The tizz kids

29th November 1996 at 00:00
Too many parents only notice their children when they're naughty. So even toddlers, like the four-year-olds Dean and Joe, will behave badly to get attention. They spent 10 weeks at an NHS day unit committed to changing their behaviour. Catherine Ormell on the fall-out from parenthood in the Nineties.

Televison programmes rarely test parents' reactions as severely as Roger Graef's Network First documentary Breaking the Cycle. The film - on ITV last Tuesday - followed the progress of troublesome four and five-year-olds, who'd been referred to a National Health Service day unit last summer. Some had been excluded from playgroups, some were at risk of exclusion, some were potential disruptives. Just the sort of kids so much on the national conscience at present.

Watching four-year old rascal Joe having a six-and-a-half minute trantrum over some washing-up, it was hard not to shout repressively at the TV, "stop it, NOW!..." And yet it was also easy to feel like Joe's father, Adam, watching the group through a one-way mirror: somebody help him, he's so distressed.

Either reaction, strict or lax, or both simultaneously - as in our household - was wrong. Like thousands of parents, around the land and of every social class, we failed this domestic test of nerves.

With rather stiffer resolve, however, the therapists at this NHS unit in Swindon persisted for an heroic 45 minutes (real time), with their strategy of ignoring Joe's bad behaviour, insisting he finished his task and praising him as he completed it. The result was revelatory. Two hours later, same child, without a squeak of protest, was happily wiping a table as requested.

Over the 10-week programme - observed by TV cameras - the staff at the child and family consultation service (the mental health arm of the Swindon and Malborough NHS Trust) systematically reinforced the childrens' good behaviour with lavish praise and rewards, using tokens which were counted at the end of the day. When the children misbehaved, they ignored it. If the kids became aggressive or refused to co-operate, staff physically held them until they relaxed into the task. In the afternoons a therapist worked with the mothers, explaining and practising the techniques, anticipating problems and teaching basic parenting skills.

Children who initially could barely sit still were, by the end of week 10, displaying skills vital for school-life: listening to instructions, concentrating well, able to complete tasks - and were well-mannered to boot.

Dean, aged four, who had a powerful scowl and the kind of knives-on-glass whine that cut his mother's good intentions to pieces, had been getting a reputation as a troublemaker, but was regarded affectionately by his playgroup supervisor at the end of the course.

This term he's started nursery and so far, so good - his teacher has no complaints and he is proving popular with friends. His mother, Rachel Davies, says she would have bec-ome a nervous wreck without the help of the centre. "Dean's a lot better but he's not perfect, mind you. He's more confident, he'll speak to people without making silly noises and he's let his father do more for himIbefore it was always 'Mum this, and Mum that'."

What were these mothers (who, as Graef exclaims, "are all good mothers, sensible and caring") doing wrong? A clue here. One American study which tracked mothers and their children, found that in a day a typical mother made 400 negative criticisms of her child and issued just 40 words of praise, including endearments.

Rachel, whose two sons Dean and Dwain, aged six, have both attended day groups, admits: "Before I'd really shout at the boys and I did smack them. But it didn't do any good; they just looked at me as though I were vacantII find now that I say what I've got to say and just walk away." As group therapist Sam Smith puts it: "What tends to happen is we give children attention when they're being naughty, we don't mean to do that, but it's very difficult to do otherwise... quite often when children are being good we will rush away and be busy reappearing when they're naughty.

"Any attention is better than no attention at all for a child so, in some ways, they actually learn to be naughty to get our attention. There's not one parent out there who is thinking 'Oh I think I'll teach my child to be naughty today', and yet lots of us are falling into that trap without realising it."

Take Joe's mother, Diana, who worked as an infant teacher for 15 years before her son was born. This sensible, intelligent woman could control a class of 30 children. But like a lot of teachers, her success in the classroom didn't transfer to home. Three-foot, whey-faced, strong-willed Joe would ask her: "Why are you so cross Mummy?" "And I would think yes, why am I so cross?" she explains. "I know how to handle children with behavioural problems in the classroom, but it's a whole different ballgame when it's your own sonI obviously you're very emotional, you can't distance yourself. If you've got a difficult child at school, you can go home and set up your strategy and have that break from your child to rethink. My relationship with Joe was very intense, there was nobody to relieve me, give me a break away from the situation.

