Conduct Problems

Acknowledgement: Parts of the materials contain copyrighted materials from PINTAR Foundation and UTAR.
Conduct problems and antisocial
behaviors describe age-inappropriate
actions and attitudes that violate
family expectations, societal norms,
and personal or property rights of
others
 Disruptive and rule-violating
behaviours range from

annoying minor serious antisocial

behaviors (e.g., behaviors (e.g.,
temper vandalism, theft,
tantrums) and assault)
• We must consider many types, pathways, causes,
and outcomes of conduct problems
• Are associated with unfortunate family and
neighborhood circumstances
• Circumstances do not excuse the behaviour, but help us
to understand and to prevent it
 Context
• Antisocial behaviours appear and decline during
normal development
• Behaviours vary in severity, from minor disobedience to
fighting
• Some may decrease with age; others increase with age
and opportunity
• Are more common in boys in childhood
• Children who are the most physically aggressive in early
childhood maintain relative standing over time
Frequencies for Common Antisocial Behaviour
Sumber: Jabatan Kebajikan Masyarakat
Perspectives
• Legal perspectives
• Juvenile delinquency: children who have broken the law
• Legal definitions result from apprehension and court
contact, so they exclude antisocial behaviours of very
young children occurring in home or school
• Minimum age of responsibility is 18 in Malaysia
• No clear boundaries exist between delinquent acts that
are reactions to environmental conditions, and those
resulting from factors within the child
• Only a subgroup of children meeting legal definition of
delinquency also meet definition of a mental disorder
9 Sekolah
Tunas
Bakti in
Malaysia
Psychological Perspectives

o Conduct problems seen as falling on a continuous

dimension of externalizing behaviour
o Children at the upper extreme, 1 or more SD above the
mean, are considered to have conduct problems
o Externalizing dimension:
o “Rule-breaking behaviour”
o “Aggressive behaviour”
Internalizing Problems
• Depression / Anxiety
• Withdrawn Depressed
• Somatic Complaint

Externalizing Problems
• Rule-breaking Behaviors
• Aggressive Behaviors
4 Categories of Conduct Problems
Psychiatric
Perspectives
• Conduct problems are viewed
as distinct mental disorders
based on DSM symptoms
• Disruptive behaviours are
described as persistent patterns
of antisocial behaviours
• Relevant to understanding
childhood conduct and their
adult outcomes is the
diagnosis of antisocial
personality disorder (APD)
 Public Health Perspectives
• Blends the legal, psychological, and psychiatric
perspectives with public health concepts of
prevention and intervention

Goal:
• To reduce injuries, deaths, personal suffering,
and economic costs associated with youth
violence
DSM-5-TR Disruptive, Impulse-
Control, and Conduct Disorders

• Oppositional defiant disorder

(ODD)
• Conduct disorder (CD)
• Intermittent explosive
disorder
• Antisocial personality disorder
• Pyromania
• Kleptomania
Oppositional Defiant Disorder
Oppositional Defiant Disorder
• Age-inappropriate recurrent pattern of stubborn,
hostile, disobedient, and defiant behaviours
• Usually appears by age 8
• Many behaviours (e.g., temper tantrums) are
common in young children, but severe and age-
inappropriate ODD behaviours can have extremely
negative effects on parent-child interactions
• These children are at high risk for developing secondary
mood, anxiety, and impulse-control disorders
 Repetitive, persistent pattern
of severe aggressive and
Conduct Disorder antisocial acts that involve
inflicting pain on others or
interfering with rights of
others through physical and
verbal aggression, stealing, or
acts of vandalism
 Conduct Disorder
• Severe antisocial behaviours
• May have co-occurring problems:
ADHD, academic deficiencies, and
poor peer relations
• Family child-rearing practices may
contribute to problems, and
families often have their own
stresses
• Parents feel the children are out of
control and feel helpless to do
anything about it
Conduct Disorder Age of Onset
• Children with childhood-onset CD display at least
one symptom before age 10
• More likely to be boys
• Show more aggressive symptoms
• Account for disproportionate amount of illegal activity
• Persist in antisocial behaviour over time

• Children with adolescent-onset CD

• As likely to be girls as boys
• Do not show the severity or psychopathology that
characterizes early-onset group
• Less likely to commit violent offenses or persist in their
antisocial behaviour over time
Are CD
and ODD
different?
 Conduct
Disorder
Oppositional
Defiant
Disorder

