Not every child has a behavioral disorder, but when you encounter it in your work field, for example, it is wise to have some information about it so that you can respond better to the child. This article describes three behavioral disorders, namely ADHD, ASD and the lesser-known DBD. In addition, the interventions for each behavioral disorder that could possibly improve communication with a child who has a behavioral disorder. For behavioral disorders, the interventions can be aimed at the parents, at the young person themselves, or at the family. Research published by the NJI in its documentation has shown that interventions aimed at learning social and problem-solving skills have the most positive effect on the progress of a young person with a behavioral disorder. Horeweg has in his book; Behavioral problems in the classroom, a practical handbook written for teachers who deal with children who have behavioral problems.
Attention deficit hyperactivity disorder (ADHD)
Attention Deficit Hyperactivity Disorder is a congenital behavioral disorder that is common among children, namely three to five percent. In addition, ADHD has a high persistence into adulthood, meaning that this behavioral disorder can often continue until a child reaches adulthood. This behavioral disorder is therefore chronic, which means that long-term treatment and guidance is required. There are three core symptoms of ADHD, namely inattention, hyperactivity and impulsivity. This behavioral disorder cannot be cured, but guidance and treatment can normalize the behavior associated with this behavioral disorder. In addition, medication can also offer this solution.
Within ADHD, the characteristics can be present to varying degrees in a child. Three forms are therefore distinguished within the behavioral disorder ADHD. ADD is the first form, affecting children who mainly have difficulty concentrating. Hyperactivity and impulsivity may occur, but are not the main feature. The second form is ADHD, in which a child’s main characteristics are hyperactivity and impulsive behavior. These children can be quiet, and are therefore always busy.
Finally, there is the combined type, i.e. ADHD/ADD, where a child has a combination of both forms. For diagnosis, the symptoms must be present in at least two environments and must be present before the age of 12. Comorbidity is common with ADHD, meaning that this behavioral disorder often accompanies other disorders and problems. Heredity plays the main role as a cause of ADHD, but ultimately the development of ADHD is determined by hereditary predisposition and the educational environment.
Interventions
- Make the expectations clear to the child in advance and what behavior is considered desirable. The child will quickly forget appointments, so repetition is important. It is important to clearly identify the target behavior that you want from the child. Above all, do not specify what the child should not do. So instead of telling a child not to be so busy, it is better to ask whether the child would like to be a little quieter.
- The child must be given space to move, so do not force him to constantly stand or sit in the same place.
- Set clear boundaries for the child, but don’t see everything. So don’t talk to the child about every little thing.
- Use interactive instructions, because participating often works better for these children than listening. This can be done, for example, by asking questions during the instructions.
- Help the child make a step-by-step plan, so divide what he has to do into steps so that he does not lose the overview.
- Encourage the children a lot in a positive way as they get started with an activity. Give the child a pat on the back or other positive gestures every now and then to improve the bond with the child and give the child more self-confidence.
- When a conflict has occurred, ask the child what went wrong and whether he knows what he could have done differently, explaining this himself if necessary. This will have to be repeated with every conflict, because children with ADHD often hardly learn from events.
Autism Spectrum Disorders (ASD)
ASD is a congenital behavioral disorder characterized by developmental problems in social and communication skills, such as delayed speech development and inability to coordinate verbal and non-verbal behavior. The second main characteristic is the limited and repetitive behavior. In addition to these two core problems, there are often also problems in other areas, such as reduced imagination and imagination, problems in the area of motor development. Five different types of autism are distinguished, namely Autistic Disorder, Asperger’s Disorder, Rett’s Syndrome, Disintegrative Disorder and Not Otherwise Specified or PDD-NOS.
The symptoms of ASD are most prevalent in autistic disorder. The problems in the development of social and communication skills often also cause problems in other areas, such as hyperactivity, mood disorders, aggression, epilepsy and self-mutilation.
Asperger’s disorder, like autistic disorder, has problems with social and communication skills, but there is no delayed language development and cognitively these children also develop normally.
PDD-NOS means that there are social and/or communication problems, and a so-called rigidity is present, just like with the autistic disorder, but it is not sufficiently visible, so the diagnosis cannot be made.
Rett’s disorder occurs almost exclusively in girls, with normal development until about six months to a year and a half. Subsequently, development deteriorates and the learned skills disappear, in combination with social and communication disorders. There is a genetic cause behind this.
