Four Areas of Focus

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Helping children develop socially, emotionally and behaviorally requires that we first understand which areas contribute most to optimal functioning. I have found that there are four main areas of focus, which include: Attunement, Narration, Communication and Behavioral Control. Each of these areas are outlined below and are listed in developmental order, meaning that each builds on the previous. Application of some areas may need to be adapted to your child’s unique developmental needs. Understanding and practicing each of the areas of focus with your child will maximize your child’s progress in therapy. You, the parent, have the most effect on your child’s development and process of change.

Behaviors are driven by internal states and serve as a means of communication for children. This means that when we want to help them change the way they act, we have to look beyond the surface behaviors and find out what’s underneath—what’s driving the behavior. Generally, what we are looking for are the emotions that give the behavior its energy and meaning. This is how we begin to understand what the behavior is trying to tell us. Developing a deeper understanding of your child’s feelings starts with emotional Attunement. Begin this skill by noticing signs of emotional change in your child. Pay close attention to changes in their facial expressions or body language and take the opportunity to comment on it (See Narration section for examples). A key ingredient of Attunement is sharing with the child what you observe in them. Try to address their emotionality first, before commenting on their behavior (unless it’s a safety issue). Aligning with their underlying feelings helps the child get to know him/her self and what drives their behaviors. This understanding is the first step in helping the child control their behaviors; it’s hard to control something you don’t understand. Coming from a place of emotional empathy also shifts the parent’s role from “controller” to “collaborator” because the child feels your desire to understand their experience foremost. In addition, it keeps the communication channel open. Kids with difficult behaviors get used to hearing “don’t do that, etc.” and eventually perceive adults as “the controller” and tune us out. Understanding their emotionality immediately changes that relational dynamic.

Narration is a way of speaking to the child that shows them several important things at once. Foremost, it shows your Attunement to their feelings and difficulties. Secondly, it provides the child with a model for how to begin to think and talk about feelings and problems. Narration is simple and very effective. Most of the time it requires simply saying the things that generally go unsaid, such as noticing a change in feelings or behavior. This is extremely valuable for children because it is how they learn to organize themselves by connecting their behaviors to their feelings and ideas. This organization is achieved first by the parent’s understanding of the child “out loud” and followed by the child’s eventual understanding of him/her self. This self-understanding, along with the ability to channel their emotions and ideas into language, provides the child with the tools they need for self-control. Simply put, a child who can understand and put their feelings and ideas into words is a child who does not need to act out to make their point.

Key functions of Narration:

• It is a way for you to attune to your child.
• It helps your child feel understood by you.
• It helps your child begin to understand what’s underneath their behaviors.
• It shows the child how to put words to feelings and ideas.
• It lets the child know that their ideas, actions and feelings matter.
• This is an important component of self esteem.

Ways to Narrate

1. Validate the child’s experience. “I can see that you don’t want to go to bed. You look frustrated and might feel like it’s not fair.”

2. Wonder what might be going on emotionally with the child. “Your face changed when Mommy left for work. Now you look sad. Do you have a sad feeling?

3. ”Narrate possible causes of upset, and possible solutions. “I think you’re screaming because I’m talking to Daddy right now. If you want my attention, you could say ‘talk to me’ and we might both pay attention to you when we’re done.”

4. Help the child connect to the feelings that drive their behaviors. “You just hit Zoe. Maybe you’re feeling angry that she drew on your picture. Let’s find another way to let her know how you feel.”

5. Help the child protest through language instead of behavior. “You started running around when I said it was time to leave. Maybe that’s your way of saying ‘I don’t want to go!’ Let’s see if I can help you stop and put some words to this idea and feeling you have.”

There are countless situations for which Narration is appropriate and each one provides the child with an opportunity for learning. On the other hand, don’t feel like you have to Narrate EVERYTHING! My rule of thumb is the bigger the feelings involved, the more important it is to Narrate for the child.

Also, when Narrating, try to avoid giving the child the solution or telling them how they feel. These are skills they need to develop themselves. We are merely wondering out-loud about possibilities. This helps them connect to their feelings and learn about how we express ourselves and solve daily problems.

Communication plays a key role in helping a child organize and express him/ her self, and in healthy family functioning. In addition, communication is the first step in having children take responsibility for themselves. A child who can be responsible for stating his/her ideas, feelings, wants, and protests is a child who is on their way to taking responsibility for their own behaviors. Helping a child protest with words is especially important because it is a chance for the child to practice putting language to an emotionally charged situation. This application of language is what will eventually replace acting out in these situations.

