EARLY 

HEAD 

START 

NATIONAL 

RESOURCE 

CENTER


Strategies for Understanding and Managing 

Challenging Behavior in Young Children: 

What Is 

Developmentally

Appropriate–

and What Is 

a Concern? 

Technical Assistance Paper No. 

10 

U.S. Department of Health and Human Services 

Administration for Children and Families 

Administration on Children, Youth and Families 

Head Start Bureau 
EARLY 

HEAD 

START 

N

4 ATIONAL 

RESOURCE 

CENTER
 

Strategies for Understanding and Managing 

Challenging Behavior in Young Children: 

What Is Developmentally 

Appropriate—and What Is a 

Concern? 

Technical Assistance Paper No. 10 

First Printing: 2006 

U.S. Department of Health and Human Services 

Administration for Children and Families 

Administration on Children, Youth, and Families 

Head Start Bureau 

Prepared for the Head Start Bureau, under contract # HHSP23320042900YC, by the 

Early Head Start National Resource Center @ ZERO TO THREE. 
Technical Assistance Paper No.
 

10
 

Strategies for Understanding and Managing Challenging 

Behavior in Young Children: 

What Is Developmentally


Appropriate–and What Is


a Concern? 

When Carol first came to the Early Head Start child-care program at 20 months, the other children
 

loved her. She had endless energy, a hearty laugh, and was the “life” of her classroom. She would run
 

and climb, inviting others to follow, and she would think of all sorts of funny things for the dolls to do
 

such as go down the slide or ride in toy trucks. However, when another child had a toy she needed, she
 

would take it—wasting no time on negotiation, but hitting or biting to get her own way. 


The other toddlers quickly became more frightened than intrigued. They started saying things such as
 

“Carol bites.” Even her primary teacher, Naomi, couldn’t stop the temper tantrums that soon followed
 

Carol’s other behaviors. By naptime, Carol was far too excited to sleep or even rest, and her noises
 

kept everyone else up, too. Soon, Carol had no friends, everyone was tired and tense, and the classroom
 

felt like a minefield. Carol’s grandmother was finding things equally difficult at home.
 

Very young children are 

learning a great deal in 

an incredibly short 

amount of time: They 

learn when we eat 

with our fingers and when we use 

spoons; when we wear clothing and 

when we wear pajamas. They learn 

all the rules of our culture: We share 

toys, but not toothbrushes; we laugh 

at some things, but not at others; 

sometimes adults tease, and sometimes 

they are serious. Infants and toddlers 

learn what is expected of them 

through their relationships with 


family members and teachers.
 

However, when only limited guidance
 

has been available, especially for a
 

child’s particular temperament, then
 

a child such as Carol may present
 

behaviors that feel challenging and
 

overwhelming to teachers and
 

parents. Early Head Start builds in a
 

variety of approaches and supports to
 

help teachers and families provide the
 

guidance young children need for
 

healthy social and emotional
 

development [1304.21 (3) (i and ii),
 

1304.24 (a)]. 

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E ARLY HEAD S TART NATIONAL RESOURCE C ENTER 

Knowing how to help toddlers 

learn to manage their own behavior 

and get along well with others does 

not come naturally to everyone. 

Fortunately, teachers and parents 

can learn the skills they need to 

help toddlers become competent and 

capable members of their own culture. 

The first skills have to do with 

understanding the typical social and 

emotional behaviors throughout the 

infant and toddler years. When the 

behavior is confusing and appears to 

be contrary to achieving the child’s 

own goals, then adults need a 

process to use to help them 

understand why the child is 

resorting to such troublesome 

activity. Finally, teachers and 

families sometimes need additional 

resources and strategies, especially to 

support their work with young 

children who require those 

caregivers to think creatively about 

how to serve them. 
Understanding 

Infant and 

Toddler 

Behavior 

Challenging behaviors may have many causes from basic biology 

to complex relationships. Many 

factors are useful in helping parents, 

teachers, and home visitors 

understand what infants and toddlers 

are telling us through their behavior. 

Adults need to know the typical 

progression of development, how 

children learn through relationships, 

how that learning influences each 

child through his or her personal 

history, and how individual 

differences such as temperament 

come into play. 

