Sunday, March 6, 2011

Child Psychology: Behavioural Management of problem behaviours in Children

The following is the out line of modules used to manage manage Problem behaviors in Children. It is not an exclusive list and is intended only for education of Parents and Caregivers. These are highly effective and proven measures of intervention.
The strategies are arranged as to be least intrusive to most intrusive. Therapist should be clear and confident about specific strategies. Parental consent is a must for using these strategies.

Depending on the degree of the problem, the strategies are used at several levels.

Level I: It includes manipulation of the antecedents that trigger the problem behaviours.
Eg. If a child is engaging himself in thumb sucking behaviour whenever he is free this behaviours can be reduced by keeping him busy in some adaptive manual activities like, counting objects, finger painting etc.

Level II: Strategies of differential reinforcement, where Differential Reinforcement refers to the process in which desirable behaviours are reinforced and undesirable behaviours are not reinforced.
1. Differential reinforcement of low rate behaviors (DRL).
2. Differential reinforcement of other behaviours (DRO)
3. Differential reinforcement of incompatible behaviours (DRI)
4. Differential reinforcement of alternative behaviours (DRA)

DRL: It is used when the primary focus is to reduce the behaviour but not to eliminate the behaviour.
Eg: If child has habit of shouting we can’t expect him to totally stop talking but he will be rewarded when he speaks at normal voice.

DRO: When a target problem behaviour has not occurred/ or been postponed for a specific period of time, then the reinforcement is provided.
Eg: If a child has a habit of getting up from seat frequently, he would be reinforced when he remains in seat for a specific period of time.

DRA: Here reinforcement is provided on occurrence of alternative desirable behaviours.
Eg: In a specific interval, if the child asks permission to go out rather than running away, he will be rewarded for asking permission (i.e. alternative behaviour).

DRI: In this module, reinforcement is provided on occurrence of the behaviour that is physically incompatible to the problem behaviour.
Eg: If child has the habit of thumb sucking, he will be engaged in some manual activity so that his hand will not be free for sucking. And reinforcement is given when he engages in that particular manual activity.

Level III:
Extinction: It simply means terminating reinforcing event that maintains problem behaviour.
Eg: If a child cries only to get the attention of adults that can be safely ignored.

Extinction is mainly used for attention seeking behaviours or if, the function is clearly measurable.
It should not be used if the function of behaviour is escape or self stimulatory.

Level IV: Removal of undesirable behaviour stimuli. It includes 2 techniques:

Response cost: If a child shows a particular target behaviour he will be made to pay cost for it.
Eg: Tokens or rewards may be withdrawn when a child breaks an object. But, this technique is possible only when the child has some token/rewards and does not run out of them to pay as cost.

Time-out: It means, removal of reward from the child or the child from reinforcing situation.
Eg.: While everybody is playing, if a child is disturbing others with a toy, the toy will be taken away from him or he will be removed from the situation for a specific period of time.
In case, if time-out room is used, the child should not be secluded for more than 1 to 5 minutes. And there should not be any recreational or potentially dangerous articles in the time- out room.
This strategy should not be used with very young children, or if they have associated medical problems like seizures etc. or if the function of behaviour is “escape” or “self-stimulatory”.

Level V:  Presentation of aversive stimuli.

Unconditioned aversive stimuli: It includes the use of stimuli like water spray directly on face or mild tick or pungent odors. But this strategy is very rarely used. It is proved to be successful in managing stereotypical behaviours.

Conditioned aversive stimulus: As in conveying verbal displeasure (Like, an emphatic ‘No’)

Over-correction: It is considered to be educative. The purpose of overcorrection is to teach student to take responsibility for their problem behaviour and teach them desirable behaviors. It involves two methods.
a. Bringing the situation back to normalcy (Restitution)
b. Teaching appropriate behaviour (Positive practice)
Eg: If a child spits on the floor, he will be made to wipe the place (Restitution) and also taught where to spit, like in a wash-basin. (Positive- practice).


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