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Behavioral Disabilities

Early child development can be seriously compromised by social, regulatory and emotional impairments. Indeed, young children are capable of deep and lasting sadness, grief, and disorganization in response to trauma, loss, and early personal rejection.

The preschool years are vital in laying the foundation for emotional development and for future social and cognitive learning. Paying attention to mental health needs in these formative and dynamic years is critically important, and new research sheds light to how to do this well.

Mental health, like physical health, is an essential part of a person’s identity. Like physical health, mental health moves back and forth along a continuum throughout life, beginning during prenatal development. Sometimes mental health problems stem from environmental stressors and sometimes they stem from biological factors. For every child, a complex interaction of these two factors exists, combined with the individual process of personality development. “Children affect their environment at the same time that their environments are affecting them.” Environmental factors are the factors people have the most control over, and therefore more information is available about how to tip environmental factors in a positive direction for healthy emotional development.

Environmental Influences

For infants, toddler and preschoolers, the influences of their parents, extended family, child care staff, and others with whom they have regular contact profoundly impact their emotional, cognitive, and social development. Attentive care-givers learn to watch for the cues babies give to signal their physical needs. However, an infants’s emotional or mental health can be more difficult to interpret. The complex interaction between infant and care-giver is based primarily on the infant’s attempts to obtain attention, comfort and support. Reading the emotional cues of the child and responding in an attentive, caring manner is as important as meeting physical needs.

Genetic Influences

Human development is shaped by a continuous interaction between biology and experience. Every child is born with powerful inborn tendencies, and these tendencies can work both for and against a child. When a child is born with a genetically predisposed tendency toward mental health problems, the environment becomes critically important to support and guide the child in a positive, healthy direction. This adds stress to the already difficult job of parenting.

Recent Research on Behavior

Culture strongly influences human development and child rearing beliefs. Knowledge, attitudes and beliefs about parenting are what shape the way that parents and care-givers interact with their

children.

The pervasive stigma about mental health problems continues to contribute to the lack of prevention, early identification and adequate services for all children, especially the very young.

Young children who display severe behavioral and emotional problems have a 50% greater chance of continuing to struggle with mental health problems into adolescence and even adulthood.

Assets, or protective factors, include good prenatal care, a healthy birth, a secure attachment to a primary care-giver, high quality care and education, love, nurturing and freedom from violence. Challenges, or risk factors, include maltreatment, social isolation, prenatal exposure to alcohol, drugs or other harmful chemicals, poverty, discrimination, and poor mental health in parents. Our job as adults is to find ways to “maximize the positive and minimize the negative.”

The use of clinical mental health diagnosis is often avoided to prevent labeling children at a young age. However, the importance of identifying problems when they do exist cannot be overemphasized, and often a diagnosis is needed to obtain payment for services. The terms “emotional or behavioral” problems or disorders are typically used to acknowledge the existence of a problem that needs addressing, without clinically labeling the child.

Challenging Behavior

Many young children, including children with disabilities, engage in behavior that is labeled by adults as “challenging”. Sometimes, the behavior is short-term and decreases with age and use of appropriate guidance strategies. Additionally, what is “challenging” to one person may not be to another. It is critical for professionals to be aware of, and sensitive to how families, cultural groups and communities define appropriate and inappropriate behavior in young children. It is important to understand what behaviors are typically associated with a particular age group. For example, adults need to understand that young children engage in behaviors that older children do not, such as throwing toys or sitting for only short periods of time. With guidance and instruction most children will learn appropriate behavior.

Some children’s challenging behaviors are not effectively addressed by adult vigilance and use of appropriate guidance. For these children, the behaviors may result in injury to themselves or others, cause damage to physical environment, interfere with the acquisition of new skills, and or socially isolate the child. It is clear that inappropriate behaviors such as these seldom resolve themselves without systematic intervention.

Prevent the Defiant Behavior

Children may well engage in challenging behavior that quite often can be eliminated by a change in adult behavior. It is possible that the child is reacting to adult behaviors such as lack of attention or unrealistic expectations. By changing adult behavior, we may prevent a child’s need to engage in challenging behavior. Prevention is the best form of intervention. It is time and cost efficient, and appears to be a major avenue by which to eliminate, not merely reduce, the incidence of behaviors.

Prevention means that the important adults in the child’s life have to look at their behavior in the classroom, home or community setting the might be maintaining the child’s challenging behaviors. For example, are toddlers expected to sit through a 30-minute circle time? Is a child getting a cookie when he screams? Effective prevention strategies that have been applied to the inappropriate behaviors of young children had included systematic efforts to teach parents to use child behavior management skills and efforts to teach alternative, appropriate behaviors that are coordinated between programs and home.

Possible Causes of Behavioral Disorders

Family members and professionals should work together to identify the behaviors, assess it in the settings where it occurs, and design interventions that are realistic to implement. Often, families are blamed for a child’s problem behavior. In a n extensive review concerning families of preschool children with conduct problems, confirmed that certain parental/family factors including depression, substance abuse, aggression, antisocial behavior, intense marital conflict, insularity, and ineffective parenting skills appear related to the presence of behavior problems for some children.

However, a growing body of evidence was cited in which other factors such as child physiological/neurological/neuropsychological attributes, communication, child social problem solving skills deficiencies, and school setting characteristics also appear directly related to the presence or absence of challenging behavior in children. While the family may or may not have contributed directly to the creation of the behavior disorder, family members are almost always significantly affected by the behavior. Families of children with serious behavioral problems reported the presence of major stressors in their lives two to four times more frequently than did families with typically developing children. Family members are likely to receive unsolicited advice with every tantrum, outburst and misbehavior. Activities that other families seem to enjoy as a mater of course are unattainable or are in constant jeopardy. Isolation becomes a fact of life.

Intervention for Children with Behavioral Problems

Many families of children with challenging behaviors have astounding stories to tell regarding their journeys through this landscape of conflicting diagnoses, bickering professionals, and expensive mistakes. There are some children whose problematic behavior is controlled most immediately by physiological factors. There are some individuals who might benefit from appropriate pharmacological treatment in order to respond to complementary environmental, curricular, or behavioral interventions.

Finally, families need partners within the working relationship involving families and early intervention professionals it is not simply a matter of whether family needs are met, but rather the manner in which needs are met that is likely to be both enabling and empowering. Parents of children with challenging behavior are often frustrated with the child, other family members, and themselves. The understanding and support of professionals can have a profound and positive impact. They need effective tools to use, appropriate resources for support, and assurance that they and their child are accepted.

Professionals and families must carefully evaluate a child’s behavior. The focus must be on promoting positive behavior and preventing challenging behaviors. In the appropriate identification of challenging behaviors, consideration must be taken of cultural and community beliefs. Developmentally appropriate expectations, and an examination of one’s own belief about behavior. When intervention is needed, such services must be developmentally, individually and culturally appropriate. They should be comprehensive, individualized, positive, multi disciplinary and consider families as integral to all decisions related to the planning and impalements of the strategies and services.

Associations

Separation Anxiety Disorder

Social Anxiety Disorder

(626) 288-8008 | dr.amy@specialdentalcare.com