• CD and ODD have much overlap of symptoms, which

raises the question of whether ODD is different from CD
• Nearly half of all children with CD have no prior ODD diagnosis
• Most children who display ODD do not progress to more severe
CD
• For most children, ODD is an extreme developmental variation
and a strong risk factor for later ODD, but not one that
necessarily signals an escalation to more serious conduct
problems
Antisocial Personality Disorder
(APD) and Psychopathic Features
• Pervasive pattern of disregard for and violation of
the rights of others; involvement in multiple illegal
behaviours
• As many as 40% of children with CD later develop APD
• Adolescents with APD traits may display psychopathic
features
• Signs of lack of conscience occur as young as 3-5 years
• Display callous and unemotional (CU)
interpersonal style characterized by lack of guilt,
not showing empathy, not showing emotions,
narcissism, impulsivity, and lack of behavioural
inhibition
Associated Characteristics
• Many factors are associated
with conduct problems in
youths
1. Cognitive and verbal deficits
2. School and learning problems
3. Self-esteem deficits
4. Peer problems
5. Family problems
6. Health-related problems
 Cognitive and Verbal Deficits
• Most children with conduct problems have normal
intelligence
• But score nearly 8 points lower than their peers on IQ
tests
• Verbal deficits are present in early development
• Affect receptive listening, reading, problem solving,
expressive speech, and memory for verbal materials

Interfere with Parents face

Interfere with the
development of difficulty to
development of Rejection by peers
ability to label understand them -
self control
emotions in others - frustration
Stanford Marshmallow Experiment
(An oversimplified version here :P)
Behavioral and neural correlates of
delay of gratification 40 years later

(Casey et al.,2011)
doi: 10.1073/pnas.1108561108
Cognitive and Verbal Deficits
• Deficits in executive functioning
• Co-occurring ADHD may be a factor
• Types of executive function exhibited may differ – Cool
versus hot executive functions

Attention, working
Incentives and
memory, planning
motivation
and inhibition
Cognitive and Verbal Deficits
• Deficits in executive
functioning related to failure
to consider future
implications of their
behaviours and its impact on
others

• Types of executive
functioning deficits may
differ for children with ODD
and CD and those with ADHD
 School and Learning Problems

• Underachievement, grade retention, special education

placement, dropout, suspension and expulsion
• Relationship between conduct problems and
underachievement is firmly established by adolescence
• May lead to anxiety or depression in young adulthood
Family Problems
• Family problems are among the strongest and most
consistent correlated of conduct problems
• General family disturbances (e.g., parental mental
health problems, family history of antisocial behaviour,
marital discord, etc.)
• Specific disturbances in parenting practices and family
functioning (e.g., excessive use of harsh discipline, lack
of supervision, lack of emotional support / involvement,
etc.)
Peer Problems
• Often form friendships with other antisocial peers
• Predictive of conduct problems during adolescence
• Underestimate own aggression and its negative impact,
and overestimate others’ aggression toward them
• Reactive-aggressive children display hostile
attributional bias: attribute negative intent to others
• Proactive-aggressive view their aggressive actions as
positive
• Some become bullies
Self-Esteem Deficits
• Low self-esteem is NOT the
primary cause of conduct
problems
• Instead, problems are related to
inflated, unstable, and / or tentative
view of self

• Youths with conduct problems

may experience high self-esteem
that over time permits them to
rationalize their antisocial conduct
Health-Related Problems
• High risk for personal injury, illness, drug overdose,
sexually transmitted diseases, substance abuse,
and physical problems as adults
• Rates of premature death, before age 30, are 3 to 4
times higher in boys with conduct problems
• Early onset and persistence of sexual activity and
sexual risk taking by age 21
• Substance use disorders and adolescent antisocial
behaviour are strongly associated
Accompanying Disorders and Symptoms
(Comorbidities)
• Attention-Deficit / Hyperactivity Disorder
• More than 50% of children with CD also have
ADHD
• Possible reasons for overlap:
• A shared predisposing vulnerability may lead to both
ADHD and CD
• ADHD may be a catalyst for CD
• ADHD may lead to childhood onset of CD
• Research suggests that CD and ADHD are
distinct disorders
Accompanying Disorders and Symptoms

