Hello and welcome to our next Therapy Connect Conversation. My name is Kirsten O’Rourke, your host for a three-part series where we unpack some thoughts and ideas to support some common challenging behaviors. Our first session was on supporting young children to engage and supporting our early learners to stay and play in those important years. Our second session is on teaching core life skills, such as communication, tolerance and cooperation.

Joining us in this series is special guest Sophia Garner. Sophia is a master’s level social worker and board-certified behavior analyst, with extensive experience working with individuals with a range of abilities, challenges, and concerns. Sophia has specialist training and experience working with families and clients who are experiencing challenging behaviors. 

Sophia, in my experience in working as a clinician with children and their families in this age group, a common question that often comes up is “how do I help my child move from one activity to the next?” Or “how do I help my child put the device away so we can go do something else?” 

Kirsten it’s actually a really common issue that a lot of kids face. With all of the time in lockdown, where all of the learning is on the device as well, it’s really hard to keep your kid entertained without a device. 

Agree. Sophia, what is tolerance? How does it help our children to build tolerance as a skill? 

Tolerance for adults is when something disappointing happens, and we often say, “Aw, okay. that’s fine,” or, “no worries.” We might even say with a little bit of attitude, “ugh, okay.” That’s still tolerance. Right? We’re communicating that we’re tolerating something that isn’t necessarily exactly what we wanted in that moment. It’s a really important life skill because as much as we would love to create an environment for our kids where everything is just wonderful for them, it’s just not real life. So, giving kids the skills to tolerate life’s disappointments that inevitably come around is really important. Before you teach tolerance though, you want to always make sure that your kids have effective communication skills. 

These are core life skills. You’ve got communication, toleration, and cooperation. Communication is almost always what we would use as a replacement for any challenging behavior that your child is experiencing, so I often think, what’s this challenging behavior achieving for this learner? And how can I give them a way to communicate that meets that exact same need or want and then, teach them how to say that. So, it could be “can I have a few more minutes”, if it’s to do with the device. Really practicing and reinforcing that. It’s like, yes. You can have a few more minutes, or yes, I will leave you alone, prompting them to use their communication response in the moment. We’re going to want to make sure that communication works with them first. It’s like, if we’re teaching them to say, “Can I have one more minute?” And then we’re saying, “No,” and expecting them to say, “Okay,” straight away, they’re going to be like, hold on. This doesn’t work. I’m not going to bother saying anything.

We need to make sure communication is working and that we’re introducing tolerance in small amounts, and we’re engaging in this tolerance response. What’s the next step?

This is where it gets interesting. Once your learner has that tolerance response and they’re saying, “Okay,” you’re going to reinforce that by giving them back the item or the experience or whatever it was that they didn’t want to lose in the first place. And that might seem counterintuitive, because you’ve just said, “Time to pack away the iPad,” and they said, “Can I have one more minute?” And you’ve said, “No. Sorry.” And they said, “Okay.” And then, it would seem like you should then take it away, however, they’ve just said, “Okay,” when you’ve said, “No,” to the device, right? That’s massive. That’s huge. We want to make sure that that response was reinforced.

And that’s showing tolerance, isn’t it? To something that they’re comfortable with.

Exactly. So I would then say, “you know what”? You just said, “Okay,” or, “No worries,” so calmly. Thank you so much. I’m going to give you a few more minutes on the iPad for saying that. Or, you can have a few more minutes on the TV because you said, “Okay,” so beautifully. And reinforcing that tolerance response. You’re now rewarding their positive behaviour.

I’m already actually thinking about my own children. I might have to try that with a few things, because I think I can see how they would be like, oh, okay. We’re building tolerance and confidence and we’re building their willingness to tolerate ‘no’, in some cases. 

