Wednesday, December 08, 2010

Trying the Nurtured Heart Approach

Although we don't say much about it on this blog, anyone who knows our family knows that Jaybird is our "spirited" child. Some would say our "difficult" child. That is to say, she's very intense -- all her emotions are BIG. She is also very sensitive, persistent ("stubborn," if you don't like what she's being persistent about), and has difficulty with transitions. All classic markers of the Spirited Child, as outlined in the book by the same name (see the link below).

She consumes about 30 - 50 percent of our parenting energy on a good day. On a bad day, more like 80 percent. A few weeks ago, we began having way too many bad days. You know you've crossed a line as a parent when you start dreading interactions with your child, or when you start feeling bullied by your five-year-old girl. And just to be very clear about this, we did try just about everything we could think of, including ramping up the severity of the consequences to something just short of corporeal punishment; it was both exhausting and ineffective.

Finally, one night while Jaybird was in an extended time-out, after a particularly bad mutual meltdown (on her part and my part), the rest of the family sat down and prayed (out loud) for help in figuring out how to live with her. And more than that -- how to love her.

The next day at Early Childhood Family Education, I heard another parent tell her story. Basically, she had a nine-year-old who was in day treatment at her elementary school; the school counselors and psychologists were recommending drug therapy. (Apparently, it took four adults to hold her down during one outburst.) Then the mom started implementing the Nurtured Heart Approach. They saw a very quick change: she went from having several calls home every week to going four weeks without any calls home. Everyone was telling the mom that the girl was like a new child.

We started implementing this approach right away, just based on what we were able to glean from it anecdotally. Even with this partial, imperfect implementation, we've seen a remarkable change. The hour-long blowout temper tantrums that were a regular feature of every day now occur much less frequently. She never used to make it through family prayer without reprimands and, usually, being sent to her room. That doesn't happen anymore. More importantly, she is happier and more confident -- you can see the pride she takes in being good. (Her little chest actually sticks out more and her smile gets bigger!)

I'm going to try to outline the approach for the benefit of any of my siblings who may want to try this approach (not that I've noticed any difficult children among the cousins, but you probably never marked Jaybird that way, either). I will also provide a link to the book and the website below; the website isn't very informative, though, which is why this overview might be helpful. I offer it with two warnings: 1) The guy who systematized this approach does not claim that this approach is necessary for all children, although any child could benefit from it; most children do fine with conventional discipline techniques. This approach has proven to be very successful with high-energy children, including those diagnosed with ADHD. 2) Please understand that this is my own personal understanding of the NHA (Nurtured Heart Approach), which I am still learning. I'm leaving out a lot of the nuance, context, examples, and additional explanation given in the book. Read the book if you want more information: Transforming the Difficult Child: The Nurtured Heart Approach.

Here's my summary:

