More Behavior Intervention

For the first few days after we saw Gerome last week, I thought to myself "maybe he came for nothing." I didn't see Joshua banging his head all that much. However, I realized later that it was because he was sick. All I did Thursday and Friday was hold, rock and cuddle with him. Then on Saturday as we continued to wrangle with our taxes (which are finally done and filed, praise God!), he started back to his headbanging behavior. I'm still not sure he's 100% himself, though. I wrote down 85% of the episodes to record the A-B-C to discuss with Gerome at our appointment today. And again, I learned a ton in the hour he was here.

Our goal is to direct Joshua to a different behavior as a result of the antecedent to get the same consequence he's looking for. So, A with "New B" will now equal C, rather than the "old B" of banging his head. Most of the times, Joshua's headbanging came out when he was frustrated over us limiting his behavior. For example, when we told him that he can't touch the keyboard when Daddy is doing taxes, he banged his head on the desk. Then we would pick him up. We saw this type of scenario repeated over and over again. Gerome said that focusing on things Joshua can do in conjunction with the limitations will help him. And, he saw me trying to re-direct Joshua's behavior and said I should take it one step further. Instead of saying, "instead let's play with the truck" and hand it to him, I should actively engage in also playing with the truck, which will interest Joshua more.

Suggestion #1: Actively engage in playing to re-direct frustration.

Gerome said to plan to take five minutes of uninterrupted play time every time Joshua bangs his head. At first, it's going to seem like all the time (especially since Joshua is banging his head several times an hour) but eventually the Bean will get used to finding something else to do instead of banging his head. He said this should occur even when we're making dinner, etc. for starters and then as the behavior diminishes, it won't feel like it's a burden.

Suggestion #2: Focus on the Do's Rather than the Don't's

Realizing that many times, Joshua is banging his head when he's frustrated as the beginnings of a temper tantrum, Gerome said to try not to say "no" for an entire week and instead think of what Joshua can do instead. So, if Joshua is playing with his sippy cup and spilling milk everywhere, instead of saying "we don't play with and dump our sippy cup" focus on the positive, "Joshua, let's drink with our cup instead." Gerome likened it to a book he read recently on investing. The first half was everything NOT to do. He was tired of the book in the beginning going, okay, well what can I do? The last half of the book focused on the positive aspects. He said we're more direct when we focus on what we want the child to do rather than what we want them NOT to do. He gave the example of saying "don't clasp your hands together." Instead, we should say "let's open up our hands" because this directs the child to respond and behave in the way you want them to. I tried practicing it already, and it's going to take some work for me. It definitely doesn't come naturally. After Gerome left, Joshua and I were eating lunch and he picked up his bowl to dump out the food on his head. I said, "nnn...honey, let's put the bowl down and eat out of it." Now, I wish I could say Joshua said "okay, mom, that sounds like a super idea!" but he didn't. That said, I'm not sure me saying "no!" would have made a big difference either. I made the request and then asked if Joshua was all done (which he now shows us with opening his hands...so adorable.) So, I'm going to accept the challenge and try to eliminate "no" from my vocabulary and be creative with what we should do instead.

Suggestion #3: Soothe Joshua while working ourselves out of the equation.

Right now, we're picking Joshua up most of the time to soothe him when he's in an outrage. Gerome said to first try and walk with him, holding his hands, over to a new activity. If Joshua still can't calm down (which Gerome saw today), then go ahead and pick him up and soothe him. But, at the same time take this as a teaching moment to help Joshua become able to soothe himself. Maybe we give him a soothing teddy bear that we hold with Joshua. Then, Joshua gets the bear and he sits on our lap. Then he sits next to us with the bear, and eventually he'll be able to go get his bear and take a few moments to calm down.

Suggestion #4: No Timeouts or Negative Reinforcement

I told Gerome that the pediatrician had said to put Joshua somewhere safe and ignore him. Should we try not holding him and putting him in the pack 'n play? Gerome said that most times, children really don't need a timeout or a spanking. He said timeouts are so popular these days and are typically not used the right way. Most times, if the child is old enough to understand a timeout, they are old enough to understand re-directed behavior. Instead of putting the child away, we should encourage the child to do something else that is constructive, which will lead them to thinking of that on their own. And, he said that we should hold Joshua and listen to his needs. Right now, he's asking for attention, showing his frustration, and unable to communicate in other ways. So, it's okay to show him love and attention and meet his needs. In the meantime, especially since headbanging can be harmful to him, we want to show him a better way to communicate and get his needs met. Through working together, we should be able to eliminate this negative behavior when we focus on the positive. So, maybe we avoid eye contact or lots of talking when we pick him up when he headbangs. But, when he comes to us in a different way, we go all out to tell him how excited we are that he's communicating in a better way, lavishing him with praise and attention.

Suggestion #5: Build Play & Communication

So, how are we going to help Joshua? By building play time. Gerome suggested putting all our toys away into containers where we have to get them out for the Bean to play with them. If we had chocolate cake sitting on our counter everyday, it wouldn't be as exciting as it would be if it were only available on special occasions. In the same way, the same old toys out and available for use everyday isn't exciting or interesting to Joshua. We should put some back for special occasions. Likewise, Gerome suggested that three times a day for 15 minutes at a time, we should try to develop a new skill with Joshua or a new 'play.' It doesn't really matter if he understands or not, the important thing is that we're interacting and he has our full attention. Gerome suggested setting up stations where one station is building blocks, another is puzzles, maybe another is play-doh. (He strongly recommended toys that don't make noise for building play.) This is exploration time and we try to teach him a new skill, rotating activities every five minutes. We let Joshua set the pace and direct the activity. In the meantime, we try to build his vocabulary. When we're interacting this way, it will give us time for Joshua to practice saying "help" and other things and he'll be learning more. Likewise, if we find something he really, really enjoys, we can use that as an activity we go to when he's banging his head. Instead of saying "no" we can go do a fun activity together.

There was even more we talked about, which I excitedly told Shawn about when he came home. We're going to try these techniques for a couple weeks and see how it goes. We're to call Gerome if we need help or pointers, and if he doesn't hear from us, he'll call us in a couple weeks to set up another appointment. He said we can always schedule more time together if necessary, but it will make more sense to give some time in between to see what works and what doesn't. I'm thrilled to learn all these new things and a little intimidated. But, I know I have to change my behavior before I can expect Joshua to change his. Please pray for us both that we can learn and grow!