BC Council for Families

By Kate Andersen

Kate Andersen is a sessional instructor with the School of Child and Youth Care at the University of Victoria. She pioneered efforts to help parents of temperamentally difficult children in British Columbia and has worked with such families for over a decade. She recently conducted her PhD research on the experiences of parents seeking help with a temperamentally difficult child.

"Alison was different from our other kids right from the beginning. At first we thought it was colic. Then when it didn't go away after four months, we wondered if we were too tired to raise a third child. And when the terrible two's turned into the even more trying three's we began to panic. Were we hopeless parents? Was she physically ill? Did she have some sort of brain disorder?

Everything was an issue with Alison. If her toast was cut the wrong way, she threw it on the floor. If I dressed her in any colour but purple she had a tantrum. Sweaters were “too scratchy,” car rides “too long.” Some days she was sunny and happy, “a delightful, creative child,” said her preschool teacher. Other days, everything upset her.

We tried everything. We were patient, we were firm, we punished, we tolerated. Eventually we realized that part of the problem was that we were being horribly inconsistent. Alison was turning us into the incompetent parents we swore we would never be. We loved her dearly, but she wore us down."

These are the words of Janet, an experienced mother of three healthy girls. Janet is a speech/language pathologist trained to work with children with disabilities and behaviour disorders. Her husband Mike is a high school counsellor. Nothing in their training or experience prepared them for a child like Alison. From the earliest months her behaviour defeated and exasperated them. Yet Alison was a chubby, healthy baby who met all her milestones on time and looked perfectly angelic.

Like all conscientious parents, the couple took their nine-month-old daughter to a pediatrician seeking answers. Perhaps it was food allergies or worse, some dreaded neurological problem. When the baby was declared normal they blamed themselves for overreacting. But calming down didn't change the situation. They toughed it out through the toddler years when Alison seemed like every other two-year-old, “only more so,” said Mike. When Alison was just over three years old, in desperation they took her to a child psychiatrist. The doctor pronounced, “Well, she's a difficult child,” then smiled wryly and asked, “So what else is new?” But there was more to learn. The doctor told them about recent research on temperament. Temperament refers to behavioural tendencies that may have at least a partly genetic or biological basis. Dr. Rule described each problematic temperament trait in turn, linking it to Alison's puzzling behaviour. “It was a lightbulb experience,” said Janet. Mike nodded.

Temperament styles

The temperamentally difficult child was first described by New York psychiatrists, Drs. Stella Chess and Alexander Thomas in their landmark New York Longitudinal Study begun in 1956. Chess and Thomas followed 133 children from infancy to early adult life. They found that a child's basic temperament could be identified in the earliest months of life, before parenting could have had much impact. Furthermore, the traits tended to stick with the child right up into adulthood although, of course, as children developed and learned, they acquired ways of modifying their responses to the world.

The researchers identified three main temperamental styles: the difficult child, the easy child and the slow-to-warm-up child. The difficult child was intense, negative, withdrawing, poorly adaptable and irregular in eating, sleeping and elimination. Such children were found to be at greater risk of developing behavioural and emotional problems. However, a poor outcome was not inevitable. If parents improved their “fit” with the child, by understanding, accepting and learning to manage temperament-related behaviour effectively, difficult children did well. If raised in a strained marital environment or when the children were managed ineffectively, the outcome was less happy. Even so, with professional help the secondary emotional and behavioural problems these children acquired could be turned around.

More recent temperament research, buttressed by new knowledge about genetics and the neurobiology of behaviour, strongly confirms the general conclusions of early temperament studies. There is now wide agreement that temperament differences in children exist from the early months of life and have a neurobiological basis. Only about 50%, on average, are attributable to genetics. Temperament is not cast in stone but some traits are less likely to change than others. Interestingly, temperament in infancy has turned out not to be as strong a predictor of later personality than temperament at a slightly older age. As children grow into the preschool years, their traits tend to become more reliable indicators of an enduring personality style.

More recently as well, clinicians such as Dr. Stanley Turecki have argued that every temperament style can create difficulties. In his best-selling book, The Difficult Child, Turecki added a high activity level, low sensory threshold, distractability and short attention span to the list of traits which many parents find difficult. This group of youngsters overlaps with those who may later receive a diagnosis of attention-deficit hyperactivity disorder, but not all children with this profile have extreme enough behaviour to warrant a diagnosis. Other research also shows that slow-to-warm-up children, often misunderstood as anxious or withdrawn, are at risk in environments that valued more outgoing children. And easy youngsters are not immune to problems if their families and teachers expected too much from them or overlooked their needs. The first step in preventing problems, whatever your child's profile, is to get to know your child's temperament.

So how is a parent to know whether their child is inflexible, negative and intense because of her temperament and not because of stress, food allergies, parenting or a normal developmental stage? First of all, don't try to diagnose your child by yourself. Start your help-seeking journey by reading the latest of the parenting books based on temperament research, Understanding Your Child's Temperament, by Dr. William Carey. This book provides the most reliable self-help method of learning more about your child's temperament. If, after exploring your child's temperament by using Dr. Carey's method, you are still not sure where the behaviour is coming from, consult a developmental pediatrician or child psychologist.