  • The Nurtured Heart Approach is geared toward emotionally intense, sensitive, highly attached children -- your classic "spirited" child. It presumes that these children, more than others, really need a lot of "input" from others in the form of interaction and structure. It also presumes that conventional discipline techniques have taught these kids that it is really easy to get a lot of intense feedback from the people around them by acting up. It doesn't matter that it's negative feedback; these kids just want your energy, in any form they can get it. The NHA seeks to break the kids of the habit of acting up to get energy. 
  • Howard Glasser and Jennifer Easley, authors of the NHA book, provide a very helpful analogy that really captures the approach. They observe that most of these "difficult" children strive hard to be successful at video games and/or sports games; more than other children, the difficult child "plugs into" these games because of the high level of interaction, feedback, and energy involved. Glasser and Easley also observe that video games and sports games offer lots of rewards (points, fun noises and visual effects) for positive behavior; negative behavior (breaking the rules or failing) consistently results in a simple, quick penalty -- the lights and sounds go away, or game play stops -- but only momentarily before game play (and the drive toward success) resumes. Glasser observes that these games are highly structured, and focus more on positive incentives than on negative consequences. At the risk of oversimplifying, the NHA strives to recreate the basic environment of a video game -- lots of positive reinforcement, combined with quick, consistent, low-intensity consequences for rule-breaking.
  • The first step in the NHA is to stop giving energy to negative behavior -- you ignore it if possible, or address it as quickly as possible, and as neutrally as possible, if necessary.
  • The second step is to reinforce -- and even create -- success by actively recognizing it and naming it whenever it occurs. Glasser points out that no child misbehaves all the time; so what you do is to give them lots of active recognition (feeding them "energy") when they're behaving in a way you want to encourage. The book spends four chapters outlining strategies for recognizing and reinforcing pro-social behavior. One element that seems important to me is that the positive reinforcement is not vague or unmerited ("Good job!" "Thanks!"). Rather, you're naming and describing very specifically the positive behavior that you're observing: "Amy, I'm really happy about how you asked Jeff to stop; you used your words in a polite voice, and even though you were frustrated when he didn't stop, you used your power to make a good choice by just walking away. It's wonderful to see your powerful self-control and good decision-making." You're not only feeding the child energy in return for positive behavior, you're providing structure by very explicitly connecting that positive input to the exact behavior that elicited it.
  • For especially difficult children, Glasser outlines a credit system whereby the child earns credits for positive behavior -- lots and lots of credits -- that can be traded in for privileges. Credits are never taken away (just as points are never deducted in a game), but the child needs credits to "buy" the privilege. Glasser and Easley call this a "time-in" (as opposed to a time-out) approach. The kid gets something tangible for his good behavior. Again, this is like accumulating points in a video game; in the game, accumulated points result in obtaining new levels or powers. It's the same idea here, except that points = privileges. 
  • Also, like a video game, the rules that one must follow in order to obtain credits are very clear-cut and well-defined. Glasser and Easley advocate formulating rules for the difficult child that are stated in negative terms ("No hitting, no lying") rather than in positive terms ("Respect others") because a negative definition is much more clearly defined than the more vague, open-ended positive definition.
  • Finally, once the positive reinforcement has been established, you set up the companion piece: consequences. "Consequences serve as the all-important limits side of this intervention," Glasser and Easley say. Going back to the video game analogy, they point out that video games do not give any energy to a broken game rule: "No points are scored. There is no payoff. The game's response to any violation is totally predictable: Oops, broke a rule. The consequence: Temporarily missing out on the action." In the NHA, consequences are meted out neutrally, without fanfare or explanation (again, not giving energy to negative behavior). Also, warnings are not given (for the difficult child, warnings are just another "payoff" for negative behavior; they know the rules, or if they somehow missed the explanation, they will figure it out through the consequence).
  • The consequence? A brief, manageable timeout -- what Glasser calls a reset. It begins when the child stops the negative behavior and quiets down, and is over very quickly afterward. The child is congratulated on successfully extinguishing the negative behavior and successfully completing the reset. "The power of a time-out...is not in how punitive or drastic it is, but rather in how 'clean' it is." A clean time-out is de-energized, with a rapid return to the pursuit of success -- much like a penalty in a video game or sports.
Again, I'm necessarily leaving out a lot of nuance and context.

I like this approach for two reasons. First, it seems to be working -- very quickly and effectively. More than once, Starling and I have exchanged raised eyebrows or shocked expressions as the expected blowup fails to materialize (like when we said "no" to a sleepover that she was invited to) -- or even at Jaybird's explicitly naming all the ways she's being good. Second, its focus on positive reinforcement and its presumption of the basic goodness of the child seem to me to be very consistent with Christian values. (Yes, some Christians emphasize the reality of sin, which cannot be denied; but presuming the dominance of sin, or that sin can only be fought with violence or harshness, seems to me to be a denial of the reality of the Resurrection. Grace has, and always will, overcome sin. Relying on that grace is the way to go. Hence the name of the blog, folks!)

The website for the book is http://difficultchild.com/ -- given with the warning that I didn't find it at all helpful for understanding the approach. For that, read the book: Transforming the Difficult Child: The Nurtured Heart Approach.

You may also want to read Raising Your Spirited Child: A Guide for Parents Whose Child Is More Intense, Sensitive, Perceptive, Persistent, and Energetic.

Finally, lest we give the wrong impression, let me just say that one advantage of raising a spirited child is that their joy and loveliness also tend to be magnified. Here's a video of Jaybird heading out into the snow, which I offer as proof of her essential sweetness. (I love her, "Aye, aye!") It's moments like these that make all the effort of parenting her so worthwhile.