“Emma runs away every chance she gets. Open a door and she bolts. Try to walk with her into a store and she screams until she wiggles free. We can’t take her anywhere!”
This is how Emma’s mother describes one of the family’s main concerns. Emma’s behavior is difficult for them to manage, and one of the routines that is especially problematic is taking her on errands. Emma seems to crave movement and dislikes being contained; she doesn’t like having her hand held, being in the shopping cart or riding in a stroller. Because of this, her family is unable to go out together, as one parent must stay at home with her. This is disruptive for the family and limits Emma’s learning opportunities too. If you were Emma’s EI service provider, how could you help?
Typical Toddler Behavior or Something More Challenging?
This is a rather common scenario for many toddlers. At one point or another, they grow out of wanting to be contained, or even slowed down. Most will move through this phase without too much strife. For some children, though, this time can be very disruptive for the whole family. It can also be complicated by a child’s limited expressive and receptive language skills, lack of attention to safety, or sensory processing differences. Improving a frequent routine like running errands can be equally, if not more important, than teaching a child a specific skill, like asking for juice or waiting her turn.
Baby Steps to Successful Behavior
Here are a few ideas for addressing this challenging behavior in the context of Emma’s family’s errand-running routine:
Find out what everyone does before, during, and after running errands – Look and listen for clues about what motivates Emma to continue running. Is there something that happens before the errand that preps her for an uncomfortable experience – like being snatched up to get in the car without warning? Is Emma somehow rewarded for the behavior (ex: she gets her mom’s phone to play on as a distraction after she tries to run – big reward!).
Ask the parent what she would like to have happen instead – Be sure to ask and not assume. What the routine looks like when it’s successful may be unique to that family, and may be different from what you envision.
Break the routine down in to its small steps… – Especially when it’s a big challenge that has been going on for a while, back up with the parent and talk or walk through the smaller steps, like getting Emma ready to get in the car, buckling her in, riding in the car, getting her out of the car seat, walking across the parking lot, putting her in the shopping cart or stroller, etc. The solution probably lies in one of these steps.
…Then break the strategies down further into baby steps – Rather than tackling the entire routine at once, start at the very beginning and inch toward a solution. For example, if Emma runs as soon as she’s out of the car, start there. Help Emma’s mother teach Emma to hold her hand in the parking lot. Coach her through taking Emma’s hand, taking a step, and stopping if Emma pulls or tries to drop to the ground. Coach her through stopping each time Emma fusses, waiting for Emma to settle down before taking another step, then praising Emma as soon as they are able to walk again. Help Emma’s mother teach her daughter what the expectations are for going out on errands. Prepare her for the time, consistency, and practice needed to teach Emma a new way of being during outings. Look at it as if you are addressing a routine within a routine; the baby steps make up the big journey – especially when improving a challenging behavior.
Be there when the parent practices – Stand beside the parent as she tries out these strategies in the parking lot. Reflect with her on what works and what doesn’t. Model if needed, but more importantly, coach her in the moment and share feedback to help her learn how to teach her child. Overcoming a challenging behavior like this can be such a confidence booster for a parent. Having someone there beside her, someone who won’t judge her and who is there to as a problem-solving partner, can not only help her help her child, but also improve the family’s quality of life and that’s a powerful thing.
Thinking about behavior in terms of the routine in which it occurs can help the service provider frame intervention strategies in a real world context. It’s only so helpful to talk about general strategies a parent might use…the “have you tried…?” way of addressing a family concern. Just talking is not very likely to help the parent change the child’s behavior or the situation. Jumping in and joining the troublesome routine is always the best way to go, but this can be unnerving for the parent who is probably afraid of what will happen with you watching. Taking a routines-based approach to challenging behavior and addressing the challenge in baby steps can be a very effective, non-threatening way to support families and make the intervention strategies you develop together much more manageable and meaningful.
What strategies have you used with families to help them address challenging behaviors like Emma’s?
Share an example from your experience!