Acceptance: the first step to management

If you have determined that your child's challenging traits are largely rooted in her temperament, then the next step towards effective management is to accept this fact. Maybe you dreamed of a quiet and easy-to-mold child but nature has blessed you with an intense and inflexible one instead. That's the reality.

The second step is to reframe negative temperament traits more positively. Every personality style has its benefits. Seeing this may require an act of faith when your youngster is a stubborn and negative four-year-old but as your child grows older you will see the positive sides emerging more clearly. The key to success is to foster the positive side by being patient and building on your child's strengths. This is one way of improving the “fit.” And as for every child, healthy development is also strongly related to a solid parental partnership and positive relationship with the child. Small wonder that so many professionals recommend family counselling and a daily one-on-one non-directive play session with the child as the first steps towards improvement when a family is overwhelmed by a challenging young child. Because each situation is different, there is no standard treatment approach. There are many valid ways to improve the “fit.”

The next step to effectively managing a challenging temperament is the toughest one. It starts with making an important distinction between temperament and a behaviour problem. Having a predisposition to be inflexible and negative is one thing; throwing your food on the floor in a rage is another. The first is temperament, the second is a behavioural or adjustment problem. Behavioural and adjustment problems may occur for good reasons, such as being overtired or having your temperament mismanaged, but the fact remains that they are, by definition, unhealthy ways of functioning in the world. And what starts out as related to temperament can easily turn into a changeable behavioural habit. To better understand the distinction between temperament and behaviour, turn to Dr. Carey's new book. It also gives you guidance about other causes of worrisome behaviour, such as sleep disturbances, illness, stress and family problems.

Many parents ask about the relationship between a difficult temperament and a specific learning disability or attention-deficit hyperactivity disorder (ADHD). It is true that some, but by no means all children with difficult temperament traits will in later childhood turn out to have a specific learning disability and/or ADHD. Since children under five are most unlikely to be eligible for either of these diagnoses, parent education about temperament can form part of an effective early intervention for such children. It is important, though, to follow through on concerns about such problems and have your child properly assessed at an appropriate age. You can obtain more information about such assessments through your local Learning Disabilities Association of C.H.A.D.D. Chapter. Language delays and disorders, which may also be accompanied by a difficult temperament, should be addressed as early as possible. Your local Health Unit or Child Development Centre can assist you to find the appropriate help with such concerns.

So what comes next, now that you've learned how to sort out temperament from other concerns?

Wise parents know that prevention is the key to the vast majority of behaviour problems. In the case of some youngsters with very extreme temperaments, prevention can mean making a number of accommodations. This sometimes causes others to criticize families for building the world around the child. But when children are young, they have very little self-control, so it makes sense for parents to assume this control and protect their children from getting into situations that they cannot handle. Remember though, that coping with small amounts of manageable stress helps build resiliency, so take care not to overprotect your child.

There are many helpful suggestions for coping with your child's individuality in parenting books on temperament available from your public library. One of the most popular is Raising Your Spirited Child by Mary Sheedy Kurcinka. Temperament experts agree that the most effective way to promote positive behaviour is to praise your child generously not only when she exercises restraint, but even when she just tries a little harder. It is also helpful to remember that, with a difficult child, progress is achieved in small steps. Backsliding is to be expected. And keep in mind the fact that your child didn't ask to be wired this way. Life can be just as hard for her as it is for you, maybe even tougher.

What if, in spite of all your positive approaches, your child defies your commands, perhaps even kicking you in the shins and calling you “poo-poo face?” Getting angry won't help. Remember who the grown-up is in this situation and stand tall! Difficult children can easily tell when you are afraid of thwarting them. Don't yell, nag or plead as this strongly strengthens, or reinforces, the misbehaviour. And don't back down. This also strongly reinforces behaviour. Instead, calmly and without anger or apology, deliver a consequence. “You hit mommy. You sit on the thinking chair for two minutes.” Don't discuss feelings or reasons at this point. Discussions close to the time of the misbehaviour will reinforce it. Later you can explain to your child the reason for the consequence.

However, take care to use consequences and other penalties sparingly. Research makes it clear that frequent punishment can make any child resentful, insecure or aggressive. If you find you are constantly punishing, it is time to take stock of the situation. Perhaps you need to revise your expectations. Perhaps you child is reacting to marital problems that must be resolved before you can expect much improvement. Perhaps your discipline methods are not working because you are not implementing them correctly. This is a very common problem.

For effective methods, turn to Carolyn Webster-Stratton's The Incredible Years, or Parenting the Strong-Willed Child by Forehand and Johnson. Instead of books, some parents prefer to use research-based videotape programs such as The Parent and Child Series by Webster-Stratton. And consider seriously seeing a clinical child psychologist for specialized help. The BC College of Psychologists Referral Service can give you the names of psychologists in your area. Psychological services are often covered by Extended Health Plans.

Now that you've resolved to become an expert parent, the last step will help you stick to your new resolutions about discipline. Sign up for a parent education and support program especially designed for families of temperamentally “spirited” young children. The West-Main Health Unit in Vancouver has been piloting such programs over the past two years and is now working on a project to develop and offer such programs in other communities. Call your health unit and let them know you need one soon.

This article first appeared in Family Connections (Spring/Summer 1998), published by the BC Council for Families.