DEVELOPMENTAL PROGRESSIONS 

Long before babies can use words to 

tell us how they feel or what they 

need, they communicate through 

their actions: facial expressions, 

sounds, and body movements. At 

first, they react immediately to any 

change in their bodily experience or 

in their environment. They grimace, 

they cry, they squirm. As adults help 

them to manage (or regulate) their 

reactions, babies begin to gain 

increasing control over their own 

bodies. For example, babies mature 

from an initial behavior of screaming 

when they are hungry to a more 

developed behavior of gesturing 

TECHNICAL ASSISTANCE PAPER NO .10 

toward the breast or bottle to still 

other strategic behaviors such as 

crawling to the refrigerator to 

eventually, at approximately the age 

of 1 year, initiating basic verbal 

behaviors such as asking for the 

“ba-ba.” We expect to see 

increasingly complex and controlled 

behavior as infants grow older. If 

Carol were only 5 months old and 

cried when someone took a toy from 

her, we would not be concerned. It 

would be an appropriate response for 

her developmental age. As a toddler, 

though, Carol should have more play 

strategies than simply hitting and 

biting. She should be able to 

experience periods of calm, and she 

should be able to recover within a 

few minutes from crying or tantrums. 
4 

E ARLY HEAD START NATIONAL RESOURCE CENTER 

Aging alone is not what brings 

about children’s increased ability to 

regulate their own reactions and find 

increasing success in communicating 

their own needs. As infants grow 

and develop, all of their abilities— 

cognitive, language, motor, social 

and emotional—are becoming more 

sophisticated and complex. Toddlers 

increasingly understand the effects of 

their actions on others as they 

become more aware of the peers and 

adults in their world. A welladjusted toddler who takes a toy 

from a peer may then attempt to 

comfort her as the previous owner 

begins to cry or run to the teacher in 

distress. Toddlers may use words such 

as mine and no in claiming or 

protecting ownership of toys. 

Toddlers develop considerable social 

skills as they create and recover from 

conflicts in their play. Early Head 

Start programs provide the 

experiences that promote this social 

and emotional development through 

planned, individualized activities 

and through their work with families 

[1304.21(3)(i and ii), 1304.24 (a)(1)]. 

Some developmental shifts create 

periods of challenging behaviors. 

Between about 7 and 9 months, as 

babies are firmly establishing their 

sense of object permanence, they 

may develop anxiety around 

strangers and become fearful and 

upset when their parents leave them, 

even in very familiar child care. 

Between 18 and 21 months, as the 

central nervous system is undergoing 

developmental changes, even the 

calmest of babies may suddenly, and 

frequently, tantrum. During the 

second year, as toddlers have big 

ideas of what they can do and very 

few words to help them get it done, 

they may suddenly turn to biting as a 

strategy. These behaviors are 

challenging—but are part of normal 

development for that age. 

As we care for babies in groups, we 

anticipate disagreements and 

scuffles, and we expect babies to be 

comforted by holding and to be 

easily redirected to other 

experiences. We expect toddlers to 

become upset and fuss and even to 

fight, but to recover and be able to 

return to play with the same friend 

who upset them moments before. 

Infants and toddlers will have 

unhappy moments, but they usually 

have the capacity to calm down and 

enjoy being with their peers. The 

establishment of this emerging social 

and emotional control depends in 

part on the child’s early relationships 

and may be influenced by the child’s 

temperament. 

Early Head Start in Action 

Our Early Head Start program uses a primary caregiver system in caring for infants and toddlers. This system is relationship based 

and is the foundation for providing guidance in all behavioral issues. 

Caregivers who can read children’s cues, know the child best, and have 

built trusting relationships with their children can guide and redirect 

misbehavior most effectively. Children are assisted through consistency. 

Their age and the individually appropriate guidance they get from 

teachers provide children with the stability to control their own 

behaviors (e.g., biting, hitting, etc.). 

Stanislaus County Office of Education Early Head Start 

Patterson, California 
TECHNICAL ASSISTANCE PAPER NO .10 

OPPORTUNITIES FOR 

LEARNING ABOUT BEHAVIOR 

WITHIN RELATIONSHIPS 

Some researchers see babies’ every 

expression of distress as an 

opportunity for interaction that will 

build relationships with an 

important adult (Robinson & 

Acevedo, 2001). Adults who 

respond quickly to soothe and 

comfort a crying infant are helping 

him to master his immediate 

physical reactions to events and 

begin to use self-calming, thinking, 

and eventually words as a way of 

coping. As infants and toddlers 

develop not only more diverse ways 

of telling adults about their interests 

and needs but also more capacity to 

act on the environment and on their 

friends, adults respond in 

increasingly sophisticated ways. 

