Rachel, a first-grader, has severe attention-deficit/hyperactivity disorder (ADHD). I first met her in preschool when we ran around my office and my backyard so that I could evaluate her. She never stopped moving. Rachel’s creativity and curiosity burst out of her—and she easily mastered grade-level school tasks. Her family and her school shared the goal of keeping her in general education classes. Medication helped—to a point. The school team and her parents struggled to keep Rachel on track.
At a school meeting, teachers and administrators expressed concerns about Rachel’s movements in the hallways. She never walked in a straight line—she zigged and zagged constantly. Sometimes she turned backward or sideways and moved in that direction for a moment, then returned to her original pathway. She bumped into other kids but didn’t seem to notice. This happened on the way into and out of school as well. In the classroom, she struggled to sit still, often standing up and walking around the classroom while the teacher was presenting material or instructions.
School had implemented behavior plans—counting the number of times Rachel walked in a straight line instead of her usual pattern. They counted how many times she got out of her seat in the classroom and then how long she stayed seated. Stickers and marbles and all kinds of rewards were in place, but she wasn’t earning many points, and she wasn’t much more able to walk in a straight line or sit still.
Rachel began to go to bed on school nights in tears, asking her mother how she could be a “good girl." She thought that not earning the marbles meant she was “bad.” She was increasingly irritable and oppositional about going to school. We weren’t in a good place.
The failed behavior plan story jumps out in many of my first visits with families or with school teams. Typically, many motivators have been put in place—and sometimes punishments are part of the picture (e.g., losing privileges, points, or computer time). But the children aren’t showing improvement. Not only that, but they may also be reacting angrily to the limits or expectations. Their behavior may get worse instead of better.
A Flawed Assumption Behind Many Behavior Change Systems
The traditional responses in parenting and classroom training programs make one single assumption in trying to fix behavioral problems. We assume that a child is controlling their behavior and willfully disobeying behavioral expectations. We might do extensive behavioral assessments that ask why the child won't do what they are told—and commonly kids are described as “attention-seeking,” “avoiding work,” “manipulating others,” or “stimulus seeking.” Yet, regardless of the alleged motivations, the problem is still seen as something the child can change with the “right” rewards and motivators.
For many neurotypically developing children, gentle behavior plans can focus the child and the adult on specific, well-defined goals for newly developing behaviors or tasks. But, for other children, especially those developing outside of the “typical” pathway, behavior plans don’t work and often make things much worse. For children with ADHD, anxiety, depression, obsessive-compulsive disorder (OCD), language challenges, trauma, autism spectrum disorder, and a wide range of other “less-than-visible” challenges, we need to focus on giving them what they need—not trying to fix them.
So what can we do? We start by ditching the assumption that kids want to fail—that they don't want what we want for them. We consider the possibility that the child wants to succeed—wants to get our approval—but isn’t able to. That they can’t do what we ask—not that they won’t. If we start from that fundamentally different place, it expands our toolbox beyond behavior plans.
Self-Regulation Is a Developmental Pathway
Once we have shifted our assumptions, our next task is trying to understand what could be keeping kids from successfully changing their behaviors. And truly—that’s a question worthy of many blog posts. However, there is a central concern that plays a role for many children. It’s a developmental pathway that we don’t often label or identify—but that is no less important than motor, language, or play skills. It’s self-regulation.
Kids’ brains and bodies develop across functions throughout childhood and adolescence. We monitor kids’ development over time. And we have age ranges for typically developing skills— walking, talking, building blocks, social play. We measure these because we can see them. We provide supports and therapies for kids who have delays in these skills, but we don’t assume they can just change their minds to learn how to skip or speak in full sentences at the same time as their peers.
But when children struggle with self-regulation, such as managing big emotions, filtering distractions, or controlling impulses to move or speak—it just looks like “bad behavior.” The developmental challenges are not easy to see outside of behaviors and external emotional expressions. Children who can’t stop moving, or stop calling out so often, or stop drawing on the board and sit down for class aren’t trying to be difficult. They aren’t trying to aggravate us. They are struggling to do differently because those regulatory skills are not as well developed as in other children their age.
Meeting the Child Where They Are in Self-Regulation
So, if a child, like Rachel, is not yet able to control their levels of motor activity the same way most 6-year-olds can, we need to give her what she needs, not try to “fix” her to be like all the other kids. She isn’t like the other kids. We can’t just expect her to do something her brain and body aren’t yet ready or able to do. After conversations with her therapist and her parents, and with Rachel, it turned out she was imagining herself in a video game during all of those zig-zag walks at school.
Once we got a sense of that, we built a plan that gave her some room to zig and zag. We set a goal with her of not bumping into people and objects, which became part of her game. Parents and school worked as a team, with the therapist and me, to find ways to let Rachel move around when she needed to in and out of the classroom—letting her stand and stretch—with the goal of not interrupting others. She could go sit on the floor on a rug, or she could stand and listen. If she was very active, she might be given an "errand" to run—taking something to the library or the counselor’s office. Her parents found opportunities to help Rachel follow instructions without focusing on staying still.
This path wasn’t easy—and there were plenty of evolutions of it over time. Some things worked, and some things didn’t. The shift in our assumption was a game-changer for everyone. Meeting any child where they are developmentally—making sure to include self-regulation skills—opens up new worlds. Kids and adults aren’t on opposing sides wherein the adults try to fix the child. Instead, everyone is on the same team, coming together to give the child what they need to thrive.
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Is Your Child's Behavior Plan Not Working? - Psychology Today
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