Approach to problem behaviour in children

Key points:

- Use the following table to take a focused history on things which can affect a child's behaviour

 

• Use the mnemonic ABC to clarify events surrounding the behaviour
• Antecedent - what were the events preceding the behaviour?
• Behaviour - what is the behaviour exactly?
• Consequence - what did the parents do to resolve the situation?
• Examination 
• physical examination 
• brief developmental assessment 
• General management (Box 1 lists out principles of behaviour management)
• Encourage positive behaviour 
• Ensure a consistent approach 
• Set clear boundaries and expectations
• Set clear consequences for actions and makes parents can follow through
• Tantrums and oppositional behaviour in toddlers (1-3 years old)
• Remain calm and do not raise your voice
• ask the child to stop and re-direct them to another activity
• if they do stop, praise them
• it they do not stop, go to quiet time (same room)
• if they keep coming out of quiet time, or are aggressive again, go to time out (in another room)
• keep conversation minimal at this time as the child might be too agitate to understand explanations 
• the child stays in time out until they are quiet and calm 
• Anger and aggression in preschoolers (3-5 years)
• Management involves prioritising behaviours in terms of severity level
• low priority behaviours can be dealt with by 
• ignoring the behaviour
• distracting the child
• logical consequences for the child's action 
• High priority behaviour, such as behaviour with associated safety concerns should be dealt with through time out as described 
• Hyperactivity or inattention in school aged children (5-11 years)
• At school, teachers will be doing the work 
• At school, removing/withdrawal of privileges 
• When to refer 
• all else fails 
• not coping at school 

References

- http://www.racgp.org.au/download/documents/AFP/2011/September/201109luangrath.pdf
- http://www.racgp.org.au/afp/2015/december/finetuning-behaviour-management-in-young-children/