Nurturing the Environment: Amy Hunter
Jonathan Faletti: So our next presenter is Amy Hunter. Amy is the assistant professor at Georgetown University. Amy is currently the mental health advisor for the National Center on Health. So please welcome Amy.
Amy Hunter: So I'm going to follow up Dr. Kraft's great presentation. Thank you Dr. Kraft. And I'm focusing on nurturing the environment, but specifically thinking about challenging behaviors. So how many of you raised your hand if you have either heard staff or parents talk about challenging behaviors or if you yourself have had challenging behaviors? Not one of us in the room has not experienced either a parenting moment or a moment as an early care professional where we have dealt with challenging behaviors. And in fact, it's the number one request for training, the topic of challenging behaviors. And without addressing, successfully responding to challenging behaviors, it's really hard to provide a supportive environment.
So what I'm going to do this evening in a brief period of time is talk about what the definition of challenging behavior is, so what is it when we're using that term? And then give you some really concrete, specific strategies that you can take with you this evening. So what is it when we're talking about challenging behavior? Well first we want to think about that challenging behavior is defined by the caregiver. So what do I mean by that? I mean that what's challenging to me may be very different to what's challenging to you. I often hear from teachers that biting is a real challenging behavior. Well for me, I've had a lot of experience understanding biting and think about biting, so biting isn't one of my hot button issues.
One of my hot button issues is boredom, the idea of "I don't know what to do." That may be kind of personal but that's my defined challenging behavior. So what's challenging to the caregiver is very different than what might be challenging to the child. And when we're thinking about what's challenging to the child, these are behaviors that get in the way of the child's functioning and learning. So often challenging behavior gets in the way of the child forming a relationship with their parent. Right? It interferes with family functioning. It may interfere with their relationship with teacher. And you bet that interferes with their learning.
Often it gets in the way of peer relationships. In a classroom you might hear other children talk about that child's behavior. Or I've definitely heard this story: Maybe you have two of the teachers saying, "Today's going to be a great day," and you ask her, "Why is today going to be a great day?" And she says, "Well, Johnny's not here today." Right? Yeah, someone said, "That's not nice;" you bet it's not nice. And it's interfering with that child's relationships with his teacher. Another defining piece of challenging behavior is really thinking about it has not responded to developmentally appropriate strategies. So the caregivers, the parents have tried techniques. They've tried things that they know, and that behavior continues to persist. A couple other things we want to think about with challenging behavior are the intensity, frequency, and duration. So often when I ask, "Well what's challenging?" and they say, "He's out of control." Have you heard that? He's all over the place. He's totally out of control. Well that doesn't tell us a lot. We really need to be specific about understanding data. Because if we don't understand these elements of intensity, frequency, and duration, how will we know if it's getting better? How will we know if the techniques that we're trying are making a difference?
So for instance, intensity looks at the quality of the behavior. So if we're talking about a tantrum, is that tantrum kicking, hitting, biting, screaming, head banging? That would be pretty intense. Or is it moving arms and legs on the ground for a couple minutes and the child is able to regroup? That's a little less intense.
Frequency: How often does the behavior occur? Does it occur three times a day? That's pretty frequent. Or does it occur three times a week? We need to collect this kind of information. Duration. And duration has really two elements. So if we're talking about a tantrum or crying for instance, duration might mean how long is it going on? Is the tantrum occurring for 45 minutes? That's one aspect of duration. Another aspect of duration is how long has this concerning behavior been going on? If this behavior has been going on for six months and the child is two, that's a very long time in a short period of the child's life.
And that tells us a lot more information. But collecting this data is very important.
Then we want to think about that there are generally two types of challenging behaviors. When we say challenging behavior, usually what comes to your mind is what? Acting out. Biting, hitting, kicking, pinching, and we could go on. Right? That's the acting out kind of behavior. That kind of behavior is really hard to ignore. It's in your face. It's saying, "Hey, look at me. Look what I'm doing." It's big, it's strong, and it scares people. I am getting your attention. But what about the social withdrawing behavior? Now that sometimes is called acting in. Those kinds of behaviors are the quiet child, the child who's not saying anything. Maybe they're not saying anything because they learn that it doesn't matter what they say. Maybe they've tried all of this acting out stuff and it didn't get them anywhere and they've given up. Sometimes I hear people say, "Oh that baby is so good. She doesn't say a peep." That's a problem. They are supposed to say a peep. They're supposed to cry. They're supposed to express their emotions. These are the children on the social withdrawing that can easily fall through the cracks.
