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"Dr. Barkley is a leader in the field who provides families with proven strategies for dealing with very challenging problems. The entire book reflects his research, experience, and wisdom. The book is informed by feedback from the many parents who have benefited from this approach, and includes practical examples and pointers for putting the techniques into action."--Charles E. Cunningham, PhD, Department of Psychiatry and Behavioral Neurosciences, McMaster University, Canada
"Dr. Barkley provides sound advice for parents based on many years of research. This is a well-written, easy-to-follow guide for improving your child's behavior."--Rex L. Forehand, PhD, coauthor of Parenting the Strong-Willed Child
"is something wrong with my child?"
It's frightening and painful to suspect that something is wrong with your child. When the cause of your worry is your child's misbehavior, especially toward you, it's confusing and exhausting, too. On the one hand, you believe that no one else your child's age acts like that ... but on the other, don't all kids disobey and challenge parental authority? Don't they all go through phases? Do you really have anything to be concerned about at all? You're probably losing sleep agonizing over questions like these. And that's the last thing you need if you usually spend your days battling with your child.
In this chapter, I hope to help you start rebuilding the strength you need to address the problems you're experiencing with your son or daughter, with the ultimate goal of restoring the precious relationship we all want and deserve to have with our children. Let's begin answering the question that's probably keeping you awake at night—"Is something wrong with my child?"—through a simple comparison. Do the following scenarios strike a familiar chord?
"Jenny's a loving, affectionate girl, and her teachers say she's very bright, but ask her to do something she doesn't want to do and watch out. It's like she becomes a different child—loud, hostile, and downright nasty. The more I try to explain that whether she goes to bed on time, puts away her toys, or brushes her teeth is not up to her, the louder she shouts 'No!' at us. She just doesn't seem to get it."
"Ben just can't behave anywhere. I've had to drag him out of toy stores and ended up in shouting matches over the candy he insists on having at the grocery store. I've gotten to the point where I do everything I can to stay home. I just don't have the energy to deal with crisis after crisis, day in and day out."
"I can see that Josh is getting depressed, irritable, and withdrawn, but I just don't know what to do. I've tried to explain to him that of course no one wants to play with him when he's so bossy. He just can't have his own way all the time. When he was the only one on the block who wasn't invited to Billy's birthday party, it broke my heart."
"I feel like I'm on one of those wheels they put in hamsters' cages, and I don't know how to get off. Annie talks back, and I yell. She yells back, and I yell louder. I threaten punishment, and she still doesn't obey. I get madder and madder until I either scare myself or get exhausted. That's when I start to back down, and before I know it I've wasted 20 minutes arguing with a 5-year-old without getting her to do what I've asked."
"I was so thrown by Susie's calm refusal to do what she was told that I actually took her to the ear doctor for special tests. That she couldn't hear me was the only logical reason I could come up with for her ignoring me so often."
"Frankie's always had a temper, always had a real mind of his own. We didn't worry too much about it when he was two—just shook our heads and told ourselves he'd outgrow it. But now we've watched all the other kids leave the 'terrible 2's' and move on, and at age 6 Frankie still throws tantrums every day, still grabs the other kids' toys, pushes and shoves to be first in line, and has to be literally wrestled into bed every night. How much longer is this going to last?"
The common thread running through these parental laments is defiance. Call it resistance, opposition, contrariness, disobedience, willfulness, irritability, sass, freshness, or any of a dozen other terms, it's the repeated failure of a child to follow rules, obey commands or comply with requests, and generally do what parents, teachers, peers, and society at large expect children to do. Defiant children frequently express anger or resentment more often than other kids. They may resist taking responsibility for their own actions, instead pointing a finger at others or even trying to "get even" for perceived offenses. Recognizing your child in one or more of the preceding descriptions may give you a little more to go on, but it still may not be enough to tell you whether something is wrong. Oppositional, defiant behavior can take a perplexing variety of forms, and parents define "misbehavior" in many different ways, depending on how they expect children to behave and how well they tolerate any behavior that falls outside those limits. Therefore, to answer the question "Is there really anything wrong, or is it just me?" you need some reliable objective measures. My colleagues and I consider a child oppositional and defiant when the child demonstrates a pattern of these three types of behavior:
1. The child fails to start doing what you ask within 1 minute after you make the request (or 1 minute following the point at which you say the child has to do what you ask, such as after the cartoon he is watching is over).
2. The child fails to finish what you've asked her to do. Some children may get up and start making their beds as requested right away, but then they run off to do something more appealing in the middle of the chore.
