Developmental delay and discipline

// News / Ask Dr. Pat / Developmental delay and discipline

By Patrick J. McGrath, OC, PhD, FRSC

Question:

My six-year-old son is developmentally challenged. His doctor says he is about the same as a four-year-old. He has difficulty obeying and has a lot of temper tantrums. I feel this is because of his delay. My husband says that we should treat him the same as other six-year-olds. What do you suggest?

Dr. Pat responds:

Children with developmental challenges are three to four times more likely to have behaviour problems than other children. But that does not mean all of these children will have behaviour problems.

You and your husband are both right. Your son's delays increase his risk for behaviour problems. Helping your child with his behaviour difficulties is similar to helping other children.

Your son's problems can be controlled, but it will take time and effort.

There are two general principles that you should follow:

Give your son lots of love and affection.
Have high, but reasonable, expectations for your son's behaviour.

Don't excuse his behaviour because he has learning problems. But it may take him a bit longer to learn how to behave.

The first step in helping your son is to pay attention to him when he behaves well. For example, you can prompt him to start cleaning up his toys by helping him, but then encourage him with "Good job in cleaning up your toys!" or with a smile or a touch. When he spontaneously behaves, notice it. Most of us don't pay much attention to our kids when they are doing well.

The second step is problem-solving when he has difficulty. Try to figure out what happens before he has difficulty. For example, he may have a temper tantrum when you ask him to stop playing with his toys to come to dinner.

If that is the case, you could:

Give a transitional warning. Get his attention and say "In a minute, it will be time to stop playing with your toys and come to dinner."
Fifteen seconds before he is to come, say "It is almost time to stop playing and come to dinner."
When time is up, prompt him: "Dinner time now." Be really close to him and take his hand and walk him to dinner.

You might set up a chart for his good behaviour. Set it up for him to succeed. You can use stickers that can be traded in for special time. Make sure he gets stickers much of the time. You can increase your expectations gradually as he is successful.

Figure out strategies to reduce his negative behaviour directly. Two general approaches are to ignore minor misbehaviour and to have a consequence for major misbehaviour. The consequences for major misbehaviour, such as a temper tantrum, could be a loss of privileges or a four- or five-minute time out.

Parents of children with developmental delay are often quite stressed. Make sure you get some relief

Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. He is also the CEO of the Strongest Families Institute, which provides mental health care to families across Canada.