Step One to Understanding Your Child with Challenging Behaviors
All of the parents I work with have children who struggle with incredibly challenging behaviors. Their kids often have a long list of diagnoses, that have accumulated over time, describing these behaviors. And while it can be comforting, in the moment, to receive a long-awaited diagnosis, most of the parents in my practice describe what follows as a feeling of being lost, desperate, and even more frustrated; having this name, this clinical word, this diagnosis, often does little to help them know how to actually support their child or to calm the chaos in their home. Instead of bringing clarity for a parent, a diagnosis — or several diagnoses, in many cases — can sometimes further cloud the picture.
Here is a short list of diagnoses — punctuated, it's worth noting, with the word “disorder”— that will be familiar to parents and caregivers of children struggling with difficult-to-diagnose neurobehavioral challenges:
Oppositional Defiant Disorder
Attention Deficit Disorder
Reactive Attachment Disorder
Post-Traumatic Stress Disorder
Autism Spectrum Disorder
Fetal Alcohol Spectrum Disorder
Sensory Processing Disorder
If you’re someone for whom this dilemma sounds familiar, you’re not alone. One of the most essential things you need to know about your child is surprisingly simple in theory, and rooted in what neuroscience research tells us about the brain and how it functions.
It starts with moving away from the specific diagnosis and seeing the brain as the organizing principle and the source of all behaviors.
When a young child whose brain works differently (due to trauma, neglect, prenatal substance exposure, medical illnesses or a myriad of other factors) is struggling behaviorally, they frequently receive a diagnosis that derives from descriptions of the child’s outward behavior. Statements such as “easily distracted" … “difficulty with transitions” … “impulsive” … ” aggressive” … ”irritable temperament” ... and “talks excessively,” are a just a few amongst a long list of challenging behaviors.
Hearing descriptions about our child such as, “often loses temper” … “often refuses to comply with rules” … “often argues with authority figures” … “often irritable” ... “feels restless or on edge,” tells us that a behavioral lens is being utilized to make the diagnosis. This isn’t invalid or wrong, but it doesn’t necessarily provide us with useful insight into the “why” behind the behaviors. And, for parents, it doesn’t move them any closer to actually knowing what they can do to help their child experience less of these distressing behaviors.
So, how do we begin to make sense of this information, in a way that is rooted in the research and helps our child settle? It starts with moving away from the specific diagnosis and seeing the brain as the organizing principle and the source of all behaviors. When someone is living with a brain difference, no matter the cause, we see behavioral symptoms result. When we have this shift in perspective, we can begin to view behaviors as symptoms of a brain that works differently, rather than actions that are intentional and manipulative. And when this happens, parents and providers can shift from reacting to reframing, in ways that are consistent with the latest neuroscience research. This is when a new path for supporting and connecting with the struggling child emerges. Shifting our perspective about the root cause of the behavior in this way almost always unveils a new set of possibilities in terms of how to understand, care and support. Over time, when this approach to parenting is applied consistently, we see our child begin to settle and chaos in our home start to dissipate.
This way of being in relationship with our child stands in contrast to what traditional parenting methods teach us, which is to see these behaviors as the target for our intervention. If we go down this behavioral path, we miss the opportunity to develop accommodations to help a child be more successful. Staying in our behavioral lens leads to more lecturing, exerting more control, and giving harsher consequences, and after all this, feeling defeated yet again because “nothing works.” We’re simply missing information that there is any other alternative. Frustration increases, along with a growing hopelessness that things might ever improve.
This idea that “the brain is the brain is the brain” is why, when we’re discussing day-to-day parenting and connecting with our child in meaningful ways, I always encourage the parents I work with to move away from these various diagnostic labels and to see the brain as the organizing principle, using the neurobehavioral model as the framework.
This focus on the brain and how our unique child’s brain works differently leads us to ask helpful, empathetic questions such as these:
If we believe — as I’m certain we should — that if a child could do better, they would, then why do we think they might be having such a challenging time with the given task or situation? Where are they lagging behind in certain skills?
What are the challenging behaviors communicating?
What are the behaviors in reaction to?
Where does the child experience difficulty in their environment (what is the problem to be solved, the trigger, or the task/expectation with which they are consistently “refusing” to comply)?
How can we link all of this information back to brain function and lagging skills?
How can we then move into brainstorming appropriate supports and accommodations, so that the child can settle in their environment, and find the greatest measure of success?
Where can I, as their parent, adjust my expectations so that they are more in-line with my child’s skills?
While there are never any one-size-fits-all solutions to parenting, if you can begin with this mindset — that the brain is the organizing principle for everything that comes after — then you’ll be on the right path, regardless of diagnosis, to better understanding and supporting your child with challenging behaviors.
Eileen Devine, LCSW works in Portland, OR as a therapist and coach supporting parents of children with special needs. She is also a consultant for families impacted by FASD, PANS/PANDAS and other neurobehavioral conditions through her private practice, working with families nationally and internationally. She lives with her husband and two amazing kids, one of whom happens to live with FASD. For more information, visit eileendevine.com.