Parenting A Defiant Child – PediaCast 090
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The Interview Edition
Dr Philip Hall is a licensed psychologist with 34 years of experience working with troubled children and adolescents. Today, Dr Hall stops by PediaCast to talk about his new book, Parenting a Defiant Child: A Sanity-Saving Guide to Finally Stopping the Bad Behavior.
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Transcription
Announcer 1: This is PediaCast.
Dr. Mike Patrick: Bandwidth for PediaCast is provided by: Nationwide Children's Hospital —
For every child, for every reason.
[Music]
Announcer 2: Welcome to PediaCast, a pediatric podcast for parents — the Interview Edition.
And now, direct from Birdhouse Studios, here is your host, Dr. Mike.
Dr. Mike Patrick: Hello, everyone, and welcome to PediaCast. It is Episode 90, our Interview
Edition, for Wednesday, December 5th, 2007. And with us today, we have Dr. Philip Hall. He is
the author of the new book out called "Parenting a Defiant Child." I'm sure there's a lot of you out
there who have found yourself in that position. So we're going to talk to Dr. Hall, coming up here
in just a little while.
01:00
Before we get started — I always say that, don't I? "Before we get started," and then you know
there's going to be some story of some sort. But I got to tell you, the drug companies pull some
stupid stunts. And I want to know who thinks up some of the things that they send out to doctors.
The other day in the mail, I got a pretty good sized box in the mail. It was a little bit smaller than
like, you know one of those round birthday cakes? You know what I'm talking about. Just like a
standard-sized round birthday cake. But this box was maybe just a little bit smaller than one of
those. I saw it was from a drug company and I just thought, "Aah!". Because it's usually just
usually cheap crud that they send.
Well, I opened this one up. I probably should've just thrown it out. But I opened it up and inside is
this cheap flimsy plastic of View-Master. Now, you remember View-Masters? Yeah, when you
were a kid. OK, maybe some of you — I'm dating myself a little bit — but no, you had View-
Masters, right? You look at it at the eyes, you pull down the little handle and then, the wheel has
the pictures and it spins around. Ok, fine. Well, this is a presentation about eyedrops for
conjunctivitis in a View-Master and not only that the View-Master's made up of really, really cheap
flimsy plastic.
02:23
I tell you, just some of the stuff that they send. And all of it unsolicited, just tons of envelopes and
folders and flyers. Some of it is useful, but most of it is not. And of course, the View-Master, I
think, is just over the top, really. I mean, give folks a break on the cost of medicine. I don't need a
View-Master, really.
[Chuckle]
Dr. Mike Patrick: All right, coming up after the break, Dr. Philip Hall's going to be here. Again,
"Parenting a Defiant Child: A Sanity-saving Guide to Finally Stopping the Bad Behavior". So
that's coming up.
Don't forget, if you have a topic that you would like us to discuss, all you have to do is go to
pediacast.org, click on the Contact link. You can get ahold of me that way. You can also email
pediacast@gmail.com or call the voice line at 347-404-KIDS. That's 347-404-K-I-D-S.
03:09
Also, don't forget the information presented in PediaCast is for general educational purposes
only. We do not diagnose medical conditions or formulate treatment plans for specific
individuals. If you have a concern about your child's health, make sure you call your doctor and
arrange a face-to-face interview and hands-on physical examination.
Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which
you can find at pediacast.org.
And with that in mind, we will be back with Dr. Philip Hall right after this short break.
[Music]
04:14
Dr. Mike Patrick: All right, welcome back to the program.
Dr. Philip Hall is a licensed psychologist with 34 years of experience working with troubled
children and adolescents. He has served at the University of South Dakota as director of the
School Psychology Program and head of Psychological Services for the Developmental
Disabilities Clinic at the University of South Dakota – School of Medicine.
Dr. Hall recently retired from the academic world but he still consults widely. He recently assisted
two off-reservation boarding schools for Native American children. Since his involvement in those
programs, the number of behavioral incidents dropped in half, academic achievements scores
increased and student surveys registered higher levels of satisfaction and contentment.
Dr. Hall's most recent project is a book aimed at moms and dads called "Parenting a Defiant
Child: A Sanity-saving Guide to Finally Stopping the Bad Behavior". And here to talk about the
book and the art of parenting a defiant child — because it's definitely an art — is Dr. Philip Hall.
05:09
So, welcome to PediaCast, Dr. Hall.
Dr. Philip Hall: Thank you.
