Protocols for Problem-Solving

This section presents vignettes about Anna, a toddler enrolled in an Early Head Start program. These vignettes illustrate how to use a problem-solving protocol to address children's behavior.

As a newborn, Anna lived in an apartment with her very young mother and a variety of her mother's friends who moved in and out. They sometimes played with and fussed over her, but they were just as likely to get involved with watching television or listening to music and not even hear her cries. This created uncertainty for Anna; her needs for food, getting her diaper changed, and being comforted when upset were inconsistently met. When Anna was 13 months old, her mother dropped her off at her grandmother's house and never came back. Although her grandmother, Mrs. Petit, was a familiar figure in her life, Anna was distressed by her own mother's disappearance; she often cried and said "mama." Mrs. Petit wanted to do her best to take care of Anna, but she wasn't sure what Anna should be doing developmentally—or what she herself should be doing to help Anna.

When Anna was 20 months old, Mrs. Petit enrolled her in an Early Head Start center. At first, the other children responded positively to her. She has a lot of energy and laughs a lot. They played next to her and followed her when she climbed on the indoor climber or ran in the outdoor play space. They giggled and laughed when she put dolls in toy trucks and pushed the trucks across the floor or sent a doll down the indoor slide. However, when another child had a toy she wanted, she said loudly, "No! Mine!" and tried to take it. She often hit or bit if the child resisted.

Now the other toddlers seem cautious around her. Naomi, Anna's primary caregiver, hears them saying things like, "Anna bites." She notices children leaving the sandbox when Anna comes over to play. In addition to hitting and biting when she wants a toy she cannot have, Anna has started falling on the ground, crying and kicking her legs. Falling, crying, and kicking also happen during transitions like cleanup time or coming inside from outdoor play. Naptime is challenging, too. Anna does not sleep; she lays on her cot and talks, sings, and hums. The noise keeps some children from sleeping or wakes them up before they are ready.

Naomi feels increasingly anxious about how best to work with Anna, and she worries about how Anna is affecting the other children. Mrs. Petit has also recently shared that Anna tried to take a toy from her cousin and then bit him. She also stopped wanting to take naps in the afternoon. By dinner time, she is so tired that she often cries and falls on the floor when it is time to stop playing and eat. Mrs. Petit says she is frustrated because nothing she does to calm Anna seems to work.

Anna's Early Head Start program had a well-established relationship with Jerry, the program's mental health consultant from the community mental health center. He helped develop protocols for identifying concerns, including choosing an appropriate screening tool, and using their ongoing child assessment tool to track the children's approaches to learning and social and emotional development over time. In addition, he provided training and consultation to staff members and families. With Jerry present, the program conducted a "problem-solving meeting" that included Naomi, her supervisor, and Mrs. Petit. They worked through their problem-solving protocol, explored Anna's history and the effect it may have on her actions, and developed a plan to improve the situation for everyone.

Many Head Start and Early Head Start programs use a problem-solving protocol to understand and manage children's behaviors. Such protocols outline steps staff and families can take to address behaviors. They also include actions such as observation and documentation, identifying the purpose or function of the behaviors through answering questions, developing hypotheses or best guesses about what the behaviors mean, and developing supportive ways to respond. Two commonly used protocols are available from the Center on the Social and Emotional Foundations for Early Learning (CSEFEL):

• Behavior Intervention and Positive Behavior Support
• CSEFEL Infant/Toddler Module 3: Individualized Intervention with Infants and Toddlers: Determining the Meaning of Behavior and Developing Appropriate Responses

Anna's program follows the protocol in CSEFEL's Infant/Toddler Module 3. The following discussion shows how Mrs. Petit, Naomi and her supervisor, and Jerry work through the problem-solving questions.

A Sample Protocol for Understanding and Managing Children's Behaviors¹

1. Observe and document.
2. Provide immediate action for any unsafe behavior.
3. Review these questions during reflective supervision or other team meetings.
   1. What is the child experiencing? What might be the child's perspective on the situation?
   2. What, when, where, how, and with whom is the behavior occurring?
   3. What is the child communicating that he or she wants or needs? What is the purpose of the child's behavior? What is the meaning of the child's behavior?
   4. What effect does the child's behavior have on others? What do others do or stop doing in response to the child's behavior?
   5. What do we (education staff and family) want the child to do now? What skills do we want the child to develop? What are our long-term goals for the child?
4. Meet with the family to deepen understanding and collaborate on strategies.
5. Determine a consistent plan for intervention.
6. Continue observation and documentation to provide data for evaluating improvement and ensuring the consistency of the intervention.
7. Consult with a mental health professional if the child is not responding and the intensity, frequency, and duration of the behavior is not improving.
8. Determine whether further referral to community resources is necessary through discussion with the family, supervisor, and mental health professional.

Positive Behavior Support²

Positive Behavior Support is a six-step process that offers an approach to providing intensive individualized interventions for children whose repeated pattern of behavior interferes with learning or engaging in prosocial interactions with peers and adults. Behaviors may include prolonged tantrums, physical and verbal aggression, disruptive vocal and motor behavior, property destruction, self-injury, noncompliance, and withdrawal. These repeated behavior patterns typically do not respond to the use of developmentally appropriate guidance practices.

