Early intervention for behavior problems

It is important that children at high risk for serious behavior problems are identified and given early intervention, writes Melissa Stormont, University of Missouri/Columbia.

Stormont reviews the characteristics of children who are at increased risk for developing and maintaining serious behavior problems and provides options for intervening with these young children.

Research has documented that parents’ ratings of their preschool children’s behavior problems are the strongest predictor of behavior problems six years later. Data shows that serious conduct disorders in adolescence and adulthood appear to be established in the preschool period.

This is why Stormont calls for early identification and systematic interventions for children exhibiting enduring behavior problems. In addition to the child’s behavior, home and school environments should be studied to identify ways they can be modified to discourage acting-out behavior and reinforce appropriate behavior.

Temperamental characteristics

Temperamental characteristics are important early risk factors, but by themselves do not strongly predict behavior problems. However, characteristics such as high levels of activity, intensity, negative mood, problems adapting, inflexibility and difficulty managing behavior appear to predict behavior problems when mixed with certain family characteristics.

Research has found that children with both hyperactivity and aggression are at high risk for future problems. Up to 67 percent of children who exhibit both hyperactivity and aggression in their preschool years continue to have severe behavior problems at age nine.

Many characteristics should be considered when determining which children are most in need of early intervention. It is important to identify preschool children who need intervention, but professionals should be careful of attaching disorder labels to young children.

Although it is clear that early acting-out patterns including hyperactivity, aggression, and challenging temperament place children at great risk for developing behavior problems, it is often the family and school contexts that contribute to sustaining problem behaviors.

Family characteristics

Specific family factors appear to be important predictors of behavior problems in children. These include marital conflict, maternal depression, low maternal education level and family stress. Adolescents with the most severe problems had more family adversity than other children when they were preschoolers.

There is a strong relationship between early harsh management by parents and children’s aggression. Negative and controlling types of parenting also place children at risk for developing and sustaining behavior problems. Children with behavior problems spend 10 times as much time in negative interactions with their mothers than those without such problems.

The children with the greatest risk of behavior problems are those who do not have either the internal resources or the external support to help them overcome early difficulties with self-regulation and behavior control. Social support for the child and family has been shown to be a buffer against serious problems in the future.

Classrom factors

Teachers, like mothers, spend significant amounts of time in negative interactions with problem children. While research has shown that more experienced teachers have better skills at managing children with behavior problems, classroom observations reveal that when problem children do comply and act appropriately, many teachers do not consistently reinforce this good
behavior.

Teachers frequently ignore these students when they raise their hands, and such students receive less teacher praise for correct responses than children without behavior problems. Many teachers are more likely to use reprimands than redirection for negative behavior in high-risk students, which sets the stage for more noncompliant behavior.

Stormont believes that, given these low rates of positive interaction between teachers and students with behavior problems, teachers need support for learning to respond to students in a manner that increases positive behavior and reduces
inappropriate behavior.

Standardized behavior scales

Children with behavior problems need interventions that support the development of more appropriate social behavior. Stormont stresses that it is important to use only standardized behavior scales when identifying children in need of intervention because isolated behaviors by themselves do not indicate that a disorder exists.

Parents’ and teachers’ input as well as direct observations of children should be included in an evaluation. It is helpful to establish supportive relationships between teachers and parents so that improved behavior can be maintained and newly learned skills can be generalized to all settings.

Teachers need more than a workshop to work with challenging behavior. They may need support to learn new skills and to implement new responses to behavior,as well as to establish collaborative relationships with families who may be under considerable stress. Stormont recommends that before teachers begin working with individual children, classwide support for appropriate behavior should be established.

Classroom supports for positive behavior include positive teacher-student interactions; clear classroom rules that are taught, posted, and consistently reviewed and enforced; less wait time for students; smooth transitions between activities; and a positive environment that includes structure and routines.

Some young children need the opportunity to role-play a behavior and receive corrective feedback and positive reinforcement in order to learn more appropriate behavior.

Many children with behavior problems will need more intensive and individualized intervention than can be provided by teachers in a classroom. School psychologists can work individually with students and help teachers and parents to support appropriate behavior.

They may also help by observing children in class and systematically identifying both the problem behaviors and the events that reliably predict and fuel them. When children with behavior problems are in adverse home environments, schools can successfully buffer them against the development of more severe behavior problems.

“Externalizing Behavior Problems in Young Children: Contributing Factors
and Early Intervention” Psychology in the Schools Volume 39, Number 2, March
2002 Pp. 127-138.

Published in ERN May/June 2002 Volume 15 Number 5

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