Handling Infants or Toddlers Challenging Behavior* Rebecca Dunn, LMSW

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1 Handling Infants or Toddlers Challenging Behavior* Rebecca Dunn, LMSW Introduction Hi, my name is Eva. Infants and toddlers sometimes behave in ways that can be confusing and even upsetting for the adults who care for them. During this training, we will talk about why infants and toddlers behave the way they do. We will talk about how parents can respond in ways that help infants and toddlers learn appropriate behavior. We will also talk about how parents can work together with child care providers to support infants and toddlers growth in this area. [Learning Objectives] By the time you finish this course, you will be able to identify the ways in which your infant or toddler uses behavior to communicate. You will also be able to define withdrawing and acting out behaviors. You will develop a better understanding of challenging behavior. You will learn about ways to prevent and respond to challenging behavior. Finally, you will learn how your child s environment can affect her behavior. How Infants and Toddlers Use Behavior to Communicate Think about behaviors that you see from your infant or toddler. Are you picturing cooing? Smiling? Crying? Clapping? When you see behaviors like these, you know that your child is communicating something. As a parent, you know that when your infant cries, he is expressing a need. This might be a need for a diaper change, a need for comforting, a need to eat, a need to get away from others, or any number of other needs. Parents learn early in their child s infancy that different types of cries can identify specific needs. There are many other ways your child uses behavior to communicate. For example, behavior like eye or ear rubbing may mean your baby is ready for naptime. Other infant and toddler behavior is harder for parents and other caregivers to understand. Why would a toddler who seems happy one minute cry uncontrollably the next? Why do babies continue to cry even after caregivers have tried many different ways to calm them? Understanding these and other behaviors can be tricky. It will be easier to understand your child s behavior if you understand that it is your child s way of attempting to communicate. This is true for even very confusing or upsetting behavior. 1

2 Just because a behavior is inappropriate does not mean that it is always a cause for concern. Some behaviors, like grabbing a toy out of a peer s hand, are common in very young children. We can teach children better ways to communicate what they want or need, but the behaviors themselves are nothing to worry about. Other behaviors are more serious, and dealing with them may require seeking help. Learning which behaviors are normal for your child s age and which are not are important steps toward helping your child learn appropriate behavior. What Is Challenging Behavior? Your child s behavior always has a meaning. It is always your child s way of communicating something. A lot of the behavior infants and toddlers use that adults want to change is behavior used to express strong emotions or hardly any emotion at all. Many times this behavior is difficult for adults, but it is not always what we consider challenging behavior. When we talk about challenging behavior we do not mean behavior that is normal for your child s developmental stage. We mean behavior that is much more severe, lasts much longer, or happens much more often than we would expect for a child in the same age range. These characteristics make challenging behavior harder for parents and caregivers to prevent and respond to than normal difficult behavior. Challenging behavior happens when your child s needs are not being met. It is his way of trying to tell the people who care for him that he has a need. Sometimes it is relatively easy to figure out what unmet need your child is trying to communicate. Other times it can be very difficult. To help you develop a mental picture of challenging behavior, draw an iceberg (or a triangle shape) on a piece of paper. Remember that most of an iceberg sits below the water. Only a very small part, called the tip, sticks up above the water. Draw a line across your iceberg to represent the water. Look at the tip of your iceberg. That tip represents those behaviors that your infant or toddler uses when she is trying to tell you that she has an unmet need. The rest of the iceberg, below the surface, represents the needs your child has that are not being met. These are the things that cause the behavior. Like the larger portion of the iceberg that is under the surface, the meaning of extreme behavior is often hard to see. Your infant or toddler has many needs. Some of those needs include: Feeling safe, Consistent, loving, and responsive relationships with adults, Structure and consistency, 2

