Why is my toddler hitting out?

Tue, Jul 17, 2012, 01:00

ASK THE EXPERT: Q: My three-and-a-half-year-old son has been hitting other children at play school. His teacher says he seems to want to connect with other children, but seems unable to do so. He even pushes and pulls at our friends’ children, whom he knows well and sees regularly. He daily attacks his one-and-a-half-year-old brother. These attacks are unprovoked and he appears to take pleasure in them. He shouts violently and suddenly for no reason and throws his toys around too.

It has become a problem we can no longer ignore. We have tried “consequences” and “time out” for his actions, but he doesn’t seem bothered by either.

He is a fully bilingual child in French and English. The language issue doesn’t seem to be a problem, as he can easily switch from one language to the other without bother. We are at a loss as to what to do. What could be the cause of this behaviour and what should we do? We desperately want to help him.

A

It is a real worry for parents when they can’t make sense of their child’s behaviour. There are a number of possible explanations and there may be separate reasons for the different behaviours you describe.

The first question is whether this is part of a wider issue in relation to his general development. How are his motor skills, independent play skills, attention, and social and emotional development? Also, did this behaviour start suddenly or is it longstanding?

Sometimes identifying a starting point can make it easier to understand the underlying cause. Difficulties with communicating at the same level as his peers might be one explanation, and fits in with what his teacher is saying.

Dr Debbie Mills from Bangor University Wales, has shown that three-year-old bilingual children have less breadth of vocabulary than monolingual children. So, while a bilingual and monolingual child might each have 400 words at age three, the bilingual child will have 200 words in one language, and the same 200 words in the other, meaning that they have only half as many verbal concepts to work with. The good news is that they catch up by about five.

As regards “attacking” his little brother, there may be a simple explanation. He was only two when the baby arrived and was probably used to having you to himself. He may have issues with sharing your attention, and takes it out on his little brother. One of the mantras of child psychology is that any attention, good or bad, can maintain behaviour. It is more than likely that the focus of attention suddenly shifts to him when he goes for the baby, and you end up unintentionally rewarding his behaviour.

You have tried time out and consequences with no success, but maybe a different strategy might work. Rather than not being bothered by sanctions, he possibly just doesn’t understand them yet. While it is good that there is now so much media focus on child-rearing skills, a major problem with TV parenting programmes is that they simplify behavioural interventions and gloss over the complex underlying psychology. There is no one-size-fits-all and any intervention has to be tailored to the individual child, their developmental stage, and the type and severity of the behaviour.

“Consequences” is where the child is warned that Y will happen if they do X. For instance “if you hit your brother, you will not watch your favourite TV programme”. It is only suitable for children who understand the relationship between their behaviour and the later consequence. Some mature three-year-olds can make the connection, but most can’t manage it until about five years.

Time out is not as simple as it looks; it is labour-intensive and easy to get wrong. It needs a lot of advance planning and should never be a “punishment” for bad behaviour.

The full psychological term is “time out from positive reinforcement”, whereby the child goes to a less interesting designated place until everyone, and not just they, have cooled down. It works from about age three onwards, and the rule of thumb is one minute of time out for every year of the child’s age.

Any intervention tends initially to make things worse and many parents give up at this point because they think it’s not working. I highly recommend The Incredible Years by Carolyn Webster-Stratton (about €20) as an excellent no-nonsense guide to parenting and behaviour management in two- to eight-year olds.

You’re at a loss in relation to your child’s behaviour, so it is probably a good time to seek expert advice. This is why professional child guidance services exist, and yours would be a typical referral to a local public child and family, or child and adolescent mental health service (CAMHS).

Your GP is the starting point for any referral. They will carry out an initial health screen and, if necessary, refer you onwards. Given the sometimes long public waiting lists, it can be tempting for worried parents to go private. A problem with the private route is that individual practitioners don’t usually work with an inter-disciplinary team.

In your case, your child’s needs might be best addressed by a therapeutic public team who can view the issues from a range of perspectives including general development, occupational therapy, parenting, speech and language, psychology, psychiatry etc. It is likely that psychology would have a key role in your case. Their input generally involves detailed history-taking, observations, possibly some psychometric assessment, and then working with you to implement strategies that are likely to work.


Dr Sarah O’Doherty is a clinical neuropsychologist.

Dr John Sharry is on leave.

Queries can be sent to healthsupplement@irishtimes.com

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