Are we Discriminating? Do Our Interventions Differ for Typical Children with Challenging Behaviors and those Children with Special needs and Challenging Behavior? Guest Blog by Adam Holstein P.D., L.P.
How is it that we come to understand a child’s challenging behaviors? In addressing a typical child’s challenging behaviors we do not jump to implement an ABA program, although one could ask; “Why not?” With typical children and typical “challenging behaviors” the clinical approach utilizes a psycho-dynamic understanding. We examine the history of the child’s emotional world and come to understand his behavior in the context of that world. That is in the context of; who the parentsare and how they address or fail to address the child’s needs is examined. How the child with the challenging behaviors views his parents is examined, understood and addressed in therapy. A great many interventions also include behavioral interventionssuch as changing parent to child interactions and/or the environment.
I have spoken with hundreds of administrators and clinicians over the years and when we talk about a child’s challenging behaviors we refer to the interactions between themselves and the child along with their feelings and what we think the child isfeeling. The dialogue invariably includes the impact pro and con of the parents and how they contribute to the child’s behavior, albeit unaware and unintentionally. We understand the parents’ contributions of a child’s behavior in large part based on our understanding of the emotional world of the child. Thisemotional world includes all significant adults and siblings.
Yet, this emotional world is not addressed frequently enough in the world of child who has special needs and who is receivingservices via, early intervention, CPSE and CSE. When working with children we address the developmental delays most often with interventions consistent with Applied Behavior Analysis. When a special needs child is demonstrating Challenging Behaviors we have many issues to sort out. We have to considerhow much of the behavior can be assign to;
•the biological disability, i.e., Autism, PDD, SID, ADD, ADHD developmental delays and so on?
•other potential underlying developmental issues?
•the child's feelings. What feeling is the child trying to communicate?
•the child’s thoughts?
•the dynamics between all significant others?
•the physical and social environment?
•the child identifying with either parent and being like the parent?
Based on our understanding of the primary contributors of any given challenging behavior we begin to intervene in a systemic manner addressing the causes of the challenging behaviors. Inthe world of typical children the approach is psychodynamicverses the world of children with special needs, the approach is behavioral. Dare I ask; “Is the educational system discriminating? Where is the therapy, psychodynamic intervention for the child with special needs?
If you have a child in your practice who is demonstrating challenging behaviors and need help understanding the behavior and how to intervene please consider the emotional communication of the behaviors. Parents too have to be willing to examine what the challenging behaviors are about beyond the manifest diagnosis their child has been given.
As always I am available for consultation.
Adam J. Holstein, P.D., L.P.
Amy Reinstein, M.S., CCC - SLP