3 Good nutrition, Good health, Opportunities for movement (like crawling and running), Adequate rest, and Environments that are engaging and stimulating (like those with age-appropriate toys and books). Challenging Behavior Example Let s talk about a specific example. Imagine an 8-month-old who cries for long periods of time after his mother drops him off in child care. Look at your iceberg drawing. What behavior do you think is the tip of the iceberg? If you answered crying, you are correct. Now think about the bottom of the iceberg, or the unmet need that is causing the behavior. What are some reasons a baby might cry for long periods of time? Some possible answers include separation anxiety, fear of new caregivers, or trouble adjusting to being in child care. Some other things that might cause this child s behavior include: He might be lonely. Perhaps he is held a lot at home, and he is not used to playing on the floor or with other children. He might be sensitive and anxious about the room noise and the other children. Or, maybe he doesn t feel well and may be getting sick. In order to learn how to respond to your child s behavior, you first have to understand the behavior s meaning. All behavior has a purpose. Infants, toddlers, and young children do not use challenging behavior intentionally to manipulate parents or caregivers. It takes time and effort to understand what your child is trying to communicate. Once the need has been identified, the next step is to find new ways to fulfill the need or to teach the child other ways to communicate his needs. Acting-Out and Withdrawing Behaviors Infants and toddlers use two main types of behavior to let adults know they are feeling distressed. These two types of behavior are acting-out behaviors and withdrawing behaviors. Most children will use acting-out behaviors and withdrawing behaviors on occasion. These 3

4 behaviors become a problem when a child uses them too often, for too long, or with too much intensity. Let s discuss acting-out behaviors first. These behaviors are usually the easiest to identify. Some examples of acting-out behaviors are: Fussing, Inconsolable crying, Frequent or intense tantrums, Pushing, Hitting, Biting, Frequent throwing, Frequent knocking things down or destroying property, Frequently interfering with or refusing to participate in activities, and Harm to self or others. Acting-Out and Withdrawing Behaviors, continued Now let s talk about withdrawing behaviors. Withdrawing behaviors are also sometimes called internalizing behaviors. They may be more difficult to see than acting-out behaviors. A child using withdrawing behavior may appear to have given up on trying to have her needs met. She may have moved away from interaction with others. For instance, if a child s cries are mostly ignored by the adults who care for her, eventually the child will stop attempting to communicate her needs. Some other examples of withdrawing behaviors are: Pulling away while being held, Rarely cooing, Rarely babbling or talking, Looking sad, Not showing preference for parents or caregivers, Not making eye contact, Whining, 4

5 Being overly compliant or avoidant with parents or caregivers, and Using fewer communication skills than have previously been used. When an infant or toddler uses a lot of acting-out or withdrawing behaviors, adults who care for him need to try to understand the meaning behind the behavior. Then, they need to respond to his needs, and help him learn better strategies to meet his needs in the future. It can be tempting to react to the behavior rather than to think about its meaning. Your child s emotions can easily stir up strong emotions in you. A quick reaction is necessary if your child is about to do harm to himself or others. However, often we decide how to react by thinking about our own feelings rather than the feelings of the child. While you might feel frustrated and angry when your child uses challenging behavior, your child might be feeling frightened or lonely. We can focus on the child s feelings by trying to understand the meaning behind the challenging behavior. When we do, we are more likely to be able to respond with empathy for his needs and to make better choices about how to solve the problem. Responding to Challenging Behavior When you see your child is upset and using challenging behavior, what do you do? Some parents punish the behavior. Some ignore the behavior. There are many different tactics available to parents who are dealing with their children s challenging behavior. Let s talk about some appropriate ways to respond to your child s distress. When you see your child in distress and either acting out or withdrawing, try using these responses: Acknowledge his distress and name his feelings. Say things like, You seem so sad. or You look really upset. Offer her comfort. For example, say, It will be okay. I ll help you feel better. Use a soothing, soft tone of voice. Use words that describe what you think he is experiencing. You look so frustrated right now. You really want that toy. Be attuned to your child s specific needs. Being attuned means understanding the unique feelings and needs of your child. Being attuned to your child is about being at one or in sync with her. By being attuned to your child, you are more often able to predict what will upset her and can respond quickly in ways that prevent or lessen challenging behavior. 5