If you ask a teacher for instance in a classroom who has maybe 18-20 children to make a list of all the children in her class, see who she forgets. That might be children on that end of the continuum. These children are at risk for developing depression later in life. They're at risk for being forgotten. So when we think about challenging behavior, it's so easy to go to this kid who's throwing chairs in the classroom, who's tearing other people's artwork up. But we have to challenge ourselves to remember: what about the kids who are acting in? What about the kids that we're forgetting? So, sometimes it's helpful to think about challenging behavior as an iceberg. Why? Do we know anything about icebergs? 90% of an iceberg is underwater. So what does that have to do with behavior? Well let's say at the tip of the iceberg, the part that you see, is a challenging behavior. Let's say the challenging behavior at the tip of the iceberg is biting.
But what else is under the water that we don't see that relates to the biting? The biting is just the behavior, but under the surface, perhaps the child is saying, "I'm scared. I don't know what else to do. I don't have other skills." Biting works. Biting gets your attention. "I'm sick. I have an ear infection that really hurts. I didn't have breakfast this morning. I'm tired. I don't know where I'm going to sleep tonight. I didn't get a good sleep last night." All of those things relate to the behavior that we're seeing. And so it's our job to really see what's under the surface. What is contributing to that behavior that we see? Take a look at this quote. I'll read it to you. "If a child doesn't know how to read, we teach.
If a child doesn't know how to swim, we teach. If a child doesn't know how to multiply, we teach. If a child doesn't know how to drive, we teach. If a child doesn't know how to behave, we..." – how come it's not so easy? It's not as automatic to say teach. We might have filled in the phrase there punish. But punishment is not teaching. Punishment is a consequence, and punishment may stop the behavior but it's not teaching the child any skills. It's not teaching the child who's biting an alternative way to get their needs met or to tell us how they feel. So we want to, through our work – whether we're working with parents, whether we're working with other teachers, whether we're providing training – help people to finish that sentence more automatically. When a child doesn't know how to behave, it's because they don't know how, not because they don't want to. And we need to teach them how. And that slide just sort of reiterates what I was just talking about. But I think I want to share with you a little story to talk a bit about what Dr. Kraft hit on this. When do we teach the behaviors? Often we want to teach in the crisis moment. I see some heads shaking. So imagine – let's put ourself in a scenario that makes this come alive a little bit – imagine you are on your way to work, you have a really important meeting, you are already running a little bit late, you're going a little fast, and a car zooms in front of you, cuts you off, and you actually get in a minor accident. You're okay, nobody's injured, but now you know you're going to be late. As you deal with the accident, you realize you pick your cell phone up and your battery's dead. You forgot to charge it the night before. Okay?
So you are not feeling too calm. Right? Your emotions are running high, you're upset, and you get it all settled. You get to work, you tell your boss what's happened, and as you're telling your boss, you're agitated. You're still really upset and your emotions are running high. And your boss says, "Hey, I've got a great strategy to make sure you charge your phone every night." Is that the right time to be teaching that moment? Yeah, absolutely not, because your emotions are running high. What do you want your boss to say? You want your boss to say something like, "Wow. That was a rough morning. Thank goodness you're okay. I can see it's really upsetting." You need some emotional connection there.
So when we think about teaching positive behaviors, we want to make sure we know when we're teaching it: When the child's calm, when they're going to be receptive. Not when their emotions are high. So we've talked about what is challenging behavior, how to define it, how to track it and get data. Now we're moving into some really specific strategies for when it's happening. And as much as you teach children the appropriate behavior during calm times, there are still going to be moments where there's challenging behavior. So I challenge you, as a number one strategy, before you respond to the child, pay attention to your own feelings. Often what we do when we discipline children or we respond in the moment of a challenging behavior is we're reacting to our own emotion. As a parent, we might be afraid. "I don't want my child to grow up and not be a good listener. I don't want my child to be a brat. I don't want my child to be spoiled. I'm afraid they're not going to be respecting adults."
As a teacher you might be saying to yourself, "I don't want anyone to think I'm a bad teacher. I'm worried I don't know how to connect to this kid. I'm frustrated. This kid is disrupting my classroom." And so you respond according to your feeling, not what the child needs in that moment. Does that make sense? So the second strategy, tip number three: understand the meaning of the child's behavior. This child who's hitting is not just hitting either for no reason at all or to get your goat. There is a reason the child is hitting. What is the behavior trying to tell me? Often behavior is trying to tell us, "I want something. I want that toy. And when I hit you, I often get it. I want to escape from something. This circle time is too challenging. I don't understand what's happening here. Coming to the store with mom is really boring. And if I have a tantrum, sometimes I get to leave."
