Child Behavior Concerns & Early Intervention

early intervention and child behavior concernsIs your child’s behavior just a phase or something more?

Just like us, a child’s behavior can be complicated and ever changing with their environment. Understanding whether there is a core issue or just a passing phase is the challenge. At teli, our Pediatric Developmental Specialists and Occupational Therapists have worked with numerous children, understanding what causes some behaviors and providing Early Intervention services to address the challenge the child is facing.  Through our staff’s work with parents, the following list of behaviors are some of the most common issues they see and provide some perspective on what steps to take to help.

Q: My child seems to have a tough time transitioning between activities. What can I do?

A: This may be a sign that a child is having difficulties processing changes in his daily routines, or in other words, his/her sensory system may be too rigid and not as flexible as it should be. As parents and caregivers, try to support the child so he or she can learn to transition easier by trying the following suggestions:

  1. Give a signal or warning that an activity will be coming to an end:
  • Slowly count to 10
  • Slowlycount down from 10
  • Flick lights on and off
  • Set a timer and have alarm ring when time is up.
  1. Use a transition object, such as a stuffed animal or toy figure, to help a child get from point A to point B.
  2. Make a visual picture schedule so the child seeswhat comes next and what to expect. This can serve as a child’s version of our adult planner or daily calendar and depending on age and situation can vary as each child is different. Seeing what activity comes next can be easier than hearing what comes next.  This can be as simple as two pictures. For example, coat and car, put coat on then get in the car, or more complex with several pictures, for example, a morning routine of play time, breakfast, library, play time, lunch.
  3. Behavioral techniques help to signal and explain change to a child, such as “First/then” and “Do this first, then that”. Pictures can also be used to help transition a child.
  4. Use few words, for example, “clean up”, “shoes on”.  Avoid long discussions.

HINT: Keep it simple! Pick a suggestion that works for you and your child. Resource: Debbie Fekos, teli Occupational Therapist

Q: How do I deal with my child’s tantrums?

A. When your child is having a tantrum, the first thing to do is to rule out the cause. Are they tired, sick, or hungry?  If none of these apply, parents should try to find a pattern to the behavior.  For example, does it seem to happen at the same time of day, during transitions, or during the same routines?  If a pattern can be established, parents can better prepare for potential tantrums. Once a tantrum is occurring, caregivers can control their reactions by speaking calmly in short, simple, and easy to understand phrases.  Caregivers can also give verbal or visual warnings that a transition is going to occur, so that children do not experience a sudden stop of an activity to a potentially less desired task.  It will also help for caregivers to talk about the daily schedule; what will be happening, who will be there, and what is expected during each routine or location prior to the day.  Caregivers should review throughout the day. Resource: Nichole Merz, teli Developmental Specialist

Q: My child seems to have a problem interacting with others, behaving aggressively (hitting and biting) towards family or peers.   How can I help him?

A: To help your child, families should try to identify a pattern of behavior.  Caregivers should be looking specifically for what happens before and after an incident of aggression, as well as the reaction of any adults.  Caregivers should also identify how their child is communicating and encourage better communication if needed.  This can include modeling words or signs for the child to use with peer as alternatives to negative behavior, as well as helping peers understand these communication attempts.  It is also helpful to state expectations for play situations before they occur in short, simple, and easy to understand phrases. Resource: Nichole Merz, teli Developmental Specialist

Q: My child seems to prefer to play alone. How do I encourage my child to play with other peers or family?

A: Play is a very important part of language and social development. Parents often become concerned if their child is playing by themselves when they are with other children. It is very important to first consider what stage of play their child is in, and then decide if it is age appropriate or delayed and in turn, evaluating what the next steps could be. There are six stages of play:

  • Unoccupied Play (Birth to 3 months), where the child is exploring movement and their bodies
  • Solitary Play (Birth to 2 years), where a child plays alone and not with others.
  • Spectator/Onlooking Behavior (2 years), where the child begins to watch other children play, but does not play with them.
  • Parallel Play (2-3 years), where the child plays alongside others but not with them.
  • Associate Play (3-4 years), where the child begins to interact with others, but not a lot of interaction
  • Cooperative Play (4+ years), where a child plays with others in a joint activity.

At different stages of development, a parent can set their child up for optimum success in play. A great place to start is evaluating what setting your child seems the most natural in, successful and at ease during play with appropriate expectations. If your child does best in quiet environments with one other child, invite another child over for a one on one play date. Another way to help is setting up activities or getting involved in groups that set up a give and take turn taking system, where the rules and expectations are clear. This can help provide a platform of interaction for a child who is having a difficult time doing so. If your child is still having difficulty contacting Early Intervention or Pediatrician is recommended. Resource: Vanessa Doherty, teli Occupational Therapist

Q: My child refuses to calmly sitting still to listen to a book being read. What can I do?

A: Reading is a wonderful activity to do with your child and it should be fun. It is always important to consider what is developmentally appropriate to expect when asking our children to attend attentively. A good guideline of attending expectations are:

Attention Span Guidelines
Age 8-9mons 9-16 mons 16-20 mons 24 mons 24-30 3-4 yrs 4-5 yrs 5-6 yrs
Minutes 1 1-2 2-3 4-6 5-8 8-10 10-20 15-20

Reading should also be a very interactive activity especially for little ones. If your child is under 2 years of age, making sounds and gestures and movements can help engage younger children in the activity of reading. Another way, is to promote turn taking, such as pointing to a picture in a book, labeling it and asking the child to imitate the word. For a child who is older, you can ask the child “what is that?” while pointing to the picture. Reading can also take place in a variety of settings, in a bed, chair, floor, hammock or swing. Also consider trying different times of the day to read, often times children respond differently to reading depending on their energy and mood levels. Other environmental factors also play a role, such as if there are distractions such as people talking or a television or radio on. Limiting extraneous distractions, being alert and comfortable are all important factors in reading with your child.

Resource: Vanessa Doherty, teli Occupational Therapist

If you are seeing some of these behaviors on a consistent basis, you may want to discuss this with your health care provider and explore Early Intervention Service for your child. Early Intervention Services can help both you and your child address the behavioral issues and develop solutions. Call us today 412-420-2400.