Advice for Young Advice for Young Child BehaviorChild Behavior

Christopher LeverChristopher LeverCommunity Pediatric ConsultantCommunity Pediatric Consultant

ObjectivesObjectivesDiscuss typical negative behavioral Discuss typical negative behavioral encounters in pediatric medicineencounters in pediatric medicineConsider some medical evaluation when Consider some medical evaluation when negative behavior presentsnegative behavior presentsHave an approach to give advice to parents Have an approach to give advice to parents regarding negative child behaviorregarding negative child behavior

StagesStages9-12 months9-12 months18-36 months18-36 months5-year-olds5-year-oldsPreadolescentsPreadolescentsAdolescentsAdolescents

Cases?Cases?

Cases?Cases?

Cases?Cases?

Cases?Cases?Food refusalFood refusal

20-month-old refusing to eat supper20-month-old refusing to eat supperOppositionalityOppositionality

3-year-old girl talking back after visits with her 3-year-old girl talking back after visits with her fatherfather

Sleep difficultiesSleep difficultiesFor your old waking up six times at night after For your old waking up six times at night after hospitalization for asthmahospitalization for asthma

The Pediatrician’s RoleThe Pediatrician’s RoleListenListenConsider pathologyConsider pathologyGive specific adviceGive specific adviceGive references and resource informationGive references and resource information

Medical Medical ConsiderationsConsiderations

Iron deficiencyIron deficiencyNocturnal seizuresNocturnal seizuresThyroid diseaseThyroid diseaseSteroid useSteroid usePain syndromes [example-migraine]Pain syndromes [example-migraine]Sensory impairmentSensory impairmentCognitive impairmentCognitive impairment

Mental Health Mental Health ConsiderationsConsiderations

AnxietyAnxietyObsessive-compulsive disorderObsessive-compulsive disorderMajor depressive illnessMajor depressive illnessPersonality typePersonality type

Other ConsiderationsOther ConsiderationsAttention deficit/hyperactivity disorderAttention deficit/hyperactivity disorderOppositional defined disorderOppositional defined disorderConduct disorderConduct disorderChild-parent interaction difficultyChild-parent interaction difficultyCognitive impairmentCognitive impairmentLearning difficultyLearning difficultyAutistic spectrum disorderAutistic spectrum disorderFetal alcohol syndromeFetal alcohol syndrome

AdviceAdviceConsider the developmental age of the childConsider the developmental age of the childNormalize behavior, if possibleNormalize behavior, if possibleEducate parentsEducate parentsThe golden rulesThe golden rules

Advice- The Golden Advice- The Golden RulesRules

Ignore what you can ignoreIgnore what you can ignorePraise specific desired behaviorPraise specific desired behaviorGive appropriate consequences for native behaviorGive appropriate consequences for native behaviorBe consistent-that means everybody!Be consistent-that means everybody!Give the child choices if possibleGive the child choices if possibleBe a role modelBe a role modelEmpower parentsEmpower parents

Recognize special situations such as single parents, Recognize special situations such as single parents, divorced parents, and different cultural viewsdivorced parents, and different cultural views

ConsequencesConsequencesNatural consequencesNatural consequencesTimeout principalTimeout principalToken economiesToken economiesLost privilegesLost privilegesCorporal punishmentCorporal punishment

Advice-summary Advice-summary themesthemes

Use simple languageUse simple languagePick your battlesPick your battlesAllow for safe and unstructured activitiesAllow for safe and unstructured activities

Other resourcesOther resourcesManaging childhood behavior Managing childhood behavior [www.sacyhn.ca][www.sacyhn.ca]Reference list’s-Canadian Pediatric Society Reference list’s-Canadian Pediatric Society or othersor othersCounseling servicesCounseling servicesPrivate psychologyPrivate psychology

SummarySummaryNegative behavior is common and should be Negative behavior is common and should be asked about during any patient encounterasked about during any patient encounterConsider medical problems directly Consider medical problems directly contributing to negative behavior.contributing to negative behavior.Know and use the golden rules of adviceKnow and use the golden rules of adviceEducate parentsEducate parentsA resource list is useful and should be readily A resource list is useful and should be readily availableavailable