3. This is an accident or a medical condition is influencing the child’s self-control.

If misbehavior is an accident, involve children in cleaning or fixing the results of the accident. Teach positive attitudes about mistakes and accidents. Don’t shame or blame children; focus on solutions.

If children suddenly behave in uncommon ways, they might be getting sick, but haven’t shown any symptoms yet. This is most common when children are tired or hungry.


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A Personal Story. When Amber was young and ran low on energy, her personality completely changed. She couldn’t make a decision, cried over little things, picked arguments, and snapped at us. (Of course, I know adults who act the same way if they have to wait too long in a restaurant when they’re hungry!) I easily recognized that she needed to eat or sleep, but if I said, “You’re just tired” or “You are hungry” she’d yell, “No I’m not!” If I forced the issue, we’d get into a power struggle and she’d fall apart even more. I had to find a way to help her be more aware of her body’s needs.

One night at bedtime, I explained how her body was like a car and that food and sleep are like the gasoline that gives a car the energy to go. When cars run out of energy, they stop moving until they get more gas. I described what bodies do when they run out of energy, naming the symptoms she often shows. I suggested that whenever she did those things, her body was telling her it needed more energy and she could choose what kind of energy she wanted to give her body. The fact that we discussed this when there was no problem made a big difference; she understood.

From then on, we tried preventing the problem by adding an after-school snack to her daily routine. She had to eat something before going outside to play. On the few occasions when she started falling apart, I now said, “Is your body telling you it needs some food or sleep?” Because I wasn’t trying to force the issue and asked her to listen to her own body, she was more willing to consider the idea. If she resisted, I’d offer a choice, “Do you want a snack or to rest?” She’d usually eat a snack or do something quiet to recharge her energy. By age eight, she automatically got herself a snack when she was hungry and voluntarily took a nap.

Illness, mental retardation, autism, food allergies, or Attention Deficit Hyperactivity Disorder (ADHD) are examples of medical conditions that influence children’s behavior. These children might truly have a limit to how much they can control their behavior when these factors are present. We can still use all the tools we’ve learned, but need to have realistic expectations about how long it might take to see progress. (Remember, a deeper problem is one of the five reasons the tools might not immediately work.) These tools will, at the least, not make matters worse and usually help speed progress. Read as much as you can about the disorder and specific strategies to use. Most are compatible tools to add to the Universal Blueprint (file them in the PU Toolset). If there are recommendations that go against some of the basic principles of The Parent’s Toolshop, discuss your concerns with a trained professional who can explain whether there is a valid reason for using that approach. While we can’t discuss all medical conditions in this book, it is important to focus on one—Attention Deficit Hyperactivity Disorder. Many children are labeled ADHD without proper diagnosis and quickly put on medication to “fix” them.



True ADHD is a biological condition and there is no single method that accurately diagnoses it. ADHD children are not lazy, defiant, or bad. They often understand what they are told, but have difficulty controlling their impulses to do what they know they should do. Other medical problems (e.g., food allergies, auditory processing problems, or learning difficulties) can cause behavior that looks like ADD or ADHD. Similar behavior can also result when children haven’t learned self-control, decision-making or listening skills. All these factors must be ruled out, before diagnosing a child with ADHD, so concerned parents want to involve a team of people from four critical areas:

  1. Parents are a good source of diagnostic information since they are with the child the most.
  2. Teachers can make observations of the child’s behavior in large groups. Children can have a “learning disability” and not be ADHD. Some children have learning difficulties because their ADHD is untreated. Often, there are environmental factors (such as too much noise) that make it difficult for children to concentrate at home or at school, but they don’t have a physical problem.
  3. Medical doctors can rule out food allergies and hearing/visual problems, which have symptoms that mimic ADHD.
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  4.   Psychologists or psychiatrists who are specially certified and trained in ADHD assessments can perform psychological testing. Parents can determine whether professional assessment might be necessary by reviewing the standard criteria for diagnosing ADHD:

Standard Criteria for  Diagnosing ADHD1*

A.   Either (1) or (2):

(1)     six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:


a. often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities

b. often has difficulty sustaining attention in tasks or play activities

c. often does not seem to listen when spoken to directly

d. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)

e. often has difficulty organizing tasks and activities

f. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework.

