Emotional Outbursts in Public (March 2012)

The Behavior Corner
Presented by Deborah Whitman BCBA

Column 2- March 2012
What will people think?!
Dealing with non-compliance and
emotional outbursts in community settings

One of the most frequent issues I am asked about and one that was posed to me as a column topic was how to handle your child when he or she refuses to follow your directions or has an emotional outburst in public or, even worse, at a relative’s house! Many of you are very well versed in basic behavior management and know that ignoring outbursts often decreases their length and intensity and that negotiating with a non-compliant child only makes them more likely to be non-compliant again. You are able to generally ignore these behaviors in the privacy of your own home but it becomes a very different scenario when these behaviors occur in public view. Although the tiny behavior therapist on your shoulder is telling you that you should be consistent and ignore the behavior, the tiny person on your other shoulder (your mother, your friend, your neighbor) is telling you that people are watching, that you are making a scene and that you need to do something or you’ll look like a bad parent. Stray looks from people around you give largely the same message. Even if you are one of those few enlightened people who really don’t care what people think you still don’t like to see your child’s issues publicly displayed and his or her privacy and dignity compromised. So what can you do?

HAVE A PLAN
The most important advice I can give is to have a plan. If your child is prone to these types of behaviors, don’t leave home without first planning what to do when an outburst occurs. It is also important to note that the plan for what to do outside of your home is almost always different from what you do inside. But, as long as you are consistent with both plans, they should work.

Your plan can be simple but must answer several important questions:

  • What is motivating my child’s behaviors?
  • How can I prevent the behavior before it occurs?
  • What intervention would be best?
  • What intervention is possible and what are the limitations based on the setting?
  • What can I be consistent and comfortable with?

WHAT IS MOTIVATING MY CHILD’S BEHAVIOR?
There is a lot more than can be said about motivating behavior but for the purposes of this column please know that your child’s behavior, like your own, is almost always motivated by one of four different functions: attention, escape, tangible or sensory issues. In certain situations power and control can also be motivators.

The first thing you need to determine is “What is my child getting out of this behavior?” To answer this question typically you need to think about what happens after the behavior. Does your child get to leave an environment that he didn’t want to be in? Does she get an item that you previously said she couldn’t have? Do you give him attention?

If your child immediately gets your attention either because you begin to negotiate, reprimand or cajole them, then your attention is maintaining this behavior. If your child typically gets taken out of the environment quickly after the non-compliance or emotional outburst occurs then the behavior is probably prompted by escape. This could be because they are tired of the environment or there is too much sensory stimulation. If in the past, your child has gotten a toy or ice cream after an outburst, then tangible functions are maintaining the behavior. Once you have determined the cause, you are ready to make create your plan.

PREVENTING THE BEHAVIOR
All of us as parents like to imagine that when we enter the community our children are going to behave. “This time it will be different!” or “I don’t think he will mind one more stop…” But the best rule of thumb is that it is better to have a plan and not have to use it then to not have a plan and be forced to react to the situation. The first thing I always recommend that parents do is “front load” interventions. Take precautionary steps. If you know your child could plop down on the floor in the middle of the restaurant and refuse to get up, or scream at the top of his lungs in the middle of the grocery store, have a plan for prevention. Front loading means putting together your plan and its consequences, both positive and negative before the behavior has occurred and making the child aware of it.

Know Your Child’s Limits
One of the most important things to remember when preparing your plan is to know your child’s limits. If even under the best circumstances, your child cannot handle an entire morning of errands without a TV break then don’t set them up for failure. If they are sensitive to noise don’t go into a loud environment without preparing them and don’t make it the last errand of the day. Practice the steps needed for them to be successful and build on each small success. It is better to make several shorter but successful trips to the grocery then one long unsuccessful one.

Know Your Own Limits
It is just as important to know your own limits as your child’s. Don’t set yourself up for failure either. If, for example, you know that you will not be able to ignore a behavior when you are visiting your family then don’t make that part of your plan. It is better to use a second or third choice for your intervention (something you can do consistently and feel good about) instead of setting up a plan that you know you cannot consistently follow.

Examples of Planning and Front loading
There are scores of examples of possible scenarios you may encounter. Here are just a few with some suggestions to give you an ideas on how to make your own plans.