Yes. No means a delay to what they want to do because you’re cooking dinner and you literally can’t stop what you’re doing because you’ve got something on the stove. Right? You just need them to tolerate hearing ‘not right now’, or ‘in a minute’, which can be so important for some kids to hear. The other thing you can do is that, if you ever notice your child tolerate something really well, and they say, “Okay,” or they just take a deep breath and they walk away, catch that. That’s gold. It’s like, stop what you’re doing. Go over to them and be like, wow. That was amazing, what you just did. Thank you for tolerating that so well. I am going to let you do it now, because you tolerated it so well. But not every time. Otherwise they’ll learn that really if I tolerate everything, then everything’s wonderful all the time, which like I said, is not real life.

In building tolerance, I like that term ‘catch the moments’. Catch the moments of tolerance and reward those. Because so often, we don’t. Do we? Because we’ve said no, because we’re busy, so we’re not in a frame of mind to be able to catch that moment. It’s like, no, I can’t. And then that’s a mind shift, I would think, for myself personally, to be able to catch that moment. 

Again, often it’s just our expectation that our children are okay with things. It’s like, you should just be okay with this, because I’m the adult. But we have to teach them those skills. Right? 

I imagine in this age group, there’s quite a few different things that tolerance encompasses. Doesn’t it? We’re talking upper, later primary years. So, there’s lot going on for those kids and there’s lots of different pressures of things that they might want or need or things that they want to do. 

I’ll quickly touch on cooperation. Just a bit of a caveat here, like if you’re finding this really challenging, or if you’re having some more extreme challenging behaviors, I would really suggest that you seek some one on one support.

Yes, because there are some really big emotions and things that go with these tolerance challenges. Aren’t there?

Yes, we will talk about that in our next session. But firstly, cooperation. We don’t always need our learners to say yes to us all the time, which is why we give them that communication response, and sometimes we honor that. If they say, “Actually, can I just have another minute doing this?” Or, “Could we do that later?” Sometimes, you’re just going to be like, okay, sure. But every now and then, you are going to need them to cooperate with some activity. That is just part of life, right? So, might have a learner who’s really reluctant to engage in particular activities, which is when you might need some more support, but just as some general tips, break it down into really small parts and reinforce those really little parts.

So, if you’ve got a kid that really struggles to transition to the bathtub, you’ve taught them a tolerance response for when they said, “I don’t want a bath.” It’s like, sorry, but we have to have a bath. And they said, “Okay.” It’s like, thanks so much for saying okay. Now, we’re going to stand up and walk towards the bathroom. Right? And you might just catch them when they’ve stood up. It’s like they’ve made the decision in their mind. Okay, I’m going to do this. And they get up and they start walking towards the bathroom. And it’s like, well, you know what? Don’t worry about it. We can do that later. Thanks so much for standing up and coming with me. What should we do? What do you want to play? It’s just catching those little itty bitty steps towards cooperating with something that they find challenging.

You’re talking again about reinforcing a tolerance response by giving back what they wanted. In this case, was not a bath. 

Yes, about having that bath or whatever it was. Obviously, you don’t stop there, otherwise, they might not have a bath for a very long time. But, it’s about breaking it down into those really small steps and helping them be successful. We can teach these skills without our learner having to experience challenging behaviors. We want to teach them that they’re not necessary for us to understand what you need and what you want and that you don’t want to do it right now. We hear you without needing to engage in those challenging behaviors.

Now I love that and the concept of building tolerance. And I think at the core, everyone wants to be able to tolerate things so that they can get by in life and do what needs to be done at certain moments in time. So, that’s really, really useful information, Sophia. I’m really looking forward to talking to you about some of these big, big emotions that might go with tolerating moments in our next session as well. Thank you Sophia for a really productive conversation about building and extending tolerance and helping out with day-to-day things.  I love how you’ve spoken about how communication skills are so important, and making sure that’s first priority. Building tolerance in small amounts, and engaging in a tolerance response, and then reinforcing tolerance. And then, catching the moments of tolerance.

Therapy Connect is a private allied health, telehealth practice. We support clients around Australia, particularly NDIS clients, that are needing access to speech pathology, occupational therapy, psychology, social work, dietetics, or physiotherapy.

If you’d like some more information about our service, you can head to our website, which is www.therapyconnect.com.au. Or, you can contact our client services team on 1 300 757 806. Join us next time for our third and final session in this series of conversations on emotion coaching.