• Depression and anxiety

• About 50% of children with conduct problems also have
a diagnosis of depression and anxiety
• ODD best accounts for the connection between conduct
problems and depression
• Poor adult outcomes for boys with combined conduct and
internalizing problems (depression & anxiety)
• Girls with CD develop depressive or anxiety disorders by early
adulthood
• Males and females: increasing severity of antisocial behaviour
is associated with increasing severity of depression and anxiety
• Anxiety may serve as a protective factor to inhibit aggression
Prevalence
• ODD is more prevalent than CD during childhood;
by adolescence, prevalence is equal
• Lifetime prevalence rates
• 12% for ODD (13% males, 11% females)
• 8% for CD (9% males, 6% females)
• Prevalence for CD and ODD across cultures of
Western countries are similar
Prevalence
• Gender differences are evident by 2-3 years of age
• During childhood, rates of conduct problems are about
2-4 times higher in boys
• Boys have earlier age of onset and greater persistence
• Early symptoms for boys are aggression and theft; early
symptoms for girls are sexual misbehaviours

Wait …
Malaysia statistics?
Sumber: Jabatan Kebajikan Masyarakat
Explaining Gender Differences
• Possible explanations:
• Genetic, neurobiological, environmental risk
factors, and definitions of conduct problems
that emphasize physical violence
• Girls use indirect, relational forms of
aggression (spreading rumours, grapevine)
• Early maturing boys and girls are at risk for
recruitment into delinquent behaviour by
peers
General Progression
• Earliest sign is difficult temperament in infancy
• Fussiness - strongest predictor for boys
• Fearfulness – strongest predictor for girls
• Hyperactivity and impulsivity during preschool and
early school years
• Oppositional and aggressive behaviours peak during
preschool years
• Diversification – new forms of antisocial behaviour
develop over time – snowballing negative cycle
 Social-
Peer
cognitive
rejection
deficits

Agression
General Progression
• Covert conduct problems begin during elementary
school
• Problems become more frequent during
adolescence
• Some children break from the traditional
progression
• About 50% of children with early conduct problems
improve
• Some don’t display problems until adolescence
• Some display persistent low-level antisocial behaviour
from childhood/adolescence through adulthood
Different Forms of Disruptive and Antisocial Behaviour
Pathways – Two Common Pathways
• Life-course-persistent (LCP) path begins early and
persists into adulthood
• Antisocial behaviour begins early
• Subtle neuropsychological deficits heighten vulnerability to
antisocial elements in social environment
• Complete, spontaneous recovery is rare after
adolescence
• Associated with family history of externalizing disorders
• Display consistencies across situations
Pathways – Two Common Pathways

• Adolescent-limited (AL) path begins at

puberty and ends in young adulthood
• Less extreme antisocial behaviour, less likely to
drop out of school, and have stronger family ties
• Delinquent activity is often related to temporary
situational factors, especially peer influences
• Not consistent across situations
• Experience greater social adversity and personal
risk compared to other typical developed
children
The Changing Prevalence of Participation in
Antisocial Behaviour Across the Lifespan
Adult Outcomes
• 50% of active offenders decrease by early 20s, and
85% decrease by late 20s
• Negative adult outcomes are seen, especially for
those on the LCP path
• Males – criminal behaviour, work problems, and
substance abuse
• Females – depression, suicide, and health problems
Causes
• Early theories focused on a child’s aggression
• No single theory explain all forms of
antisocial behaviour
• Today conduct problems are seen as
resulting from:
• The interplay among predisposing child, family,
community, and cultural factors operating in a
transactional fashion over time
Genetic Influences
• Aggressive and antisocial behaviour in
humans are universal
• Run in families and across generations
• Adoption and twin studies
• Indicate 50% or more of variance in antisocial
behaviour is hereditary
• Suggest contribution of genetic and
environmental factors
Prenatal Factors and Birth Complications
• Pregnancy and birth factors
• Low birth weight (less than 2.50kg)
• Malnutrition (possible protein deficiency) during
pregnancy
• Lead poisoning
• Mother’s use of nicotine, marijuana, and other
substances during pregnancy
• Maternal alcohol use during pregnancy
Neurobiological Factors
• Overactive behavioural activation system (BAS –
accelerator pedal) and underactive behavioural
inhibition system (BIS – brake pedal)
• Heightened sensitivity to reward;
fail to respond to punishment
• Variations in stress-regulating mechanisms (lower
psychophysiological / cortical arousal)
• Most children respond to discipline and punishment by
reducing their antisocial behaviour.
However, the opposite occurs with children with conduct
problems - may increase antisocial behaviour / more defiant
• Structural and functional brain abnormalities in
amygdala, prefrontal cortex, anterior cingulate, and
insula
Neurobiological Factors
• Early findings suggest three neural systems
are involved:
• Subcortical neural systems
• Aggressive behaviour – dysfunction in the integrated
functioning of brain circuits involving the amygdala
• Prefrontal cortex
• Decision-making circuits and socioemotional
information processing circuits
• Frontoparietal regions
• Emotions and impulsive motivational urges
Social-Cognitive Factors
• Social-cognitive abilities – skills involved in
attending to, interpreting, and responding to social
cues
• Immature forms of thinking (lack of social
perspective taking)
• Cognitive deficiencies (failure to use verbal
mediators to regulate behaviour)
• Deficits in facial expression recognition and eye
contact
• Researchers presented a comprehensive social-
cognitive framework model – cognitive and
emotional processes are mediators
Steps in the Thinking and Behaviour of
Aggressive Children in Social Situations
Family factors
• Severe forms of antisocial behaviour
• Are associated with a combination of child risk
factors and extreme deficits in family
management skills
• Influence of family environment is complex
• Reciprocal influence
• Child’s behaviour is influenced by and influences
the behaviour of others
• Child behaviours exert greater influence on
parenting behaviour than the reverse
Family Factors Coercion: the action or practice of
persuading someone to do something by
using force or threats