In Disintegrative Disorder, children initially develop normally until they are at least two years old. After this, they lose a large part of the learned skills and similar problems arise as with autistic disorder.
Fortunately, Rett’s Disorder and Disintegrative Disorder are very rare. Comorbidity is also common in ASD. ASD is known to exhibit many psychiatric symptoms, and forty to sixty percent of individuals with ASD also have an intellectual disability. In addition, there is also an increased risk of epilepsy in people with ASD. The cause of ASD lies in several genes, but interaction with the environment also plays an important role in the development of ASD. ASD cannot be cured, but symptoms can be reduced and development can be promoted through appropriate upbringing and education, and possibly appropriate medication.
Interventions
- Do not use vague open questions, but ask the child specific questions. Use only the necessary words, and preferably no imagery.
- Give clear instructions to the child. The Give me the five principle can be used, namely what, when, with whom, where and how.
- Agree with the child a clear place where he or she can retreat.
- Do not punish the child in conflicts, because the child will not learn anything from that. Then talk to the child and explain the cause and effect, in order to understand the logical consequences of his actions.
- Formulate rules in a positive way, so don’t: Don’t spill the glue, but; try to work neatly with the glue. In addition, it is often useful to explain why the child has to do something, because otherwise they often do not understand why they should or should not do something.
- When a child is angry, do not maintain continuous eye contact and do not demand this from the child, this only gives more stimuli to the child. Also, do not touch the child unless necessary.
- Be considerate of a child’s personal space, especially when the child is not feeling well. So literally keep a little more distance.
Disruptive Behavior Disorders (DBD)
DBD consists of two behavioral disorders: Oppositional Defiant Disorder and Conduct Disorder. When various rebellious, antisocial or aggressive behaviors occur repeatedly over a long period of time and have a bad influence on the functioning of that person, it is called ODD/CD. ODD means oppositional defiant disorder, which is a kind of mild form of antisocial conduct disorder. Oppositional defiant behavior involves severe resistance to adult guidance. CD means antisocial behavior disorder, which is a more serious form than ODD. Antisocial behavior is endangering the rights of others by, for example, fighting or stealing, but also violating social norms and rules and aggressive behavior. ODD and CD often go together. This can take the form of a child first having an oppositional defiant disorder, and then developing an antisocial behavior disorder, whereby symptoms of the oppositional behavior disorder often remain visible.
In addition, there are also children who only show an antisocial behavior disorder in adolescence. It is also possible that a child has ODD after which the disorder disappears, or antisocial behavior disorder does not develop. Children who show antisocial behavior disorder early on have more aggressive symptoms, more comorbidity with other disorders and there is more persistence of the behavior disorder into adulthood. ODD and CD arise from a combination of one or more child factors and environmental factors. The interaction between a child’s characteristics and an environment that responds to this in an incorrect way can be a cause of this behavioral disorder. The environment is shaped partly by the child’s factors, but also by the characteristics of the parents and the family. Comorbidity actually always occurs with these two behavioral disorders, such as the combination with ADHD, anxiety disorder and reading and language disorders. Treatment can prevent the conduct disorder from developing further, and may not continue into adulthood.
Interventions
- Set clear boundaries for the child with positive rules. In the event of a conflict, make a choice from two alternatives from which the child must choose. State succinctly in advance the consequences if the child exceeds the limits.
- Give the child a time-out place when he does not follow the rules. Place him here immediately, and only briefly explain why he should be there, do not argue with the child. Do hold the child responsible for his actions. Only start a conversation later and ask the child, for example, how he would feel if someone else did something like that to him, so that the child becomes aware of his own behavior and choices. Stay as businesslike as possible.
- Make sure the child stays busy, because often when the child has nothing to do, he or she starts to act annoying. For an activity, first tell the child why we are going to do something, and only then what he should do. Then there is less chance of discussion.
- Do not use sarcasm and give the child clear messages, use the word now when the child needs to do something immediately. Do not give assignments in question form.
- Give the child lots of compliments, even about small things, and talk to the child about his activities. The child needs to know that you are there for him despite everything.
- Do activities with this child that are not too demanding, so that it is certain that the child can complete the activity. The child is much more likely to become frustrated when something does not work out, for example, and so there is more peace in the group.
- Talk to the child, and don’t just talk to him. This way, the child thinks more along when discussing a rule, for example.
