I want to comment today on a most interesting
presentation I attended at a meeting of the Delaware Valley Group chapter of
the World Association for Infant Mental Health. Lisa Poelle, author of The Biting Solution (see www.stopthefightingandbiting.com)
discussed the complexities of toddler biting and offered some approaches to
solving this often-difficult problem. Biting is a behavior that deeply
distresses parents and caregivers of toddlers . It can be medically dangerous
to the bitee, but even beyond that it has an out-of-control, “animal-like” vibe
that causes some degree of panic-- and
if it can’t be stopped, children are often kicked out of child care programs when
care is essential to the family’s working hours and income.
Lisa differentiated between “garden variety
biting”-- the occasional chomp that any
infant or toddler may take when teething or just experimenting-- and the chronic biting in anger or
frustration that may occur many times a day and that gets children thrown out
of child care programs. The first will probably resolve by itself; the second
needs help and guidance to help the child get back on track developmentally and
to prevent either chronic aggressive behavior or other problems that can stem
from constant disapproval and punishment.
Why do children bite, not just once but chronically?
It’s all too easy for adults asking this question to fall into the “fundamental
attribution error”-- the belief that
people do things because of their own internal characteristics. They want to bite!
They like to hurt people! They want to control everybody and everything! If we
think that these are the reasons why toddlers bite, we probably won’t be able
to think of any solution except to make them not want to bite, and to accomplish this by punishing them-- even, classically, by “biting them back”.
The title of Lisa Poelle’s talk, “Chronic Biting
Extinguished”, immediately puts a very different spin on the biting problem. By
talking about extinction of a behavior (the reduction in its frequency when it
is not reinforced), she positions problem biting as a learned behavior. From
that point she is able to consider not only how a child has learned to bite,
but how he or she can be helped to learn not to bite, but to use more mature
social skills instead.
Thinking about chronic biting as learned (rather
than something fundamental to a child) also opens up the option of considering
the difference between learning and performance. There are many things each of
us has learned to do, but we don’t do them all the time. We can perform an
action under the right circumstances or refrain from performing it under the
wrong circumstances, and all this without having to forget how to do it. If the
circumstances-- the environmental
characteristics—are altered, our learned behavior can become more or less
likely to occur. In driving a car, we ordinarily apply the brake only when we
want to slow or stop, but if the rear-view mirror shows a truck barreling down
on us, we may tap the brake several times to get the attention of the truck
driver.
Because children too perform in different ways in
response to the environment, Lisa Poelle discussed many factors that influence
the performance of a learned behavior, over and above the fact that it was
learned rather than innate. Her handout (and her book) provided an action plan worksheet that guides
caregivers to observe multiple factors that can influence the occurrence of
biting--- factors that may not be easily observed by busy adults who are responsible
for a number of children. Lisa suggested that only by careful observation of
contributing factors can anyone create an action plan that will help a child
not only stop biting, but start using more appropriate behaviors when
frustrated.
Lisa’s action plan worksheet begins with examining
the child’s developmental status. Does he
know how to share or take turns? Was the child premature, or is she
tall, giving the impression of being more mature than she really is? Do adults
expect too much of the child, and do they need to offer guidance in social skills?
A second issue is the child’s recent experience of
changes and previous experiences in general. Are the parents either excessively
strict or very lax at setting limits? Have they moved to a new house, had
Grandma come to live with them, had a new baby, had parent conflict rise to
high levels? Has there been a change in child care providers?
What are the child’s verbal skills like? There may
be good receptive language but limited expressive language, and there may also
be facial expressions that are hard for other children to read.
The child’s physical condition may be an important
factor that increases or decreases biting. Toddlers need plenty of sleep and
may not get it for various reasons. They may be hungry or thirsty more
frequently than many day care centers plan for.
Temperamental differences can make some children
need extra guidance with respect to biting. Children who are low in
adaptability can be easily frustrated and need extra help around transitions or
other challenging situations. Low thresholds of sensory responsiveness can make
children generally irritable, as they quickly notice small differences in
temperature or taste and are bothered by constricting clothing or tags on
clothes. Those with negative mood quality may have blank or sulky expressions
that discourage other children (and some adults) from approaching them in
friendly ways.
The physical environment of the day care center may
create problems for children and make biting more likely. Overcrowding, colors
and sounds that are too stimulating, a lack of novelty or challenge in the toys
available, a lack of soft things to sit on or play with, too few play
spaces-- all of these may cause a
vulnerable child to respond with biting to another child who is too close or
who interferes with play.
Finally, the child care setting and the parents may
be using ineffective practices for limit-setting. Forcing children to apologize
may simply lead to continued biting followed by “sorry”. Time-outs may be ineffective
and may simply raise the child’s frustration level. Lisa suggested “instructive
intervention” both at the time of a bite and planfully at other times, with
much emphasis on the child’s understanding how he feels himself-- not so much on the “how did you make Tommy
feel?”-- and what he can do to express
this without biting or other aggression. (One very practical idea was to
provide a damp washcloth or teether that the child can bit on when tense.)
Just a couple of comments from me about the
limit-setting issue: one point is that it’s much easier to get someone to do
something different than to “just stop”. What do you do when you’ve stopped?
That question is more than a toddler can answer. A second point is that when
setting limits for toddlers, we need to go to the toddler and get down
face-to-face with him or her. Calling from across the room, or looming over the
child, is likely to have a frightening and frustrating impact if it has any
impact at all. Finally, a little more about “how you feel” rather than “how he
feels”: toddlers show the beginnings of empathy and of Theory of Mind, the understanding
that other people think, feel, or know things other than what the toddler
thinks, feels, or knows-- but they are
not very good at this, and months and years will have to pass before they get
much better. They cannot effectively perform the mental gymnastics of thinking,
“I don’t like to be bitten. Tommy is like me. Therefore, Tommy also does not
like to be bitten”. In any case, it doesn’t really matter whether they know how
Tommy feels, if the issue is development of their own impulse control and
social skills. Those are abilities they can develop best if they are aware
of-- and have words to describe and talk
about—their own feelings. They didn’t bite Tommy because Tommy felt good or bad,
they did it because they themselves were angry and frustrated. While “thinking how he
feels” can be an excellent learning device for 6-year-olds, “thinking how you feel”—and knowing what you can do
about it-- is developmentally appropriate
for toddlers.
The late, great Sally Provence used to say “Don’t just
do something; stand there and watch”. Unless we stand and watch in the ways
Lisa Poelle has suggested, chances are that we will not be able to figure out
what factors are encouraging a child to bite. And, by the way, unless parents
and child care providers can work together cooperatively, and be candid and
open about the situations at home and in child care, they will not be able to put
together all the information that’s needed to solve the problem of chronic
biting.
N.B. I hope everyone has noticed that there is no
mention here of “therapeutic restraint” as a solution for toddler aggression.
From a layman: Bites with those devilishly sharp little teeth is excruciatingly painful. I remember, after 25 years, the time my little girl, seemingly out of the blue, bit my posterior a good one while I washed dishes. I howled and teared up. She never bit again, but I've wondered what she was thinking. It seems that observing like an anthropologist is key to being a parent – to understand these small aliens in our homes.
ReplyDeleteAs Pogo used to say-- "how sharper than a child's tooth to have a thankless serpent!"
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