g. often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)is often easily distracted by extraneous stimuli

h. is often forgetful in daily activities

(2)    six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:


a. often fidgets with hands or feet or squirms in seat

b. often leaves seat in classroom or in other situations in which remaining seated is expected

c. often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to feelings of restlessness)

d. often has difficulty playing or engaging in leisure activities quietly

e. is often “on the go” or often acts as if “driven by a motor”

f. often talks excessively


a. often blurts out answers before questions have been completed

b. often has difficulty awaiting turn 

c. often interrupts or intrudes on others (e.g., butts into conversations or games)


B.  Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C.  Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

D.  There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of . . . [another mental or physical disorder.] (Author’s paraphrasing.)


*Diagnostic criteria is reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. copyright 1994, American Psychiatric Association.


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There are actually three types of attention deficits: (1) Inattentive (ADD), (2) Hyperactive/Impulsive, and (3) Combined type (ADHD). ADHD can also appear in children who have other neurological (brain and nervous system), psychological, and learning disorders, so a thorough diagnosis process is vital.



No one approach can “cure” ADHD and treatment must be long-term. Therefore, effective treatment plans should address all the possible factors that influence ADHD. The best treatment plan uses the first four interventions at the same time and may or may not include the last (medication).

  A.   Parent education is the most important part of treating ADHD. The Parent’s Toolshop includes every parenting skill that ADHD experts recommend. Most of the strategies are adaptable to school and other settings. If a child does not have true ADHD, just problem behavior that mimics it, it is important for parents to spend time teaching children important behavioral skills.
  • ADHD  children  have  a  high  degree  of  variability—they  are  consistently  inconsistent. These children do have good days—and it can be their undoing—because the adults around them may expect them to have good days every day.
  • Teach children organizational techniques, such as making lists, using self-reminders, using a planning calendar, and making desk, drawer, or closet organizers. These skills are also important to teach children who do not have ADHD, but have similar behavior problems.
  B.   Consistent behavior management. Parents, educators, and others who work with ADHD children should not feel inadequate for having difficulty managing ADHD children. They must repeat themselves often to make progress or just keep situations from getting worse.
  • ADHD children have a hard time being self-motivated toward long-term goals. They have difficulty paying attention or sticking with tasks unless the tasks provide instant gratification, or are novel, stimulating, and fun. This is why they have no difficulty playing video games for long stretches of time. Use positive, creative teaching methods that will maintain their interest. Teach children how to remind themselves to stay on track and find their own way to get the job done. (It is important to consider whether excessive TV viewing and video games have conditioned the child to only pay attention to stimulating events.)
  • ADHD children respond well to   external rewards, but also get quickly addicted to them. Provide frequent, positive feedback, such as nods, descriptive encouragement, smiles, pats, and high-fives. Only add external motivators if the internal rewards are long-term. If you use external rewards (such as extra privileges, games, computer time, or free time), always comment on the long-term, internal rewards of a task or behavior and teach children how to setup self-rewards. This reduces children’s dependency on   rewards and praise from others.
  • Effective reprimands are immediate, brief, unemotional, and consistent. Reprimands are ineffective when they are delayed, long-winded, harsh, critical, or emotional. Selectively ignore attention-seeking, minor behavior that is not aggressive or disruptive.
  C.   Effective classroom environment. There are many small changes teachers can make in the school environment that greatly benefits ADHD children. Many of these changes will help every child’s ability to concentrate. For example, face children away from windows and stand in one location when speaking, so all the children can see and hear the instructions. Unfortunately, we can’t list all the ideas in this resource. (See the list of recommended reading at the end of this chapter.) Parents and educators should at least know about the following factors and incorporate them in their teaching style.