Dr. Mike Patrick: I appreciate you stopping by.
I guess a good place to start would be just to ask you, what really is a definition of a defiant child?
Dr. Philip Hall: Well, Dr. Mike, let's get to that from a parent's perspective. From a parent's
perspective, the defiant child is when we say a request and a child frequently almost all the time
adamantly refuses. A defiant child can't stand being told no. When you say no, they have a major
behavioral meltdown, I would say.
Dr. Mike Patrick: Sure.
Dr. Philip Hall: And they want their demands met. And when they want something and still, they
want it after being told that they can't have it at the moment.
Dr. Mike Patrick: Right. We've all seen kids like this. And probably many parents out there see
it in their house as well. So, definitely a common problem. The book starts with prevention, and of
course, I think that's just a great idea. So, what are some general ways that parents can prevent
their children from becoming defiant in the first place? Or is it just human nature, is there any way
to prevent it?
06:18
Dr. Philip Hall: Oh, there are definitely ways to prevent it. The key is affirm, affirm, affirm. If we
value our child and if we have a valuing relationship with our child, we really won't see defiance.
And with that, we have to be consistent with our expectations. And while we're dealing with
discipline and teaching the child appropriate behaviors, we have to be calm and cool. If that's the
way we're going to do those things, we'll be fine.
Dr. Mike Patrick: Great. I guess it sort of goes into this concept that you introduced in the book
called the coercive cycle. I guess this is the kind of thing that sets up defiance in the child. So
what exactly is the coercive cycle and then how do you break that if it's already established?
07:00
Dr. Philip Hall: That's an excellent question. A coercive cycle is when a parent makes a request
and a child says no in some emotional way. And the parent thinking, "Well, that's not acceptable,"
makes the request even stronger, "I really mean it, you've got to do it." And then, the child really
throws a temper tantrum — bangs the wall, screams, maybe wakes up her little sister who's
sleeping. And the parent says, "This isn't worth it, I'm going to withdraw the request." And what
that does is strengthen that refusal behavior in a child, and once it's strengthened, it becomes
stronger and stronger. So that's the coercive cycle.
Dr. Mike Patrick: Sure. And how do the parents go about breaking that?
Dr. Philip Hall: The book really gives a new way, a new unique way. I think you set up a routine
where you make not complying the child's problem. So you set up tasks and then… The coercive
cycle, the problems usually comes at unpredictable times. Bedtime is a typical one. You tell a
child to take a bath and the child says no, and that's the beginning of the coercive cycle. But if
you've set up some routines and say, "You know you need to take a bath and then you brush your
teeth and then we're going to have a snack." And the parent can control the snack, then if the
child doesn't take a bath, the parent at the moment doesn't have to get in to the coercive cycle.
They can just wait until it's snack time and remind the child, "You need to take a bath." So that
makes the child's refusal the child's problem.
08:35
Dr. Mike Patrick: Right.
Dr. Philip Hall: If they want that snack, then they need to take a bath and brush their teeth.
Dr. Mike Patrick: Excellent, excellent. And another concept that you bring up in the book — and
I guess this sort of goes into dealing with breaking that coercive cycle — are household rules. And
then, you talked about some tools as well. So, why are household rules important?
Dr. Philip Hall: Expectations have to be clear. Everybody in the household needs to know what's
the expected behavior. And I think as with all rules they would say, in our household, these are the
basic rules, and they're very clearly laid out and we don't want them to be fuzzy or confused or to
change one day from the next day.
09:21
I think, just in particular, if I'm dealing with a child who has behavior problems, I just need the
minimum rules — you can't hit, you can't throw things, you can't disrupt the household.
Dr. Mike Patrick: Right. You don't want to be overwhelming.
[Laughter]
Dr. Philip Hall: Oh, no. No, no. And it sure is tempting, isn't it?
Dr. Mike Patrick: It is.
Dr. Philip Hall: "Well, if that works, let's have this one. Let's have this one. Let's have this one."
Dr. Mike Patrick: Yeah.
Dr. Philip Hall: Yeah. Then, you lose the point.
Dr. Mike Patrick: So whatever the problem behavior is, you want the rules that are sort of
associated with that behavior. And then, do you talk about the rules on a daily basis? Do you
write them on a piece of paper and crayon and put them on the refrigerator? How do you
communicate the rules with the kids, or do you only bring up the rules when they break them?
