The world is an increasingly complicated place. Because of ready access to social and traditional media, children are often exposed to tragic events across the country and around the world. In addition, they also must learn to deal with daily pressures, such as school related demands, extracurricular activities, peer pressures and responsibilities at home. Within this context, young people are learning to handle strong emotions, understand social relationships, and make good decisions, all of which are challenging. Many children struggle with these challenges; and as a result, they often experience related feelings of loneliness, worry, sadness, and anger. While teachers and peers provide important models for fostering social and emotional learning, parents are the first and most important teachers of these skills. Moreover, the summer months offer more opportunity for parents to engage productively with their children in a manner that will enhance their child’s social emotional and behavioral functioning. Summer well-child visits are an excellent time to engage with the families you serve about their children’s social and emotional development.
Parents and other caregivers are children’s first teachers, and they are essential to helping children develop healthy social and emotional skills. Many of the challenges children confront are to be expected and represent some of the normal developmental transitions that every child and adolescent confronts. However, children also have qualities that make them different from others and provide the hallmark for their unique personality. As a pediatric primary care provider, you can discuss social and emotional development with the families you serve and encourage parents to adopt strategies that will increase healthy development. The following recommendations provide an overarching approach for helping children develop effective emotional and behavioral skills; however, parents can use these recommendations while adapting these skills to their unique circumstances and the child’s unique personality. Most of the tips provided are appropriate for both young children and adolescents; however, some modifications might be needed depending on the child’s age and skill level. Please note that the term parent will be used throughout this newsletter to refer to all primary caregivers.
RECOMMENDATIONS FOR PARENTS:
All parents can teach their children social and emotional skills and many of these skills can be incorporated into the routines of family life. Recommendations for teaching and modeling the skills are organized in three categories: support strategies, structure strategies, and response strategies.
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Support strategies are those that will help parents to further develop and maintain a positive and understanding relationship with their child across all phases of development.
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Structure strategies are those that will help children understand limits and boundaries as well as consequences of positive and negative behaviors.
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Response strategies are tips for understanding and responding to children when they are engaging in challenging behavior that would be improved through social and emotional skill development.
Support Strategies for Parents
Support strategies can be used to maintain a warm relationship and to help focus on understanding a child’s feelings and behavior.
1. Give positive attention. Daily life can be very hectic, and regardless of how difficult a child may have been during the day, try to enjoy some positive time together. This time could be for as little as 5 minutes. Let the child direct that time. The child might want to play a game, read a favorite story, or even just talk about his or her day. Notice what is being said and describe it so the child knows you are listening (e.g., “I notice that you picked the red game piece again. Red must be a color you like!”).
2. Spend time playing together. Play might be one way parents build a routine of paying attention to a child. Taking time to play with each other lets families enjoy positive experiences together and have some laughs. Play also can be a great teaching tool. Playing games with children provides excellent opportunities for adults to think aloud and model how to solve problems, make decisions, and handle winning and losing (e.g., “Wow! You got me this time. Maybe I’ll win next time. Good game!”).
3. Listen to the child. Try to notice when children or adolescents like to open up and talk. It might be during a particular routine, such as bedtime or when you are in the car together. Indeed, during the early adolescent years some of the most productive conversations often occur when the parents are driving to and from soccer practice, parties and after school activities. When parents take a few minutes to pay close attention to what their child wants to share, they show them that they care.
4. Practice problem solving with the child. When a child is faced with a problem, help him or her work through it, rather than get stuck in a way of thinking that is not helpful. Help the child name the problem specifically and think about whether it is a big problem or a little problem. Help brainstorm ideas for fixing the problem and making good choices; for example, say “That’s one possibility. What else might you try?”
5. Praise the child. Give the child positive feedback when he or she makes good choices, particularly when social and emotional skills are first being learned. Helping them foster good problem-solving skills will help them to generalize this problem-solving approach to new situations and will eventually be useful in their interactions with peers. Be specific with feedback and celebrate the child’s ability to relate to others.