6 Help your child find a safe and appropriate way to meet his needs. For example, when your baby throws his empty cup and screams, help him find another way to get what he wants. Say, You want more milk. You can point to your cup. You don t need to throw it. Make sure that your expectations for your child are realistic. Consider her age and developmental stage. You cannot expect a 12-month-old to sit through a two-hour movie without problems. If you need information about developmental stages, ask your pediatrician or your child care provider. Why Is It Important to Respond Appropriately? It is important to respond appropriately if acting-out or withdrawing behaviors become a problem for your child. These behaviors can interfere with your child s development if not corrected. If left alone, challenging behaviors can make it difficult for infants and toddlers to build close relationships with adults and peers. These relationships are critical for children s healthy development. They help children create their own sense of self. Think about a baby who is extremely fussy. Her behavior might cause her to receive less positive attention or nurturing from adults. This might cause her to be delayed in her social development. For instance, she might smile less often or not respond to her name. Another example is a toddler who frequently bites his peers when he is stressed. Other children may begin to avoid him. If they do, he won t have as many opportunities to learn to play with his peers or develop age-appropriate language skills. A third example is a baby who is quiet and hard to engage. People might have a hard time feeling emotionally connected to her. This might mean she ends up being left alone too much by her parents or caregivers. That could cause her to have fewer opportunities to bond with the important adults in her life. When challenging behavior is not resolved, the behavior may: Become habitual, more frequent, and more difficult to change, Lead to a child receiving less positive care from his parent or provider, Affect relationships with peers, and Affect other developmental areas. 6

7 It is more expensive, more intrusive, and less effective to change challenging behavior later in a child s life. This means our emphasis should be on relieving the distress children may be experiencing when they are very young. When Challenging Behavior Persists You have tried to determine the meaning of your child s challenging behavior. You have responded to the behavior in a consistent and appropriate way. You have helped teach healthier ways for your child to express her feelings or needs. What happens when you have done everything we ve talked about and your child s challenging behavior doesn t go away? The answer is to dig deeper. There are a number of reasons why children engage in challenging behavior. Some of these include an undiagnosed health problem (maybe your toddler is not hearing well because of repeated ear infections); a developmental surge (like an infant who is beginning to walk); or a developmental problem. Talk to your child s pediatrician about the types of behavior you and other caregivers are seeing so you can rule out medical conditions as the source of the behavior. There are also family circumstances which can impact very young children. No family is perfect. Every household has its share of negative emotions like anger or sadness, and big changes like divorce or death. Your child s well-being depends on the quality of his relationships with the people who care for him. Your infant or toddler has had a short life, but if he is showing challenging behavior, something in his recent experience (like separation from a parent or a move away from extended family) might help explain his behavior. Examining your home environment can help you understand what your child has experienced. Keep in mind that each family s circumstances vary widely. We know that experiences such as divorce or domestic violence will affect young children negatively. Did you know that even positive changes can be challenging to an infant or toddler? These could be things like a move to a nicer home, or an extended visit from a well-loved grandmother. Too much excitement or too many changes over a period of time can make it difficult for a very young child to understand his surroundings. Sometimes challenging behavior is caused by a combination of factors. A family issue can combine with the child s natural personality or temperament. These cases usually require you to address all of the causes of distress to fully change the behavior. For example, a shy toddler whose home language is Spanish may struggle to adapt to a child care setting where the primary language spoken is English. Think about the challenges your child might be facing. See if you can think of ways in which multiple factors might be contributing to your child s behavior. Maternal Depression 7

8 One family circumstance that can have a strong influence on young children s well-being is maternal depression. This is a sensitive subject for many families, but it is important that parents understand the impact it can have on children. Maternal depression affects children because it can lead to mothers being less responsive and warm toward their children. Research has shown that warm, responsive care is the best kind of care for infants and toddlers. Depressed mothers often feel emotionally detached from their children. They provide basic care like food and shelter, but not the warm, responsive care that best meets infants and toddlers needs. For example, a mother experiencing depression may respond to her child s crying, but not to positive behaviors like smiling and cooing. Maternal depression is also worth mentioning because it is surprisingly common. The Early Head Start Research and Evaluation Project of 2002 found that 48 percent of participating mothers reported that they were depressed. Some studies have found that as many as 90 percent of new mothers experience some feelings of depression or blues. Some symptoms of maternal depression are: Feeling sad, blue, or down in the dumps, Loss of interest in things that used to be enjoyable, Feeling worn down or restless, Trouble sleeping or sleeping too much, Loss of energy, feeling tired all the time, and Increase or decrease in appetite or weight. While any mother can experience depression, some mothers are at a higher risk. Some risk factors include: Low socioeconomic status and/or financial stress, Domestic violence, Substance abuse, Depression during or after previous pregnancies, Unplanned pregnancy, Complications during pregnancy or childbirth, including preterm birth, and Experiencing multiple stressful life events. 8