10:05
Dr. Philip Hall: No. I like your idea of writing them out and putting them on the refrigerator. First of
all, like you said, there should be a short list that should be posted on the refrigerator and the
child's bedroom on the back of the door. They should be visible and a reminder. First, we'd start
on the rules. I may even ask the child in the morning or in the evening before the time when bad
behavior might occur. Then I'd say, "Let's review the rules. Can you remember what the rules
are?" And the child is naturally going to know. And that inevitably sets me up for an affirmation
and say, "Wow, it's outstanding, you remember the rules. That's really good."
Dr. Mike Patrick: Great. Great. And some of the tools that you talk about in the book, one of
them is sticker charts. I'm not sure that you call it exactly sticker charts, but I know that's
something that a lot of parents do. What's a good effective way to use a sticker chart?
11:01
Dr. Philip Hall: Well, there's a number of subtle points under that, Dr. Mike. And I think one is the
behavior that you're asking for, that you're dealing with has to be very specific. It can't be like
"Have a good day." It can't be like "Don't do anything bad." Maybe it's "Take a bath on time," if
that's the big issue that you're having trouble with. Or maybe it's "Go to your room when you're
upset." I think that would probably be even a better one. When you're really upset, the plan is to
go to your room.
Then, the sticker chart, I like situations where there's no lose, win-win. So at the end of the day,
we fill out, put a sticker if you did your plan. Put a sticker if you didn't do your plan. And at the end
of the week, we review the plan. And are there stickers, yes or no? It's a fun one. I'm glad you
filled it out. I'm glad you're honest on this day that you didn't follow your plan, that's outstanding.
Dr. Mike Patrick: Yeah, I think that's an important point. Because I mean, no one bats a
thousand.
Dr. Philip Hall: Exactly.
Dr. Mike Patrick: I mean, you're going to have bad days and that's acceptable.
12:05
Dr. Philip Hall: Right. And all the plan is doing, all the stickers are doing, is reminding the child of
what the expectation is and getting the child involved in thinking about when he puts that sticker
on there, he's thinking about what behavior we're talking about. So you've accomplished the main
point as soon as you put that sticker out. Even if it's a no, he's thinking, "Yeah, that was a
mistake."
Dr. Mike Patrick: Right. And then…
Dr. Philip Hall: Go ahead.
Dr. Mike Patrick: For older kids, would it work to say "OK, there's a goal…" Let's say that you
want to work toward and they can choose what that goal is going to be or something that they
really want. Then, when they get X number of stickers or they have stickers for X numbers of
days, then they can work toward the goal. I guess it's kind of like then, when you said "If you don't
take your bath, then you're not going to get the rest of what's coming… the snack or what they
want." So I guess that's another way you could work sticker charts with the older kids.
Dr. Philip Hall: That's true. Yup.
Dr. Mike Patrick: And then, one of the other tools that you talked about are time-outs. And we
recently talked about time-outs on PediaCast. What's an effective way? Like when do you do a
time-out and sort of if you could step us through how you go about doing that?
13:20
Dr. Philip Hall: I think time-outs are things that have to be handled very carefully. If we use time-
out as a punishment, that "By gosh you're gonna do it" or "I'm gonna put you on time-out and
you're gonna stay there until you apologize," yeah, I have trouble with that, the use of time-out. I
like time-out as… the day after a child has a very bad behavior to sit down and talk about it in a
supportive way and say, "Gosh, I think she likes the way you behaved."
And if you have a positive relationship with a child, the child will, in his way, he'll say that wasn't
very good. "Well, I noticed when you get angry, a bad behavior comes out. What could you do
instead?"
14:04
And you work out and then basically, then the time-out becomes a quiet place. And so the child is
making a good decision — "when you're overstimulated, when you get angry, let's go to our quiet
place and I'll help you. How can I help you get to that quiet place?"
And so, I like time-out as a cooperative agreement with the parents … "I'm going to help
you calm down. I'm going to help you make a good choice here," as opposed to "I'm going to
throw you in time-out and I'm going to keep you there, or else."
Dr. Mike Patrick: Right. What about the littler kids that you can't really reason with quite so well.
We're talking like two and three-year-olds. What sort of time-out scenario plays out for them?
Dr. Philip Hall: You know, I would do a similar thing but I would simply tell them. We can't
negotiate it, we can't talk about it. They're not at that level of … in moral development. We can simply say, "I need to help you calm down. You're really upset. We're going
to go here and I'm going to help you calm down." And so, that might be a little more prompted,
physically prompted, to help them calm down.
