1. Psychosocial etiology of behavioral difficulties in children and adolescents: Challenges in identifying and addressing them in a timely manner Diana Monteiro, Ph.D. The Hyderabad Academy of Psychology

2. Psycho Social According to Wikipedia, “Psychosocial means it relates to one's psychological development in, and interaction with, a social environment”psychologicalsocial environment As adults we control much of the child’s social environment

3. Psychosocial etiology So what is a child’s social environment? – Other children, adults – Lots of play Psychological environment – Temperament – Interaction of biological and emotional needs

4. Mental health problems Occur out of one of three areas or a combination of all three areas: – Biological – Psychological – Sociocultural Psychosocial

5. Evidence that social area affects kids Approximately 10-15% of all typically developing preschool children have chronic mild to moderate levels of behavior problems (Campbell,1995). Children who are poor are much more likely to develop behavior problems with prevalence rates that approach 30% (Qi & Kaiser, 2003) Children who are identified as hard to manage at ages 3 and 4 have a high probability (50:50) of continuing to have difficulties into adolescence (Campbell & Ewing, 1990; Campbell, 1997; Egeland et al., 1990). What does this mean for the kinds of children we have in our care? 5

6. Child’s basic needs Food Shelter Safety Protection Emotional connection Which are Socially based needs?

7. So basically High quality caregiving + high quality environments ≠ No challenging behavior

8. Challenges in identifying behavioral difficulties Thomas, Chess and Korn (1982) – To debate whether a child’s characteristics or parental perceptions or other environmental influcences are more important is antithetical to the view which sees them ALL as all-important in a constantly evolving sequence of interaction and mutual influence (p.15). Thomas, A., Chess, S., and Korn, S.J. (1982). The reality of difficult temperament. Merrill-Palmer Qauterly, 28(1), 1-20.

9. Challenges for adults We are used to labeling difficult children not difficult behavior Let’s start by assuming that every child has difficult behavior Some pathological and most not Adult interventions strongly influence how a child will develop behaviorally

10. Identify functions of Behavior Functions of Behavior To Get/ Obtain Attention Objects or Activities To Escape/ Avoid Sensory Input/ Stimulation

11. Reframing bad behavior: Understand why children “misbehave” To escape from doing an activity, task or event that they do not like or feel incompetent in To get attention They may have difficulty in performance and comprehension Personal reward and gratification To be in power, to take control over others, or revenge Adult must observe children’s behavior to determine possible causes for misbehaving and the “reward” the child is receiving for acting this way.

12. What are challenging behaviors Repeated behaviors that interfere/prevent learning Repeated behaviors that prevent positive social interactions Examples: – Tantrums – Hitting, biting, pushing, pulling hair, spitting, etc. – Swearing, using negative language, shouting, ridiculing others, etc. – Destroying property, games, materials, etc. – Withdrawing, not interacting, refusing to obey rules

13. Challenge is to remember All behavior happen within a particular context All behavior serves a purpose Children learn to behave or misbehave based on whether it addresses their needs Understanding why children act the way they do is the first step in problem solving Interventions must have a contextual fit Interventions must have team-based approach/ process

14. Addressing behavioral difficulties in a timely manner

15. Why should we address these behaviors Children with serious behavioral problems (who do not receive necessary attention and assistance) are more likely to: – Fail in school – Be less productive citizens – Develop more serious behavioral problems Delinquency Aggression Anti-social behaviors Drug abuse

16. Steps in Analyzing Child’s Behavior Adult should discuss the following issues in consultation with other adults who may also be interacting with the child: What behavior is of concern to the adults? When does this behavior appear: – Identify potential causes for the behavior – child is frustrated, child is tired, child is uninterested – Who is around the child? Where is this behavior more likely to take place at? What happens after the child misbehaves? – Do other children give the child what he/she wants? – Does the child get to stop doing the activity? – Does the child get more attention?

17. Does the child have any kind of disability or learning difficulties? – Is the child hyperactive, impulsive, have difficulty concentrating/ paying attention – Does the child have any kind of physical difficulties – movement, visual, hearing – Does the child show signs of difficulty in communicating, autism, mental retardation – Does the child have a learning disability – reading, writing, math, memory, etc. How can you change the behavior? – Discuss approaches to reinforcing child and guiding them towards appropriate behavior Discuss behavior with child, what is expected of them and what actions will be taken when they misbehave Assist child in developing skills to carry out activities or perform in a way that is not frustrating or limiting to the child. Steps in Analyzing Child’s Behavior

18. Questions