If you child gets upset in the grocery store:

1.     Allow your child to pick one or two items out as soon as you enter the store.
2.     Give your child a list of items to find in the store with or without you and check them off. When he finishes his “scavenger hunt” he will get a prize preferably some preferred item in the grocery

If your child plops down after you have done errands and refuses to go on:

1.     Make a list of places you need to go and have your child cross each one off the list as you get there. Make a preferred activity or special treat the last errand. If you child is pre-verbal then make pictures.
2.     Make a contract with your child before leaving the house. “If we get all the errands done cooperatively then we can…” (stop for ice cream, get baseball cards, play a video game). “If we don’t get all the errands done cooperatively then we will not stop.” Don’t make idle threats or promises that you will not see through.
3.     Tokens/coins- give your child one token or actual coin for successfully completing each errand. Then at the end of the trip they can cash them in. This is also a great way to teach money value. If you use real coins, go spend them.

If your child is going to have to go somewhere you know they dont want to go (ie. someones house, a party, the dentist):

1.     Use First and Then cards
Give your child a card that has the word “FIRST” with a space and “THEN” and a space (card stock or a laminated one work best). Put the words or pictures for the non-preferred activity FIRST and THEN the preferred activity.

  • FIRST we are going to the dentist and THEN we can go to Game Stop.
  • FIRST we are going to the soccer game and THEN we can go for pizza.

 2.     Set up a Transition Activity
Pick a favorite game, for Nintendo DS, iPhone or other device that can only be used in transport to and from a non-preferred activity.

WHAT TO DO IF THE BEHAVIOR OCCURS – SOME POINTERS
If despite your best preventative efforts your child still engages in inappropriate behavior you should try to respond rather than react.

Don’t Shout or raise your voice
Remain calm don’t shout or raise your voice. I say this both because long term it isn’t the best consequence and your child will quickly become accustomed to it but also because if you shout you appear to your child and to all of those around you that you are not in control. Appearing to be in control is a very important part of handling an outburst.

Review the plan
Remind your child quietly of the plan you made, what they need to and what they will earn. Then give them a chance to turn it around.

Use gentle prompting
After reminding your child use gentle physical prompts to guide them back to where they need to go.

Ignoring the behavior
If your child typically engages in the behavior for your attention, try to ignore their outbursts while quickly and gently moving them out of the public place. An effective way to use planned ignoring, even if you need to physically assist them in moving, is to not speak directly to them, avoid eye contact and move quickly. Once your child has calmed down and is compliant again you can engage them.

Review and Move on
If your child has sufficient verbal skills you can calmly review with them what happened and what the consequences are and then move on. Do not continue to discuss it or remind them of the incident as this can actually backfire and give them more attention.

Here are two examples:

“I am sorry Johnny but we will not get the ice cream because you did not stay at the table at the restaurant. Hopefully next time you can make a different choice.”

“I’m sorry Suzy our deal was that you would walk with me through the grocery store and then you could play Wii. But since you did not walk through the grocery store nicely, there will not be Wii when we get back.”

After going over the behavior and the consequence, change the subject. It’s important to avoid engaging in new negotiations. I suggest that you don’t go over the plan or the consequences until you are back in the car or at home and out of the public situation.

REMEMBER: If you child did make the right choice make sure to go over this in a similar but positive way.

“Johnny I am so happy that you stayed at the table at the restaurant. Now we will stop for ice cream! That was our deal!”

“Suzy you were great in walking through the grocery store! Now, when we get home you can play Wii! Nice job!”

It would take pages and pages to adequately cover every situation you might face out in the world. Instead I invite you to please ask me follow up questions or present me with examples and I will be happy to do another column on this topic.

FOR NOW JUST REMEMBER A FEW KEY POINTS:

1. Know your childs limits and respect them (don’t do 10 errands when you know they can only manage 5)

2. Know your own limits and respect them – set up a plan that you can manage

3. Have a plan – Front load it, letting your child know what they can expect for both positive and negative behaviors in different situations

4. Stay calm

5. Follow through – both with positive and negative consequences

6. Move on – review what happened and then let it go so as not to give more attention

Good luck and see you next month!
Debbie