Aggressive behavior by a child is a major problem for families. When a pattern of aggressive behavior is seen intervention must be sought. The first step is a thorough assessment as to why the behavior may be occurring. Are specific antecedents or associations evident? Are the behaviors specific to certain people or surroundings? Have there been any recent social, emotional or personal events that may have triggered the onset of the aggressive behavior? Often these issues are complex and difficult for you to assess on your own. In these situations seek out the help of a knowledgeable and experienced professional.
After a determination of possible cause has been made a decision about therapeutic intervention is the next step. Numerous types of interventions may be appropriate. It is important to choose an intervention that is evidence based and reasonable in terms of financial, emotional and personal cost to the family. It is best to avoid the use of medication as a first line treatment unless the severity of aggression warrants.
After initiating an intervention you must monitor the behavior as it relates to the chosen therapeutic intervention and you must perform an ongoing assessment of environmental effects of both the aggression and the therapeutic intervention. Treatments and your child’s response to the intervention do not just affect the child, siblings, parents and the family. After considering each of these issues all negative and positive effects must be monitored in an ongoing fashion.
Throughout this entire process utilizing supportive services to foster communication and relationship building, while at the same time decreasing moderate and toxic stress must be pursued. Every parent and family who deals with aggressive behavior needs support. All levels of stress cannot be eliminated but the moderate, severe forms must be managed and the toxic forms that hinder and prevent interpersonal relationships must be eliminated. This may involve routine self-care strategies such as progressive relaxation techniques or guided positive imagery as well as non-traditional activities including taking long walks, quieting the mind with a good book, getting more sleep, enjoying the arts, eating healthier or spending more time with a beloved pet. Options are as varied as your interests and willingness to explore allow.
In terms of direct intervention for your child you must find a professional you trust to give you advice. Non-pharmacologic behavioral interventions for your child can be beneficial. Psychotherapy that is insight directed and based on cognitive and behavioral principles should be considered and pursued as appropriate. You may also find family directed services that alter the way you interpret and respond to your child’s behavior are not only reasonable but effective. Some children due to their age or temperament have patterns of self-regulation, reactivity and flexibility that lead to explosive patterns of behavior including aggression. These patterns make it hard for you to be attuned to their needs with the sensitivity, attention and responsivity needed. For these children changing the way you understand, relate and respond can bring dramatic positive results.
If pharmacologic intervention is determined to be necessary then the medication should be evidence based and chosen to target and treat the underlying condition. Be clear about what behaviors you have targeted and monitor these patterns before and after the medication is initiated. Some medications require time to build up in the blood stream so discuss the response profile of the medication with the physician who prescribes the medication. It is important your expectations match the bioavailability profile for the specific medication. Since children are not the same size appropriate dosages must be prescribed and at all times an understanding and awareness of possible side-effects identified, explained and discussed. Multiple drugs should be avoided due to potential interaction issues as well as increasing the difficulty of interpreting responses.