Wednesday, July 22, 2020

Time-outs or Collaborative problem solving and Co-regulation

It is generally accepted that corporal punishment cannot be used to discipline children because it is abusive causing not only physical pain and damage but also negative emotional and severe traumatic damage. The same negative effects may be caused by how we restrain children who are out of control, put them in time-outs especially for longer periods and also verbal abuse in the form of yelling, shouting, threatening and criticizing. How much more so, when we deal with young children, toddlers and infants who are the most vulnerable of children. Educators acknowledge that punishments and threats, causing children to suffer does not help change their future behavior and at most elicits only temporary compliance. Punishments, even if we use the euphemism " consequences" just generates anger, defiance and  desire for revenge. Moreover, it models the use of power rather than reason and ruptures the important relationship between adult and child. Crucial to the development of young children is their learning to trust a caring adult and learn from them." There are many terrible things in this world, but the worst is when a child as afraid of his father, mother, or teacher. He fears them, instead of loving and trusting them. If a child trusts you with his secret, be grateful. For his confidence is the highest prize." -Janusz Korczak Unfortunately, many children may  look well-behaved, they are not self-regulated , it is fear.

The behavioral strategies to challenging behaviors focus on time-outs and token economy systems using rewards include praise. Time-outs are still problematic because they are perceived by children as punitive and hence cause more stress and emotional dysregulation. Allan Kazdin says the research recommends maximum time-outs of 2 minutes. Howard Glasser sees a time-out as an opportunity to change gears and can be seconds. The child gets a reward for calming down and doing a quick time out. Rewards are also problematic because they are also experienced as controlling, rewards punish when a kid fails to get a reward and they also generate more anxiety in children. Rewards often " hijack " the problem, undermine intrinsic motivation, fail to deal with the underlying problems and teach kids lacking skills. The focus of rewards and punishments is compliance and addressing the adults need from control. They don't support the needs of children, in fact they thwart those needs. Children need to feel unconditionally loved because of who they are and not what they do. Kids receive more love and attention when they do well and learn that acceptance is conditional. Trying to manipulate people or even kids to do things one wants is not moral. I remember a teacher feeling terrible for a kid who was given a piece of chocolate for every time he complied- part of some ABA treatment , treating him as if he was a pet dog.  A mother also complained about rewards in the ABA program – instead of building relationship and intrinsic motivation, the reward offered the child the opportunity to stop what he was doing for a preferred activity and also at the expense of connection with his mother.
The alternatives to rewards and punishments, " doing to " children is " working with"  children include focusing on healthy attachments, being receptive to the child's needs especially in stressful situations and solving problems in a collaborative way with children so that the solutions are mutually satisfactory and address the underlying problems. According to Ross Greene – Collaborative and Pro-active Solutions,  CPS , challenging behavior arises when the demands placed on the child outstrip the skills the child has to respond in an adaptive and flexible manner. In general these kids lack crucial problem solving skills to be adaptive and tolerate frustration. The process of collaborative problem solving not only solves the problem , but solves in a way that the child is picking up various cognitive skills, relationship and trust between the adult and the child is enhanced and we are supporting the autonomy of the child instead of fixing the child. This occurs when we try to see the problem from the perspective of the child, when we drill-down to understand their concerns and they share in generating the solution. The forerunner of problem solving approaches is Myrna Shure's  "I can problem solve " program and book " Raising a thinking child. Based on 25 years of research the approach does not teach children what and what not to do and why, but rather , it teaches them how to think so they can decide for themselves what and what not to do and why. The process involves teaching the vocabulary for problem solving including " word pairs ". Myrna Shure says her approach works for kids as young as three. Ross Greene says that children as young as three have a problem solving vocabulary, but we in fact collaboratively problem solving with non-verbal toddlers and infants. Observing their behavior, their chief mode of communication gives us an idea and clues about  their needs and concerns. We respond to their cues-  cries, laughter , their facial and other non-verbal language with our words, and plenty of non-verbal language .It is detective work , but it is collaborative. While a child's verbal skills may be lacking , their language receptive skills are more advanced so we can help them use sign language – thumbs up or thumbs down, the five finger method , the colors of the zones of regulation to help a child communicate how he is feeling.  We can narrow the focus by using Yes/No questions, then ask , can you tell me more ? We can make tentative suggestions about what we think is the concern or problem and then ask a Yes/no question. We can suggest solutions. We can use the work of Myrna Shure to teach collaborative problem solving language, a vocabulary to express needs , concerns or a perspective, feelings etc .  We can use google pictures depicting problems and possible solutions. Problem solving is a slow process in which we need to give the child a time to think and not rush them into a solution. We need to then role play the solution, show them the procedures of doing things. And let them role play. Problem solving of course is best out of the moment. Out of the moment we can also focus on building skills and bonding- creating relationship by using guided participation , joint attention in the various activities in the home or garden. R.D.I – Relationship Development interventions helps the child to see the parent as an ally and seek their guidance.

Mona Delahooke explains why rewards , consequences fail and what the child needs is co-regulation. Her work is based on Brain science of Dr Dan Siegel -  and Stuart Shanker

Co-regulation means engaging a child emotionally with empathy and slowly trying to direct a child away from his emotional brain to using his prefontal-cortex , so thinking can take place.