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    • There are three steps to the learning process (learning, understanding, and remembering) and four ways people learn best (seeing, hearing, doing, and teaching). Education commonly presents information through visual aids (books) and uses discussion to explain and practice the information. Some teachers add hands-on learning. If a child cannot learn or understand information until they have an opportunity to do hands-on activities, they may be behind other students who primarily learn through sight and hearing. This is only one example of how someone’s learning style affects their ability to learn and retain information. The most effective teaching approach, however, incorporates all four learning styles at each step of the learning process, to account for the various combinations of learning styles.
    • In addition, everyone uses eight different areas of the brain2 at each step of the learning process, but each person is stronger in some areas than others

a. Words (written or spoken), songs.

b. Numbers, patterns, and other logical strategies.

c. Music, sound, rhythm.

d. Pictures, visualizing, building structures, drawing, doodling.

e. Physical movement, sports, dance, repetitive movements.

f. Socializing with others, reading body language.

g. Internalizing, imagination, self-discipline.

h. Nature, plants, animals, and outdoors.

    • ADHD children often participate in special programs, such as tutoring and reading groups, that take place during school hours away from the classroom. While they learn important skills in these programs, they also lose the extra time they need to complete schoolwork, absorb and process information, or simply get a mental break. They may get farther behind in their work and have difficulty adjusting to the transitions.
  D.   Psychological Treatment. Locate a psychologist, psychiatrist, or therapist who is knowledgeable and experienced in treating ADHD. They can address the following special issues of ADHD:

  • Treat depression and anxiety.
  • Explain how the mind/brain works and doesn’t work.
  • Teach anger control, social, self-motivation, self-reminding, and relaxation techniques.
  • Build self-esteem, since ADHD children are often discouraged.
  • Provide marital and family therapy. ADHD affects the whole family (the ripple effect). ADHD children should not be labeled “problem children” or blamed for other family problems. 
  E.   Medication therapy

  • Medication is only one type of treatment and should only be used as a last resort. Some medications have negative side-effects and most are considered “controlled substances.” Some employers (the military for example) will not hire adults who used these “drugs” in childhood. Given these risks, parents must seriously consider whether medication is really necessary. Above all, never use medication alone or as a replacement for any of the other treatments.
  • Medication will not fix ADHD; it only manages it. Medication for ADHD works like eyeglasses on vision problems; glasses don’t fix the eyes, they simply help people see better. Poor vision and ADHD are both lifelong problems. As children mature and master self-regulating skills, they can often reduce or eliminate the need for medication.
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Some behaviors are considered “normal” for children of a particular age or who have a diagnosed medical condition. “Normal” doesn’t mean parents excuse unacceptable behavior. We need to teach children the skills they need to move beyond their current limitations and develop the maturity and skills they need later in life.


4.  The  child  does  lack  the  information  to  know  better.

Sometimes children simply don’t know or remember how they are supposed to behave. Rules at home might be different from the school’s or a neighbor’s rules. “Knowing better” involves a logical understanding and  an ability to consistently control the behavior. If we teach skills (Independence Toolset) and give information (Clear Communication Toolset) this type of misbehavior often stops or lessens, but this process can take time and practice.

Age alone does not determine if misbehavior is PU or PO. Children can be old enough that we assume they “should know better,” but haven’t learned or mastered the necessary behavior skills. For example, teens reared in violent homes or communities have learned violence. While we can expect other teens to resolve conflicts peacefully, these teens have not learned these skills. In these cases, our focus is to teach skills, as in PU behavior.


5. The child has not consistently shown he or she has mastered the skills to behave properly in this situation.

This last deciding factor usually accounts for the previous four. Children often haven’t mastered skills because:

    • They are too young and haven’t had enough practice or experience.
    • It doesn’t come naturally to them (personality traits).
    • They aren’t feeling well or have to compensate for a biological barrier to using the skill.
    • They don’t know about or fully understand how to use the skill.

The key to accurately answering “true” or “false” to this statement lies in understanding the words of this definition. “Consistent” means repeatedly or many times. “Shown” means we have seen the child act appropriately. Still, just because we have “told” children how to behave and maybe even seen them behave this way does not mean children have mastered the behavior. “Mastered” skills are behaviors children use very well and are almost a habit. 

When we see PU behavior, we want to figure out the positive skill we want them to use and then ask ourselves, “Have I seen my child regularly use this skill, often enough that I am positive he or she is fully capable of behaving properly?” If not, we need to work more on teaching skills and not assume the child is intentionally misbehaving.

