Hesperian Health Guides
Communication improves behavior problems
HealthWiki > Helping Children Live with HIV > Chapter 4: Communicating with children > Communication improves behavior problems
When children older than babies behave badly, it can be difficult to remember that their behavior is a kind of communication and they may not be able to behave differently at that moment. Children who experience loss, illness, or other difficulties in their families may struggle with feelings they do not know how to manage in other ways. Although their behavior may make you angry or hopeless, what children behaving badly need is your help learning:
- how to deal with anger, sadness, hurt, disappointment, or too much excitement.
- how to better communicate their feelings.
- how to calm themselves down.
To help children learn those skills, we adults often need to learn or better use the same skills.
Good communication can help when children:
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 Mama! Mama! |
 My tummy hurts! |
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Contents
Responding to tantrums
A tantrum (or temper tantrum) is an outburst that usually happens when a young child cannot get something he wants. The child may scream, cry, lie on the ground kicking, or hit or bite the caregiver. Many children between 1 and 4 years old have tantrums sometimes, and usually stop having them regularly by the age of 4 or 5. Hungry, tired, or ill children have tantrums more easily. Children with disabilities may have tantrums if others find it difficult to understand them or meet their needs, or if they are very slow to learn.
Children do not have tantrums on purpose to annoy or upset caregivers. But if children do not get the attention they want when they behave well, they may have tantrums because they learn a tantrum gets them what they want.
| Kwame is playing by himself. He wants his mother to play with him. | When she ignores him, then yells at him, Kwame has a tantrum. | Then Kwame’s mother goes to him, and gives him her full attention. |
 Ma!
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 Waaa! Aaah!
Kwame! Stop that! |
 Shhh. Mama is here now. |
| Refusing attention when Kwame is being good... | and giving it only when he screams and yells... | encourages bad behavior. |
 Are you helping Mama cook? |
 Waaa! Aaah! |
 I hear you drumming. |
| Giving attention when Kwame is being good... | and refusing it when he yells... | encourages good behavior. |
What to do when a tantrum happens
During a tantrum, a child loses control. You cannot expect more from the child at that moment. Hitting, pinching, shaking, or threatening a child often makes a tantrum worse. Even though you too may feel very upset, you must wait for the child to calm down so your communication can reach him.
- Stay calm. Take some deep breaths while you decide what to do.
- Stay near your child, even if you are not speaking to or looking at him
- Give your child time to calm down
- Do not bribe your child or give in to a tantrum. Doing so only teaches that a tantrum will get a child what he wants.
If your child has a tantrum in a public place, such as at the market or clinic, take the child away from the situation until he calms down. Once you and the child are calm, return to the activity. Do not teach a child that throwing a tantrum will get her out of an important activity, such as going to the clinic.
To prevent tantrums
Uh-oh.
Aaaah! |
Nadia? Come help me pick tomatoes! OK? |
- Have reasonable expectations for a child’s age, and give children clear, simple directions.
- Notice and praise good behavior.
- Plan ahead when possible. For example, if you know you will have to wait at the clinic all day, bring a snack or toy to keep your child fed or occupied while waiting. Prepare children for changes.
- Watch and listen to your children so you know if distress is building. If you know when a child always wants something, such as walking by a certain shop, you may be able to distract the child before an upset takes hold
Responding to hitting, fighting, or destructiveness
When children older than about age 3 fight a lot, break or steal things, or are cruel to other children (or animals), it is often because they hurt inside. They may be angry, afraid, or sad about things that happened to them, and do not know how to express those feelings. Many boys act this way because they learn that fighting is something boys can do to gain respect or get something they want.
Children acting this way are often very insecure. They relate poorly to other children and do not make friends, which makes things worse. One of the worst things about this way of acting is that it pushes others away, including caregivers, when children most need support.
To help a child who fights or hits:
- Talk with him about things that might be upsetting him.
- Help him develop self-confidence. Show him affection and recognize him when he is helpful.
- Clearly explain what behavior is not acceptable and what will happen if he does not respect the rules.
- Try to stop other children from teasing him or starting fights. See if you can enlist friends of his or older children to help with this.
- Help him learn self-control and find better ways to express feelings of anger or discomfort. Talk with an older child about how he might ask for help, walk away from things that upset him, or think of something he likes to do instead.
Show a good example by staying calm and firm with the child when you are angry yourself or upset with him, rather than hitting the child or losing your temper. If you punish him, give a fair punishment that helps the child learn.
A child who is used to fighting, hitting or kicking as a way of handling feelings needs time to learn other ways. Try to be patient and keep working on it.
| The boy who became mean |
Josiah is 6 years old and does not know about HIV, but he knows his mother is ill. He walks with her to the clinic and they wait for her turn. Sometimes he plays with other children there. But recently his mother has been taking a new medicine and they must go more often to the clinic. She is more tired and sometimes stays in bed a lot. Now he has fights at the clinic, tells lies, and makes up mean stories about other children.
What can I do? I am so tired and ill. I don’t have the strength to raise a child who causes so much trouble!
Many children are like this when their mother is sick. He sees you are weak and worries about you. But he is too young to know what to do, so he acts badly. Do you talk to him about your illness? 
When I am too tired to do much, how do you feel?
Like this, mama. Josiah’s mother thought about how she could talk to her son. As they walked home, she talked a little about her illness and then let Josiah ask questions. She tried to answer simply but as best she could. 
I know how that feels — it’s like a stone inside you. I am sorry, baby. Whenever you feel that stone, you come give my hand a squeeze. When I feel that way, it helps if I tell someone. |
Responding to sleeping problems
Some problems with sleeping may be helped by following a routine at night. Do not let the child play very active games, hear scary stories, or watch TV just before going to bed. Turn down the radio or TV. Make her comfortable and tell her a quiet story or talk about a good thing that happened that day.
If your child wakes from a nightmare, comfort and calm her. Tell her it was only a dream and she is safe. Let her tell you about the bad dream, but make sure she sees that she is safe first.
Sometimes children wake in the night screaming and cannot be comforted or touched. These are night terrors, and are harder on the caregiver than the child. To help, just watch the child and see that she does not hurt herself. Wait until the screaming stops and the child is fully awake. She will not remember her screaming and will usually go back to sleep quickly.
Responding to bed wetting
Children dealing with difficulties may slow in their development or act younger, losing abilities they had developed. A common problem is wetting the bed when the child no longer wears nappies or diapers. Bed wetting is hard for both children and caregivers.
Do not beat or scold a child who wet the bed — it will not help. He does not do it on purpose and usually he is already upset and ashamed. Make sure he has clean clothes and bedding, and does not smell of urine when he goes to school.
To make wetting the bed less likely:
- Do not let your child drink too much in the evening before bed.
- Have him go to the toilet right before bed.
- Just before you go to bed yourself, wake him to go to the toilet again.
- Keep a bucket in the room to make going to the toilet easier.