3. The child violates rules of conduct already taught. Does your son know that swearing is unacceptable in your house but do it anyway? Does your daughter understand the rule "no snacks without permission" but constantly take food from the refrigerator without asking? Noncompliant and defiant behavior is most likely to appear at home or in public, but your child may also be acting out at school, leaving his desk in class without permission or talking throughout a teacher's lecture.
One of the most problematic aspects of identifying defiant behavior in children, both for their parents and for psychologists, is that these three types of behavior can take so many forms and that they appear with widely varying degrees of aggression. Some kids, like Susie above, are pretty passive in their avoidance of requests and rules. Others, perhaps Jenny and Frankie, might express their defiance very vocally, even physically. Many parents report that their children shout and swear at them or even hit or push them when asked to do something they don't want to do. Oppositional, defiant behavior can run the gamut from whining, complaining, and crying to arguing, yelling, screaming, and swearing. It may range from simply drifting away from chores to destroying property and getting into fights. Maybe you've seen some of these tendencies in your child:
Oppositional, defiant children ...
Change from content to angry in seconds.
Fight the inevitable, such as going to bed, going to school, or coming to the table at mealtimes, even when they know that eventually they'll be forced to comply.
Insist on having their own way when playing with friends.
Argue as vociferously about performing the little tasks as the big ones, as long as it's something they don't want to do.
May lie or cheat to escape responsibility for their actions.
Like to "get back at" people instead of forgetting about minor slights.
Are easily irritated.
May seem hostile toward particular people for no obvious reason.
Deliberately disobey their parents and sometimes other adults.
Break rules indiscriminately.
Verbally refuse to follow instructions.
Badger, annoy, or taunt people, sometimes apparently for fun.
Interrupt others' play.
Seem to have a chip on their shoulder.
Can't control their temper as well as other children of their age.
Often break or destroy things out of anger.
May indulge in self-destructive behavior such as holding their breath or banging their head.
Show little respect or regard for their parents, especially Mom.
If all of this is beginning to paint a pretty accurate picture of your child, read on. This chapter tells you what else you need to know about your child's behavior to determine whether you have a bona fide problem to be solved or just a phase to be endured. It explains how and when defiance is diagnosed as a disorder and what other problems may accompany it. In the following pages, you'll gain an understanding of how severe your child's problem might be and whether you need help beyond this book. Most of you, however, will be reassured to discover that you don't need professional help to manage this problem. In fact, the more you learn about the nature of defiance in children, the less you'll view it as "something wrong with your child" and the more you'll see it as a difficult situation or pattern of interactions with highly workable solutions. I trust you'll finish this chapter with new hope that you can meet this challenge and restore the loving relationship with your child that you both deserve, and that this problem does not have to stand in the way of your child's achieving a happy, healthy adulthood.
When Does a Phase Become a Problem?
If these behaviors are a relatively recent development, you might not have any reason to be concerned. Even a week of "No, I won't!" can seem like eternity, but the fact is that unless this behavior has been going on for at least 6 months, it may prove temporary. How do you know, and what might be going on in that case?
As horrifying as it may seem, what your child is doing may be completely normal—for his or her age. You shouldn't consider an 18- or 24-month-old abnormally defiant just because she says no to everything. Nor would I say that 9-year-old Harry had a disorder just because the nice third grader has turned into an occasionally belligerent, rule-breaking fourth grader—so have all his classmates. Perhaps you need only hang in there, as parents do during other trying phases, such as the "terrible 2's" and the "torturous teens."
A 5-year-old who says "no" to everything like someone half his age, however, is another story, and so is the 12-year-old who continues her immature practice of throwing tantrums when asked to do something that doesn't appeal to her. In these cases, you have to look at the child's pattern of behavior throughout childhood. Some children show signs of difficult temperament from a very early age, so their parents aren't so much surprised as dismayed when difficult turns into defiant.
When the behavior is brand new, though, you have to consider the possibility that some other factor is causing the child's defiance. Children may "act out" in response to everything from puberty to moving to their parents' divorce. Defiant behavior may be their expression of stress caused by a parent's or sibling's illness, a parent's extended business trip, or a new baby in the family. A prolonged illness of his own could throw the behavior of your normally even-tempered son out of kilter, just as passing a developmental milestone can wreak havoc with the attitude of your formerly cooperative daughter. The key is the duration of the behavior. We have found that the stress of a single event usually resolves itself within 6 months, so new defiant behavior generally should not be cause for alarm unless it lasts longer than that. When it does, you need to determine whether an ongoing stressor is at work. If you know that something in your child's or family's environment continues to weigh on the child emotionally—strife between parents, a major change in family lifestyle, and so forth—you may want to seek counseling. Anytime your child demonstrates an abrupt, radical change in personality, you should get a medical opinion. See Chapter 3 for advice on obtaining professional help.