The six steps of Positive Behavior Support are:

1. Building a Behavior Support Team
2. Person-Centered Planning
3. Functional Behavior Assessment
4. Hypothesis Development
5. Behavior Support Plan
6. Monitoring Outcomes

What is the child experiencing? What might be the child's perspective on the situation? Children use the best ideas they can devise to solve the problems in their lives. For example, toddlers struggle to learn the rules of their society and try very hard to "get it right."³ Those rules, however, can seem arbitrary and contradictory to a young child.

Mrs. Petit shared that, for the first nine months of Anna's life, Anna watched her mother and her mother's friends carrying on, laughing, teasing, and taking what they wanted from one another. They all appeared to get along and have a very good time. Mrs. Petit admitted that while she doesn't grab things from others, she doesn't mind when Anna does. She wondered if when Anna sees that the other children have the toys they want, she thinks she's supposed to have the toys she wants, too.

Jerry suggested that, for Anna, the Early Head Start program may feel very much like the endless parties at her mother's apartment—lots of people, lots of activity and noise, and everyone taking what they want. Mrs. Petit described how Anna's mother's friends even took away Anna's crackers just to see how they could make her cry. They were teasing and meant no harm.

However, Jerry pointed out that the teasing was probably distressing for a young baby who had her treats taken from her. He also emphasized that she was learning some things from her mother's friends about how people behave in groups. As Naomi started to understand how the experience might feel from Anna's perspective, she realized Anna was misdirected rather than mean.

What, when, where, how, and with whom is the behavior occurring? Behavior that bothers adults can seem constant and endless. Careful observation can help education staff move beyond their own reactions and analyze and understand the behavior. These familiar, simple questions can focus an observation and highlight the situations in which the behavior occurs. For example:

• What happens? Does Anna grab for a toy and bite when she is resisted, or does she bite as a first step and then take the toy from the crying child?
• When? Does Anna bite or hit once a day? Seven times? One hundred? Does she come in biting? Does she bite in the late morning when she is tired? Are the episodes where she falls to the ground, cries, and kicks her legs related to the biting? When do they happen? How long do the episodes last?
• Where? Does Anna grab toys indoors and outside? Does she grab a toy from a friend when there is a duplicate toy available? Does she behave the same way in open active spaces and in quiet protected spaces? Is the room arranged in a way that provides space for both active play and cozy cuddling?
• How? Does Anna issue a warning or is her behavior sudden and unpredictable?
• With whom? Who is Anna likely to bite, hit, or grab things from? Is only one child affected, or does she use these behaviors with several or all the children in the classroom?

Observation can clarify the actual behavior and the circumstances surrounding the behavior.

Naomi described Anna's grabbing, biting, and hitting as constant, but by using the observation protocol that Jerry provided, she discovered quite a lot about Anna. In the morning, Anna entered the room full of energy and went right to the climbing and rocking toys. She wandered from activity to activity after that, never settling long enough to explore. Outside, she was always on the move. Indoors, her grabbing, biting, and hitting were more focused than Naomi had realized. Two younger, smaller children were the targets, usually when they had possession of her favorite doll or when they sat on the top of a little climbing structure near the window. Episodes of falling on the ground, crying, and kicking her legs during transitions were specifically related to having to stop playing with her favorite indoor or outdoor toys. They lasted about two to four minutes. Based on this information, Anna's inability to calm and focus during the day became as great a concern for the adults as the biting had been.

What is the child communicating that he or she wants or needs? What is the purpose of the child's behavior? What is the meaning of the child's behavior? Careful observation is pivotal in creating strategies. When observations are analyzed, they can reveal important clues to understanding children's motivations. The mental health professional's perspective can help staff and families discover underlying reasons for the behavior.

Jerry offered some thoughts about Anna's behaviors. He suggested that although biting, grabbing, and falling to the ground, then crying and kicking all carry messages, Anna's aimless wandering and constant movement also speak to her understanding of the world. Anna's early experiences were highly uncertain. She was surrounded by young, active friends of her mother, but her own needs for food, warmth, and comfort were inconsistently met in response to her cries. The music and activity around her likely provided more stimulation than she could manage. Her own energy was focused on getting by until someone fed her, or later as she was able to crawl and then walk, finding ways to help herself.

Jerry's perspective helped Naomi and Mrs. Petit become aware of Anna's overriding sense of unpredictability in her life. He recognized the combination of early experience and the wandering behavior as a potential sign that Anna does not feel safe enough to focus her attention for very long on anything. Her constant movement and vigilant observation of the room become exhausting; still, she does not rest. Although it was clear the biting and other disruptive behaviors had to stop, Jerry, Naomi, her supervisor, and Mrs. Petit decided that helping Anna feel safe and calm might be the most effective plan to focus on first.

