If this approach views challenging behavior as a learning disability, then where do consequences fit in? Are you saying that I shouldn’t punish my child when s/he misbehaves?

We aren’t allergic to consequences. We’re just practical about their use. By definition a consequence is an event that occurs after the fact. So consequences – especially the natural variety – are inescapable (the child who lacks social skills has no friends; the child who exhibits oppositional episodes is sent to the principal’s office daily). Thus, the above question usually refers to formal consequences. For the record, we think formal consequences are wonderful, but only if they are effective. We are significantly less enthusiastic about consequences when they are ineffective. We think consequences are effective at two things: (1) teaching a child basic lessons about right from wrong – for example, don’t hit, don’t swear, don’t explode (of course, we would only teach these lessons if we were convinced that a child was unaware of them), and (2) giving a child the incentive to behave adaptively (assuming, of course, that the child is not motivated already). Since every child we’ve worked with was already familiar with the basic lessons and since we believe children are already motivated to behave adaptively (secondary gain is, we believe, greatly overrated as an explanation for why a child would choose to endure repeated punishment), we are unconvinced that formal consequences have an important role to play in the treatment of challenging kids. We don’t think it makes sense to use consequences just because consequences are the only tools in one’s toolbox. But most importantly, rewards, punishments or any other form of consequences don’t teach thinking skills.

Does this mean that we aren’t supposed to set limits with our child?

Hard to imagine not setting limits with any child! But it’s all in how you set the limits. One way to set limits is by imposing your will. As you may already know, we call that Plan A, and there are some major downsides to Plan A. In challenging kids, Plan A precipitates challenging behavior. In “ordinary” kids, Plan A is yet another lesson on the “might makes right” principle.Another way to set limits is to work collaboratively with a child to ensure that your concerns (those concerns that make you feel that some limits need to be set) and the child’s concerns (those concerns that explain why he’s having trouble meeting your expectations) are both satisfactorily addressed. This, as you probably already know, is called Plan B, and we think it’s a more effective, durable way to set limits with kids.

What about safety issues? Those are non-negotiable, right?

Depends what you mean by non-negotiable. Clearly, if someone is about to get hurt, imposing your will to maintain safety is the thing to do. But if the unsafe behavior is ever likely to recur, then you’ve got some predictable problems to solve and skills to teach that likely will require more than mere imposition of adult will.

What confuses me is that my child seems able to hold it together sometimes – like when we’re in public. Doesn’t that mean that he can control it?

All of us are capable of looking good for discrete periods of time under certain circumstances, and most of us look better in public than when we do in the comfort of our own home with the people we know and trust the most. Your child is probably working very hard to keep it under control in some circumstances but doesn’t have the skills to do it all the time. Of course, knowing the types of situations your child has the hardest time with can also give you valuable information about the problems you need to solve and skills you need to teach.

What about medicine for challenging kids?

Medicine can be life-saving for some kids and make matters worse for others. It really depends on what difficulties your child is having that are causing the problems in the first place. No medicine teaches a child cognitive skills he may lack. Medicine sometimes just makes it more possible for the skills to be taught.