When  in  Doubt,  Assume  Misbehavior  Is  PU

Eliminate the possibility that children don’t know better, before assuming they are deliberately misbehaving. If their behavior is really PU and we react as though it’s PO, the behavior won’t improve. Children still won’t understand and will feel more discouraged, which leads to PO misbehavior.

Give children the benefit of the doubt. Just because their behavior is irritating (such as tapping a foot), it doesn’t mean it is “on purpose.” Only if we’ve taught them the skills, they’ve behaved “better” on a consistent basis in the past, and are behaving negatively in a deliberate way, is the behavior “on purpose.” The key to recognizing PO behavior is intent; PO behavior is deliberate.


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PU  Behavior  Can  Turn  into  PO  Behavior

Our reactions to PU behavior influences whether children use the behavior later as PO behavior. If we give the behavior negative attention, the child receives a payoff. A classic example of this is when children say a swear word, but don’t know what it means. In this situation, their behavior is PU. If children get a big reaction, they may intentionally repeat the behavior later for attention. Then the behavior would be PO. They knew they were not supposed to use the word and normally don’t, but to some children, negative attention is better than no attention at all. If we keep in mind that “children usually repeat any behavior we reward,” we can consciously control our responses to PU behavior and redirect it, instead of accidentally rewarding it.

  We can react to PU behavior and turn it into PO …             … or we can effectively respond, preventing PO. 



When responding to PU problems, we want to follow the universal PASRR formula. Here we will find many helpful tools to prevent or respond to PU problems. Let’s review some of the tools we’ve learned that are especially useful with PU behavior and add a couple more tools.


Step  A:  Prevent  the  Behavior  (Prevention  Toolbox)

We can prevent many PU behaviors or, at the least, influence how quickly children learn appropriate behavior skills. We can use the Prevention Toolbox anytime, to prevent PU behavior or at any time in our response.


  • Choose helpful beliefs, attitudes and perceptions about PU behavior, such as “The child hasn’t mastered the skill yet.” This can help us stay focused on teaching the child better skills and being patient during their learning process.
  • Model the behavior skills we want children to develop. If it is a mental process that is difficult to observe, we openly model the behavior, a skill we learned in the Independence Toolset.

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  • Express unconditional love. Children need to know we love them no matter what. We want to show we understand they aren’t perfect and are trying the best they can, even if their best effort is less than desirable.
  • Use descriptive encouragement. Discouragement can cause PU behavior to turn into PO behavior, so encouragement can prevent both PU and PO behavior. Notice positive behavior, describing what we see and how the behavior helps the child or family.
  • Acknowledge any effort or improvement children make to control their behavior or use new skills.
  • Avoid labeling children by their behavior. Help them see their potential. 


  • Plan ahead, to prevent PU behavior. For example, if we know our children don’t handle long shopping trips, or get over stimulated in crowds, we can prepare for these times. We can explain what we will be doing, what behavior we expect, and plan frequent breaks. We can bring activities children enjoy, rearrange the order in which we run errands, or arrange child care so we don’t have to bring children with us.
  • Use positive words to make requests. Saying “no,” “don’t,” “stop,” or demanding obedience offers no new information and often results in a tantrum or power struggle. When we tell children what they can do, they learn positive behavior more quickly.
  • Routines are especially helpful with children who are still learning skills. We can also fall back on our routines to guide children in appropriate ways, “I know you don’t feel like taking a bath, but remember, bath comes before books!”


  • Nudge, but don’t push children when developmental factors are causing PU behavior. Instead, teach skills, offer encouragement, and trust a child’s natural timetable. We need to be extra patient if they regress during the transition from one stage to another.
  • Give information when PU behavior occurs in children who “don’t know any better.”
  • Teach skills one step at a time, give simple directions and many chances to practice the skills. We need to see they can behave appropriately on a regular basis, before realistically expecting them to do so.
  • Offer quick tips, let children be responsible for their own mistakes, and notice the difficulty of tasks and skills children are learning but haven’t mastered.

