Editor's Note: This article is intended primarily for professionals interested in the use of temperament related concepts in the treatment of preschool children. However parents may also benefit from understanding some of the choices and interpretations that professionals have to make in providing help.

Alice Shannon is an experienced family therapist whose background in temperament prepared her to successfully evaluate and treat a needy youngster without jumping immediately to medication. An earlier version of this article was published in 2006 in the Psychotherapy Networker. This version is reprinted here with the permission of the author. Alice is listed on the B-DI Providers page.(Ed.)

Teaming up to Tame a Preschooler

According to a recent Yale University survey of nearly 4,000 preschool classrooms released in May 2005, more than 10 percent of teachers reported expelling a preschool-aged child during the previous year. This expulsion rate actually exceeded that of children in grades K-12 in all but three states. Grounds for expulsion were largely aggression toward other children-hitting, kicking, biting, hair-pulling, throwing things and verbal attacks.

Expulsion is generally viewed as a consequence that only affects troublesome teenagers, whose behavior problems are in a different league from those of young children. But parents and teachers who are exposed daily to actions of young children are often appalled by the raw aggression and wildness of some preschoolers, and may regard it as an ominous indication of what lies ahead.

However, the Yale study may say as much about the nature of schools today and the attitude of adults and the mental health community as it does about any trend towards increased aggressiveness among young children. Many parents and teachers have surprisingly unrealistic expectations about what is appropriate and attainable conduct in young children. When dealing with children who are aggressive and disruptive, they fail to understand that some emotionally overloaded children may simply not be able to control their behavior no matter how many times they've been told to 'be good' and how well they 'know' that biting or kicking or punching is against the rules. Children don't all learn to read, ride a bike or tie their shoes at the same speed, according to the same schedule, nor do they learn to contain their aggressive impulses and master self-control at the same rate.

Also, contrary to general view, not all children with behavioral problems suffer from buried 'anger issues' that need to be worked through in therapy. Most of the children I see have not experienced psychological trauma either. The difficulty is usually due to a poor fit between the child's temperament and the styles of parenting and teaching to which he or she is exposed. Many of the children with 'anger issues' are very intense, active children with a tendency to loud and dramatic expressiveness in general. True, they may look and sound scary when upset, but that same intensity can make them enthusiastic and delightful company when they're in a good mood.

Unfortunately, young children with self-control issues aren't all treated equally. The Yale study found that rates of preschool expulsion varied widely. They were twice as high in private schools and faith-affiliated centers as they were in public schools or Head Start programs. Why the difference? Public schools are more likely to provide classroom based behavioral consultations, an invaluable resource for both children with behavioral problems and their teachers.

Benjamin was an intense and volatile child. A bright, artistic, well- coordinated boy of 4, he also had a hair-trigger temper and a volcanic way of expressing it. At his Head Start program, when he was upset, he would kick over chairs, attempt to kick and punch both the teachers and other children. When other children made him mad, he'd called them 'stupid,' raise his fist at them, or threaten to have his mother's latest boyfriend beat them up.His vocabulary of foul language-usually delivered in a full roar-- was quite impressive for a child his age.

Angie, his single, overwrought, working mother, found him a handful at home, but even she was shocked by what she was hearing about his out-of-control behavior at preschool. She had trouble believing that trained professionals couldn't deal with her son, but she kept getting calls to pick Benjamin up when his behavior was considered out of control. The school also informed her that his schedule was being reduced and he was at risk of being expelled if his behavior didn't improve. However, while his actions probably would have gotten him expelled already from a private preschool or day-care center, his school geared up for action.

Head Start programs are required to have a mental health professional on staff or on contract. In my community, there's a staff mental health coordinator for these schools. After spending a morning observing Benjamin at school, she called a Child Study Team Meeting, which included staff members of the Head Start program, Angie, and herself. Since I've worked with young children with behavioral issues for many years and am well known to the mental health coordinator, I was invited onto the team, too. We discussed Benjamin's strengths, his behavior patterns, what seemed to work and what didn't in getting him under control, and what might be done to help him.

Too often, kids like Benjamin elicit an authoritarian, 'get-tough' response from adults. This tends to encourage power struggles, since children often respond by getting angrier and more rebellious. The team decided that helping Benjamin make an alliance with an adult who could influence his classroom behavior might work better. We also discussed the importance of helping Benjamin's mother and others in daily contact with him learn new approaches for encouraging self-control without confrontation.

The school assigned an aide to Benjamin to 'shadow' him in the classroom. The aide's mission was to try to intervene early and calm him down, when difficulties arose and work with him to find better ways to respond when he was feeling upset. The aide's time would be tapered off as Benjamin's behavior improved. The team and the aide met about once a month over the course of about six months to evaluate Benjamin's progress, discuss how strategies were working, and determine new approaches. Referrals were also made for supportive community resources, such as a support group for Angie where she worked on personal issues and developed tools to handle her own frustrations. Angie and Benjamin were also given a referral to see me.

Taking the Parents into Account

Ideally my first observation of a child occurs before I meet him or her, as an anonymous classroom visitor. During my visit, I could see that Benjamin was bright, active and intense. Happy or angry, he was loud and dramatic. Fast to anger, the fierceness of his rage was etched dramatically in his face, and I could see clearly why other children were afraid of him.

