Positive Relationships: Behaviour - Making a noise

In our nursery, we have a child who will be three in a couple of months' time. He is a happy child but he frequently emits a high pitched scream. Sometimes it is because he wants attention, while at other times there seems no logical explanation. The noise is horrendous and brings the nursery to a halt. Apparently he does the same at home. He has been doing this several times a day since he was two years old. We thought he would just grow out of it once he was talking more, but if anything it seems be getting worse, even though his speech is now very good. With the parents, we have tried several techniques including reprimanding him and also ignoring him.

The first thing when you hear a high pitched scream is to rule out that a child is unwell. High pitched cries especially in babies are often a sign that children need immediate medical attention and so should not be ignored. In the case of this child, I would be inclined first of all to ask the parents to rule out that the child has any underlying medical conditions such as a chronic ear infection.

Once we have ruled out underlying medical conditions, the next thing to consider is this child's speech. You did not say whether, when he started screaming, his language was typical for his age - most two-year-olds are using a few words and are even starting to put two words together to create mini sentences. Where children's language is delayed, they are more likely to adopt other ways of communicating and also venting their frustration. This is why screaming and tantrums are often found in younger children.

From the child's perspective, a scream is an effective tool as it usually results in an immediate adult response. I would speculate that in the case of this child, the need to communicate and express himself was the start of the scream, but now it has developed into a habit, which is why you cannot always pin down a reason behind each scream.

STRATEGIES

While identifying the cause is useful, let's turn our attention to strategies for helping the child to move on. My starting point would be to keep a record of when the child screams both at home and in the nursery. (I was pleased to see that you and the parents are working closely together on this.) Keeping a joint diary for a week might elicit clear situations when a scream is more likely.

If you are lucky and there is a clear pattern, it will be relatively straightforward to manage it. All you would need to do is to change the routine or usual circumstance to head off the scream. For example, if the child screams just before lunch, distract the child with a puppet or hold lunch in a different place. This, along with some positive attention, might do the trick.

If this approach does not work, then you will need to become more of a detective and address this behaviour by focusing on the reinforcements that are prompting the child to repeat this behaviour. In which case, let's look at the scream itself.

While uncomfortable for everyone else, the act of screaming probably feels good. I wonder if it is giving the child some release and also a feeling of strength. It would be great to convert this feeling into something more acceptable. You might like to look out for some musical instruments that reproduce the loudness of the sound - a big gong made from a metal dustbin lid or a wide resonating drum. The ideal would be something that involves a large gross motor movement resulting in a satisfying bang.

Whatever you decide, it also needs to be very accessible to begin with. Do expect that, in the short term, you may find that the noise level does increase in the nursery as other children are also likely to join in. From this, you can move to a range of other instruments, including some that are easier on the ear!

The next piece of this quite complex jigsaw is to focus on adults' reactions. It is likely that both you and the parents show a strong reaction to the screams and that you are unwittingly providing the child with plenty of attention. I note that you have tried reprimanding the child, but remember that this too is attention.

While you have tried ignoring the child's screams in the past, I suspect that you need to go back to this approach once again. Ignoring the child at the point at which he screams will need a very unified and sustained approach. Consistency will be the key and so everyone has to be sure that they can 'hold' the line. It will also require a commitment to not responding to the child at the point of the scream for several days. Ignoring something as unpleasant as a scream is not easy - my own approach is to turn my back or, if possible, to walk away. This gives a clear signal that the behaviour is not welcomed.

Ignoring the scream will not be sufficient in itself in view of the child's use of it to gain attention. This child will also need plenty of positive adult time. Check with the parents that they have the emotional energy to do this. I say this because behaviours such as this are quite wearing and sometimes parents lose the knack of responding positively to their children.

If needed, suggest strategies such as sharing stories or playing games as well as involving him in routines at home, such as sweeping the floor.

I would not expect the screams to end overnight, but over a few days, if this approach is working, you should see a reduction in their frequency. Keeping a note of progress will also help everyone to remain consistent.

While I would be hopeful that this approach will work, it might be that this child's needs are more complex than your letter suggests. Do be ready to talk to parents about a referral if needed.