written by: LauraLMSW
• edited by: Elizabeth Wistrom
• updated: 8/2/2012
Behavioral and emotional disabilities present predictable challenges. Heightened awareness and acknowledgment of triggers will allow for the necessary preventative measures to avoid distress.
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Strive for Prevention
Managing emotional behavioral disability is possible due to the presence of predictable challenges. Heightened awareness and acknowledgment of triggers will allow for the necessary preventative measures to avoid distress. Reinecke (2006) said that emotional crises are best managed through prevention which involves using strategies while identifying the specific triggers and signs of an impending emotional ‘meltdown.’ Strategies include methods for the reduction of anxiety or other impeding emotional states. Intervention to minimize triggers, or to prepare individuals for their encounter, requires finding ways for diffusing the trigger situations when pre-meltdown signs are observed (Reinecke, 2006). Attentive examination of problematic situations will reveal commonalities that can be altered or avoided to promote smoother transitions between daily living activities.
An understanding of a child’s responses to adverse circumstances and identifiable events is necessary (Turner, 1989). If a child struggles with crowded areas and groups of people are a typical trigger, they must be informed of the possibility of overcrowded environments that they may be entering. Anticipating stressful and emotional situations is a basic preventative action. Many people, regardless of their abilities or emotional states, dislike the unanticipated. Precautionary messages should be used as a courtesy to the person who is challenged by environmental triggers. Intervention requires the people with emotional or behavioral disabilities to help themselves along with additional support from those in the surrounding area. For example, a child could practice deep breathing as a calming technique, while those in the area could attempt to remove aggravating stimuli from the immediate area. An adult may assist the child in leaving the area if altering the surroundings is not possible. A mutual effort can be used for the final preventative measure, which is to use calm periods to problem solve an appropriate course of action (Reinecke, 2006). Children benefit from prompting to consider realistic options and the best ways of coping in environments that they may minimally understand which may be increasing their fear and anxiety. Greater understanding and forethought will help the child to better manage the triggers that threaten their daily functioning.
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Techniques and Tools
Emotional behavioral disability requires interventions that are sensitive and guiding. Behavior modification is a practical approach that is user friendly for children who may feel overwhelmed by increasing demands and expectations. Behavior modification is described by Turner (1989) as the break down of a child’s behavioral manifestations into sequences, so they can reward and reinforce positive behaviors and eliminate negative unwanted behaviors. The rewards can be based on a child’s interests or a token system can enhance a child’s economical understanding and motivation. Allen-Meares and Fraser (2004) said it is sometimes necessary to couple reinforcement procedures with corrective teaching. This process helps children to better understand their behaviors and effectively transfer learned skills into a variety of social situations.
Self-management is a set of strategies that a person uses to alter his or her own behavior to make a behavior less aversive to others and replace problematic behavior with more productive behavior (Allen-Meares & Fraser, 2004). Children who implement behavior management are empowered to have a strengthened sense of control over their actions and the resulting circumstances. Feelings of powerlessness are detrimental in the modification of behavior. Children must take responsibility for their behavior and in order to do so they must not attribute that accountability to anyone other than themselves. Reinecke and authors (2006) said that the self-management intervention involves five steps which are operationally defining a target behavior, identifying functional reinforcers, choosing a self-management method (e.g., notebook, stickers), teaching the individual to use the method, and teaching self-management independence. This break down of behavior into multiple steps may be easier for a child to process, practice and observe for replication. Children must learn the desired behavior before they can begin to incorporate it into their daily activity. Once they see who and what is supporting them in the environment, possibly indirectly, they may feel less isolated in their attempts at behavior modification. With a sense of ownership and pride they can document their progress as a process of learning and a tool for continuation of self-management.
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Emotional behavioral disability does not define the child who is challenged by them. In fact, it is important to identify a child’s strengths and further develop his or her pro-social behavior that may be overshadowed by the problem behaviors (Allen-Meares & Fraser, 2004). Merely focusing on deficits depletes a child’s sense of self-worth and certainly limits their ability to manipulate their behavior to make positive changes. The motivation and determination necessary in behavior modification will not be present if a child feels belittled. It is important to build children with behavioral and emotional disabilities up by acknowledging their assets and assisting them with practical tools to enhance their sense of mastery and growth potential. Children with emotional or behavioral disabilities may not know how to process their emotions in an acceptable manner. According to Reinecke and authors (2006), written and visual techniques, such as cartoon-like emotion cards and emotion ‘thermometers,’ can be teaching tools to help characterize the nature and intensity of emotions. The fundamental understanding of emotions and moods cannot be assumed. The significance of feelings can vary from person to person and to best identify problematic emotions the individual must describe the meaning they associate with each. Once a name and connotation are assigned to the feelings, the intensity can then be analyzed as a possible catalyst to incremental stages of behavior.
