Behavioral Management Training for Families of Emotionally Handicapped and/or Developmentally Delayed Children

A major deficit exists in the delivery of mental health services to developmentally delayed and/or emotionally handicapped children and their families. Individuals well seasoned in child psychiatry and related fields recognize that it is impossible to effectively treat children and maintain behavioral gains without family involvement and follow-up. Unfortunately, statistics suggest that most treatment of developmentally delayed/emotionally handicapped children focuses only on the child.The incorporation of family members in the treatment process is essential and can be accomplished by teaching families to use basic behavioral management prinicples. Psychiatric clinical nurse specialists, and other nurses proficient in behavior management, can provide the training and intervention needed to assist families in managing the children.Nurses at the Children's Mental Health Unit (CMHU), University of Florida have developed a family training program to help meet the needs of families who must interact regularly with handicapped children. Preliminary research data indicates that the family training conducted by CMHU nurses has provided families with an effective means of reducing stress and concretely handling problem behaviors.Behavioral management principles including cuing, reinforcement, time-out, and extinction are presented and family members are instructed in the practical use of a specific behavioral plan. This is illustrated in the case vignette of J. H., a child presenting with severe self-abusive behavior. This vignette also illustrates the importance of crisis intervention, stress management, and follow-up in the treatment of the child and family.