9 If you or a mother you know may be experiencing symptoms of depression, seek medical treatment. Speak to your licensed healthcare professional about available options. For information about community mental health providers, contact your state s health department. Residents of Texas can call the Department of State Health Services at Working with Caregivers A child s challenging behavior may take place only at home, only in child care, or in both settings. In order to understand and respond to these behaviors, parents need to work in close conjunction with their children s other caregivers. Children in a child care setting are exposed to new surroundings. These can include new adults, new peers, new toys, and often new routines and expectations. For many children, the stress of adapting to these new surroundings causes challenging behaviors to be magnified in the child care environment. It can be embarrassing to parents when their children are exhibiting challenging behaviors. If your child s caregiver approaches you to discuss your child s behavior, remember that you both have your child s best interest at heart. A discussion about challenging behavior is not an attack on your parenting skills. Neither is it an accusation of an unhealthy home environment. Working together with your child s caregiver gives you the best possible chance of understanding and responding appropriately to your child s behavior. You have a wealth of knowledge about your child. Your child care provider has a wealth of knowledge about child development. Together you can form a successful team to respond to any challenges your child may face. Communicate with your child s caregiver often. Keeping one another informed about what is going on with your child gives you both a more complete picture of your child s experience. Talk to your caregiver about your child s likes, dislikes, strengths, changes in routines, and anything else specific to the child. If your child is experiencing distress either at home or in child care, communicating those concerns will allow you to work as a team. Young children need consistency. When the routines and expectations at home are very different from those in child care, your child can become confused. For example, if your toddler carries his favorite toy everywhere at home, but toys from home are not allowed in child care, he may feel distressed. This confusion and distress can lead to challenging behavior. Working with Caregivers, continued 9

10 Most child care programs ask staff to continually observe the children in care. If your child starts exhibiting challenging behavior, these observations can be a valuable tool for gaining insight into the meaning of the behavior. Observations should: Be conducted by more than one person and may include any person who interacts with the child, Be done at various times of the day on multiple days, and Be recorded in a similar way so that the information from multiple sources can be easily compared and analyzed. If your child care program does not already collect observations, you can request that your child s caregivers begin recording observations of your child. Information from the observations can be used in a discussion between with the caregivers to decide how to handle the behavior. This meeting should involve sharing thoughts and ideas with your child care provider. It might be helpful to share information about the strategies you have used at home. Your child might respond better if her caregivers implement the same strategies in child care. Often, parents and caregivers will work together on creating a behavioral support plan. This plan is normally comprised of simple strategies to help improve your child s behavior. Your involvement is a crucial part to the success of the behavioral support plan. After everyone has tried the plan out for awhile, you will probably want to check back with your child s caregivers to discuss whether your child s behavior is improving in the ways you had hoped. Remember to talk about any behavior changes you have seen at home. Change in behavior may take time, but it is possible with cooperation between parents and caregivers. Seeking Professional Help Some children will require more help than their parents and caregivers can provide. Asking for help with your child s challenging behavior does not mean you have failed as a parent. Parents who seek help for their children are parents who care about their children s well-being. To get the best results, seek help from a mental health professional in a timely manner. Once you have sought help, follow your mental health professional s recommendations in your family s every day life. By working with your mental health professional, your child s caregivers, and your family, you can reduce your child s distress and lessen or prevent challenging behavior. Bringing it All Together Challenging behavior in infants and toddlers can be frustrating for parents and dangerous for children themselves. This course has addressed ways to understand and respond to challenging 10

11 behavior so that children can learn more appropriate ways to express their needs. Here are the major messages we d like you to take home. Challenging behavior is like normal behavior, except that the child uses it too often, for too long, or with too much intensity, and it becomes a problem. There are two main types of challenging behavior: acting-out and withdrawing. Infants and toddlers use behavior to communicate unmet needs to the adults who care for them. In order to correct challenging behavior, parents and caregivers must first understand what the child is trying to communicate. Once the meaning of the behavior is understood, parents and caregivers should work together to meet the underlying needs of the child, which should ultimately lead to improvement in the child s behavior. Children may need to be taught more appropriate ways of expressing their feelings. Thank you for your attention and for your commitment to providing the best possible child care experience for your child. * This course was developed and produced by the Texas AgriLife Extension Service of the Texas A&M University System in cooperation with the Texas Department of Family and Protective Services, Child Care Licensing Division, and using funds provided under the American Recovery and Reinvestment Act of