Areas of Specialization - Children and Adolescents
Behavior Problems in Children and Adolescents
Attention Deficit Hyperactivity Disorder (ADHD) - Children and adolescents with ADHD often have difficulty concentrating, exhibit low frustration tolerance and are easily bored as they move from one incomplete task to another. These children tend to be impulsive and hyperactive as they insufficiently consider problem situations or follow directions and their schoolwork reflects significant inconsistencies in quality, accuracy and speed of completion. Thus, children and adolescents with ADHD often experience conflict at home and school, have poor academic performance, and difficulty initiating and sustaining friendships. Cognitive behavior therapy for ADHD concentrates on teaching problem solving and self-control techniques, social skills training, and organizational and time management strategies for improved academic performance and peer relationships. Anger control training additionally teaches a combination of cognitive restructuring and inhibition of aggressive and impulsive behaviors through self-regulation and relaxation techniques. Parent skills training (described below in Parenting), education about ADHD, and collaboration with teachers and schools are crucial components of successful treatment.
Oppositional Defiant Disorder (ODD) - All children have times when they are oppositional, especially when they are sleepy, hungry, or stressed. During these periods, children may be argumentative, talk back, become easily annoyed, disobey and defy their parents and teachers. Oppositional behavior is a normal part of development and frequently appears in two to three year olds and early adolescents. However, when these behaviors occur at greater intensity and frequency compared with other children and adolescents of the same age and developmental level and when it negatively impacts family, academic and social functioning, it becomes a serious concern that requires intervention. Parent skills training (described below in Parenting) can interrupt these negative patterns of behavior. In addition, the inclusion of school based interventions may be a necessary component in developing a comprehensive treatment plan to address oppositional defiant behaviors occurring outside the home.
Enuresis
(Bedwetting) - Enuresis in
children is repeated urination during
the day while wearing clothes and/or
nighttime bedwetting. During periods
of stress or transitions children
may wet themselves and they are
typically ashamed and distressed
by their accidents. Behavioral treatments
generally include: Retention control
training in which a child is taught
improved control over their bladder.
This is accomplished by attending
to bodily internal cues and rewarding
subsequent urine retention in increasing
time increments; Cleanliness training
is intended to teach the child to
be responsible for making their
own bed and removing any wet bed
linens; and Awakening training during
the intensive training period entails
positive practice and rewards for
dryness during the night.
Behavioral treatments generally
include:
• Retention control training
in which a child is taught improved
control over their bladder. This
is accomplished by attending to
bodily internal cues and rewarding
subsequent urine retention
in increasing time increments;
• Cleanliness training is
intended to teach the child to be
responsible for making their own
bed and removing any wet bed linens;
and
• Awakening training during
the intensive training period entails
positive practice and rewards for
dryness during the night.
These are just a sample of some
behavioral interventions that may
be appropriate to treat enuresis.
Thus a comprehensive assessment
is necessary to develop a behavioral
treatment plan that is tailored
to the child's unique needs and
circumstances.
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