Teach Problem Solving
Parents see impulsive reactions and often do not realize that the child mat not know the steps required in order to be reflective and then take purposeful action. Usual comments such as "Work out the argument yourselves" do not work. Similarly, just having a child delay his responses does not lead to more effective responses. These children often feel helpless and extremely frustrated that their efforts are not successful. Anger and sadness are frequent reactions. Parents can actively teach their child how to think. Parents must demonstrate cause and effect ("If you hit children, then they will be annoyed") and probability ("What is likely to happen if you always interrupt people when they are speaking?"). Consequences of actions should be considered. A key concept is that there are alternative solutions to a problem ("If no one is home, you can call me at work; go to a neighbor; play outside until I get home"). Whenever possible, children should first be asked what things they think should be done. The goal is for the child to be able to think up and evaluate the results of several possible solutions.
Whatever the age of the child, the parent can teach the application of problem solving to situations as they arise. Fifteen minutes of conservation reviewing a situation that happened is a worthwhile investment of time. A key is the child's perception that the parent is not blaming or criticizing but is truly interested in helping the child become more reflective and effective. After reviewing other approaches to an incident, the child should be asked if he could anticipate when such a situation might arise again. The impulsive child is then being prepared to act more thoughtfully and responsibly. Some impulsive children require a type of conditioning, so that they automatically switch to a calm, problem solving approach in the heat of the moment.
Self-talk as a means delaying gratification is a very powerful method in counteracting impulsivity. The child must learn to postpone pleasure. Waiting their turn in a game, not eating candy before dinner, not interrupting a conversation, not blurting out ideas-all may have to be taught. Recent research highlights the effectiveness of having children say, "I can wait my turn" to themselves. By teaching them how this self-talk helps them to be patient, children gradually learn to apply it in various situations. "It's good to learn how to wait" stresses the positive aspect of being able to wait and not act instantly.
Parents should model the effective use of self-talk in solving their own daily problems. For instance a parent might verbalize in front of a child, "I'd better stop and think before I do this." It is also very effective when siblings and peers model appropriate self-talk, e.g, "I know I'm late, but there's nothing I can do about it. I'll hurry but I'll stay calm." The behavior corresponding to these thoughts is then demonstrated.
A parent might also use pretend play to show a child how to think and act in certain problem situations. If a child is having difficulty, for example, handling teasing from a peer, the parent might pretend to be the child in the situation and role play appropriate thoughts and behaviors: "I won't hit her even if I'm angry. I will tell her how angry I am and that she shouldn't say that anymore." Then the parent acts out, saying to the peer, "I'm angry at being called names; you cut that out." Pretending that the peer does not stop, the parents might then say, "I'll just walk away and ignore her" (and act this out). This type of role playing can be very educational.
Self-talk may be tremendously enhanced by using reminder cards or pictures drawn by the child or the parents. The pictures serve to remind the child how to act more appropriately. The child who does not listen to others might draw a face with huge ears and write underneath LISTEN TO WHAT PEOPLE ARE SAYING. A large card might be displayed, stating THINK BEFORE I TALK. The key ingredient is for the child to learn to think of the image on the card during the actual situation. Therefore, when the teacher or person is speaking, the child thinks to himself, "Listen to what she is saying" or "I think before I talk."
Reward Reflective Behavior and Penalize Impulsive Acts
Children should be taught self-reinforcement, where they compliment themselves for waiting or for thinking of a better approach to a situation. Also, any instance of calm, reflective behavior should be rewarded by adults. Whenever impulsive children delay a response and consider consequences, the parent should specifically compliment them. Parents must catch the child tolerating frustration and immediately reinforce this rare event. ("That was terrific. You lost that game and you still kept playing.") When the child acts impulsively, have the child demonstrate how to consider alternatives and then reward him with praise or accumulated points to earn a reward. (See section on hyperactivity for examples of setting up a reward system.) Many children respond to the continuous reinforcement of reflective behavior with a rapid decrease in impulsivity.
For those children who are less responsive, research has demonstrated the effectiveness of "response cost" and "time out" procedures. When a child constantly talks out impulsively or immediately wants his way, a brief "time out" in his room can be effective, if calmly and consistently employed. Similarly, when using points or tokens, a loss of these earned symbols can be used for very unacceptable behavior. For example, for impulsive complaining about food and rules, a child can lose five points. For patience and not complaining during a meal or before bedtime, ten points is recorded. Extra play, allowance, or television viewing time may be useful daily rewards. Firm limits and expectations are clearly spelled out by these sanctions.
Prompts and Cues
Very impulsive children may have to be shown a concrete cue such as making a C with their left thumb and index finger, which stands for "control." Under stress, they can look at this C, calm down, relax, and not impulsively lash out or speak out. They therefore learn to cue themselves to calm down and be more self-controlled. learning to praise themselves for this better behavior is essential.
Similar to hyperactivity, there are methods used by professionals that are particularly effective with impulsive children. many means are used to promote a psychologically and physically calm feeling. Muscular relaxation and various biofeedback procedures have been successful. Controversial, but frequently effective, is the use of psychotropic drugs of very impulsive children can respond to some combination of the preceding methods if used consistently in a positive manner. Even those children who require medication can soon be withdrawn from medication if appropriate parental methods are used with the child who is in a more receptive state.