Behavior Problems
At one time or another, all parents have concerns about some of their child's behaviors. It is the pediatrician's role to help determine if this behavior is within the realm of normal (at the same time assisting with any necessary intervention) or if the problem signals a more serious disorder. A temper tantrum, "picky eating", or resistance to toilet training might be perceived by the parent as a problem, yet the pediatrician might recognize that the behavior is within the realm of "normal." The parents will often seek advice from the physician, and the physician is in a position to offer assistance through counseling. We refer to these as "normal behavior problems."
Discipline
Often parents do not have sufficient guidance on how to effectively discipline children. It is not always intuitive how to get children to follow directions or rules and how to teach them new skills. If parents do not have family members to teach them, are not connected with other parents, or do not seek reading materials on their own, they may be frustrated at how difficult it is to get their children to behave in expected ways.
The pediatrician can be of help in discussing effective discipline techniques. However, a common mistake is giving 1-2 minute advice at the end of a clinic session. If it were that easy, the parent would likely have already discovered this method. It may be more effective to set aside a separate visit with the family to discuss strategies to improve compliance with rules and following directions. Another strategy may be to provide reading material (handouts or references to books) for the parent to keep or read and return.
Some of the most important messages to give parents about disciplining their children are listed here:
- Children may have bad behaviors, but they are not bad children.
- Words hurt, so be careful what you say.
- Rewarding good behavior is more effective than punishing misbehavior.
- Children need praise
- Punish to teach, but never in anger.
- Children can be disciplined without hurting them.
- It is important to follow through with what you say (i.e. avoid idle threats).
- Spend time with your children - teaching them, reading to them, playing with them, loving them
Common Problems
Common problems about which parents might seek the pediatrician's help include the following:
- tantrums
- picky eating
- head-banging
- sleep difficulties - not wanting to go to bed, and/or waking in the night and not being able to return to sleep without parental intervention
- toilet training difficulties