You also may want to seek help if you notice other symptoms along with your child's defiance. Some defiant children also have attention-deficit/hyperactivity disorder (ADHD). Although you may be able to manage the child's defiance with the help of this book, you'll want the advice of a professional on ADHD; again, see Chapter 3. As you'll learn in Chapter 2, other problems can also accompany defiance, including depression or even bipolar disorder—here, too, you'll want a professional evaluation.
Even if you've determined that your child's defiant behavior may very well be a passing phase, an evil necessity of development, or a temporary condition, do read through the principles in Chapter 4 and techniques in Steps 1–8 in Part II, paying particular attention to accentuating the positive in your child. There's no point in letting temporary conflict create a permanent rift between you and your child, so remember to emphasize incentives over punishment, to pay attention to the acceptable behavior your child displays, and to build some form of pleasant time together into every day. And always do something about it if you find your child's behavior is wreaking havoc in your family. I've found that the program laid out in Part II can make any defiant phase pass much more smoothly. Try it if you think taking action will give you peace of mind and restore a modicum of tranquility to your home.
When Does "Difficult" Become "Disorder"?
Let's assume your child's behavior fits the profile for defiance that we've drawn so far, it has continued unabated, and you know of no external stressor in your child's life. Does this mean something is seriously wrong with your son or daughter? Do you need to rush your child off to a psychologist, psychiatrist, or pediatrician for diagnosis and treatment? Not necessarily.
Unless your child is showing defiant behavior far more often than is typical of other children who you know, or your child is prone to violence, you probably don't need a professional diagnosis or professional help. Except in severe cases, where the child is greatly impaired by the defiant behavior, affixing a clinical label to your child's problem may not have any practical purpose. We all know adults who are called "high-strung" or "demanding" or "rigid." We may not find them easy to deal with, but we chalk that up to temperament. It may be perfectly feasible for you to view your child this way.
If you're not comfortable leaving it at that, the only reliable way to know the difference between a child with a difficult temperament and one with a psychological disorder is to have the child undergo a professional evaluation by a qualified psychologist or psychiatrist. If your child's problem is severe, this evaluation can identify any intertwined disorders—such as ADHD—and ensure that your child gets the necessary treatment for other problems that often accompany a behavioral disorder. Otherwise, you can go a long way toward improving your child's life and yours with self-help such as the program in this book. In fact, even in severe cases this self-help program can be of great use, perhaps in conjunction with professional therapy.
In Chapter 2, I explain why some of the causes of defiance often make it receptive to pretty simple treatment when it is due solely to disrupted parenting without drugs or psychotherapy. The main thing the program in this book requires is your diligence, your parental commitment to applying the recommended principles and techniques consistently.
Some parents, of course, simply rest more easily after they have gotten the advice of an expert. If you choose that route, be aware that you won't find consensus within the professional community on how and when to diagnose noncompliance/defiance as a true disorder. What mental health professionals call oppositional defiant disorder (ODD) is really a set of behaviors, and behaviors are difficult to measure. That may be why some scientists, such as Jerome Wakefield, PhD, believe that in order for a behavioral problem to be diagnosed and treated as a disorder, a "harmful dysfunction" must be identified. A harmful dysfunction should be defined in part by the presence of an "aberration in an internal, normal mental or cognitive mechanism." In other words, a troublesome behavior pattern, some believe, is not enough; there must be something organically "wrong" with the child to justify diagnosing and treating the behavior as a disorder.
No one has identified a specific physical dysfunction that generally causes defiant behavior, but that does not mean that many psychologists, including my colleagues and me, will not treat the problem. It can occur in conjunction with other legitimate disorders that do have biological bases, such as ADHD or bipolar disorder, and even arise in part from these disorders. Regardless of whether your child's defiance occurs alone or with another disorder, we believe this problem is simply too distressing to ignore.
As already mentioned, the problem with measuring behavior is that so many factors are involved. A child's behavior at any given moment will be determined not only by internal factors—temperament, health, brain damage or dysfunction, and others—but also by an almost infinite number of factors in the environment. Another complication is, as behavioral psychologists will explain, that virtually all behavior can be considered normal. Because behavior is almost always relative, it's degree that matters—how frequent, how constant, how severe the child's defiance is, and whether or not it interferes with effective functioning in major life activities, such as school and social relations.
Excerpted from Your Defiant Child by Russell A. Barkley, Christine M. Benton. Copyright © 2013 The Guilford Press. Excerpted by permission of The Guilford Press.
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