So, "I want something," or, "I want to escape from something." And often, "I don't know how to tell you in any other way. I don't have the verbal skills to tell you I'm feeling sad right now or I'm feeling scared right now or that child is too close to me and it makes me uncomfortable." And then tip number three, and I kind of threw in a few other tips to make it more than three, but stay calm and respond to the child's emotions. Before you can correct, you need to connect with the child's emotions. So when we stay calm, we validate the child's feelings. "You look really sad right now. I can see you're really upset." And one of the best ways to help a child feel that you are connecting to them, that you really get what's going on is to be either at their eye level or even below their eye level. Because what does that do? That communicates to the child that this is not a threat.
So Dr. Kraft talked about when a child is in a high stress mode and you are standing above them, looking down at them, it just ratcheted up a bit more. Now they're even more scared or they continue to be scared. But if you come down to their level or even below their level, it communicates to their brain, "This is safe. We can calm down now. There's no more threat here." Offer comfort; "I'm here. I'm here for you. Tell me. Tell me what's going on." And use simple, few words. Often when our emotions are running high and when emotions are running high with the child, we tend to over talk. We tend to get in lecture mode. It's not the time for them to be hearing much of what we have to say. So I have a quick little video that I think is going to illustrate some of these points.
Teacher: Emily. We don't want to put your hands on him. That hurts when you put your hands on my friends.
Boy: I don't like it.
Teacher: You're right. You don't like it. You tell her. Emily, did you hear his words.
Emily: I don't like it. Teacher: Yeah, and she didn't like it when you put your hands on her.
Amy: So what did you see there? What did you see that teacher doing? She came down to his level. It's exactly what I was talking about. Her eye level was right at their eye level, if not even below. Now someone had asked me, "Well what if my child's having a tantrum on the floor? How do I get down at their eye level?" I can't tell you how many times, as a therapist or as a consultant, I've gotten down on the floor, all the way down, to be able to look at eye level with a child. It communicates more than your words ever could. What else did you see in the video? She was calm. Her voice was calm. Again, it doesn't matter the words, but the tone of voice is communicating something. And she really gets that this is the work of early childhood. This is what it's about. This happens 20 times a day. This is the teaching, dealing with the conflict, promoting social-emotional development. That's her job. What else did you see? Anything? Yeah, "You don't like that." Has anybody heard of Dr. Harvey Karp? "Happiest Baby on the Block," "Happiest Toddler on the Block" are his books, but he talks about really amping up that reaction. So saying, "You don't like that!" really at the level that the toddler is communicating, and what he says is that that is when the child knows that you get it. Now there's two schools of thought there. One is you really amp it up; you really exaggerate it; you really show that you understand at that level of emotion. The other one is that you're calm and you're lending your calm to the child. But either way, you as the adult are in control. And you're responding to the child's emotions and letting them know that you understand their feelings and that you're there for them. Anything else that you saw in that video?
Audience member: She validated both of them.
Amy: She did – she validated both children in the struggle. There's no right or wrong here. Now one of the things I always mention when I show this video is often I hear teachers say, "Use your words." There's nothing wrong with saying, "Use your words." However, think back to the situation I told you about where you're driving down the highway and the car cut you off and you're already stressed. What kind of words do you have access to in that moment? So when our emotions run high, we are not using the problem solving, creative thinking part of our brain. And what do we know about toddlers? They have even less access to words. They don't have the words to begin with. So if you are going to say, "Use your words," you need to make sure that in the calm and neutral times you're teaching the kids what those words are and how to use those words. Use the word "friends." So promoting social-emotional skills by saying – you're really building a community. "We're all friends here. This is our classroom. We're in this together. We solve problems healthy ways." Anything else that you saw in that video?
So just to summarize the three basic points and strategies you can take home tomorrow – tonight if you see children tonight – check in with yourself first. And this strategy works with even conflicts with adults, exactly. Pay attention to what the other person needs, rather than just reacting to your own emotional experience. Understand the meaning of the behavior. What is this – you're a sleuth. You're a detective trying to figure out what is the child trying to say to me? What does the behavior mean? And then stay calm and emotional connection first. So connection before correction.
Jonathan: Okay thank you, Amy, so much for presenting. [Applause]