Issues in Quality Child Care: a Boys Town Perspective.

Dowd, T., Herron, R., Hyland, T., & Sterba, M. (Eds.). (1998). Issues in Quality Child Care: a Boys Town Perspective. Boys Town, NE: The Boys Town Press, pp. 209 (soft-cover).

The title of this book, Issues in Quality Child Care, suggests a discussion of topics of debate in the child-care field. However, the book's subheading, Reflections on the Vital Signs of Caregiver-Child Relationships, Quality Teaching, Why Children Misbehave, Crisis Teaching, and Reducing Aggression in Children, more accurately reflects its contents. This book is comprised of a series of articles written by the professional staff of Boys Town that describes aspects of the Boys town model of intervention for troubled children. The articles are loosely related and provide interesting descriptions of what the authors believe are critical skills for child-care workers. The overall focus of the book is on skills that foster a therapeutic relationship and comprise therapeutic teaching. The introduction states that the child-care skills described in the book are "practical approach[es] to helping children learn how to replace negative behaviors with positive behaviors."

The introduction does not explicitly state the target audience for this book. However, it appears that the articles were written with child-care workers, and perhaps parents, in mind. Nontechnical, "user-friendly" language is used throughout the book. Straightforward descriptions of therapeutic caregiver skills are presented along with rationales for the importance of the skills. Realistic examples are presented to illustrate the skills. Occasional quotations (e.g., "If you see someone without a smile, give him one of yours.") keep the text grounded for a child-care worker and parent audience.

The first article provides a brief description of the history of the development of the Boys Town model of child care. In addition, an overview of the relationship-development and therapeutic-teaching techniques is presented. The "child-care technologies" presented are based on learning theory and had their origin in the Achievement Place project at the University of Kansas. As Boys Town has expanded nationally and gained experience with technology transfer to new programs, new ways of teaching children and training caregivers have been developed. The remainder of the book presents a collection of articles that describe some of the key components of the technology.

The second article, Vital Signs of Relationships for Care givers, describes seven ways of building strong relationships with youths: smiling, having fun, play, humor, laughing at yourself, joking and playful teasing, empathy, praise, listening, thoughtfulness, and give and take. Each of these ways is described as a quality of a healthy relationship. Examples are provided.

The third article, Quality Teaching, begins with a description of the importance of a quality relationship between the child and caregiver in providing effective therapeutic teaching. The article ends with a description of "corrective teaching interactions," which are used in response to a youth's misbehavior. Eleven components of a corrective teaching interaction are described, and examples of actual interactions are provided to illustrate how the components fit together in a corrective teaching interaction.

The fourth article is titled, Why Do Kids Misbehave? The authors very briefly describe two theories that seek to explain how children learn to deal with conflict inappropriately. G. R. Patterson's "coercion process," published in 1982, and N. J. Long and M. M. Wood's "conflict cycle," published in 1991, are presented with short examples.

The fifth article, Crisis Teaching, describes how to handle one's own reaction to crisis situations with youth's, how to de-escalate the situation, how to teach the youth self-control skills, and how to proactively teach for the future prevention of crises. Skills identified as essential for a child-care worker during a crisis include offering a "cool-down" time, spending more time telling a child what he or she is doing right, talking more softly and slowly, remaining relaxed physically, avoiding arguing and watching your words, using statements of empathy and concern, using positive correction, and individualizing the approach taken to each child. Self-control strategies that can be taught to children are briefly described and include deep breathing, journaling or drawing, taking cool-down time, positive self-talk, and muscle relaxation. The article also discusses the use of proactive teaching to teach self-control skills at times other than during a crisis. Opportunities for proactive teaching are describe d along with examples of actual teaching interactions.

The final article, Reducing Aggression in Children, appears to have been written more for a parent audience than for child-care workers. The article describes how to identify when aggression is no longer the typical stuff of children and is becoming a problem. It then describes how to deal with aggression, using some of the components of effective teaching described in the earlier articles. There is also a brief section on distorted thinking or self-talk. Four cognitive distortions (arbitrary inference, magnification, dichotomous reasoning and over generalization) are outlined along with some skills that youths can be taught to offset the distortions.

In general, the book contains a set of loosely related articles written for child-care workers and perhaps parents. Each article could stand by itself as a useful reference. The concepts and skills presented would be useful to any child-care worker and could greatly enhance therapeutic effectiveness. The articles probably should not be used as a stand-alone training curriculum, though, but as a supplement to an established staff training program. For example, the crisis intervention strategies appear to be excellent, but if used in isolation without all of the other components of effective child-care work, might result in less than desired outcomes. Child-care workers, and perhaps parents, will find the articles in this book very readable. The skills presented will enhance their effectiveness with troublesome kids.