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Borrowing from the Professionals: Cognitive Behavioral Treatment
Research supported interventions, or evidence-based interventions, offer insight about effective perspectives and actions. Two evidence-based psychosocial interventions are Cognitive Behavioral Treatment (CBT) and Parent Management Training (Mallon & Hess, 2005). These interventions require professional guidance, but their basic elements reveal how they can be of assistance to a child with emotional behavioral disability.
Cognitive Behavioral Treatment has proven effective for a variety of emotional and behavior disorders exhibited by children and adolescents, including anxiety and depression, adjustment disorders, eating disorders, and conduct disorders (Mallon & Hess, 2005). The cognitive processes of children with emotional or behavioral disabilities may be impaired causing social tension. Mallon and Hess (2005) said that cognitive distortions are believed to play a major role in affective disorders in children, because their immature cognitive development heightens the possibility if misinterpreting or misperceiving situations or events. Cognitive distortions are a crucial reason to increase communication with a child experiencing emotional or behavioral challenges. The child will not be able to express or elaborate their thought processes if they are not encouraged and engaged in open communication. It is important to remember that the child will not know that distorted thought processes may be the cause of emotional and behavioral challenges. CBT helps a child recognize how cognitive distortions influence dysfunctional occurrences.
The focus of CBT is on (1) changing cognitive distortions that contribute to the child’s anxiety or depression; (2) learning new behaviors and skills for coping with anxiety-provoking situations; (3) testing newly acquired skills in novel situations; and, (4) processing their outcomes with the therapist (Mallon & Hess, 2005). Analyzing the environments in which a child often struggles may reveal faulty thinking and actions. An example would be if a child is simply running toward the group of children he or she would like to play with on the playground and not initiating any verbal form of communication. The children will not know the child’s intentions and may even run away. A child experiencing such perceived resistance might continuously feel rejected after many failed attempts at joining a group. The child will have to learn how to ask the other children if he or she may join them in play. The child will have to practice this skill and may experience anxiety before, during or after implementation. Coping skills to relieve this anxiety could include deep breathing, visualization techniques and positive self-talk. Professional therapeutic help will allow for the processing of outcomes in order to reveal significance and insight for future interactions.
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Borrowing from the Professionals: Parent Management Training
The second evidence-based treatment for children and youth with oppositional and aggressive behaviors is Parent Management Training which is based on research that shows that parents or caregivers unintentionally reward a child’s bad behavior by overresponding to the child when such behavior occurs and, at the same time, ignoring the child when his or her behavior is positive (Mallom & Hess, 2005). A child may learn that they can have a lollipop every time they are out shopping with their parent if they start to cry or display a tantrum. The parent is simply trying to pacify their child by doing so, but they are also reinforcing the disruptive behavior. Mallon and Hess (2005) said the child’s behavior is reinforced by the parents’ attention even when the attention is negative, such as yelling, name-calling, threats, or physical aggression and so the focus of parent management training is on teaching parents to alter this pattern by not responding to their child’s provocative behaviors, by attending to and rewarding positive or desired behavior, and by ignoring or delivering mild forms of punishment to extinguish bad behavior. Instead of always catching their children doing something wrong, they must catch them doing something right and praise them for it. The parent management training intervention helps parents to set clear rules and expectations for their child to follow and parents are taught how to negotiate and compromise with their child to achieve desired outcomes (Mallon & Hess, 2005). This approach is especially useful for adults working with children who experience emotional behavioral disability because the children are further perplexed by the mixed signals that they receive. Adults or parents who begin to enforce a more strengths-based intervention will feel better as a result of giving praise rather than constant discipline. Children may feel more valued and capable of making efforts to regulate their behaviors and emotions.
Allen-Meares and Fraser (2004) said origins of behavior problems are associated with conditions in the home and community causing the need for a united effort between parents and schools in order to provide the consistency needed to develop appropriate behavior. Cognitive Behavioral Treatment is an example of an intervention that may help a child to better understand and flourish in their community. If misperceptions are corrected, children with behavioral or emotional disabilities may be able to relate to and find a niche in the community. Additionally, Parent Management Training provides the home component with compassionate direction that recognizes the natural reactive responses and replaces them with more effective reactions. This training not only supports children with behavioral and emotional disabilities, but it also reinforces positive parenting techniques that will result in greater adherence.
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Allen- Meares, P. & Fraser, M. (2004). Intervention withchildren and adolescents: An interdisciplinary perspective. Boston, MA: Pearson.
Mallon, G. P. & Hess, P. M. (2005). Child welfare for the 21st century: A handbook of practices, policies and programs. New York: Columbia University Press.
Reinecke, M., Dattilio, F. & Freeman, A. (2006). Cognitive therapy with children and adolescents. New York: The Guilford Press.
Turner, F. (1989). Child psychopathology: A social work perspective. New York: The Free Press.