At best, adults are able both to 

support the complete dependency of 

the newborn and increasingly respect 

the growing autonomy of the 

toddler. At all times, however, the 

adult is showing the baby, “I notice 

what you do. I care about what you 

feel. I keep you safe. I help you to 

grow.” Early Head Start staff 

members receive ongoing training in 

how to use their role as teachers and 

home visitors to support this positive 

development through relationships 

[1304.52(k)(1 & 2)]. 

Carol’s earliest experiences did not 

help her learn to calm herself down. As 

a newborn, Carol lived in an apartment 

with her very young mother and a variety of her mother’s friends who moved 

in and out. They sometimes played with 

her and fussed over her, but were as 

likely to get involved with watching television or listening to music and not even 

hear her cries. She was never certain if 

she would be fed or diapered or even 

noticed. As soon as she could maneuver 

around on her own, she learned to take 

what she needed. For her, it was the 

best strategy for survival. 

Toddlers are constantly watching 

the people they trust to help them 

learn how they should behave. They 

look to a familiar adult for 

reassurance when a stranger walks 

into the room or as they hesitate at 

the top of a slide. They see how 

adults treat one another and other 

children to determine their own 

reactions. And they constantly assess 

adults’ reactions to them for 

messages of love and their own 

worth. For babies, getting no 

response at all to their actions carries 

its own disturbing messages. 

The deeper the adult’s 

understanding of normal 

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E ARLY HEAD S TART NATIONAL RESOURCE C ENTER 

development, the easier it will be to 

respond well. When a toddler looks 

the adult in the eye, says “no” to 

himself, and still reaches for the 

electric plug, the average adult may 

feel that she is dealing with defiance. 

The knowledgeable early childhood 

professional, however, will recognize 

that this toddler is figuring out that 

other people see things differently 

from him, and he is gathering 

evidence as to just what this 

discrepancy means. He is checking 

to see whether the “rule” about 

electric plugs that seems to matter so 

much to Daddy (but not to the 

toddler) can be circumvented if the 

toddler acknowledges that he knows 

the rule “No.” 

Of course, some behaviors are 

easier for adults to understand than 

others. Adults who can easily 

comfort an overtired young infant 

may feel exasperated when a toddler 

keeps biting the other children. 

Even when they understand that 

biting is typical toddler behavior, it 

is hurtful and upsetting, and it can 

make an adult angry. However, it is 

important to remember that the 

toddler who is biting is also 

watching and learning from the 

reaction of the teacher or parent. 

Each child comes to Early Head 

Start with unique experiences and 

expectations, shaped by her very first 

moments with her family. Each child 

brings her own, personal history to 

each new moment of exploration or 

interaction. 

Carol was 9 months old when her 

mother dropped her off at her grandmother’s house for a couple of hours— 

and never came back. Although 

Gramma Jones was a familiar figure in 

her life, the disappearance of her own 

mother was very upsetting for Carol. 

Mrs. Jones wanted to take care of 

Carol but saw her as awfully independent for such a young baby. She wasn’t 

sure what she should be doing. 

Babies also learn even deeper 

lessons from relationships. Most 

babies learn that people who love 

them and care for them are always 

there for them. When loving parents 

must be away from their baby, they 

make sure the baby is cared for by 

someone who is responsible and 

responsive. Babies learn about the 

depth and continuity and reliability 

of relationships through their 

everyday experiences. They develop 

a personal history and personal 

expectations of relationships. 

Some babies, however, have a 

personal history that provides very 

different lessons about life. Carol, for 
TECHNICAL ASSISTANCE PAPER NO .10 

example, had a mother who could 

not be counted on to feed her and 

care for her—and who then suddenly 

disappeared. When Carol was very 

little, she was vigilantly aware of her 

mother’s location and her 

availability. As soon as she could 

crawl, she was equally aware of 

where food scraps and bottles were 

left lying around so she could help 

herself to food. Carol’s personal 

history brings a quality of frantic 

urgency to current situations that 

other babies perceive as safe and 

comfortable. 

Developing an understanding 

of what behavior means to the 

child is extremely important. 