Structure Strategies for Parents:
Structure strategies are those that will help parents think about how to provide structure within your child’s environment and daily life, how to set effective limits, and how to help children understand consequences of misbehavior.
6. Build routines. Children feel a level of safety when they have daily routines that they can rely on. Parents can help by establishing routines for getting up and getting ready for school in the morning, for homework, for mealtimes, for bedtime, and so on. For children at every age, establishing or adjusting a routine is a learning process. Parents can help by first thinking through the steps of a routine, then teaching the routine to the child. The child may resist routines at first, but almost all children find routines to be comforting.
7. Set clear expectations for positive behavior. Setting expectations is important because it teaches children how to act in the world, and it also shows them that parents are involved in their lives and are paying attention. Expectations include general ideas that guide behavior, such as “Treat others as you would like to be treated,” or they might be specific to a situation. For example, before going into a store with young children, parents may remind them to keep an indoor voice and stay seated in the cart. For adolescents going out with friends on a Friday night, parents might expect them to communicate where they are going and with whom, and when they will be back.
8. Providing consequences for appropriate behavior is oftentimes more important than singling out misbehavior. When a parent focuses on rewarding a child when they display desirable behaviors, the likelihood that the behavior will be repeated is increased. The more children engage in positive behaviors, the less opportunity there is for them to engage in behaviors that are inappropriate.
Response Strategies for Parents
When a child engages in problem behaviors, response strategies can be used to help parents remain calm and to better understand the child’s behavior. These strategies will also help the child learn that problem behaviors are not useful and that regulating emotions and practicing coping are helpful.
9. What is a child communicating through problem behavior? Engaging in challenging behavior is a way that children and adolescents attempt to communicate. Is the child seeking parents’ attention—positive or negative—or indicating that a request is too difficult? Is the child tired, hungry, or anxious? How might the child’s strong emotions be interfering with his or her ability to communicate accurately?
10. Redirect. When the child is engaging in problem behavior, be sure to redirect them to what is expected of him or her. Consider reminding the child about the expectations for certain behavior that parents have talked about. Focus on talking about what to do rather than what not to do. The parent might say, “Remember, the expectation was that you would be home by 10,” rather than “You were late again”.
11. Consider natural consequences. If redirecting the child’s response doesn’t work, consider what the natural consequence would be. For example, if the child is having a hard time sharing with siblings after multiple reminders about sharing, the parent might take the toy away for a few minutes.
12. Use planned ignoring or time-out. If the child is misbehaving to get attention, the parent can use planned ignoring or a time-out. Planned ignoring means that the parent simply stays neutral rather than spend time paying attention to the misbehavior. Time-out is similar and includes remaining calm while directing the child to sit in a time-out spot (or to go to his or her room, particularly for adolescents). Time-out can be effective in removing attention from the child and giving the angry or upset child a chance to cool down.
13. Help the child persist. If the child is misbehaving to avoid something unpleasant, such as cleaning up his or her room, then planned ignoring and time-out might not work. In these cases, the parent might need to think about how to break the task into manageable parts and give positive feedback for completing each part.
14. Reflect on what happened. Once the child has calmed down and the socially and emotionally challenging situation has settled down, the parent should take time to reflect with the child about what happened. It often helps to ask how they could have coped differently with any strong feelings, and what they might do to redirect their feelings differently if a similar situation comes up again. Parents can also help their child think about how to fix any damage that was done. Many parents find that the end of the day is a good time to reflect with children on how the whole day went, including both positive and not so positive things.
15. Seek support. When the misbehavior is chronic, or the strategies parents are using don’t seem to be working, encourage them to reach out to others for support. Parents can contact the child’s school to find out if a certain behavior happens at school and if any intervention strategies have worked there. Additional resources in the community include, psychologists, family therapists or parenting support groups.
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