My mother started a child care center when my little brother was four years old and I was seven. She taught for 20 years and by the time I began studying formal child development ten years later, I had spent time with hundreds of children ranging in age from three to six. Yet with all my mother's skill, she found that some children were not in the textbooks: children who had internal rages, who attacked, who destroyed, or who had vulnerabilities that rendered them out of control.

Research indicates that the number, nature, and severity of disruptive behavior problems are increasing. By three years of age, children are capable of inflicting great bodily harm on others. I have met a number of families whose children have been expelled from child care homes and centers before their third birthdays. In my work with Head Start and Early Head Start, I have consulted with a number of programs that have been overwhelmed by having as many as three of these children in a classroom of eight. We must ask ourselves several questions. First, what can cause well meaning programs to reject a child still in diapers? Second, what caused the child's problem in the first place? Third, what can and should Head Start programs do to resolve these problems?

Signals for Help
These children are easy to spot in a classroom, at home, or in public. They bite, hit, destroy, and erupt like volcanoes on a regular basis. Unlike many young children who may do these things occasionally or even during a fairly intense stage that may last a few weeks or months, these children feel overwhelmingly difficult to those dealing with them. They are unpredictable, difficult to channel into other activities, and almost impossible to calm down once they act up. Usually they show no remorse or guilt, and discipline strategies such as time-outs are often ineffective. The child that sent me scurrying from my mother's child care center into mental health training walked around saying that he could kill. He stabbed another three-year-old in the neck with a pencil. Two-year-old Danny at my own therapeutic preschool reportedly tore his crib sheets into shreds at six months old and was a perpetual biting machine who called himself, "Me Bad Teeth. " Four-year-old Henry dismantled everything from doorknobs to cubbies at his day care center. Sent to mental health clinics, children like these may receive diagnoses of Attention-deficit/Hyperactivity Disorder (ADHD) or Oppositional Deviant Disorder (ODD).

What are the Origins of these Behaviors?
There is no simple answer, and people in the field must be like detectives, realizing that the story is different for every child.

The origin may have a biological base, with brain make-up being the root of the difficulty. Babies may come into the world with a regulatory disorder. These atypical physiological, sensory, attention-related, motor, or affective processes can seriously affect a child's behavior. Chemical addictions that pass through a placenta to a fetus may affect some babies. Chronic mental illness inherited from parents and extended family members may start to show up at young ages.

The relationship between parent and child is critical. Attachment problems, temperament/personality conflicts between parent and child, maltreatment, developmentally inappropriate discipline, and inconsistent and insensitive parenting all call for attention and intervention within the relationship.

Life events can determine out-of-control behavior. Juggling between multiple caregivers, crowded, unresponsive child care arrangements, and exposure to traumatic events all take their toll with some children. Our society is particularly difficult for children with its frightening violence, premature sexuality, exposure to over-stimulating, inappropriate media, substance abuse epidemics, and overwhelmed, fragmented families.

Helping to Regulate the Uncontrolled Child
Head Start's policy is to work with the neediest of the needy, to pioneer new strategies for challenges faced by young children and program staff, and to embrace parents and community partners in the work. Head Start institutes and builds training for teachers, caregivers, and family advocates to succeed rather than give up. The central focus is always what it will take to help that child be successful.

Information contained in the Head Start Program Performance Standards, Zero to Three publications, and training guides are good general resources. Parents and community partners (Part C and Part B, mental health consultants, pediatricians, and social service agencies) are critical, and the national and regional Head Start training and technical assistance contractors are on board to help find solutions. All of us are gaining more expertise at surfing the Internet.

Besides these formal resources, I suggest the following practical advice.

1. Find someone to provide one-on-one shadowing. I tell volunteers, trainees, or assigned staff to velcro themselves to that child and learn to predict and prevent disruptive behavior. If one child is about to hurl a block at another, the assigned adult should firmly but gently help the child place it down with appropriate words such as, "Blocks can hurt. This one belongs right here." If more than one person provides the support, assign people in a predictable, consistent way so that the child can build relationships and experience stability.
   
   
2. Help staff and parents be creative, first understanding the probable reason for the child's out-of-control behavior and then planning appropriate intervention. Example: Henry used to dismantled everything because his psychotic father threatened to tear the children apart limb by limb if they got off the couch or out of bed. Intervention included getting the father into treatment and on medication and finding a toolkit for Henry to use to dismantle appropriate items to his heart's content.
   
   
3. Provide staff with consistent mental health consultation, instructive and experiential training, and weekly supervision when they are handling difficult situations. A wonderful child psychiatrist met with my staff for several hours weekly on a regular basis to understand behavior, to plan, and to evaluate effectiveness. If a number of primary caregivers, especially parents, are involved with a child, the communication and planning needs to include all of them. The more the child experiences loving, firm, and consistent care, the more effective the intervention will be.
   
   
4. Provide a combination of behavioral controls and reasonable consequences; well-trained, consistent staff; facilities that offer quiet spaces and comfort; activities that permit out-of-control children to work through difficult feelings; and a psychiatric recommendation for medication reserved only for older preschool children who require more than tight structure.

Regular communication and planning with parents and other primary caregivers are generally the formula that leads to success. With everything in place, I have seen very challenging children transform themselves into socially successful children who are ready to learn over the course of a year.

As early childhood educators, we are remarkably creative and innovative. If we allow ourselves to really feel and understand, we may receive the gift of effective intervention with the tools of our trade.

Alice Eberhardt-Wright is an Infant/Family Specialist in Region VII. T: 785-478-4085; E: AliceEW@aol.com.