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Temperament in pediatric practice
with Stella Chess, MD
Clinical applications
Using temperament concepts with clients/patients

Practitioners in several disciplines incorporate temperament concepts into their professional practices...
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Normal Misbehavior
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Soothing, Not Scolding (continue)

I also helped Angie to make adjustments in their daily routine to soothe and encourage her son. She rearranged her work schedule to have more time to help Benjamin get settled at school in the morning, so that his day didn't begin with a rushed transition. He loved being read to, so I encouraged both Angie and the school staff to utilize that interest by reading stories to him about handling anger and frustration. Angie also got him into swimming classes, providing him with an appropriate outlet for his energy and athletic ability. Finally, she curbed Benjamin's access to violent video games and made sure she maintained a bedtime routine so that he got enough sleep.

Though his father was not in the picture, Benjamin loved male attention, wrestling and rough housing-which he got from some of Angie's male friends. But as therapy and our team meetings continued, everyone began to notice that whenever Benjamin spent time with one of her friends, who encouraged him to be physically rough and ignore rules, his aggressive behavior at school increased. Angie decided to be more selective about the men Benjamin spent time with.

Angie had personal work to do in therapy, too. She admitted that she did a good deal of yelling at home when she was frustrated. She began managing her own stress better by keeping a journal, exercising and attending a support group for women who had been victims of domestic violence. She also started using some of the techniques her son was being encouraged to use, like pausing to take some deep breaths instead of yelling

In six months, Benjamin became better able to handle his frustration and anger. Things like minor changes in the school-day schedule stopped bothering him altogether, and when he did get upset, he was more likely to move aside to calm himself down, express his feelings, or ask the teacher for help. His disruptive behavior became increasingly benign-such as his continued tendency to blurt out answers rather than waiting for his turn. When he moved on to elementary school with more academics to focus his energy and intelligence on, that helped too. His teacher says he sometimes gets off task, but is easy to redirect. Benjamin is now in 2nd grade and continues to do well.

The kind of behavioral missteps Benjamin displayed, however aggressive they may have seemed to his teachers, are not usually an indication that a child is on his way to showing up one day at high school with a gun. Overreacting to such problems can make them far worse, putting a small child with behavior problems at risk for continued difficulties. Fortunately in Benjamin's case, his mother had a strong commitment to him, attending therapy sessions and team meetings when she was tired, or dealing with housing or work related problems. In addition Benjamin and Angie also had a 'head start', a team, a village if you will, of people helping and supporting them. Had Benjamin been expelled from school, it isn't likely they would have gotten that kind of help and their story might have had an entirely different outcome.
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