Dr. Mike Patrick: Right.
Dr. Philip Hall: But still in that context, "I'm helping you calm down, and when you get control of
yourself, we'll go back to what we were doing."
15:14
Dr. Mike Patrick: Right. And in the book, you talked a little bit about the basket hold. I assume
that's something you want… It's like the last resort kind of thing.
Dr. Philip Hall: Absolutely, the last resort. I can't say it any other way, that's the last resort. When
the child is breaking things, destroying property and has had really what I call an emotional
meltdown, then you may have to physically restrain the child.
Dr. Mike Patrick: Right.
Now, and again, I would encourage folks to pick up the book and put that in context and sort of
how you go about doing it. It's very important.
16:00
Now, the next steps, sort of walking through the book, once we talk about the younger kids, we
get in to the school years. And I guess, if parents are pro-active in keeping there from being a
coercive cycle or breaking it, then the school years are going to be easier than if you're just
starting dealing with the defiant child during the school years. But so, are there any other ways
that parents can be proactive in preventing school problems?
Dr. Philip Hall: You're asking excellent questions, Dr. Mike.
Dr. Mike Patrick: [Laughter]
Dr. Philip Hall: Years of experience, I'm hearing them. Oftentimes, parents, when they have a
behavior problem, feel that they're the problem. They are very reluctant to come to schools, they
are very reluctant to meet with teachers. That's very unfortunate. They sort of isolate themselves
from getting help. I think parents are responsible to a child, but we're not responsible for the
child's behavior. So we should accept the idea that if my child has a problem, my job is to be the
best advocate I can for helping the child. And that involves forming a team with the school, not
being hesitant.
17:15
If you know that's going to happen, why not initiate it? Why not visit with the principal before the
school begins and say, "I have a child who can have some behavior problems and he needs a
teacher who's flexible but also highly structured." If principals know that, they know who can be a
good match for that child's special need. And then you go on and visit with the teacher.
But one of the things I really like to stress is the child's strengths, not just the behavior problems.
But what are the child's strengths? How can you as a teacher relate with him by knowing what
he's good at or what she's good at? And then, teachers love to know what works. 'When he's
upset at home, here's what I do and here's what works."
18:01
Dr. Mike Patrick: Right.
Dr. Philip Hall: So it gives them a heads up. It also makes it very easy for them to phone and
communicate with and let you know how things are going.
Dr. Mike Patrick: That seems like a great idea. And then, the school's going to be sort of ready
for that child and it's not going to come as a big surprise. And they'll probably approach the child
with a little bit of a different attitude as well. So, that is just so important.
Now, what about medical evaluation has sort of a role in this in addition to the psychological?
Because a lot of the kids do end up having attention issues and impulse control issues that really
medicine can help. Do you agree with that or do you think…
Dr. Philip Hall: Yeah, a 100%.
Dr. Mike Patrick: OK.
Dr. Philip Hall: I agree with it a 100%. I know that about 30% of the children who have
oppositional defiant behaviors also have attention-deficit disorders. And many times, those
children respond well to medication.
19:00
Dr. Mike Patrick: I'm still surprised at the number of parents that I see who come in to my office
because a teacher maybe said that they think they have ADHD and they want them to come in.
And there's so many parents that their first initial reaction is, "I don't want them on medicine." I
don't know, really, I think more and more, there's this push on a parent's point of view not to
medicate their children but sometimes, it's just really almost not fair to the child not to do it.
Dr. Philip Hall: Oh, absolutely. We've both seen in nine years of experience, you're probably
dealing with a couple right now, so am I. That this child could just not make in the classroom. And
every day in school, frankly, is a miserable day for these young children. And many of them
respond so well to medication and that's just like turning on a light bulb in a dark room.
Dr. Mike Patrick: Right.
Dr. Philip Hall: There's so much help here, so much content and they start to find success. And
then, I can start to work with them about developing some skills.
20:04
Dr. Mike Patrick: Right. Right.
One of the things I really like about the book is — and parents who picked this up, they'll see what
I'm talking about — you have on just about every page a little box that says key concepts. And it's
really nice to be able to sort of flip through to find out what problem a particular parent is dealing
with and those really catch your eye and guide you to the right place in the book to look. So I think
that's a great idea.
Dr. Philip Hall: Yeah. Good.
