Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Welcome, I'm a professional counselor and behavioral-consultant. I'd like to chat with you for a few moments to better understand your question and the situation you're describing.
Good morning. Do you have few moments to chat right now?
Yes I do.
Thank you. I'll start by saying that I'm sorry to hear that you're going through this right now as a parent. It must be very stressful and difficult at times. I'd like to begin by asking:
How has your son done academically historically and now? What kind of grades?
In Kindergarten and 1st grade he for the most part made A's & B's with an occasional C. This year his grades are mostly B's, with a C in language arts, and of course A's in music & P.E.
Thank you. Have you seen any behavior problems at home or during play etc with and without peers? How's his behavior at home?
He has good and bad moments at home. There are times when he listens very well and doesn't give us any problems and then there are times that he doesn't want to do what we ask. We usually have to tell him several times to do something before he will. He still will throw the occasional temper tantrum, but I have been trying to work with him on this by talking it out.
Have you seen significant changes in behavior recently at home or is this a typical pattern? Also, how was behavior at school historically prior to the events described in your post?
I would say it is probably a typical pattern at home. As far as school - He had minor issues in K & 1st grade, but only received a paddling once in school for each grade. He has always had difficulty sitting still and paying attention 100%. Here is a quote from his Kindergarten teacher (I recently reached out to his previous teachers for insight) "I can remember Dylan had a lot of difficulty sitting still and completing his work independently as well as listening and paying attention. Also, a few times he got in trouble for rough housing with other students in our room. Kindergarten is usually an adjustment time for students to learn how to obey school rules and learn how to pay attention and how to learn. I can remember Dylan being very active. I know that he is 100% boy (meaning likes to play and be active), and that maybe he just isn't that concerned with school now. It may be a just be a tough year for Dylan."
Thank you. I'm just reading and will respond in few moments...
Thank you so much for the clear information you've provided here...
Sure, just looking for help
I have to say that I agree with the idea of getting to your family doctor to rule out any medical issues. As a school board behavior consultant and treatment program psychotherapist for kids in residential treatment settings, I've seen behavior changes result and resolve from medical and dietary changes..
As far as ADHD/ADD goes I strongly recommend that you bring this up with Dylan's pediatrician as well. They are usually trained to provide screening and then advise on further formal assessment where indicated...
I see you are typing so I will wait for your next response. I do have some other suggestions as well.
We have started to limit his sugar intake and have started him on Fish Oil supplements.
I see. I'm not medically trained so it's out side of my scope of practice as a counselor to comment on medical or dietary changes. But I can sure talk about evidence-based parenting interventions at home and school.
Do you have a good relationship with your son's teacher right now?
Somewhat. I feel like she wants to help Dylan do better and she constantly tells us that she isn't picking on him. However, at times I feel like she is looking for the smallest thing in his behavior, but that could just be the Mama Bear coming out. I also feel that since the other child has "issues", she is a little more focused on working with him then with my son.
Well one of the most powerful school behavior change/support tools is simple observation and data collection sheets....
I've found it very helpful working with many teachers to provide say simple "ABC sheets" that she/he can right down short, specific descriptive behavior accounts on along with the time of day, the "antecedent" (what happens just before the behavior) and the "consequence" or what happens right after the behavior.....
This simple behavioral charting approach does so many wonderful things at once:
It provides real data about what situations, people, times of day etc trigger the behaviors of concern...
It provides a very clear description of the behavior itself so everyone is on the same page
And most of all it provides a reliable source of information for creating preventative or "front end" behavior change interventions....
For example, the teacher may discover (as most do) that the vast majority of problem behaviors involving more than one child, most often take place outside of immediate adult supervision....
A front end intervention in this case would involve reducing opportunities for unsupervised interaction...
Problem behaviors may take place at certain times of day or during specific kinds of activities...
Knowing this allows for teachers to intervene in targeted ways during those times and activities.
Also, there may be a social skills issue. For example, one or both boys may have behavioral issues when it comes to sharing or resolving conflict etc. Once you know where and why the problems are really happening, you can actually teach very simple social skills strategies to prevent problems before they happen. What are your thoughts?
I think these are some really good ideas. The teacher has been keeping a notebook of the times when she has had to get on to my son. She started this because I wanted to know what he was doing that was getting him on "yellow or red". (A bit of background...the kids all start each day with a green card, then if they don't follow rules, etc. they move their cards to yellow (a warning) and then if they continue to behave incorrectly their card moves to red).
She has also implemented using sticks with my son. He is given 5 sticks each day and if she has to tell him more then 2 times to stop doing something or to listen she removes a stick. If he loses 3 sticks, he moves his card to yellow. If he loses all 5 he gets a red. He has also been working with the counselor some on his behavior in class.
Would the ideas above be something that they would do along with what is already being done?
