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(Pediatrics in Review. 1997;18:266-270.)
© 1997 American Academy of Pediatrics

Addressing Behavior Problems Among School-aged Children: Traditional and Controversial Approaches

	IMPORTANT POINTS

 

1. Children's behavior can be modified by providing appropriate environmental interventions.
   
2. The first step in addressing behavioral problems in children is to identify the specific problem, what preceded and encourages that behavior, and what other psychosocial issues are occurring within the family.
   
3. Important elements in improving parents' ability to manage their children is to make them more reinforcing and positive, to improve their consistency, and to make them more contingent in their application of their parenting.
   
4. The pediatrician must consider a spectrum of activities to help parents that range from providing suggestions and reading materials to referring for individual family therapy with a mental health clinician, depending on the severity of the problem.
   
5. All therapies should be demonstrated to be efficacious and not significantly harmful before they are recommended for use. This requires well-controlled scientific studies, including blinding and use of a placebo.
   

In discussing behavior problems, particularly in school-aged children, it is important to note that the age-old argument about nature versus nurture is clinically counterproductive. Children's behavior reflects the interaction of their temperament and inherited personality, the history of their experiences, and the particular nature of each situation. In most circumstances it is impossible to determine what proportion each of these elements contributes to a given manifestation. Likewise, the proportions are likely to vary from child to child and even from situation to situation in a single child. Although it is difficult to modify children's personalities, it is possible to modify behavior by identifying and correcting adverse situations in the environment and by introducing appropriate interventions. Previous experiences cannot be changed, but if adverse environments can be corrected early, there is a greater possibility of preventing or diminishing their impact.

Identifying adverse situations, such as child abuse or neglect, marital discord, or inappropriate class placement, is an important aspect . . . [Full Text of this Article]

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