The Monitor on Psychology’s October 2019 article, “Teaming Up to Change Child Discipline” described how parenting advice such as “spare the rod and spoil the child” is now debunked and outdated. This is an important shift, considering that 60% of children aged 3-4 in the US are spanked by their parents. In regards to the progress we’ve made in the parenting arena, the article cites alternative approaches including, The Incredible Years, Triple P-Positive Parenting, and “1-2-3 Magic” as more progressive. Here’s where I disagree. All of these approaches, including the publicly funded Parent- Child Interaction Training (PCIT) condone time-outs as a modern parenting disciplinary tool. Our interventions will depend   on knowing  the difference between top-down and bottom-up behaviors.
Bottom-up behaviors are instinctual and unintentional. They are survival-based stress responses, and operate through the activation of the brain’s threat-detection system. Infants only have bottom-up behaviors. They are called bottom-up because they come from cues in the body and areas of the brain that are driven by instincts.
Top-down behaviors are deliberate and intentional. Top-down thinking and behaviors develop over many years through connections to the prefrontal cortex of the brain. They are called top-down because they are literally driven by the top part of our bodies, the “executive function” center of our brain.
These two types of behaviors have completely different causes and should lead to very different solutions depending on the type of behavior. But this isn’t happening. Too many approaches to helping behaviorally challenged children and teens are based on the assumption that all challenging behaviors are alike.  And the main way we solve them? Punishment.
·         Me - the top down behavior may be influenced by rewards and punishments but only to the extent of short term compliance , usually feeling compelled and forced , displaying amotivation . This brings us back to the question of motivation and in particular intrinsic motivation - when kids needs for autonomy, competence and relatedness are met , kids will be more self determined and their well being advanced- Self Determination theory. So with bottom up behavior rewards and consequences won't even buy short-term compliance and behavior  behavior.
I don’t believe time-outs are progressive because we know more about human behaviors than ever before. We now know through brain and developmental science that there’s something even more foundational than teaching or discipline. It’s called emotional co-regulation. The shift I propose is understanding that emotional co-regulation (helping the child’s emotional journey causing the behavioral challenge) is the new paradigm.
While time-outs were a leap forward from corporal methods such as spanking, they rely on a false assumption: that all behaviors are motivated and incentivized and thus susceptible to teaching the child a lesson. This is a false assumption because many childhood behaviors are not the result of deliberate malintent or misbehavior, but are instinctive responses to stress. When children can’t connect to caring adults to reduce their subconscious perception of threat, they experience stress responses, which often show up as behavioral challenges.
The popular programs described in the Monitor’s article are agnostic of the powerful force of the autonomic nervous system on childhood behaviors. This popular paradigm views all behaviors as incentivized and motivated, rather than instinctual and safety-seekingWhen we view behaviors from the lens of safety-seeking, we find that soothing the child through our gentle interactions (emotional co-regulation) is the answer, not issuing consequences.
Relational safety and the neuroception of safety sets the floor and then we do what the parent and child need in the moment to stay safe, and feel calm enough to think. 
The Monitor article thus fails to ask the most important question when it comes to discipline: is this a purposeful misbehavior or a response to autonomic stress? If it is a response to stress, then any technique that blames a child’s intentions—will be ineffective. The reason? All techniques that degrade the social engagement system increase autonomic distress. The parenting programs mentioned in the article suggest time-outs when a child’s behaviors increase in severity or the child doesn’t respond to positive reinforcement. On the contrary, in the shift I’m proposing, when a child’s behaviors increase in severity, that’s a sign that the child needs more engagement and not less. 
ME- More engagement of course means we don't impose our help on the child if our attempts to calm him down, just escalate the child's emotional reactions. A time-out is forced isolation and separation. Leaving a child , but sitting close by without intervening except by offering a child something to drink or a snack, or asking if he would like to calm down in a / his " comfort corner " is not time-out. We are still providing the conditions to help the child self-regulate.
I respectfully submit that many popular “evidence-based” parenting programs are working from a simplistic model that measures compliance and other easily tested outward signs of “progress” but leave out the child’s physiology. A child may look more compliant after a time out, but will likely also be more stressed internally. 
So what can we do to update parenting practices for behavior challenges? Replace them with tools that are inclusive of the human drive to feel safe. The message for teachers, administrators, and parents: Instead of trying to extinguish unwanted behaviors, we should shift our paradigm from behavioral compliance to physiological safety. As a clinician, I have found that the subconscious perception of threat underlies most challenging behaviors, and the solution isn’t through a time-out or “counting to three,” but through social engagement.   As Alexander Van Hiejer says, “When a flower doesn’t bloom, you fix the environment in which it grows, not the flower.”
 It's about bringing a neurodevelopmental lens to our outdated methods of working with children's challenges. Mainstream psychology hasn't kept up with neuroscience and is still enamored with behaviorism and reinforcement schedules. Until we realize that the intervening variable of physiological state influences a child's behaviors, and that emotional co-regulation is the pathway to resilience, providers will continue to use outdated models that don't place emotions and relationships at the center of all interventions.
I share more about how we can understand and support children in my latest book, Beyond Behaviors.