Skip to content

Child Behavior Problem? Consider a Bio-Psycho-Social Approach to Assessment and Treatment

April 21, 2016

When children surface with behavioral challenges, there can be many underlying factors giving rise to the behavior.

The first step in the helping process is for both parents to meet with a professional with knowledge, training and expertise in child behavior issues. That professional should interview the parents without the child present and conduct a bio-psycho-social assessment. In other words, the professional should ask questions to help determine if the issue underlying the behavior has a biological or physiological basis, a psychological basis, a social basis or a combination of factors thereof.

Depending on the information gleaned by the professional, the next steps may include receiving reports, seeing the child directly, referral for additional assessment and/or guidance to the parents to help manage the behavior directly.

For example;

  1. Eight-year-old Ryan had problems at school yet was well behaved at home. He was fine on his own, but in groups his behavior deteriorated and it was difficult for the teacher to gain his attention. The assessor met with the parents and learned that Ryan had recurring earaches as a toddler and that although his hearing cleared up, the assessor was concerned that Ryan was likely left with an auditory processing disorder. Ryan was sent for additional testing that confirmed the assessor’s concern. Help for Ryan included preferential seating at school and his teacher using visual as opposed to verbal strategies to gain his attention when the classroom was busy or noisy. Behavior quickly settled down.
  2. Nine-year-old Bethany was described as having anxiety. She was apparently nervous when asked to go from one class to another and frequently appeared nervous when asked to go to bed. Her teachers and parents would always provide additional special time for Bethany to adjust to expectations. After enjoying her special time, then she would follow through with expectations. The assessment determined that this wasn’t anxiety in its true form, but a means of getting out of task. Bethany learned that if she simply resisted expectations she would be punished, but if she said she was nervous or scared, her parents and teachers would give in to her wishes. As parents and teachers held her accountable to expectations, her behavior subsided.
  3. Seven-years-old Jacob had stomachaches. He had been to see his doctor and was even scoped. There was no physical basis to his complaints. In meeting with the parents it was discovered that there was abusive behavior between the parents. In meeting with Jacob, he revealed that whenever he heard his parents fight, he would go between them and say his stomach hurt. According to Jacob his parents would then stop fighting and start concentrating on him. This was his strategy for keeping his parents safe. Therapy was directed towards helping the parents manage their relationship peacefully. His stomachaches went away.

It is important for parents to appreciate that treatment or therapy or intervention follows a good assessment.

Without a reasonable assessment, help may not be directed appropriately. This leads to treatment failure and can make the situation worse.

Be wary of therapists who seem willing to ask few questions of the parents and go directly to working with your child.

Child behavior problems can be multi-faceted and the best approach starts with a multitude of questions and includes a good developmental history. See someone who will take a bio-psycho-social approach.

Do you know someone who might benefit from this information? Please scroll down and share this article. Need help for a child behavior problem? Call me.

I am Gary Direnfeld and I am a social worker.

Gary Direnfeld, MSW, RSW

Linked In

Gary Direnfeld is a social worker. Courts in Ontario, Canada, consider him an expert in social work, marital and family therapy, child development, parent-child relations and custody and access matters. Gary is the host of the TV reality show, Newlywed, Nearly Dead, parenting columnist for the Hamilton Spectator and author of Marriage Rescue: Overcoming the ten deadly sins in failing relationships. Gary maintains a private practice in Dundas and Georgina Ontario, providing a range of services for people in distress. He speaks at conferences and workshops throughout North America.

If your relationship is faltering, then set it as your priority.

Read: Marriage Rescue: Overcoming ten deadly sins in failing relationships

One Comment
  1. Good to see this.

    Too often we seem to concentrate on the biological at the expense of other areas.

    Biology will always be involved as we are biological entities, however the biological usually contributes to making things more likely and is rarely (if ever) the only contributing factor.

    Full assessment is always vital otherwise treatable problems are missed and physical disorders can be ignored.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: