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Published On June 10, 2015

CLINICAL RESEARCH

The Explosive Child Revisited

Bad behavior in children may come from a lack of certain cognitive skills. Studies show that those skills can be taught.

Nearly one in five children in the United States engages in serious disruptive behavior that may range from tantrums to outright violence. And for years, most child therapists considered such problems to be pleas for attention or attempts to avoid responsibility—and that rewards or punishment would motivate trouble-making kids to do better.

But a 2007 Proto article, “Calming the Explosive Child,” explored the idea that chronic bad behavior in children might be brought on by underdeveloped cognitive skills—akin to a learning disability such as dyslexia. The story also suggested that explosive children might be “defused” by showing them empathy and helping them cultivate flexibility in thinking, frustration tolerance and other cognitive abilities. That’s an approach known as Collaborative Problem Solving (CPS). 

Since then, this method of helping difficult children has been finding a wider audience. The approach was developed in the department of psychiatry at Massachusetts General Hospital, which is now home to a CPS- focused program called Think:Kids.  

J. Stuart Ablon, who leads the program, and his team of psychologists have been training teachers, psychologists, corrections officers and other professionals to use the CPS method and teach it to others. At the other end of the country, Think:Kids trainers from Oregon Health & Science University have trained hundreds of staff from more than 50 agencies across the state in the CPS model. Ottawa, meanwhile, has adopted the CPS approach in all of its youth services facilities, and more than 5,000 school safety agents in New York City have received CPS training. Recent inquiries from Australia and New Zealand could take Think:Kids even farther afield. 

Many who work with difficult children were initially skeptical about the CPS philosophy. “But we’re certainly seeing a shift,” says Ablon, who notes that evolving ideas about the origins of behavioral problems are helping to drive interest in CPS. For example, neuroscientists have shown that brain development is altered in children subjected to chronic stress or trauma. Meanwhile, CPS fits well with the growing embrace of a treatment philosophy known as trauma-informed care, which recognizes that children exposed to persistent stress and trauma often develop disruptive or destructive behaviors.

While there has been limited research on CPS itself, a 2004 study at MGH involving 47 families found it to be more effective than traditional approaches for managing disobedient and defiant children. A larger follow-up study funded by the National Institute of Mental Health was published in March; it found that the behavior of nearly half of the kids treated with the CPS approach were “much” or “very much” improved after six months, a response similar to that of children disciplined with traditional reinforcement techniques. And Ablon and several colleagues recently studied 320 children in Ottawa. They found that CPS was associated with improved impulse control and flexible thinking, as well as increased empathy in caregivers for children who chronically misbehave. Says Ablon, “Adults are coming to see that these kids lack the skill, not the will, to behave.”