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Experts urge parents to take a 'positive' approach to children's behavioural problems; 'THE EVIDENCE IS CLEAR THAT PUNISHMENT DOESN'T WORK'.


PARENTS of persistently badly-behaved children should be trained on how to manage anti-social behaviour under guidance published today by health officials.

Classes should teach parents to encourage positive behaviour instead of focusing on punishment and simply telling them "no", experts said.

The National Institute of Health and Clinical Excellence (Nice) and the Social Care Institute for Excellence (SCIE) have drawn up a raft of recommendations to help parents deal with children demonstrating repeated behavioural problems.

Professor Peter Fonagy, chief executive of the Anna Freud Centre, who worked on the guidance, said evidence-backed advice should include telling parents to avoid the word "no".

He said: "If our kids misbehave, our response to it is not always the most rational, most reasonable and most effective response.

"Words like 'no, don't do that' can appear to be the best possible intervention, except that for a kid where the word 'no' triggers misbehaviour, there needs to be alternative strategies to help them reinforce good behaviour."

He added: "In some parent training programmes the first few sessions are all about learning to play with your kid, learning to do something positive, getting money into the bank so the kid finds something really rewarding in being with you as a parent."

He said that ignoring negative behaviour and focusing solely on the positive is very difficult without support.

Prof Fonagy said punishment leads to worse behaviour in children with conduct disorders, adding: "Sometimes our instinctive responses are unhelpful.

"Punishing bad behaviour is an instinctive response. We demand justice and we think that by punishing we will make things better."

Professor Stephen Pilling, director of National Collaborating Centre for Mental Health, who also worked on the guidance, said: "Programmes - 'Scared Straight' is one - that focus on punitive approaches don't work. The evidence is clear that they make kids worse."

Under the recommendations, classes for parents will be offered where the child is three to 11 years old.

Prof Fonagy said it was easier and more cost-effective to treat conduct disorders when children are young.

He said: "It's obviously better to intervene early. The brain is just like any other organ of the body, illness itself causes damage to the organ.

"Intervening early will save you considerable money in the long run."

Prof Pilling said treating conduct disorders would save money that would otherwise be spent in the criminal justice system.

He said: "By any standard that Nice operates, these treatments are clearly cost-effective.

"If you put in criminal justice costs, these interventions are dominant. It's actually cheaper to provide them than not to provide them, they're saving money."

He added: "The cost of not treating a 10-year-old with a conduct disorder for the next eight years, over the rest of their childhood, is in the PS80,000 to PS100,000 range."

Nice also set out guidelines for diagnosing conduct disorders and distinguishing the medical condition from general misbehaviour.

A conduct disorder can be identified by persistent and severe anti-social behaviour across different contexts, including home, school and social settings, according to Nice clinical guidelines.

Prof Pilling said: "What distinguishes conduct disorder from the kind of difficulties that all of us might have as children is its persistence, that it's a problem that can be identified early on in childhood, that the difficulties are really significantly higher than you would encounter in ordinary family life. That's because the behavioural difficulties are not just in one setting."

According to Nice clinical guidelines, conduct disorders develop in children as they get older, affecting 7% of boys and 3% of girls aged five to 10 years old, and 8% of boys and 5% of girls aged 11 to 16 years old.


Never say 'no' to a naughty child is the latest expert advice
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Publication:Western Mail (Cardiff, Wales)
Date:Mar 27, 2013
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