Alternative Solutions for Managing Behavioral Disorders

By Diona L. Reeves
taken from http://www.earlychildhood.com

According to the National Institute of Mental Health, Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common mental disorders in children. Given this fact, it is no surprise that parents and physicians are seeking solutions to effectively manage behavioral problems, often in the form of medication such as Ritalin® or Methylin®. But as many teachers and clinicians will attest, medication is not the only alternative, nor should it be the first consideration. After all, medication does not change a person; it only modifies the person’s behavior. This is why many children who take medication for behavioral problems must continue to do so for years.

If medication does not always serve as a permanent solution, then it seems reasonable that other alternatives could work just as well. This article will examine those alternatives, as well as highlight the beneficial role teachers have in helping parents determine the type of treatment that is appropriate.

The Challenge
ecause teachers interact with children on a consistent basis and can objectively assess children in the same age group, they are excellent candidates for helping to manage children’s behavior. However, it is an enormous responsibility just to implement curriculum goals and manage a classroom. Should teachers be expected to participate in the management of children with behavioral problems as well?

Some teachers simply will not have the ability to focus on one or two children exclusively. But it is in their best interest and the best interest of the entire group of children for them to try to become involved. According to Daniel Adam Johnson, an educator and administrator for nine years, “Although the time to meet with parents may be difficult to come by, such a proactive investment may prove beneficial in the end to everyone involved.”

By addressing behavioral problems directly, teachers might be able to head off future disruptions, thereby promoting a harmonious classroom environment and increasing overall learning capacity. The following steps outline an approach for teachers that involves parents and health professionals in the assessment of behavioral problems:

When you first suspect that a child has a behavior problem, document your assessment objectively. Do this for several weeks and review the notes at the end of this time period to see if you can establish a pattern for misconduct. According to Johnson, checklists that are clear and concise work well at promoting objectivity. Such tools may head off parental defensiveness and provide a sound basis for communication.
Schedule a meeting with the parent. This will allow you to openly share your observations and discuss possible changes or solutions.
Recommend that the parent meet with a health professional to eliminate any health problems as a cause. Provide a copy of your notes and observations for the parent to take along.
Ask that the parent provide you with any relevant information or recommendations given by the health professional. If needed, make a referral to a mental health professional or arrange a meeting with the school counselor.
Work with the parent to implement the health professional and/or counselor’s recommendations. Continue to note the behavior and progress of the child and follow up with the parent regularly to assess the situation.
Through this approach, teachers can promote effective communication among all caregivers, an essential component in managing behavioral problems and establishing a healthy, productive classroom environment.

The Value of Knowledge
In addition to working with parents and health professionals to determine the best approach for a child with a behavioral disorder, it is advantageous for teachers to become familiar with current medications and potential side effects. For teachers wanting a quick reference, the AAP provides the ADHD – Treatment with Medication and other fact sheets at http://www.aap.org.

Not all teachers will have the time or resources to research the different medication and treatment options. In this case, you might request an information pamphlet if a parent tells you that his or her child is taking medication. This documentation is often included in the prescription packaging and is easy for a parent to copy. Not only is this information an easy reference tool, it will also help you to be aware of possible side effects.

If a child is on medication, it is also likely that the parent or health professional will want feedback about the child’s behavior. In this event, keep an activity log and share this with the parent regularly. Some medications may take several months before maximum effectiveness is reached so be sure to follow the child’s progress over an extended period of time. Also be sure to share any unusual behaviors, actions, or physical concerns with parents, as these could be a reaction to the medication or a symptom of an underlying problem.

Alternative Approaches
Although medication has been proven effective, there are other alternatives for behavior management to consider first. When considering such treatments, it is important that other causes, such as an inability to effectively communicate because of a language or hearing problem, be ruled out. As an educator, you can provide valuable feedback about the types and timing of disruption to help parents and physicians pinpoint any secondary causes. The following list details other forms of behavior management.

Individual Education Plans (IEPs)
Typically used for children with autism and learning disabilities, this approach entails meeting with the parent and child to determine the child’s goals for the year. This type of meeting allows the parent to participate in the child’s growth as well as helps the child feel a sense of accomplishment at the completion of each goal. Formal IEPs, however, require additional legal considerations before implementation. For more information about this, refer to the Autism Society of America’s website at http://www.autism-society.org.

Support Groups
Support groups can take many forms, whether it is a group of parents sitting down together to discuss their children’s struggles or a health professional meeting with a parent, teacher, and child to determine the best form of treatment. Even peers can serve as support for one another. Whenever possible, however, serve as a mediator for these groups to prevent them from turning into gossip sessions or attacks on a child’s character.

Cooperative Learning
Cooperative learning activities are important to any attempt at behavior modification. According to Johnson, activities that fall under this category move away from teacher-centered, lecture-style classrooms and allow children to be more active throughout the day. Some educators have even found block scheduling plans to be an effective course of action. In addition to the aforementioned suggestions for behavior management, the following alternatives related to health and well-being can be helpful:

Healthy Lifestyle. Although it has not been scientifically proven to aid in behavior management, promoting good nutrition and healthy exercise habits can do no harm. Allow children to play outside as much as possible or be creative and design some low-impact physical activities for the classroom. You can also request that parents include healthy snacks in their child’s lunch or, perhaps, have parents rotate and provide healthy snacks for the class once or twice a week.

Routines and Schedules. Although some children may adapt fairly easily to changes in bedtime or eating schedules, most children need a routine that they can adhere to from day to day. Sleeping habits, in particular, are subject to upheaval if bedtimes are not consistent. Provide parents with the knowledge that children thrive on routine. For parents who are struggling in this area – for instance, those who have two jobs or who work swing shifts – refer them to a counselor who can assist them in establishing a healthy routine for the entire family.

Whether a change in nutrition, exercise, or sleep habits modifies behavior, such natural alternatives can only be beneficial, as they will teach children healthy habits that can last a lifetime.

Conclusion
Behavioral problems are an important issue to address. Not only do they affect the families involved, they can have a significant social cost as well. Children with behavioral problems may be branded throughout the program as troublemakers or difficult learners. Such stigmas can affect their performance as well as their attainment of life goals. For this reason, it is important to find an equitable and viable solution for all parties involved. Although medications serve an instrumental role in helping many children deal with their behavioral problems, it is important to remember the consequences such as long-term side effects and dependency on the medication. It is crucial, therefore, to evaluate all aspects of a child’s behavior and determine what is best for the child. Educators, in particular, should have an integral role in this process and help families determine the best mode of treatment or alternative approach for addressing this issue. Perhaps Johnson sums it up best: “As an educator, the end goal has always been—and always should be—to make children happy, healthy, and productive.”



Diona L. Reeves serves as Editor-in-Chief for CYKE, Inc., a multimedia firm dedicated to improving the emotional and physical health of children through websites, CD-ROMs, and teacher curricula. Ms. Reeves has written articles for the American Academy of Pediatrics, Healthy Childcare magazine, and numerous health-related websites.


Resources

The American Academy of Pediatrics supports the concept of three-way involvement among parents, health professionals, and teachers, believing that it is the best way to monitor a child’s health and development. To learn more about this concept, referred to as the “medical home,” please visit the AAP website at http://www.aap.org.

The National Institute of Mental Health published Attention Deficit Hyperactivity Disorder, a detailed booklet that describes the symptoms, causes, and treatments of ADHD. This publication is available online at http://www.nimh.nih.gov/publicat/adhd.cfm.