Q&A: Coping with a Difficult Temperament
Q. Our seven-year-old son is very sensitive and throws many tantrums. He usually starts his day in a bad mood, causing immediate distress in trying to get him off to school. He is doing well in school where he has an excellent teacher who runs a very structured classroom. But, at home, he makes a fuss about everything that doesn’t go his way, spoiling dinner, games, and bedtime. He seems to need a lot of attention, yet he often spoils it when we try to give it to him. When he’s in a good mood, he is terrific. He’s also very caring with a baby sister. But right now we are mostly angry at him. How can we turn things around?
A. This boy was probably born with a difficult temperament. Research has shown that children may be classified into three temperaments: easy, slow-to-warm-up, and difficult. “Difficult Children” are estimated to be about one in twenty but are often brought to the attention of pediatricians and child psychologists. These children tend to be irregular in their biological functions as infants, have difficulty adapting to change, are hard to please, get into bad moods easily, and have intense emotional reactions. Many of them seem to have hypersensitive sensory systems, i.e., loud noises are painful, certain materials in their clothing are irritating, food consistency and taste contribute to being a finicky eater, and, in general, they are hyper-aware of what is happening around them.
One of the important messages here is that the difficulties experienced by children like the boy described above are not caused by “bad parenting.” These children enter the world with great distress and are difficult to console from day one. Parents, however, do play an important role in influencing the course of this child’s life. The more they allow the child’s behavior to “run the house,” the worse the behavior will get. On the other hand, if the parents can offer structure, clear limits and consistent reinforcement of positive behaviors, maintain a sense of humor, and make an extra effort on behalf of this child, then there is a good chance that the child’s difficult behaviors will fade over time.
Structure is important. Note the difference it makes in school for this seven-year-old. These children need very predictable environments. Typically I will recommend that parents create a large poster chart visually depicting each step required to get ready in the morning with a time next to each one. They can refer to where the child is on the chart and what the chart says the child should be doing next. This makes it less of a parent-child struggle; the chart becomes “the nag”! You can do the same thing with bedtime. Notice that in lower grades, classrooms have similar charts about starting their day.
Structure is also helpful when facing new events or going into situations that are likely to be overly stimulating for these children, e.g., holidays and birthdays. Review the event ahead of time to help your child prepare for what may happen and plan breaks to help him unwind. This may mean taking him for a walk, ride, or going to a quiet place in the house to play a game or watch a video. Often parents know that their child has a time limit to his tolerance or they can see early signs of “losing it.” Plan the down times accordingly. Sometimes children can learn to ask for a time-out when they feel like they are losing control.
One of the key concepts is to get out of the pattern of giving your child a lot of negative attention and trying to shift to making most of your attention a reward for positive behavior. This means frequent use of brief time-outs, with very little extra conversation, when you child’s behavior is unacceptable. It also means finding ways to reinforce positive, adaptive behavior such as time when your child plays quietly and appropriately. Too often we ignore a child until he creates a fuss.
One technique for reinforcing positive behavior is to give a child a slip of paper with a “5” on it that can be redeemed for five minutes of parent attention whenever the child has been playing quietly, plays well with a friend, gets through dinner without a fuss, or runs an errand with you without a tantrum. If the child throws a tantrum during a game at night, do not play a game with him the next night. If the child approaches you in a negative, abusive manner, walk away, telling him you will be willing to listen after he calms down. During calmer times, role-play some of these situations to help him learn alternative ways of behaving.
It is important to recognize, and tell the child, that you cannot control his behavior, only the consequences. Avoid physical confrontations, even with very young children who are easy to pick up and carry to their rooms. Teach the child that he has choices and that he is responsible for the consequences of his actions. Do this in a slow, steady manner, always retaining your sense of humor, with as much patience as you can muster, and gradually, the “difficult child” will turn into a feisty, spirited, caring young adult!