/2010
2
Session Format
Brief Review / Update
New Information Presented
Discussion
Assumptions
Everybody pretty much does the best they can with what
they’ve got.
Parents
Kids
Professionals (Teachers, Counselors, Doctors, Etc.)
Behavioral Problems start when the demands of the
environment overwhelm the kid’s ability to cope or adapt.
3. 10/7/2010
3
Assumptions
Our perception of what causes a problem behavior
always guides what we do about it.
“He’s got a disorder…”
“She’s just a brat…”
“I’m a bad parent…”
“He had too much sugar/caffeine/insert foodstuff here…”
Caution!
We’re about to start talking about various kinds of
problems/disorders
Beware “Med Student Syndrome” – When talking about
various disorders, it’s easy to image you have them all!
Remember – Let the doctors and specialists do the diagnosing!
Also Remember – It’s ok to ask your doctor or therapist (or
other professional) about these things, and/or to call their
attention to something that worries you. They, after all, are
here to Help!
4. 10/7/2010
4
Introducing the Inflexible/Explosive Child…
Dr. Ross Greene of Harvard has spent a lot of time
working with this population—and has written a book:
Parenting the Explosive Child (highly recommended). He
tells us:
If the child could change, the child would change.
The child’s (mis)behavior is best understood as the result of
lagging cognitive skills or abilities.
If we can help them get the skills that they need, these kids’
behavior will improve.
BUT – before we can intervene to teach any skills, we need to
understand what skills they lack, and what cognitive deficits
they have to deal with!
Cognitive Deficits— “Thinking Problems” –
Typical of the Inflexible/Explosive Child
Easily and quickly overwhelmed when a situation
demands adaptability
Trouble thinking through ways to resolve frustrating
conflicts
Lower frustration tolerance and more intense feelings of
frustration than most others of his/her age
Tends to think in concrete, black-and-white terms
Trouble with “Executive Functions”
Trouble with Sensory Processing
5. 10/7/2010
5
Executive Functions?
Yes! Executive Functions!
Shifting Cognitive Set (“Shifting Gears”):
The ability to shift from one mind-set to another. An
explosive child has trouble shifting from their own agenda
to their parent’s agenda through understanding and
adaptation. In a similar way, some adults are known to
have similar problems shifting from a “work” mindset,
where they are the boss, to a “home” mindset, where
they have to respond more empathetically and sensitively
to other family members.
Executive Functions?
Yes! Executive Functions!
Organization and Planning:
The anticipation of problems and the selecting,
monitoring, and adjustment of strategies in response to
problems. A child who wants to watch television a few
more minutes before coming in to dinner must efficiently
– within a few seconds – organize and plan a coherent
response to a parent who is expecting rapid compliance.
This is why some parents say that their explosive child do
just fine unless something doesn’t go their way.
6. 10/7/2010
6
Executive Functions?
Yes! Executive Functions!
Working Memory:
The ability to “hold that thought” until the brain has a
chance to think something through. If children are unable
to hold a thought long enough to think through possible
solutions to the problem (“My Mom wants me to come
in for dinner, but I want to watch television for a few
more minutes”), they are likely to respond with their first
impulse (“No, I’m not coming and you can’t make me!).
This, of course, only makes the situation worse.
Executive Functions?
Yes! Executive Functions!
Separation of Affect (“Putting Aside Feelings”):
The ability to “shelve” an emotional response long
enough to think through various solutions to problems.
The inability to separate affect from thought can help to
explain the rigid, self-centered thinking patterns, lack of
empathy and social tact, and the inability of these
miserable children to achieve insight into their condition.
The reasoned statement,“I got angry today after Ms.
Robinson called me in from recess early so I could catch
up on some missed assignments” becomes “Ms. Robinson
is a mean teacher. I hate her and I never want to go back
to her class” without the ability to separate affect.
7. 10/7/2010
7
Sensory Processing Problems
In order to accurately perceive the world:
1. Your senses have to pick up the “signal” (or, if you like, the
“stimulus”).
2. Your nerves have to carry the signal to your brain
3. Your brain has to accurately decode/make sense of the signal
Of course, problems can occur at any point in this
process!
Examples of Sensory Processing Problems
Auditory (Hearing)
•Responds negatively to unexpected or loud noises
•Holds hands over ears
•Cannot walk with background noise
•Seems oblivious within an active environment
Body Position
•Continually seeks out all kinds of movement activities
•Hangs on other people, furniture,objects, even in familiar
situations
•Seems to have weak muscles, tires easily, has poor endurance
•Walks on toes
Visual (Seeing)
•Prefers to be in the dark
•Hesitates going up and down steps
•Avoids bright lights
•Stares intensely at people or objects
•Avoids eye contact
Movement
•Becomes anxious or distressed when feet leave the ground
•Avoids climbing or jumping
•Avoids playground equipment
•Seeks all kinds of movement and this interferes with daily life
•Takes excessive risks while playing, has no safety awareness
Taste and Smell
•Avoids certain tastes/smells that are usually part of kids’ diets
•Routinely smells nonfood objects
•Seeks out certain tastes or smells
•Does not seem to smell strong odors
Touch
•Avoids getting messy in glue, sand, finger paint, tape Is sensitive
to certain fabrics (clothing, bedding)
•Touches people and objects at an irritating level
•Avoids going barefoot,especially in grass or sand
•Has decreased awareness of pain or temperature
8. 10/7/2010
8
What about ADHD, ODD, and the Rest of
the Alphabet Soup?
Problems with Executive Functions are (arguably) the
defining characteristic of ADHD, and are associated with
many other behavioral disorders diagnosed in kids.
Sensory Processing Disorders can be mistaken for ADHD
Sensory Processing Disorders often Co-Occur WITH
ADHD, Autistic Spectrum Disorders, and other
behavioral disorders
We’ll talk more about the commonly diagnosed
behavioral disorders next time!
Further Reading / Resources
Books
Armstrong,Thomas. (2010). Neurodiversity: Discovering the
Extraordinary Gifts of Autism,ADHD, Dyslexia, and Other Brain
Differences. Cambridge, MA: Da Capo Lifelong Books.
Ayres,A. Jean. (2005). Sensory Integration and the Child—
Understanding Hidden Sensory Challenges: 25th Anniversary Edition.
Los Angeles, CA: Western Psychological Services.
Greene, Ross. (2010). The Explosive Child: A New Approach for
Parenting Easily Frustrated, Chronically Inflexible Children. New
York: Harper Paperbacks.
9. 10/7/2010
9
Further Reading / Resources
Websites
Ross Greene / Collaborative Problem Solving
http://www.livesinthebalance.org/
http://www.ccps.info/
Sensory Integration / Sensory Processing
http://www.sensory-processing-disorder.com/
http://www.sinetwork.org/