"I got annoyed with myself because I thought 'I know all this about the business of being positive'. But when they said to me things like 'absolutely ignore him', then they watched me with Joe. I was watching him out of the corner of my eye and they said, 'he knows you're aware, go into a different room or do something different'."

Diana suffered the standard pressures of Nineties parenthood. She had her children in her mid-thirties, carried on working full-time after Joe was born because they needed the money. She felt isolated with grandparents 80-plus miles away. Meantime, her husband, Adam, a computer analyst, worked a 50-hour week. A further source of stress was that Joe had a difficult start, two operations in his first year to remove a benign tumour in his mouth.

By the time their daughter Anna was six-months-old and Joe 312, Diana was constantly tired. "Joe wasn't a very happy little boy and I wasn't a happy mother. I don't feel that we were bad parents, but I think that with some children you have to have even stronger parenting skills. The unit helped us to develop them. Joe's got very high expectations of himself and he gets frustrated.

"He's always been nervous and found new situations difficult and he probably will always be like that. But now he actually says he's nervous and tries to recognise the feeling. He's no angelIbut he's got more strategies and so have we."

Diana's now started working again as a supply teacher, her experience has given her an interest in special needs, and she's considering an Open University course. The concern raised in the film that Joe might be tainted by attending the group, hasn't materialised. Seven weeks into his first term at school, he's settled in well, is roaring ahead with his reading, has not run into any problems.

Joe was unusual in the group as his mother referred herself. She knew about the unit, and rang up initially just for advice. The other children were referred by health visitors, GPs, consultant and, in some cases, local schools - with the permission of parents.

The therapists at Swindon's child and family consulation service would like to run more parent support groups, expand their training for teachers, give fraught parents extra support, but are frustrated by lack of money. The costs are Pounds 1,780 per child for each 10-week course. Funding from the local education authority has not been forthcoming, although it does fund a teacher for three days a week to help with the groups.

Pauline Mayes, unit manager for the under-8s, admits they are currently at saturation point. "Some of the children who came in the summer, were waiting five months. By NHS standards, that's not very long, but in terms of these children's lives, it's crucial."

Parents might not be offered a group place, but individual or family therapy if they won't recognise a problem, don't want to change, or have marital problems. The unit can call on a range of other specialists, including art therapists, psychotherapists, clinical psychologists and psychiatrists.

Sometimes the parents or children are given extra help after the course ends - Dean, Dwain and Rachel are now getting family therapy. "I have lots of bad days, but I can handle those days better," says Rachel. "The centre's helped a lot, but it's not a miracle cureIit's very hard to keep it going. It's so easy to say 'no' and then give in."

Mayes says the group Graef followed was an easy one because none of the children was violent. The day I visited, the staff were grey with tension - fearing for their safety. Any lapse in their "red hot peripheral vision" might result in a chair being thrown. And this was week eight.

Most of the staff have been bitten at one time or other and Mayes chipped a tooth when she was headbutted by a small child. These difficulties aside, they estimate their success rate at 90 per cent and, remarkably, they have never excluded a child.

Roger Graef believes every town should have such a unit. "It's truly shocking that this work has been going for 20 years and it hasn't been replicated, " he says. "It's not that there aren't parent support classes, there are, but they don't do 10 weeks systematic step-by-step stuff like this with both parents and kids."

Graef, like many criminologists, has a strong sense of "there but for the grace of God go I". "We ask where did we go wrong, and the answer is, we didn't support them when they did good things, we only noticed when they were bad," he says. "For me it was like a huge lightbulb going off in my mind because I grew up in a family where that was true. All I can remember of my childhood, truly, were the criticisms my parents gave meIand I was quite a successful child in some ways, but still my parents were incredibly demanding.

"I started directing plays when I was very young and I can still remember my mother telling me everything that was wrong with the production. I said to her, I think I can figure that out for myself, what I need is for you to encourage me, and she said, 'Oh no, lots of people will do that, only I will tell you the truth'. As a result I have no positive memories .. I've no doubt she loved me, but that was her idea of love."

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