Responding  to  PU  Behavior

When prevention doesn’t work, or we need to immediately respond to PU behavior, taking the next steps of the Universal Blueprint’s PASRR formula.


PU problems are onions; the outer skin is the PU behavior, the inner layers are the child’s feeling or underlying reason for the behavior. PU behaviors are often the result of feelings like frustration, lack of control, or inaccurate beliefs. Here are some specific statements we can use at each step of the F-A-X Listening process, although you may have difficulty using the last two steps (A and X) with very young children.


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Focus  on  Feelings

  • Give the feeling a name. “That’s (feeling)!”
  • Connect the feeling with the event. “Sometimes you feel _____ when (event).”
  • Use wishes and fantasy. “I bet you wish . . .”

Ask  Helpful  Questions

  • “What can happen when people (misbehavior)?”
  • “Do you know why it’s important to (behavior you want to see)?”

X-amine  Possible  Options

  • “How can you (what child wants) without (parent’s concern)?”
  • “What else can you do when you feel like (misbehavior)?”


Even if PU behavior is normal, we still need to stay calm and respectfully state our concerns, expectations, and limits.

Keep  Your  Cool  Toolset

  • If we don’t control our anger, our unhelpful reaction will most likely start PO behavior. Avoid getting hooked into the problem behavior and deal with the real issue—the child’s feelings or lack of skills.

Clear  Communication  Toolset

  • Describe what you see, without blaming, shaming, and name-calling. Say, “I see chips all over the floor” instead of “You left a big mess. You are such a slob!”
  • State limits and expectations. Instead of saying “Don’t hit,” say, “When people are really angry they need to (appropriate anger energy outlet).”
  • Use quick reminders, one word, nonverbal or flash codes, and notes.

Usually the first three steps in the Universal Blueprint’s PASRR formula (prevention, listening, and communicating) provide enough resources to resolve PU problems. When the problem continues, we move to the PU Toolset to Redirect behavior.


Acknowledging feelings (Step B) and Setting limits (Step C1) are what we say. Redirecting the behavior(Step C2) is usually what we do while we are speaking. We can redirect problem behavior with a verbal statement or by taking action. Here are some extra tools especially helpful in redirecting PU behavior.

 Ignore  Behavior  When  Appropriate

This tool is only useful if the behavior is not dangerous. It is particularly helpful for irritating PU behavior, such as whining. By not giving the behavior attention, parents prevent giving a payoff that can turn PU behavior into PO behavior.

Ignore the behavior, not the child. A parent can acknowledge feelings, “I can tell you really want something” or encourage cooperation, “If you can use words I will know what you want and can get it for you.” We can also say nothing and only respond when the behavior stops or when the child talks or acts in an acceptable way, possibly unrelated to what they were doing. (We learn more about ignoring behavior in the PO Toolset.)

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 Offer an Acceptable Alternative

If children are doing something that isn’t okay, tell them what is okay. With younger children, we may need to physically redirect them. This tool is closely related to “offer choices within limits” and “Don’t say ‘Don’t.’” The possibilities for use are nearly endless:

  ►    Trade a dangerous object with a toy that’s appropriate for a baby or toddler.
  ►    When preschoolers play too rough, say “you can play rough outside or find something quiet to do inside. You decide.

If we have safety concerns about school-aged children riding bikes around the whole neighborhood, we may approve of them only riding around our block several times.


If preteens want to plan a winter indoor boy/girl party, suggest a springtime outdoor party with acceptable coed activities. Avoid lectures about romantic possibilities that would express distrust.


When teens resist a visit to relatives, suggest bringing a friend, an activity to do, or make a deal that they don’t have to go somewhere else if they go there.


Most parents are familiar with the effectiveness of distracting young children, especially those under four years. Because young children are so focused on the present moment, it is easier to change their focus.

A Favorite Story. Many years ago, I read a story in “Welcome Home3 ,” a national publication for stay-at-home mothers. As I remember the story, a mother and daughter were at the playground close to their apartment. The toddler resisted leaving. The mother saw a pretty butterfly and suggested they follow it. This got them out of the playground. But the mother didn’t stop there. She saw some flowers ahead and they went to look at them more closely. By following the various interesting sites along the way home, she arrived at their front door. Finally, she suggested they go visit their dog and see what he was up to. By using distraction, this mother avoided an argument that could have ended with her carrying the daughter, kicking and screaming, from the playground. Neither would have learned anything constructive and their fun time at the play-ground would have been spoiled by the way it ended.

