Behavioral problems are correlated with academic difficulties (Todd, Horner, Sugai, & Colvin, 1999). Additionally, children with anti-social behaviors often experience a high co-occurrence with academic and social deficits. For children with learning disabilities (LD), all three of these areas, behavioral, academic, and social, present challenges. Although learning disabilities may be the cause for students to engage in maladaptive behaviors, often disruptive behaviors can be the cause for deficiencies in academic achievement, grade retention, placement in a more restrictive setting and poor interpersonal relations among peers and adults (Kazdin, 2003).
Treatments and Format
Two treatments have consistently shown empirical evidence in the treatment of anti-social and behavior problems: parent management training (PMT) and problem-solving skills training (PSST). These treatments have been designed by Alan Kazdin (2003) at the Yale Child Conduct Clinic. Parent management training involves procedures that train a parent to affect changes and alterations in their child’s behavior in a home environment. PSST focuses on the cognitive processes involved when dealing with interpersonal situations.
Both PSST and PMT are provided by a trained professional in the mental health profession, often a psychologist, but it can also be from a social worker or counselor on an individual basis to children and families (Kazdin, 2003). Both can be provided as a systemic approach in reducing the maladaptive behaviors and are not mutually exclusive. However, when a parent is not available or unwilling to participate in PMT, PSST is a viable option and operates as a stand-alone intervention. In other cases, PSST is not a practical option because the child is too young to teach cognitive problem-solving strategies, so PMT is the only viable option and also operates as a stand-alone intervention. This article will focus on PSST and a future article will explain PMT.
Problem-Solving Skills Training (PSST)
PSST focuses on the individual’s cognitive processes (perceptions, self-statements, attributions or perceived causes, and problem-solving skills) that affect their behaviors (Kazdin, 2003). For example, aggression is not triggered by environmental events but by the individual’s perception and interpretation of the events. The individual’s appraisals of the situation, anticipated reaction of others to his/her behavior and the self-statements they employ in response to particular events are all influenced by the individual’s cognitive processes. Aggressive children often interpret ambiguous intent of others in a hostile manner due to their faulty and distorted thinking patterns and react with aggression (Kazdin, 2003).
PSST consists of developing interpersonal cognitive problem-solving skills and prosocial behavior.
Emphasis is on how the children approach (thought processes) situations.
Children are systematically taught to engage in a step-by-step approach to solve interpersonal problems by making statements to themselves that focus attention to certain aspects of the problem or tasks that lead to more effective solutions.
Treatment employs structured tasks involving games and stories.
Therapists model the cognitive processes, apply verbal self-statements to problems, and deliver prompts, feedback, and praise to develop correct use of the skills.
Treatment usually combines modeling and practice, role-playing, reinforcement and mild punishment (loss of tokens or points).
Description of Yale Child Conduct Clinic (Kazdin, 2003)
PSST consists of 12-20 weekly sessions with the individual child or adolescent lasting 30-50 minutes.
Central to treatment is developing the use of 5 problem-solving steps, which are verbal self-statements that involve the identification and use of prosocial responses.
The steps serve as verbal prompts to engage in thoughts and actions that guide behavior.
Each self-statement represents one step in solving a problem.
To assist in acquiring and producing appropriate problem-solving skills, reward systems and role playing are utilized.
The therapist focuses on situations that the child actually encounters with peers, parents, siblings and teachers in the real world.
The therapist models the application of the steps to one specific situation, identifies alternative solutions, and selects one of them.
The child and therapist role play that solution.
Throughout the role playing, the therapist prompts the child verbally and nonverbally to guide performance, provides social reinforcement (smiles, praise, "high fives," applause), specific corrective feedback, and models improved ways of performance.
Children begin each session with tokens that can be exchanged for small prizes at a "store" after each session. During the session, the children can lose chips for misusing or failing to use the steps. However, social reinforcement is more heavily relied upon than token reinforcement.
Homework assignments are designed by the therapist to help generalize skills learned in sessions to the real world. Parents are trained to help the child use the problem-solving steps by the therapist.
The Problem-Solving Steps and Self-Statements
1. What am I supposed to do?
This step has the child recognize and define the problem.
2. I have to look at all my possibilities.
This step asks the child to generate alternative solutions to the problem.
3. I had better concentrate and focus in.
This step instructs the child to evaluate the self-generated solutions.
4. I need to make a choice.
The child chooses the best solution.
5. I did a good job or Oh, I made a mistake.
This final step evaluates the outcome of the chosen solution along with checking whether the problem-solving process was followed correctly. If not, then the problem-solving process is repeated.
Behavioral problems often co-occur with learning difficulties (Todd, Horner, & Sugai, 1999). Frequently, it is unclear when a student is disruptive in the classroom if it is primarily due to learning or behavioral problem. Since challenging behaviors may often lead to learning difficulties and visa-versa, it is prudent for teachers to refer students with chronic disruptive behaviors who do not respond well to typical good classroom management techniques. PSST has been shown to be highly effective in teaching more prosocial responses. However, only a trained professional in PSST should conduct this as an intervention. Teachers should refer a child with anti-social behavior to their school psychologist, counselor or social worker.
Kazdin, A. E. (2003). Problem-solving skills training and parent management training for conduct disorder. In A. E. Kazdin & J. R. Weisz (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 241-262). New York: Guilford Press.
Todd, A. W., Horner, R. H., Sugai, G., & Colvin, G. (1999). Individualizing school-wide discipline for students with chronic problem behaviors: A team approach. Effective School Practices, 17, 72-82.
Michael David Benhar, Ph.D. is an Assistant Professor in the Social Sciences Department at Suffolk County Community College. Dr. Michael David Benhar teaches undergraduate and graduate courses in Developmental Psychology, Exceptional Child, Classroom Management, and Assessment. He has co-authored a chapter on students with disabilities. In addition, he has worked as a school psychologist in a preschool for children with special needs.