• Coercion theory
• Parent-child interactions provide a training
ground for the development of antisocial
behaviour
• Four-step escape-conditioning sequence
• The child learns to use increasingly intense forms of
noxious behaviour to avoid unwanted parental
demands (coercive parent-child interaction)
• Children with callous-unemotional traits display
significant conduct problems regardless of parenting
quality
Family Factors
• Attachment theories
• Children with conduct problems have little
internalization of parent and societal standards
• There is a relationship between insecure attachments
and the development of antisocial behaviour
• Family instability and stress
• Unemployment, low SES, multiple family transitions,
instability, and disruptions in parenting practices are
stressors
• Parental criminality and psychopathology
Societal Factors
• Individual and family factors interact with the larger
societal and cultural context in determining
conduct problems
• Social disorganization theories – adverse contextual
factors are associated with poor parenting
• Neighbourhood and school – social selection
hypothesis
• Antisocial people tend to select neighbourhoods differ
from one another before they arrive, and those who
remain differ from those who leave
Societal Factors
• Media

Can / Will portrayal of

violence in media
increase children’s
antisocial behaviour?
 TV violence verges on There is little evidence
child maltreatment and for a causal relation
that we can reduce between TV violence
murders by unplugging and aggressive
the TV? behaviour?

In U.S., by the times a child is 12 years old, he or

she has witnessed 8,000 or more murders on TV
and well over 100,000 other acts of violence.
Answer …
Yes, TV violence and aggression is
significantly correlated.
1. A short-term precipitating factor for aggression
and violent behaviour that results from priming,
excitation, and imitation of specific behaviours
2. A long-term predisposing factor for aggressive
behaviour acquired via desensitization to
violence and observational learning of an
aggression-supporting belief
But …
• It is UNLIKELY that media alone can account for
substantial amount of antisocial behaviour in young
people
• Exposure to media violence will not turn an
otherwise well-adjusted child into a violent criminal
• Anyhow, the association between media violence
and aggressive behaviour is as strong or stronger
than those for cigarette smoking and lung cancer
Cultural Factors
• Across cultures, socialization of children for
aggression is one of the strongest predictors of
aggressive acts
• Rates of antisocial behaviour vary widely across and
within cultures
• Antisocial behaviour is associated with minority
status in the U.S.
• Likely due to low SES
Treatment and Prevention
• Some treatments are NOT very effective:
• Office-based individual counselling and family therapy
• Group treatments can worsen the problem
• Restrictive approaches (residential treatment, inpatient
hospitalization, incarceration)

