Behavior Management Clinic

The clinic provides family based care with assessment and treatment delivery from a behavioral and cognitive behavioral approach. Caregiver training in effective behavior management techniques and procedures is common however children are also be treated individually or in groups to address internalizing problems, emotion management, and social skills deficits. Several clinicians within the Behavior Management Clinic are certified Parent Child Interaction Therapy (PCIT) providers.

Behavior difficulties treated in this clinic include:

• Noncompliance
• Sleep/toileting problems
• Tantrums
• Habit disorders (tics, hair pulling)
• Physical Aggression
• Anxiety/mood disorders
• Disruptive/destructive behaviors
• Poor impulse controls
• Mild self-injury
• Social skills deficits
• Elopement

The overarching mission and focus of the clinic centers on evaluation and treatment of behavioral, social, and emotional problems of childhood. We seek to assist parents and/or other caregivers to understand and effectively manage problem behaviors and to help children acquire skills that lead to improved functioning. We also endeavor to provide training and support to community providers and agencies working with our children and families (through consultation). Treatment is systematic, evidence based, and involves parents/caregivers’ active participation. Prior to treatment, a behavioral assessment is conducted utilizing indirect methods such as clinical/behavioral interview (parent and/or child) and administration of standardized behavior rating scales and questionnaires. Direct observation of parent-child interactions, both naturalistic and analogue, is often conducted prior to treatment. Specific, measurable treatment objectives delineated at the outset of treatment, are revisited throughout care and prescribe the timing of treatment termination. Treatment includes ongoing monitoring of contextual variables that may impact care and inform treatment planning.

Success Story:

D.M. was an 8-year-old male diagnosed with attention deficit hyperactivity disorder (combined type), disruptive behavior disorder and mild intellectual disabilities. Presenting concerns at intake included school difficulties, (i.e., disruptive behavior, poor academic achievement), short attention span, hyperactivity, physical aggression, arguing with twin sister, interrupting and noncompliance. At the time of the initial evaluation, D.M.'s attention deficit and mild retardation had not been diagnosed; therefore, referrals were initiated to Kennedy Krieger's Developmental Pediatrics and Neuropsychology services. The child had a history of in utero drug exposure and removal from biological parent's care. He and his twin sister were cared for by the maternal great grandmother. Outpatient treatment focused on caregiver training in behavior management and assistance in ADHD diagnosis and education. The caregiver was trained in the use positive reinforcement, planned ignoring, three-step guided compliance and time-out. Following training and mastery of these skills, the caregiver received assistance in developing and implementing a home reinforcement program. Over the course of treatment, D.M. had a 93 percent reduction in aggression, 85 percent reduction in sibling arguing, 80 percent reduction in interrupting and an 80 percent reduction in noncompliance. The family was seen for 19 sessions in all (three devoted to intake, direct observation, and feedback, 12 treatment sessions, four maintenance sessions). Over the course of treatment, D.M. was also started on stimulant medication.