Yes if the teacher or other school staff did simple ABC data collection and targeted more specific behavior change goals for your son (1 or 2 at a time based on level of importance) then the stick and card programs would be more effective approaches...But..
Ideally the teacher would use "positive reinforcement" to fuel positive behavior change. Right now she is actually "clinically behaviorally speaking" using what's called "negative punishment". She's introducing a negative consequence (giving negative cards or taking a way sticks) to stop a problem behavior....
The best behavioral science teaches us clearly that it's far better to provide rewards for showing desired positive behavior. For example, giving sticks in exchange for follow through on the desired behavior, say "waling away from conflict with the other boy" would be far more effective. Punishment in this context has been shown to reduce problem behavior when the teacher is present but it actually makes the problem behavior worse when the teacher is not looking.
There are some positive consequences they have done in this behavioral plan, it would be pretty long to copy & paste it here, but I could.
Do you want feedback on the school behavior management plan as part of the answer to your question?
Yes if you could.
All right. Lets see if it copy/pastes.
Behavioral Management Plan for Dylan Copeland
This plan is being written to help improve Dylan's behavior in the classroom and to help him build a better relationship with his peers. It will include strategies that will be implemented throughout the day and it will also include rewards and consequences.
The students have 3 cards in their number pocket which include green, yellow, and red. Each day every student starts on green. When a student does not follow the rule, he or she will pull a yellow card (this is a warning card). If the student continues to not follow classroom rules the card will be pulled to red. At the end of the day all students that are still on green will receive a sticker on their calendar which is located in their homework folder. If the student pulled a card, he/she will color that space yellow or red depending on what their card is pulled to. At the end of the week their calendar for the week will show what their conduct grade is for the week. Ex. Stickers all week-A+, one yellow-A, two yellow A-, one red B+ and so on. Each day the parents will know how their child behaved that day so the conduct grade for the week should be one that they expect their child to have.
Be polite to others
Respect others- including teachers
Walk quietly in the halls
Do your best work
Keep your area clean
Obey all school and county rules
Dylan's plan: Dylan will be expected to follow all classroom rules, but he will have a visual reminder of how he is breaking the class rules. Every morning I am going to give him 5 sticks to keep at his desk. If I have to tell him more than 2 times to do something he will give me back a stick. I will give him 2 chances before I take a stick because there might be a slight chance that he would have not heard me the first time. When he gives me back 3 sticks I will make him put his card on yellow. If I get all 5 sticks he will be on red. Of course if he does something major like fighting or something of that nature, he may go to yellow or red. Hopefully this will be a visual reminder and will make him aware of his behavior and he will get better at controlling his actions.
He will also have a visual reminder from Ms. Hamilton. He has a chart with six desirable behavioral traits written on it for every day of the week. If he complies with these traits, I will give him a sticker. Each day (if possible) he will show Ms. Hamilton his chart and she will counsel with him on areas that need improving.
Physical Separation from Alex
Dylan and Alex seem to have a problem getting along together. The teacher has separated them in the classroom. Dylan is seated at the front of the room and Alex is seated at the back of the room on the opposite side. The teacher has arranged the classroom where Dylan will NOT need to be in the vicinity of Alex when he is moving around the room (getting pencils, throwing trash away, taking AR tests, etc). When they are in line, the teacher will make sure that they are not beside each other in line. If they are, the teacher will remove one or the other to another place in line. At lunch and in the computer lab, the teacher will make sure they are not sitting at the same table. The PE teachers and music teacher will be told to make sure they are separated when they are with them. Also, Dylan will be going to the bathroom at a separate time than Alex.
The consequences of him not complying will be lowered conduct grades, emails and/or phone calls to parents (which may result in restrictions from certain privileges at home), missing time in PE, being removed from classroom and placed in another teacher's room for 30 minutes, in school suspension (he will do his class work in principal's office) being paddled by teacher and/or principal, and Saturday School.
Praise from teacher, stickers on calendar, stickers on chart (Ms. Hamilton) reward from Ms. Hamilton, better conduct grades, could result in better grades on tests, extra time to draw at the end of the day or during AR time (per Mrs. Tyson).
Got it. Let me read and then respond....
I need to step away for just a moment
No problem. I'll respond in the mean time having read the what you posted....
Again, the best available behavioral interventions for kids in school and at home have shown that the real secret to effective and lasting behavior change is to use what's called contingent "positive reinforcement."
Contingent in this regard, means immediate positive reinforcement....
Positive reinforcement (PR) is anything that reliably changes behavior. So by definition, it can't fail to change behavior. Examples of PR include immediate effective praise, stickers, etc, it's really about finding out what works best with Dylan....
For example at home, you might also want to do some basic ABC data collection. You may see patterns and trends that you would otherwise not see. You could then experiment with your own front end parenting interventions. That means for example figuring out when, where and why tantrums take place and making preventative changes in the environment and/or teaching a social skill that gets him what he needs or wants in a way that is more positive for everyone involved....