Next I like to meet alone with the parents of young children like Benjamin. I want to hear candidly about stress levels and concerns, and don't want to risk having a parent blurt out in front of the child something like, "If he's like this already at 4, he's going to end up in jail for sure." These meetings allow me to gather additional information about the child's temperament, the family situation, and parent's concerns. I also give them feedback from my classroom observation, if that has already occurred, and discuss what kind of interventions might be the most helpful.

In these initial meetings, I used to load parents up with suggestions like techniques for being firm that minimize head-on confrontations-because I could see how desperate they were for something concrete to do right away. Now I'm more likely to keep my initial suggestions to a minimum, telling them, for instance, that they should prioritize their concerns.

Soothing, Not Scolding

When Benjamin and his mother came to see me together for the first time in my office I watched how they interacted. I now had information about Benjamin from his mother, from the school staff, from my observations and from seeing parent and child in my office. Because of my interest in the work of Stella Chess and Alexander Thomas on temperament and how different children interact with the world, I soon suspected that Benjamin was low-adapting. Children with this temperament characteristic have difficulty with new experiences or tasks and need a period to adjust to changes of activity or location. I also thought he was high in sensitivity, which means he could be easily overwhelmed by outside stimulation. I shared my assessment of Benjamin's temperament with the Head Start staff at the next meeting.

Because Benjamin was so bold and eagerly involved himself in everything, the staff had missed signs that he had a hard time adapting to transitions. Often his "aggression" was an energetic reaction to the stress he felt when obliged to make quick changes from one activity to another. While no one wanted Benjamin's behavior to continue unchecked, knowing this made the staff more sympathetic.

I suggested that when the staff noticed Benjamin was beginning to get upset, they observe his behavior out loud in a neutral tone. For instance, when another child accidentally bumped into Benjamin, it would trigger his high sensitivity and he would often lash out at the child verbally or physically. However, when a teacher saw that and commented to Benjamin, "Boy you are looking really mad! You almost got knocked over," it became an opportunity for Benjamin to slow down, become more aware of what he was feeling and make better choices himself about how to respond or to seek help. When he started to become agitated, I suggested they could also help him calm down by offering him a hug, or giving him some time to himself-to play with puzzles, for example, an activity he found soothing.

Once Benjamin got upset, he lost the ability to respond to staff and really blew up if they approached him. I suggested the staff keep his low adaptability in mind and minimize those situations by giving Benjamin warnings before changes and transitions in the schedule, reminding him that while he had a hard time with new things, it got easier for him after a while. "Remember when you had to sit at a different table at lunch yesterday and how unhappy you were at first? By the end of lunch I saw you laughing and laughing."

I also advised the staff to take advantage of Benjamin's sense of humor, engaging him playfully rather than sternly to minimize power struggles and defuse potential blow-ups. The staff should also be on the alert for times when Benjamin didn't blow up during stressful times and talk to him then about what "tricks" he had used to keep himself from exploding.

I also helped Angie to make adjustments in their daily routine to soothe and encourage her son. She rearranged her work schedule to have more time to help Benjamin get settled at school in the morning, so that his day didn't begin with a rushed transition. He loved being read to, so I encouraged both Angie and the school staff to utilize that interest by reading stories to him about handling anger and frustration. Angie also got him into swimming classes, providing him with an appropriate outlet for his energy and athletic ability. Finally, she curbed Benjamin's access to violent video games and made sure she maintained a bedtime routine so that he got enough sleep.

Though his father was not in the picture, Benjamin loved male attention, wrestling and rough housing-which he got from some of Angie's male friends. But as therapy and our team meetings continued, everyone began to notice that whenever Benjamin spent time with one of her friends, who encouraged him to be physically rough and ignore rules, his aggressive behavior at school increased. Angie decided to be more selective about the men Benjamin spent time with.

Angie had personal work to do in therapy, too. She admitted that she did a good deal of yelling at home when she was frustrated. She began managing her own stress better by keeping a journal, exercising and attending a support group for women who had been victims of domestic violence. She also started using some of the techniques her son was being encouraged to use, like pausing to take some deep breaths instead of yelling

In six months, Benjamin became better able to handle his frustration and anger. Things like minor changes in the school-day schedule stopped bothering him altogether, and when he did get upset, he was more likely to move aside to calm himself down, express his feelings, or ask the teacher for help. His disruptive behavior became increasingly benign-such as his continued tendency to blurt out answers rather than waiting for his turn. When he moved on to elementary school with more academics to focus his energy and intelligence on, that helped too. His teacher says he sometimes gets off task, but is easy to redirect. Benjamin is now in 2^nd grade and continues to do well.

The kind of behavioral missteps Benjamin displayed, however aggressive they may have seemed to his teachers, are not usually an indication that a child is on his way to showing up one day at high school with a gun. Overreacting to such problems can make them far worse, putting a small child with behavior problems at risk for continued difficulties. Fortunately in Benjamin's case, his mother had a strong commitment to him, attending therapy sessions and team meetings when she was tired, or dealing with housing or work related problems. In addition Benjamin and Angie also had a 'head start', a team, a village if you will, of people helping and supporting them. Had Benjamin been expelled from school, it isn't likely they would have gotten that kind of help and their story might have had an entirely different outcome.