Once children are older than four, distraction takes a different form. With older children, we can try several other techniques:

  • Simply change the subject, refusing to argue.
  • Add humor that in no way “puts down” the child.
  • Give a friendly hug or tousle of the hair, or simply a knowing smile that says “That’s inappropriate. Want to try again?”

  Environmental  Engineering

Parents often fear that unless they control children, the children will take control. When we control a situation, we avoid controlling children with orders that lead to power struggles (PO problem). The most well known form of changing the environment is “child proofing.” By removing dangerous objects or restricting dangerous areas, young children can explore more freely. There are more ways, however, to control the environment that are useful with children of all ages:

  • Add something interesting to the environment when they are bored.
  • Remove from the environment, when there’s too much going on and they can’t filter out distractions.
  • Restrict the environment, creating special areas for certain activities. For example, have a special homework nook, a specific play-doh area, or one room for all the toys.


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  • Enlarge the environment by moving outside or to a larger room when they need more personal space or room for active play.
  • Rearrange the environment to make things more accessible, which encourages independence.
  • Simplify the environment when there are too many changes or activities that overwhelm them.
  • Organize the environment by establishing routines and rituals.

 Identify  PU  Behaviors  and  Their  Triggers,  Then  Make  a  Plan

Changing PU behavior usually takes longer than other behaviors, because the child’s maturity and skill development take time to improve. With more severe or disruptive behaviors, we may need to develop a more comprehensive plan.

1. Identify the PU behavior you want to work on. Decide what you want children to do.

2. Observe when the behavior occurs and doesn’t occur.

When the behavior occurs, ask yourself, “What is the child doing when it happens? What am I doing? What else is going on? What triggers it? What is the child getting from it?”

When the behavior does not occur, ask yourself, “What was different? Could this factor prevent the behavior? When is it okay to behave this way? What is the child getting from the behavior?”

3. Control triggering events. “Triggering” events cause or influence the behavior to occur. Reduce the factors that trigger the PU behavior and strengthen the factors that encourage appropriate behavior.

4. Break the response chain. Disruptive behavior can be a habit. One step leads to the next step, which leads to the problem. What is the typical pattern? To eliminate PU behavior, we must help the child learn new skills to replace the old habitual behavior.

5. Give encouragement. Acknowledge effort toward the positive behavior and any improvements children make. Focus on internal motivators and rewards. “(Friend’s name) appreciated it when you (describe appropriate behavior).” If there are external rewards, wean children off of them quickly.

6. Track the progress. Notice steps toward the goal and any improvements. Recognize barriers and develop a plan for removing them.


The PU Formula 

Using the PASRR Formula with PU Behavior

To use the PASRR response formula with PU behavior, use statements similar to the following examples:
Step A: Prevent the problem. “When people want _____, they (teach skills).”
Step B: Acknowledge feelings. “I can see you want/feel _____ . . .”
Step C1: Set limits and express concerns. “. . . but (explain concerns).”
Step C2: Redirect behavior. “You can (offer an acceptable alternative) instead.”
Step C3: Reveal discipline. (We’ll learn this in Chapter 13, “Discipline Toolset.”)

Here are a few examples:

  “I can tell you’re really angry, but hitting hurts! You can hit this pillow instead.” (We could substitute hitting pillows with another anger energy release activity.)


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  “I know you think not wearing a helmet is safe if you ride your bike on the sidewalk. Even though cars might not hit you, you could still wipe out on the cement. When people in our family ride bikes, they do it safely. You can wear a helmet or walk.”
  “You’ve said a lot of your friends are getting body piercing. I’m not surprised you want to do it, too, since it’s a way to express who you are. I’m worried about the risk of infection and other health risks. I’d be willing to give you permission to do something safer but just as cool. What are some safer options?” (Continue with brainstorming a win/win solution.)