What effect does the child's behavior have on others? What do others do or stop doing in response to the child's behavior? Tracking how other children and adults respond to a child's behavior is important because it helps identify the consequences that follow the behavior.⁴ Typically, consequences reinforce or maintain the behavior because the child gets what he or she wants or needs (e.g., a favored toy, a request for help, an escape from an undesirable activity).

Jerry helped Naomi and Mrs. Petit see that biting, grabbing, and falling on the floor, crying and kicking always resulted in Anna getting the toy she wanted, a delay in doing something she did not want to do (e.g., transitions, nap), and extra one-on-one attention from Naomi and the other classroom teacher. Jerry also suggested that these "maintaining consequences" offered Anna some predictability. He said it might be useful to identify different ways to respond to these behaviors, as well as respond to Anna when not she's engaged in these behaviors.

What do we (education staff, family) want the child to do now? What skills do we want the child to develop? What are our long-term goals for the child? Adults are more likely to tell young children not to do things than to tell them what they want them to do and offer them support to do it. Reframe skills and goals more positively. This can lead to more effective and strengths-based strategies.

As adults approach children's behaviors with effective strategies, the nature of the relationship begins to shift. It takes time and effort to understand the intent of a child's communication, but the payoff is worth it because children will feel valued and important. They will learn that adults will "hang in there" and try to understand what they are communicating through their behavior. Children will learn to communicate their intentions, feelings, and emotions in developmentally and culturally appropriate ways.

With time and effort, adults may feel more competent about, more interested in, and more empathic to the child's experience. The child may begin to gain skills as a partner in a mutual relationship.

Mrs. Petit tended to let Anna run around the house. In past efforts to cooperate with one of the program's requests, she tried to sit down and read a book with Anna. But as soon as Anna jumped up, Mrs. Petit abandoned the effort (a maintaining behavior). Now, she decided to try saying, "Please sit with me, Anna, while we look at this book." Naomi also realized that she rarely tried to actively engage Anna in play or sustain her interest. She decided to try telling Anna, "Please stay here and try this with me."

The next morning, Naomi noticed Anna dropping a doll down the slide. As Anna began to wander off to the next activity, Naomi called her back playfully and said, "That was really funny — your doll going down the slide. Have you ever dropped a ball down a slide? Come here. I'm going to try it." Anna was surprised but interested.

Laughing heartily when Naomi dropped the ball, she then retrieved it and repeated the action herself. Naomi invited her to find more things they could drop down the slide together, now guessing which would go quickly and which slowly. Anna sustained interest in this activity for several minutes and returned to it later on her own.

Naomi and Mrs. Petit began to fill Anna's day with other little moments of supported interest. Their invitations to play included directions such as, "Now sit here with me for a moment."; "Can you add two more blocks?" "Can you stir this just a few more times?" Slowly, Anna started to become calmer and participate in more exploratory play.

Naomi was equally clear about the biting, telling Anna, "No biting, Anna. Ask your friend for the doll. Bring your friend a different doll to play with. Play with this while you are waiting for the doll." Naomi was providing Anna with a variety of alternatives for getting her needs met.

Head Start in Action

Teachers who work with 3-year-olds in a Pennsylvania Head Start program find it is helpful to begin by using the child's name, kneeling or sitting down at the child's level, and being direct:

• "Jason, sit in the chair."
  Instead of, "Jason, if you stand in the chair you might fall and hurt yourself."
• "Maria, tap Jamar's shoulder gently." Then the teacher can model a gentle tap.
  Instead of, "Maria, if you hit Jamar hard on his shoulder. That might hurt him."
• "Miguel, paint on the paper."
  Instead of, "Miguel, why are you painting on the floor when there is paper right in front of you?"

It's important to come down to the child's level so the child knows you are speaking to him or her. Teachers can’t assume young children know what we want them to do, especially if we do not explain the situation to them. What is obvious to us is not obvious to a young child. By expressing the action you desire upfront, you tell the child what you want him or her to do very simply. Use modeling as necessary to guide children. Consistency that is developmentally appropriate and offered lovingly is the key!

1 U.S. Department of Health and Human Services, Administration on Children, Youth, and Families, Office of Head Start, Child Care Bureau, Center on the Social and Emotional Foundations for Early Learning, Infant/Toddler Module 3 – Individualized Intervention with Infants and Toddlers: Determining the Meaning of Behavior and Developing Appropriate Responses (Washington, DC, 2011).

2 U.S. Department of Education, Office of Special Education Programs, University of South Florida, National Center for Pyramid Model Innovations, Behavior Intervention and Positive Behavior Support (PBS) (Washington, DC, n.d.).

3 Emde, Robert N. and JoAnn L. Robinson, "Guiding Principles for a Theory of Early Intervention: A Developmental-Psychoanalytic Perspective," Handbook of Early Intervention, J. P. Shonkoff and S. J. Meisels, eds., (New York: Cambridge University Press, 2000), 160-78.

4 U.S. Department of Health and Human Services, Administration on Children, Youth, and Families, Office of Head Start, Child Care Bureau, Center on the Social and Emotional Foundations for Early Learning (CSEFEL), Preschool Modules: Individualized Intensive Interventions (Washington, DC, 2013).

Last Updated: October 23, 2020