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Why It’s a Mistake to Prioritize Behavior Goals Over Social-Emotional Development

July 30th, 2017 | 18 Comments | Blog

It was almost dinner- time, and little “Max” was hungry and tired. After a busy and active afternoon, he was in the midst of a lengthy home session with his behavior therapist when his mother stepped in the door from work.

Smiling with delight, the boy instinctively ran toward the door to offer a greeting, only to have the therapist instruct him to sit down and finish his task. When the boy tried again to reach his mother, the therapist stood in the way, blocking him. Frustrated, Max burst into tears, screaming and striking him in protest. It took him several long hours to calm himself down again.

The mistake? The therapist was focusing on behavioral goals without regard for the child’s social and emotional functioning. As a consulting child psychologist, I routinely observe this approach to treating children’s developmental delays and mental health challenges. Not only is it ineffective, it has the potential to cause unnecessary distress to our most vulnerable children, teens, and their families.

As the psychologist Ross Greene has written, children do well when they can. When a child doesn’t consistently comply with what we ask of him, we should understand that the child is probably not making a deliberate choice to misbehave, but rather adapting to an immature social-emotional system that is still developing. The first step to fix this problem: stop trying to manage and control a child’s behaviors before the child has the developed the capacity for self-control.

Too often, adults react to problematic behaviors—whether in the form of language, physical actions, or emotional outbursts—by issuing consequences for this “choice.” But that approach assumes the child can choose to behave otherwise, that she has the capacity for “executive function.” But many vulnerable children, teens—and even young adults—require years of experience to acquire that capability.

Max certainly hadn’t. His interventionist’s demand to sit still exceeded Max’s developmental ability to comply. Not only that, he should have praised his enthusiasm for greeting his mother, which reflected the kind of human connection that should be be a primary goal of all his therapies. Such supportive relationships form the foundation that is essential to building brain connections and, in turn, the future capacity for behavioral control and executive function.

Of course, there’s nothing wrong with helping children develop skills, tolerate delayed gratification or strive for more advanced capacities. But here is the primary problem I see in education and behavior therapy: when we insist that vulnerable children control their behavior before they’re able to, there’s a potential to do more harm than good to their mental health and social-emotional development.

We can shift the paradigm by using developmental approaches that are informed by neuroscience and based in compassionate best-practice principles. The first step: pay attention to what the child is showing us in his/her body.

Look for these indications of physiological stress:

  • Physical responses such as crying, protesting, increased heart-rate, wide-open eyes, trying to escape, hitting, or otherwise striking out
  • Signs of disengagement, including flat, still or frozen facial features; lack of interest or reaching out to others; monotone or flat vocal tone; lack of exploration; or slow or decreased body movement

If you observe a child exhibiting stress responses, make these your priorities:

  • Before anything else, give the child cues that he or she is physically and emotionally safe.
  • Understand the behavior as a stress response: what we are asking of the child exceeds his ability to carry out the task.
  • Be flexible about changing plans and immediate treatment goals to prioritize warmth, engagement and understanding when a child exhibits stress responses.

In short, paying attention to what the child is showing us in his body—rather than how well he complies with requests—is the best way to determine whether the child is ready to learn or acquire a new skill.

When we prioritize a child’s emotional life, behaviors will improve organically over time as the child experiences safety in mind and body. All of us who work in the mental-health and developmental disabilities fields should understand the central importance of this solid foundation for children and families. A child’s relationships and emotional stability are the best markers for treatment goals and serve as the best foundation for future growth.

I describe a roadmap to achieving this goal for pediatric professionals in my new book on social and emotional development.

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  • mdelahooke

    Thanks for your interest in this article and feel free to comment!

  • Beth Tolley

    Mona, thanks so much for this great post! As the sister, parent and grandparent of individuals who struggle(d) with behavior and social-emotional issues, your post hit home. Their struggles take an enormous toll on them and on the entire family. The misguided services provided to my family members (holding them accountable when they did not have the skills to be able to do what was being asked of them) and guidance provided to family members did so much harm for these vulnerable, already hurting family members. I can understand that this occurred 50 years occur when we didn’t understand the science of brain development, but it is very hard for me to understand (let alone accept) that this occurred 25 years ago and still occurs now when we have so much more information, knowledge and evidence about effective interventions. I think this blog should be required reading for all students in all human health fields as well as all candidates renewing their licenses in all human services fields (doctors, therapists, social workers, educators, etc.) as well as for new parents and child care workers.

  • mdelahooke

    Beth, thank you for your comments. I”m thrilled that you found this article helpful and I agree with everything you said here! We can and must do better and bring our treatment techniques up to par with developmental neuroscience and best practice. Wishing you the very best!

  • Craig-Kylie Hailes

    This was very helpful. My 3.5 yr old son displays these stress responses in particular when he is in his swimming lessons. I find it hard to help him through it as he’s in the pool and I can’t get close enough to him.
    Any suggestions on how I can manage this better?

  • mdelahooke

    I can’t answer questions about specific situations, but in general when children exhibit stress responses, the idea is to increase relational engagement (and the child’s feelings of safety), to have patience and slow things down.

  • ShaunMarie

    I would love to know more about how we apply this to teens.

  • mdelahooke

    Yes, such a great comment. With teens what we do and say is different, but the underlying emphasis on emotional co-regulation is the same. I really like the strategies Tina Payne Bryson and Dan Siegel present give parents their book, “No Drama Discipline”. Are you familiar with it?

  • Bethany Koehler

    This article makes a lot of sense. My question is in response to the quote that insisting that children control their behavior before they are ready, will have negative effects on mental and social development. How are teachers supposed to manage this in a classroom of 25-30 students of which many of them have delays in social emotional development? Observing repetitve lash out kinds of behaviors has negative effects on the others. It can be perceived that the behavior expectation is lowered when it looks like there is no consequence. This can have a negative snowball effect.

  • mdelahooke

    Hi Bethany, Yes, such an excellent point! I totally agree that all the children are at risk when they witness another child in a stress response, it raises the stress level for all the students. What I am suggesting is that we need to shift the lens to support the social and emotional development of each and every student in every classroom, special needs or otherwise. I’m not blaming educators at all, they are simply not exposed to the information necessary to go beyond behavioral approaches to one that is developmental and relationship based. I know it can be done successfully because I have colleagues who run entire schools on that paradigm (such as Celebrate the Children in New Jersey). I recommend the educator’s certificate program at the Profectum Foundation for continuing education on how to do this. It’s a non-profit organization dedicated to educating professionals across disciplines in social-emotional development. Thanks for commenting.

  • Saket Thote

    Thank you very much for this article! I have a 4 year old daughter. She is very good at following instructions, but only on her terms. If she is forced to do something that she does not agree to, she really goes to extreme of shouting and clinching her teeth. I get worried about her. I am going to make more efforts at focusing on her emotional development. My concern is – how to determine the fine line between developing emotions and “caving in”? Please advise.

  • mdelahooke

    Thanks for commenting! It’s a really good question, and I think that the most important thing is recognizing emotions. In neuroscience that is coming up as an essential factor in building resilience. I’ll have a new post on that next week! Also, have you read Tina Bryson and Dan Siegel’s book the Whole Brain Child? I think it explains your concern very nicely. Wishing you the best.

  • Brooke Clayton-Rudd

    This blog post is little more than thinly-veiled ABA bashing, coupled with self-promotion (not that there’s anything wrong with that – it’s your blog). The scenario you described does not show “therapist was focusing on behavioral goals without regard for the child’s social and emotional functioning”, it shows the therapist being a total knob (I’m Australian, so insert whatever insult is appropriate). ABA is the “application” of behaviour analysis, what you’ve described is at best behaviour analysis without the application to life. Contrast this to my scenario: “Little ‘Max’ was from a rural town and taking part in a supervision session at the clinic in the city. A tram went past the building and Max continued with his session. Some weeks later, in another session when a tram went past Little Max looked up, approached the window and was excited to see what was making this unusual sound. His parents and therapy team were thrilled with his reaction and from there included trams and other forms of transport in both his therapy sessions and general play.” My Max’s therapists and supervisors were not knobs.

  • mdelahooke

    Hi Brooke, I wish all behavior therapists espoused the holism of relationships and emotions, it sounds like you do! Unfortunately in my “neck of the woods” my colleagues and I observe situations like this on a regular basis. That’s why I write, frankly, to help shift the lens to support relationships as the foundation of treatment across disciplines. Thanks for commenting.

  • Julaine Brandsoy

    The Pyramid Model (from the Center for the Social Emotional Foundations for Early Learning) framework is a training I highly suggest. It helps teachers learn specific strategies for supporting all students in our classrooms. I have been utilizing these strategies effectively for nearly 20 years. It begins with building a supportive relationship with students, especially those exhibiting challenging behaviors.

  • mdelahooke

    Fantastic, thanks for sharing!

  • As a mom, this hurt my heart to read. You’re spot on. We experienced t his problem with my son’s school- they expected more of him than he was capable of performing, and they aggravated the situation by refusing to implement the interventions recommended by his counselor. (And were, in fact, in legal violation of his IEP, but that’s a long story.)

    It’s nice to see professionals recognizing this as a problem. It gives me hope for the future of kids like my son.

  • Simply from a fellow-parent’s point of view, you might also look at Cynthia Tobias’ “You Can’t Make Me! (But, I Can be Persuaded),” and Dr’s Cloud and Townsend’s Boundaries With Kids.

    A caveat- both books approach these issues from a Christian point of view, and secular-minded parents may find disagreements in the thinking, but I found the basic foundations- the idea of putting love for the child first in all interactions, and in setting aside the parental ego in favor of directing the child calmly and lovingly- to be solid.

    Best of luck, Mama. My own “strong-willed child” (who fitted your description perfectly a few short years ago) is 17 now and finally finding success for himself.

  • mdelahooke

    Thanks Mary. I’m so sorry about your son’s suffering. I’m working hard to collaborate/train colleagues to see multiple perspectives and base interventions on compassionate best practices to support kids like your son. Wishing you all the very best!

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