• Comprehensive two-pronged approach includes

• Early intervention / prevention programs
• Ongoing interventions
Psychological treatments have a small effect
in reducing parent-, teacher- and observer-
rated CD problems in children and
adolescents with clinical CD problems or
diagnosis.
Effective Treatments for Children
with Conduct Problems
Parent Management Training (PMT)
• Teaches parents to change the child’s behaviour in
the home and in other settings using contingency
management techniques
• Focus on
• Improving parent-child interactions
• Promoting positive behaviour
• Decreasing antisocial behaviours
• Makes numerous demands on parents
Problem-Solving Skills Training

Focuses on cognitive Five problem- Children learn to:

deficiencies and
distortions in
solving steps are
interpersonal situations used to:
Identify thoughts, Appraise the situation
feelings, and behaviours Identify self-statements
in problem social and reactions
situations
Alter their attributions
about other’s
motivations
Learn to be more
sensitive to others
Multisystemic Therapy
• Intensive family- and community-based approach
• For teens with severe conduct problems who are at risk
for out-of-home placement
• Attempts to empower caregivers to improve youth
and family functioning
• Effective in reducing long-term rates of criminal
behaviours
• Reduces association with deviant peers
Preventive Interventions
• Main assumptions
• Conduct problems can be treated more easily and
effectively in younger than older children

• Counteracting risk factors /strengthening protective

factors at young age limits /prevents escalation of
problem behaviours

• Costs to educational, criminal justice, health, and mental

health systems are reduced
Preventive Interventions
• Incredible Years intensive multifaced early-
intervention program for parents and teachers
• Support for effectiveness of early interventions in
reducing later conduct problems and maintaining
positive outcomes

• Fast Track program to prevent development of

antisocial behaviour in high-risk children, using five
components
http://incredibleyears.com/
Other Intervention Programs
Parent-Child Interaction Therapy (PCIT)
https://pcit.ucdavis.edu/pcit-web-course/

http://www.livesinthebalance.org/
2 Phases
• Phase 1 –
Child Directed
Interaction (CDI)

• Phase 2 –
Parent Directed
Interaction (PDI)
Observe this mother playing with her child.
• Is she warm?
• Is she engaged?
• Is she responsive?
CDI Skills

Do’s
CDI Skills

Don’ts
Observe this mother playing with her child.
• Is she warm?
• Is she engaged?
• Is she responsive?
Observe this mother who is trying to get child to keep toys away.
• What strategy she used?
• Parents behaviours?
• Quality of interaction
Observe this mother who is trying to get child to keep toys away.
• What strategy she used?
• Parents behaviours?
• Quality of interaction
Example of Coaching Session
https://pccarelearningcenter.com/
Collaborative & Proactive Solutions Lecture
https://www.youtube.com/watch?v=4cto6J9dK8A
 Technique:
Collaborative and Proactive Solution
Highlights of results:
Compared to usual care, the CPS group had improvements in:
• Child irritability (Effect Size (ES): −0.4)
• Quality of life (ES: 0.4)
• Executive functioning (ES: −0.4), and
• Family functioning (ES: −0.7).
“Ican’t”, “I won’t”, “You can’t make me!”:
Meltdowns, Shutdown, and Regulation

1
 Presentation - Objectives

• The Collaborative Problem Solving model:

TM

guiding principles
• The link between problem behaviors and
missing skills
• Effective interventions vs. unproductive
explanations

2
 Choosing the
Collaborative Problem Solving TM

Model

Children do well if they

can….TM

4
 Children Do Well If They Can TM

…if they can’t, we adults

need to figure out
what’s getting in the
way, so we can help

5
 Skills that support the 3 Rs :
TM

self-Regulation, Relationship and

Resilience
• Thinking skills
• Executive skills
• Emotion regulation skills
• Communication skills
• Social skills
• Sensory-motor skills
6
 When skills are missing
• Troubling behaviors may occur in the face
of a problem
• Behaviors can be extreme and cause for
alarm:
– Kicking, hitting, spitting, screaming, profanity,
throwing, breaking, etc.
• Behaviors can be milder and cause for
concern:
– Hiding, refusal, withdrawn, crying, etc. 7
 Behavior is the clue,
not the problem TM

• Meltdowns, tantrums, explosions and

shutdowns: consider this is code language

• “Something critical is missing for me in this

moment”
and
• “I don’t know how to get what’s missing”
8
 A different view:

Problem Behavior =
A Missing Skill or
an Unsolved Problem

9
 A different view:
• A problem behavior often is an attempt to
solve a problem in the face of lagging
skills

10
 Skills That May Be Lagging
• Regulating emotion
• Expressing concerns and needs
• Handling transitions
• Thinking flexibly without getting “stuck”
• Taking into account the point of view
of another person
• Generating multiple solutions
• Having a sense of time; being able
to wait

11
 Assessment of Lagging Skills
and Unsolved Problems

• Parent input: listen for the missing skills in the

stories of behaviors and problem situations

• Teacher input: what are the likely, predictable

problems that occur

• The stories will point you to the lagging skills

12
 Prioritize and Plan

• What are the top 3 lagging skills?

• What will you address first:

– The easiest?
– The most problematic?

• Get agreement from the team

– These are the lagging skills we are going to address for now
– Not those others at this time

• How will we teach new skills?

13
 Opportunities Abound to
Address a Lagging Skill

• Before a predictable problem situation occurs

• Situations in which unmet expectations occur
AND not yet in a meltdown

14
Our Response to Unmet
Expectations

Plan A: Impose adult will

Plan B*: Collaborative Problem

Solving

Plan C: Drop it for now

15
Our Response to Unmet
Expectations

Plan A: Impose adult will

Plan B:

Plan C:
16
 Plan A: Impose Adult Will
• “No”
• “You must”
• “You can’t”
• “1-2-3”
• “I’m the decider”
• “You’re grounded”
• No more computer time!
• “You better stop or else”
• If you want your allowance,
you’ll do it
Plan A is one way to
pursue adult
expectations.
17
 Plan A: Imposing Will

• Pursues adult expectations

• Does not teach missing skills
• Does not result in a durable solution
• Does not create affinity in the relationship

18
Our Response to Unmet
Expectations

Plan A: Impose adult will

Plan B:

Plan C: Drop it (for now, at least)

19
Plan C: Drop it
(for now, at least)

• “Okay”

20
 Plan C: Drop it (for now, at
least)

•Reduces meltdowns or challenging behaviors

•Builds relationship - child feels you understand

•Does not pursue adult expectations

•Does not teach skills
•Does not result in a durable solution

(Plan C may be used as part of overall strategy for a highly explosive child)

21
Our Response to Unmet
Expectations

Plan A: Impose adult will

Plan B: Collaborative Problem Solving

Plan C: Drop it (for now, at least)

22
 Plan B
Collaborative Problem Solving
• 1. Empathy & Reassurance

• 2. Define the Problem

• 3. Invitation

23
 Plan B
Collaborative Problem Solving
• 1. Empathy & Reassurance

• 2.

• 3.

24
 1. Empathy and Reassurance

• Get the child’s

concern on the
table

Reassure the child that his/her concern will

not be “blown off the table”
25
 Plan B
Collaborative Problem Solving
• 1. Empathy & Reassurance

• 2. Define the Problem

• 3.

26
2. Define the Problem

• Identify and
summarize both the
adult’s and the child’s
specific concerns

27
 Plan B
Collaborative Problem Solving
• 1. Empathy & Reassurance

• 2. Define the Problem

• 3. Invitation

28
 3. Invitation

• Let’s figure this

out together

• How can we make it

work for you and for
me?

Note: Don’t be a genius!

29
 Review:
Our Response to Unmet Expectations

Plan A: Impose adult will

Plan B: Collaborative Problem

Solving

Plan C: Drop it for now

30
 A B C Chart
PLAN Pursue Reduce Teach Lagging
Expectations Meltdowns Skills

A
Adult imposes will
on child

B
Both collaborate on
finding a solution

C
Child’s perspective:
Expectations are
reduced or
removed

31
 A B C Chart
PLAN Pursue Reduce Teach Lagging
Expectations Meltdowns Skills

A
Adult imposes will
on child

B
Both collaborate on
finding a solution

C
Child’s perspective:
Expectations are
reduced or
removed

40
Your explanation
guides
your intervention

41
 “Dead End” Explanations

• He just wants attention

• She is stubborn
• He never listens
• She just wants control
• Teenagers are disrespectful
• He is autistic
• She has attachment disorder
42
 Explanations Guide Actions

DEAD END EXPLANATION: PLAN B EXPLANATION:

He just wants attention He doesn’t know how to

control his impulses

ACTION: Ignore him ACTION: Build this skill

43
 Explanations Guide Actions

DEAD END EXPLANATION: PLAN B EXPLANATION:

She just wants control She doesn’t know how

to take the perspective of
the other person.
ACTION: Don’t give her
what she wants or she
ACTION: Build this skill
will take over.
44
 Explanations Guide Actions

DEAD END EXPLANATION: PLAN B EXPLANATION:

He doesn’t know how to

He has autism
ask for what he wants

ACTION: Lower your ACTION: Build this skill

expectations
45
 “Dead End” Explanations
Lead to These Likely Actions

• She is stubborn: insist louder

• He never listens: use rewards and consequences
• Teenagers are disrespectful: ground them
• She has attachment disorder: show her who is the
boss

46
 An Empowering Explanation

• There is a lagging
or missing skill

• There is an
unsolved problem

47
 Unsolved Problem =

• Two concerns
that have yet to
be reconciled

48
 A B C Chart
PLAN Pursue Reduce Teach
Expectations Meltdowns Skills

A
Adult imposes will
on child

B
Both collaborate on
finding a solution

C
Child’s perspective:
Expectations are
reduced or
removed

53
 Plan B Teaches Skills

• Staying calm enough to think

• Expressing own point of view
• Taking into account other’s point of view
• Finding a realistic and mutually
satisfactory solution

54
 Behavior is the clue,
not the problem TM

• Meltdowns, tantrums, explosions and

shutdowns: consider this is code language

• “Something critical is missing for me in this

moment” (Lagging or missing skills)
and
• “I don’t know how to get what’s missing”
(Teach new skills)
55
Your explanation
guides
your intervention

56
 A Better Intervention

• Collaborative Problem Solving

– Teaches skills:
• Thinking skills
• Executive skills
• Emotion regulation skills
• Communication skills
• Social skills
– Solves problems
– Empowers adults and children

57
 Conclusion

• Describe three guiding principles of the

“Collaborative Problem Solving” model

• Identify problem behaviors that indicate

missing skills

• Distinguish the difference between

effective interventions and unproductive
explanations
 Resources
• www.ccps.info
– For more information about Collaborative Problem
Solving
• The Explosive Child
by Ross Greene, Ph.D. and Stuart Ablon, Ph.D.
• Treating Explosive Kids
by Ross Greene, Ph.D. and Stuart Ablon, Ph.D.
• Lost at School by Ross Greene
• www.childrensinstitute.com
58
Collaborative Problem Solving (Plan B)

• Once lagging skills and unsolved problem are

identified, it is time to begin CPS with the student

3 ingredients to the process:

1. Empathy Step- This is where you gather information
so as to clarify the student’s concern or perspective on
the unsolved problem
2. Define the Problem Step- Here, the teacher
communicates their concerns or perspective on the
unsolved problem.
3. The Invitation Step- Student and teacher brainstorm
solutions to address the concerns
Step 1: Empathy
 This is where you gather information so as to clarify the
student’s concern or perspective on the unsolved problem

 Goal is to get the student talking to obtain the best

possible understanding of the unsolved problem

 Important to start with a neutral statement

“I’ve noticed…” “What’s up?”
“Tell me more about it”
“I am wondering what is going on?”

 Be willing to be patient- allow for silence if needed

***
Step 2: Define the Problem

 Here, the teacher communicates their concerns or

perspective on the unsolved problem

 Generally adult concerns fall into 3 categories-

safety, learning, or how the behavior is affecting
one’s self or others

 Sample statements to use:

“My concern is…” “The thing is…”

***
Step 3: The Invitation Step

 Student and teacher brainstorm solutions to address both

concerns
 Must let student know you want to get both concern’s
addressed
 The step involves restating the two concerns so as to
summarize the problem to be solved
Sample statement: “I wonder if there is a way…”
❑ Then give the student the first opportunity to generate a
solution
Sample statement: “Do you have any ideas…”
Brainstorming Solutions
 Solution must be realistic and mutually satisfactory

 Sample statements:
“ Hey, there’s an idea. The only problem is I don’t
know if its realistic for you to ______ . Let’s see if
we can come up with a solution that you can do…”

“Well, there’s an option. The only thing is if I let you

do______ your concern would be addressed but my
concern wouldn’t. Let’s see if we can come up with a
solution that works for both of us.”