Abnormal Psychology

Childhood Disorders 667

undercutting the child’s self- esteem (Frick & Muñoz, 2006; Hinshaw et al., 1993;

Jensen et al., 2001).

Targeting Psychological Factors: Treating Disruptive Behavior

Treatments that target psychological factors have been developed for oppositional

defi ant disorder, conduct disorder, and ADHD. These treatments usually employ

behavioral and cognitive methods to address disruptive behaviors. One reason for

such behaviors is that children with any of these disorders tend to have low frus-

tration tolerance and diffi culty in working for delayed—rather than immediate—

reward. Thus, behavioral methods may focus on helping such children restrain

their behavior and accept a delayed reward. Specifi c techniques include a rein-

forcement program that uses concrete rewards, such as a toy, and social rewards,

such as praise or special time with a parent. These methods slowly increase the

delay until the child receives either a concrete reward (“Now you can have that

toy”) or a social reward (“You did a great job, I’m proud of you”), which should

motivate the child to control behavior for a delayed reward in the future (Sonuga-

Barke, 2006).

Behavioral methods for treating all three disorders may also be used to modify

social behaviors, such as not responding to others aggressively or not interrupting

others. For example, when children enter preschool or kindergarten, it may be the

fi rst time they have to sit quietly for a length of time and wait for a turn to participate.

Often the teacher will ask children to raise a hand and wait until called on to answer

a question. A child with ADHD will be more likely than other children to speak out

of turn or to keep vigorously waving a raised hand, trying to get the teacher’s attention.

A program of rewarding the child for increasingly longer times of not speaking out

or waving frantically can teach the child to behave with more restraint, which can

ease relations with classmates.

Cognitive methods seek to enhance children’s social problem-solving abilities.

Specifi cally, the therapist helps the child interpret social cues in a more realistic

way—for instance, acknowledging that the other person may not have hostile

motives when he asked you to move your backpack—and develop more appro-

priate social goals and responses (Dodge & Pettit, 2003). Through skills-building,

modeling, and role-playing, the treatment also shows the child how to inhibit angry

or impulsive reactions and to learn more effective ways to respond to others. The

therapist praises the child’s successes in these areas. To enhance the generalizability

of the new skills to life outside the therapy session, parents and teachers may be

asked to help with role-playing and modeling and to use praise in their contacts

with the child.

When a child’s symptoms interfere with functioning in school, an IEP may spec-

ify classroom accommodations, such as increased time to complete tests and more

frequent but shorter breaks throughout the day.

Targeting Social Factors: Reinforcement in Relationships

Most of the treatments that target social factors are designed to help parents—and

teachers when necessary—to make more systematic and consistent use of operant

conditioning principles: reinforcement, punishment, and extinction. Through oper-

ant conditioning, such treatment is designed to shape a child’s prosocial behavior

and decrease defi ant or impulsive behavior. In addition, group therapy and various

other techniques may be used to improve social skills.

Contingency Management: Changing Parents’ Behavior

Contingency management is a procedure for modifying behavior by changing the

conditions that lead to, or are produced by, it. Treatment may target parents of

children with ADHD, to help them set up a contingency management program with

their child—particularly in cases in which the parents have been inconsistent in their

use of praise and other reinforcers as well as punishment (Frick & Muñoz, 2006).

Contingency management

A procedure for modifying behavior by

changing the conditions that led to, or are

produced by, it.

P S

N

P S

N