At school and at home, once there is a specific behavior change goal, it's best to:
1) Make sure he know's how and when to do the pro-social replacement behavior;
2) Catch him being good right in the moment at first each time he does it; this could mean giving stickers and praise, it could also mean giving effective praise and giving rather than taking a stick or giving a more positive card.
Another thing that can be really helpful...
Is to set up a basic token economy where the focus is on Dylan gaining privileges at home and school for good behavior....
The best program in the country often use point and level systems for example where a child has 1 or 2 behavior change targets based on the ABC data collection, and then they earn a certain number of points or stickers which can then be traded in for access to nightly and weekly privileges....
What's most important here again is the focus on earning contingently for needed behavior change. So for instance, parent's are encouraged to start with a clean slate (no privileges) when there's a problem behavior and to be clear on the desired replacement behavior or expectations for that day, say a social skill. Each time the child does what is expected or when cued, he or she earns points and praise as immediately as possible to when the desired behavior choice is observed....
The child can then start to earn privileges with in a few minutes or hours, which makes the behavior change as desirable to the child as their desire to access their privileges. This quickly fuels positive behavior change rather than wasting time on delayed punishments like grounding or weeks end grades etc....
That's a good approach.
Same basic ideas work in school settings too. What are your thoughts?
To be clear, the child exchanges points or access privileges as soon as he or she earns enough points for that privilege. He or she can also loose points when he or she does not follow through.
I think that is a really good idea. How can I get a hold of the ABC data collection sheets or information? We also kinda do a reward system now, but it isn't until we get the grades for the week, so kinda backwards. If he comes home with an A in conduct he gets video games for the weekend and pizza on Friday night. I guess we could still do it, just change the way he earns the reward as you suggested.
For example, enough points at school means access to that nights TV or video game privileges etc at home. Not enough points means no or only limited access to that privilege(s)
I really hate to do this...but I have to go to lunch so that I don't mess up the phone answer schedule here. Is there anyway we can talk again later, or not?
I really like the suggestions you are giving me
I'm online today until about 4pm EST. I may be answering another customer's question. But I do get an alert when customer's return to chat. I can then get back to you as soon as I am finished working with the other customer or with in a minute or 2 if I am free.
When do you plan to return?
Ok. How do I get back to you? Around 12:15 CST
What time is it right now where you are?
That's in about an hour and 15 minutes. Just come back to the chat window here through your justanswer account. I'll get an alert then and return asap. Our chat record will still be here to.
ok. talk to you soon.
bye for now...
Hi there. Sorry, I had an internet connection problem, so I was offline for the last 3 hours on hold with Rogers cable....
Are you available for chat?
Great. So do you have any questions?
I liked the ideas you were sharing with me. I was actually able to share a little of them with my husband at lunch. We wanted to know where we could get the ABC forms. Also, they are thinking of moving one of the boys to a different classroom for the remainder of the year. Something tells me that it will be my son who is moved. Should we wait and see if he is moved to maybe start these new techniques, or go ahead and discuss them with the teacher now?
It can't hurt to do ABC data collection. Even if there are no behavior problems ABC data can be used to pinpoint and intervene with academic issues or even to document and support ADHD related behaviors.....
At least, I would say, it makes sense to do such data collection as long as the behavior issues you first mentioned are happening....
Let me do some quick research to find some forms...back in a few moments...
Here's one example: http://www3.nefec.org/doclib0/files/Sumter%20ABC%20DATA%20COLLECTION%20FORM%20_2_.pdf
let me look again...
Here's a quick break down of how it works: http://www.iidc.indiana.edu/?pageId=444
I printed the first form, let me open the other.
Ok and I'm still looking for you...
Just the first 2 pages of this one:
Downloading the last one
Having a little trouble downloading the second instructions, but I will try it again later.
Printed all the other
Have I answered your question ok today?
You have! :-) You have also given us a lot to discuss and we will probably talk to our Pediatrician about things as well. I was glad that I found this forum today. You have helped me relax and look at things from a different perspective.
That's great. If you want the best help for intervening behaviorally at school and or at home in the future I'd recommend contacting a Board Certified Behavior Analyst. You can work with them online and or by phone and get lots done in 2 or 3 sessions. If ADHD/ADD is an use then this kind specialized behavioral support can make a world of difference and reduce the use of medications where possible. They (BCBAs) are incredibly affordable and provide state of the art tools and interventions specifically for a given situation (and teaching style).... just one more link for you:
Well, I'm glad to have helped out with my answer to day. Thanks for answering all my questions too!
No problem. I will definitely look at these links as well. Thank you soooo much!
This whole chat will save right?
Yes it will. Once you press the green "Accept" button, you can come back I think for up to a week to access this page. I believe that you can print a transcript as well. Contact customer service right away if there are any problems.
ok. Thanks again. Have a great day/evening.
Take care and I wish you and your family the very best!