Counselors teach parents how to manage unruly children

Caleb-Ray Richmond came into this world prematurely, but by the time he was 2 years old, he was the ruler of his family’s Milwaukee home.

When things didn’t go his way, when his fatigue spiraled into hyperactivity, toys would fly across the room, fists pounded the floor and the tears seemed never-ending.

“Caleb was boss and we were doing what Caleb wanted,” says his mother, Kayla Richmond.

He raged in temper tantrums many times a day. Playtime with his 9-year-old cousin routinely dissolved into heated arguments.

Caleb’s parents sought help. For eight straight weeks, a counselor came to the Richmond home, working with Caleb and his mom, teaching how to let Caleb lead in playtime and how Richmond should use consistent discipline tools, such as timeouts and ignoring any whining.

The Milwaukee-based Behavior Clinic, jointly run through Penfield Children’s Center and Marquette University, focuses on treating children up to age 6 with therapy in families’ homes.

For young children with severe behavioral issues, getting help early on is considered essential to success in school and life as an adult. Children with severe behavioral issues face increased risk of expulsion from preschool and child care programs.

The Behavior Clinic treats more than 100 children each year and has a waiting list of 70.

“Our approach isn’t rocket science. It’s teaching parents how to manage kids in a successful way,” says Robert Fox, director of the Behavior Clinic and a professor in the counseling and educational psychology department at Marquette.

Essentially, counselors coach parents using hands-on training each week with developmentally appropriate techniques.

Parents catch their children doing good things; they have systematic consequences, such as a timeout for writing on the wall and then making sure the child helps clean the wall; and they stick with the same consequences for less-than-ideal behavior.

On a recent follow-up visit, family counselor Kimberly McCormick watched Caleb, who turns 3 this spring, and Richmond play with big Lego blocks, dump trucks and cars.

Caleb shrieked with joy after successfully balancing toys on top of each other and delivered high-fives to his mom, McCormick and other visitors.

“Kayla is the epitome of what we want people to do,” McCormick says. “She’s been really on top of things and consistent.”

Consistency is key, and for it to be effective, everyone in the household has to be on board.

Richmond says she, Caleb’s father and her mother all teamed up. Her mom watches Caleb during the day while his parents are at work.

“It was a learning process for all of us,” Richmond says. “It’s different when you share the rules with three people.”

She says they had to make sure they all were practicing the same concepts with Caleb. And it’s worked.

His tantrums have diminished and he cries much less. He plays much better with his cousin, Richmond says, with much less quarreling. He does still have some issues, such as calming down at night to get to sleep.

Nearly half of families that start out the program drop out before the end; it takes on average 11 or 12 weeks for families to complete the program.

“We front-load all the stuff at the beginning,” Fox says. “We get in as much as we can in as short a period as we can.”

Many factors come into play that make it difficult for some families to stick with the in-home sessions – maturity, and barriers such as living in poverty, having several young children at home and very little social support, and living in high-risk neighborhoods, according to Heather Rotolo, clinical director.

Families also may have very little structure or routines in the home.

“Everybody’s off. They’re off schedule and they’re off emotionally,” Rotolo says.

By the time they seek help at the Behavior Clinic, she says, “sometimes parents will say they don’t even like their kid anymore.”

In the first session, parents learn to thrive with their children again, Fox explains, primarily through nondirected play.

Play therapy helps change children’s behavior when they’re too young for talk therapy, says Andrea Begodka, who works with children as part of the psychiatry and gastroenterology departments at Children’s Hospital of Wisconsin in Wauwatosa.

When children start in the Behavior Clinic program, Fox says, 85 percent of them will meet the criteria for a psychiatric diagnosis. By the time they complete the sessions, less than 20 percent will have a formal psychiatric diagnosis.

But even if families don’t complete the full program, they can still see some meaningful changes quickly.

“With these kids, if you can get the parents on board, you can see change in three or four weeks because the kids are so young,” Fox says.

Denee Harvey, of Milwaukee, watched her 3-year-old daughter Teagan transform from throwing tantrums when she didn’t get her way to being more social, loving school and having far fewer tantrums.

“I felt like she was the bully,” Harvey says. “It got progressively worse. We’d go to a store and she’d throw a fit if she didn’t get her way. Me being a mom, I’d give in.”

Teagan was diagnosed with oppositional defiant disorder. She also has a slight delay in her speech development, so she was often frustrated when trying to talk, Harvey says.

Before they started the Behavior Clinic program, Teagan would have tantrums three or four times a day. Now she has a tantrum at most once every couple of weeks, her mom says.

“It’s made a world of difference. We communicate a lot better,” Harvey says. “We do our child-led play and it gives her the feeling that she’s in control for once.”