The Phoenix Child Magazine - Fall 2007Tracking Behaviour Change in your Child

The growing trend towards researched proven interventions in helping children and families has certainly led to greater specification within the field. Entire books are commonly developed around a single behaviour in need of change, such as how to get your child to sleep in his own bed, how to expand her meal repertoire, and how to establish more effective communication with teenagers. With the significant amount of research dedicated to exploring these techniques, a couple of principles become clear: relationship variables are recognized as paramount to the success of any technique. Further, some interventions have consistently demonstrated long-term effectiveness and clinically significant change, while other methods are unlikely to produce desirable gains and can even be harmful to both children and their families. With the large discrepancies in success rates, it is no surprise that parents are now more critical than ever in the strategies they commit to – time and effort appears to be the norm in the implementation of these techniques. Alongside more empirically supported thinking, tracking the success of interventions has indeed become the standard. Yet one of the common themes of parent confusion surrounds gauging the effectiveness of the strategies that they have been diligently working at with their children.

Individualized Program Plans (IPP) at the school level were developed with the purpose of assisting children and teens experiencing academic and social challenges. The IPP document identifies who will make up the team, what strategies will be attempted, and how/when the effectiveness of the techniques will be monitored. A more formalized measure of assessment typically begins the process and provides a baseline for the skills or behaviour in question. The ranges of measurable issues can be limitless, from current reading levels, to peer conflict situations at recess, to remaining seated while completing independent work. The next step is to decide upon strategies that will be implemented over the duration of the interval. Finally, the behaviour will be reassessed at the goal deadline to determine if the strategy was indeed successful at closing the gap between current functioning and more desirable levels of functioning. Of course, one of the greater confounding variables in this process surrounds the tracking system itself. Without proper monitoring at both the pre- and post-levels of assessment, the end result can turn into a science experiment without any objective data. In the end, one is left with mere opinion and subjectivity.

Such is the reason why any skills or behaviours must be broken down into more concrete and recordable units. The possibilities for this endeavor are unlimited. For remaining seated during independent work time, one teacher might utilize the actual amount of minutes (in a percentage-based system) spent in his or her chair during math or writing activities, while another teacher may utilize a more negative system that tracks the number of times they have had to reprimand the child during independent work time. In a different example, a common complaint from parents attempting Time Out procedures is the duration of severity of raging behaviours that occur while the child is in the Time Out setting. These parents (who will soon experiment with methods such as wearing headphones and ignoring the outburst so as not to provide negative attention), will ideally utilize a timer and jot down the length of time it takes for the child to noticeably calm him or herself behind the closed door. Many parents who visit my clinic relate that while interrupting the temper outburst to soothe their child might produce immediate stoppage to the tantrum, the long-term effect may be that raging outbursts are actually longer and more intense – as if their child caught on that screaming longer and louder works to end the Time Out.

The following is a tip to help parents better organize their intervention and increase the effectiveness of the techniques they attempt. After deciding how such skills and behaviours will be concretely and objectively defined, a baseline must be established. A baseline should be considered the amount of times that this behaviour occurs over an agreed-upon stretch of time (at present). Parents would ideally continue utilizing methods and strategies the way they have in the past (in spite of the fact that these past strategies proves ineffective). New techniques should not be implemented during this week. For tracking many behaviours, I recommend the use of golf tickers (golfers use these to track the amount of shots they take – they can be found in any golf store). The idea is to have the device available (e.g., in your pocket) at any time. For some behaviours that are difficult to track over an entire day, I recommend choosing a consistent one-hour period each day (e.g., dinnertime). In nuclear family situations, I recommend that both parents participate in this process. Each parent should choose a different hour from which to monitor this behaviour. I recommend that they keep their ratings separate and private. This will help parents to recognize whether or not they deem a similar behaviour as an offense. Of course, another goal of this independent tracking method is to encourage the participation of both parents. These monitoring forms should not be placed in view of the child. As soon as the week of baseline establishment is complete, I would advise parents to then pay less attention to this evaluation process and instead focus more on adhering to the treatment strategy of choice. The most obvious reasons for the lack of tracking during this phase surrounds the honeymoon phase of any new intervention being attempted (which results in part simply from the increased attention directed to the situation). Contrarily, certain techniques may result in immediate declines and regression in behaviours (e.g., longer raging behaviours in Time Outs) before the behaviour shows improvement. This follows the principles of extinction, whereby the behaviour in question worsens before it gets better. The child will certainly attempt to test whether he or she must just scream longer and louder to achieve their goal. Clearly, extreme patience is advised during these times.

As the date of goal attainment ensues, I recommend that the behaviour again be tracked in the same fashion as baseline establishment. The only difference will be that that during this particular week of tracking, the strategy in question will be utilized with the same level of regularity that has been occurring over the intervention phase. At this point in time, a decision will be made to either continue with the implementation of the strategy, to reduce and fade out the strategy over time, or, in cases where the strategy has been ineffective, to evaluate whether the intervention was implemented correctly and whether or not the intervention must be tweaked or changed altogether. It is obvious that developing and sticking with tracking systems such as the one I have just described will require a significant amount of planning, effort, and consistency. My experience with such systems, however, has been that the initial brainstorming required typically pays off exponentially in reducing confusion, and ends up saving countless hours in the end.