You’ll want to help the child state their idea “I don’t want to go to bed!” and then help them say how it makes them feel “It makes me mad!” Praise them for telling you how they feel and then validate their position and feelings. If you can, reward them for using emotional language by being flexible. “Since you told me your idea and feelings instead of screaming, I’m going to give you five more minutes to play and then it’s bed time.”

Hold expectations for complete communication in your family. Have children practice giving you the “whole idea”, which might mean that you remain patient and wait for them to put the idea into words. This can be especially difficult if the child has a language delay and you have developed a pattern of anticipating the child’s needs and stating them for them. Take careful notice and see if you do this. If so, move from interpreting for the child to coaching them in finding and using their own words. A good rule is, the more difficulty the child has with language, the more the child needs to practice putting together their own words, feelings and ideas.

Instead of saying it for them, help by giving them the first word or two to start their idea. “I want… or I don’t like…” and have them finish the idea. This is also a great way for them to begin to use emotion words “It makes me feel…”

Adjust your communication for processing problems, attention difficulties, etc. (i.e. go slow) and hold the expectation just above what you know the child can already do.

Behavioral Control
Because Attunement, Narration and Communication change the relationship between you and your child, behavioral change usually follows. However, in some circumstances these elements are not enough to change deeply engrained behavior patterns. In addition to the first three focus areas, you will also need to set limits on undesired behaviors and hold expectations for the ones you want. Setting limits means letting the child know that certain behaviors are not acceptable, period. It will require you to be firm, and above all, CONSISTENT in your responses. With physical safety issues (e.g. hitting, running away, biting, etc.), it may require you to hold the child as well. Children test limits because they know, or are trying to see, if you will eventually give in. This is why it is critical for both parents to be consistent. When the child learns that you will not give in, no matter what the protest, they will eventually stop testing. After setting a limitallow the child to have their feelings, as long as they are being safe. Empathize with their wish and upset, and stay clear about your decision. If the child attempts to engage you in power struggles, restate your decision once and then tell them that you are done discussing it then disengage from further conversation. Note- if the child has a pattern of wanting control, allow them acceptable choices within your decision (i.e. “Putting on your seatbelt is not something you can say ‘no’ to. But if you can do it without screaming, you can help Daddy pick the music we will listen to in the car.” In addition, also provide situations where they get to practice being “in charge” of things (e.g. play, games, etc) to satisfy this developmental need.

EXPECTATIONS Expectations go hand in hand with Limits and are simply the behaviors which you expect your child to practice. When setting limits, it’s also important to remind the child of the behaviors you expect from them, and sometimes, the consequences if they choose not to meet your expectation. Also, remember that expectations sometimes need to be flexible depending on your child’s mood, fatigue level, etc. Learning (new behaviors) is built on success not failure, so adjust your expectations, at times, to help your child make a successful step toward meeting the behavior you want.

CONSEQUENCES Like limits, consequences need to be applied immediately and consistently. They should also be connected to the situation, if possible. For example, if the child is not being safe (at the playground, mall, etc.) they cannot be around others and need to go home. Time-Outs, Breaks, Quiet-Time, etc. are useful only when paired with Narration and Review. The point is that you want some learning to take place after they have been removed from the difficult situation. After the Break, require a Review before they are released to go play. The Review should contain:

• What happened? Help them figure it out.
• What were they feeling?
• What did they do with that feeling?
• How can they get that feeling out in a better way?
• What will they do next time (i.e. “Use feelings words and not hit”).
• Apologize (if necessary).

Expect that your child will resist new limits and consequences initially. If the child begins tantrumming, keep them and yourself safe and wait it out. Allow them to have their feelings until they are done. Don’t try to Narrate once a child has begun tantrumming because they are not taking in much information. Wait until the upset is over and then ALWAYS Review what happened.

Also, try to remain NEUTRAL when talking about their feelings, even if you were angered or embarrassed by their display. It’s important that children not feel ashamed or bad about expressing their feelings. Be clear that the feelings are okay; it’s how they chose to express them that you did not like.

NOTE TO PARENTS Parents are exponentially more effective when operating as a team. Practice these skills together and have them become a part of your normal family functioning. Also, presenting a united front with respect to Limits, Expectations and Consequences is ESSENTIAL. Support each other and agree to discuss disagreements in private.
Lastly, care for yourself. Model for your child emotional and physical self- care. This is hard work and you will need support. Get as much help as you need and monitor your own stress level. Also, don’t feel like you have to be perfect at these new skills. Practice learning how to be in this type of helping relationship with your child. The more you practice, the easier it will be and the more you and your child will benefit.