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Overview of Behavioral Problems in Children

by Stephen Brian Sulkes, MD

Children acquire many skills as they grow. Some skills, such as controlling urine and stool, depend mainly on the level of maturity of the child's nerves and brain. Others, such as behaving appropriately at home and in school, are the result of a complicated interaction between the child's physical and intellectual (cognitive) development, health, temperament, and relationship with parents, teachers, and caregivers.

Behavioral and developmental problems can become so troublesome that they threaten normal relationships between the child and others or interfere with emotional, social, and intellectual development. Some behavioral problems, such as bed-wetting (see Urinary Incontinence in Children), can be mild and resolve quickly and spontaneously as part of normal development. Other behavioral problems, such as those that arise in children with attention-deficit/hyperactivity disorder (ADHD—see Attention-Deficit/Hyperactivity Disorder), can require ongoing treatment.

Most of the problems described in this chapter arise out of developmentally normal habits that children easily acquire. The goal of treatment is to change undesirable habits by getting children to want to change their behavior. This goal often takes persistent changes in actions by the parents, which in turn results in improved behaviors by the children.

Treatment

Behavioral problems need to be addressed early because behaviors are harder to change the longer they exist. Sometimes, parents need only to be reassured that the particular behavior is normal or to hear a few simple suggestions. One simple suggestion is for parents to spend at least 15 to 20 minutes a day in a pleasurable activity with the child or to call attention to desirable behaviors (“catching the child being good”).

Additional strategies for modifying behavior include the following:

  • Clearly defining for the child which behaviors are desired and which are undesired

  • Establishing consistent rules and limits

  • Tracking how well the rules and limits are followed

  • Providing appropriate rewards for success and consequences for inappropriate behavior

  • Minimizing anger when enforcing rules and increasing positive interactions with the child

If a behavior problem does not change in 3 to 4 months, doctors may recommend a mental health evaluation.

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