Monday, December 28, 2009

New Routines for the New Year

by R. Scott Benson, M.D.

A reader asked what to do before you get to the doctor asking about medication for a child’s school behavior problems. I thought it appropriate to answer that question and take advantage of the tradition of setting New Year’s resolutions.

In general, the answer is increased structure, not punishment. Set routines that head off trouble before it starts. Families can improve structure with a behavior plan. You will get the best success if you focus on one problem area to address and promote a positive behavior that would prevent the problem. And it will take 2, 3, even 4 weeks to see consistent change.

Let me give an example. I asked a second grader “What time do you get up in the morning?” He gave his mother a puzzled look, hoping she would answer the question. But I pressed a little, “Tell me about getting up in the morning.” Now we get the interesting part. “Well, my mother wakes me up, but I can stay in bed. She calls me a couple of times before she sends my dad in. Then I get up.”

Many families do this kind of complicated dance every school morning. Of course, it adds to the parents’ frustration when the same sleepy-head child bounds out of bed early Saturday if cartoon time is scheduled.

One family faced with this fight every morning decided to send Dad first. And they kept score with punch tickets which could be traded for a treat (a special late movie on Friday, a lunch out with Dad on Saturday). And they practiced their lines, “Good morning, this will be a great day.” Or something similar.

Has you family found a different solution to this problem? What are the other conflicts that repeat every day in your house?

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