Correction to This Article
A reference in this article to an online discussion about managing difficult children inaccurately said described Alan Kazdin as a child psychiatrist. He is a psychologist.

Take My Kid, Please!

By Sandra G. Boodman
Washington Post Staff Write
Tuesday, March 25, 2008

They are the children no parent dreams of having, but many are struggling to raise.

As a group they bear various labels: difficult, challenging, hard to handle, defiant, volatile, willful. For nearly a century, experts have advised parents to employ a variety of often contradictory methods to deal with them.

Yet parents who must navigate the minefield of daily life often complain that they haplessly ricochet from one approach to another, with little or no success.

"Every part of everyday life became a huge task that affected our whole family," said one Washington father, who asked not to be identified to protect the privacy of his son, now 11, whom he described as difficult from birth. "It was relentless."

The confusion and angst surrounding how to cope with a child who routinely throws prolonged tantrums long after the "terrible twos," chronically forgets to turn in homework or otherwise refuses to get with the program are shared by parents whose children wouldn't be defined as difficult. ("Difficult" can be an elastic term that reflects the fit between a parent's and a child's temperaments.)

Now two new books by veteran psychologists offer advice for parents culled from decades of clinical practice. Both volumes emphasize behavior modification, an approach the authors say can be useful for parents who are stymied by difficult behavior that occurs habitually or sporadically. The authors recommend "positive parenting," which basically urges parents to "catch children being good," coupled with a systematic regimen designed to extinguish unwanted behavior by failing to reward it. Behavioral approaches generally involve setting clear limits, consistently and calmly adhering to them, and prompting and rewarding desired behavior. Some satisfied parents liken the methods to those for training a dog.

"Effective Parenting for the Hard-to-Manage Child" by Washington area psychologists Georgia DeGangi and Anne Kendall (2008, Routledge, $24.95) is written in a workbook format and aimed at parents of children 12 and younger who have a variety of emotional problems. Some take medication for attention deficit disorder, depression or anxiety, while others are socially clueless or stubbornly oppositional. Experts agree that although drugs may help suppress some troublesome symptoms, they do not change difficult behaviors, a point made in both books.

Yale psychology professor Alan Kazdin is the author with Carlo Rotella of "The Kazdin Method for Parenting the Defiant Child With No Pills, No Therapy and No Contest of Wills" (2008, Houghton Mifflin, $26 ). Kazdin's regimen, demonstrated in an accompanying DVD, is based on nearly two decades as director of the Yale Parenting Center and Child Conduct Clinic, working with children often referred by schools or courts. Kazdin said his techniques reflect the best available scientific evidence about what works -- and more important, what does not.

"Most popular parenting books violate the tenets of what we know is effective," Kazdin said. Many, he observed, advocate that parents "understand your child, talk to your child so he won't be angry. It's wonderful to talk to your child, but talking won't change his behavior for a minute," added Kazdin, president of the American Psychological Association.

Both books reflect an emerging consensus in the field of child development.

"Difficult children have always been around," said Michelle Macias, a professor of pediatrics at the Medical University of South Carolina who chairs the American Academy of Pediatrics section on developmental and behavioral pediatrics. These days, she noted, "the variability of child development and behavior is better understood."

"There is quite a range about what parents consider difficult," Macias added, some of it unrealistic. She said she commonly encounters parents who know nothing about basic child development or workable parenting strategies.

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