Dr. Mike Patrick: And then, the other part, you have some applications, some work sheet
things in the book. Can you talk about those a little bit?
Dr. Philip Hall: Well, they're very intentional. A lot is required if parents have a child who's having
significant behavior problems. It's not going to be an overnight quick fix. And it also doesn't have
to be overwhelming and daunting. And so, we laid out at the end of each chapter very specific
things that a parent will want to make sure they do and make sure they check off. And they're in
the right sequence, a good scope and sequence. So if you do what's in the end of the first
chapter, and it lets move to the second chapter and so on, it should really help you keep focused and also feel positive.
21:20
You're not going to get an overnight change in one of these children. So, you start off with the
things that you can do and check those often and you should reward yourself and congratulate
yourself and say, "OK, I got that done. Now I could do the next thing." And as you do those things,
the child's behavior will get progressively better. So it should give parents some good feedback
that they're making progress.
Dr. Mike Patrick: That's great. Now, where can parents find the book. I did see it at Amazon.
So we'll put a link to that in the Show Notes. But is there any particular…
Dr. Philip Hall: That would be the place to go. I really think amazon.com. And any other book…
Like Barnes & Noble's or Borders also have it but amazon.com seems the primary book seller.
22:16
Dr. Mike Patrick: Great. And then, do you have any other sites that you want to promote at all?
Dr. Philip Hall: No. I don't have a website. I should have a website but I do not, and I probably
never will have one.
Dr. Mike Patrick: And you don't want to give out your email address, too. No I'm just…
[Laughter]
Dr. Philip Hall: I know. You're right.
Dr. Mike Patrick: All right, well, thanks for stopping by PediaCast and talking about your book.
We really appreciate it. Again, the book's title is "Parenting a Defiant Child: A Sanity-saving
Guide to Finally Stopping the Bad Behavior".
So, thanks for stopping by. We appreciate it.
Dr. Philip Hall: Oh, you're most welcome. I appreciated it.
[Music]
23:19
Dr. Mike Patrick: All right, thanks go out to Nationwide Children's Hospital for providing the
bandwidth for this program. Also, to Vlad at vladstudio.com for helping us out with the artwork.
And to Dr. Philip Hall for stopping by and talking about his book and also the art of parenting a
defiant child. As I said before, it's definitely an art.
Also, of course, thanks to all of you for stopping by.
And we have had a few more reviews in iTunes. And I appreciate everybody who's taken the time
to do that. If you haven't, my goal is to try to get 200 reviews by the New Year, and it's going to be
tough I think. I think we're to about 156 now. So we're going to need quite a number of you to step
up to the plate and try to get those 200 reviews by the end of the year. And I don't have anything
to offer you. I just say, please make it your little gift to me for Christmas. Just a review on iTunes
would be just very, very helpful.
24:24
Also, our stream is up and running. So typically, we are on air during the 7:00 to 8:00 hour,
Eastern time. That's the most likely time that you're going to find us. And if that changes, I'll let you
know. In order to listen to the program live as we put it together, all you have to do is go to
pediacast.org, click on the Live link and there are instructions there for you on exactly how to do it.
Basically, you're going to either need iTunes or if you're a Windows user, you could also use a
Winamp. And then, you want to point that to our stream which is simply live.pediacast.org. So
that's all you have to do, live.pediacast.org. You can open that stream again with iTunes or
Winamp and if you need specific instructions, it is available on the Live page at pediacast.org.
25:22
All right, we do have more of your questions and comments are going to be coming up in shows
in the next couple of days, so stick around.
And until, tomorrow — hopefully tomorrow, it might be Friday, we'll see with the big snow storm
coming, apparently that's what they tell us. You know, if they tell you you're going to get two to four
inches you get like a half an inch usually. But supposedly, there's this big snow storm coming, this
Alberta Clipper that's going to come through Ohio, and I'm on a call tomorrow, so not sure if we're
going to have a show.
Actually, I'm doing this on Tuesday night. So you're going to hear this on Wednesday, and I'm on
a call Wednesday. So I'm on a call today.
[Laughter]
26:00
Dr. Mike Patrick: Sorry, I'm a little loopy. So, I don't know if there will be a show on Thursday.
There should be definitely be one on Friday, we'll see. But regardless, it's your questions and
comments that we're going to get to.
Boy, talk about going off in a tangent here.
Until then, this is Dr. Mike, saying stay safe, stay healthy and stay involved with your kids.
So long everybody!
[Music]