Every child has his own 

social and emotional goals. He wants 

to feel protected, cared for, 

understood, and loved. Similarly, she 

wants to feel sure that she will have 

the food, warmth, nurturance, 

attention, and encouragement she 

needs. Babies will do whatever they 

need to do to ensure that their needs 

are met. If no adult willingly provides 

the attention and nurturance they 

need, most children will find ways to 

take care of themselves—at 

considerable cost. 

Temperament Traits 

1. Activity level: natural, child-initiated amounts of physical movement 

2. Biological rhythms: regularity of child’s eating, sleeping, 

elimination patterns 

3. Approach and withdrawal: child’s initial reactions to a new situation 

(Are they drawn to it or frightened by it?) 

4. Mood: prevalence of calm, cheerful interest or sadness or irritability 

5. Intensity of reaction: energy level or vitality of emotional expressions 

6. Sensitivity: level of response to sensory experiences such as light, sound, 

textures, smells, tastes 

7. Adaptability: the child’s ease in adjusting to changes in routines or in 

recovering from being upset 

8. Distractibility: how easily the child’s attention is diverted from his previous focus 

9. Persistence: how well a child can stay with an activity that becomes 

somewhat frustrating 

INDIVIDUAL DIFFERENCES— 

TEMPERAMENT 

Of course, the adult’s knowledge, 

good intentions, and skills are only 

part of the complex behavior story. 

Even the most willing adults are 

sometimes confounded by the nature 

of a child’s reactions to events. The 

construct of temperament has been 

helpful for many early childhood 

professionals in understanding the 

inborn, biological differences that 

seem to cause children to have such 
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E ARLY HEAD S TART NATIONAL RESOURCE C ENTER 

unique responses to the world. 

Temperament does not predetermine 

behavior nor is it an excuse for 

behavior. However, being alert to 

temperament can help adults not 

only to understand why children 

react to events differently but also to 

provide individualized support in 

regulating those reactions. 

Early personality researchers 

determined nine traits that appear to 

be biologically based, to remain 

fairly constant over time, and to 

affect a child’s reactions to other 

people and the environment 

(Thomas, Chess, Birch, Hertzig, & 

Korn, 1963). Together, these nine 

traits are considered key components 

of the child’s temperament. The 

traits are described here in the box 

“Temperament Traits.” 

The original researchers realized 

that traits tended to appear in 

groups, and they called these 

groupings temperament types. Easily 

adaptable children with regular 

biological rhythms, pleasant moods, 

average sensory thresholds, and good 

persistence are described as 

“flexible.” Children with difficulty in 

approaching new situations are 

described as “fearful.” Highly 

distractible children with irregular 

biological rhythms, intense 

reactions, and low sensory thresholds 

are described as “feisty.” 

Carol was a feisty child. She brought 

her energy and intense reactions into 

every relationship. In many ways it was 

this “gusto-filled” approach to life that 

made her so attractive to the other children at first. However, her intensity 

made it difficult for her to negotiate 

or pause and consider other people’s 

feelings. 

Feisty children can be joyous 

when their caregivers and the 

environment are responsive to the 

way they operate. Temperament 

alone is neither good nor bad, but 

the match between the child’s 

temperament and the expectations 

of the environment may or may not 

serve the child. Active, energetic 

adults might adore a feisty child. 

Quieter adults may prefer flexible or 

even fearful children. 

Carol’s teacher, Naomi, was a quiet 

person. Even though she loved working 

with toddlers, she wished they would get 

along better with one another. 
TECHNICAL ASSISTANCE PAPER NO .10 

How Early Head 

Start Programs 

Support Infants 

and Toddlers 

Who Exhibit 

Challenging 

Behaviors 

Mental health has always been one of the services of Head 

Start and Early Head Start. Dozens 

of Head Start Program Performance 

Standards address the mental health 

systems and the service requirements 

that a program must meet to 

promote mental wellness and ensure 

the timely identification and 

intervention of mental health issues 

[1304.24(a)(3), 1304.21(a)(3), 

1304.24(a)(2)]. 

Although other early childhood 

care and education programs may 

respond to challenging behaviors by 

expelling the child (Gilliam, 2005), 

Early Head Start uses comprehensive 

planning first to identify social, 

emotional, and behavioral issues and 

then to help children resolve them. 

STAFF TRAINING 

All staff members benefit from 

ongoing training in issues 

concerning the meaning of behavior 

in very young children. That 

training helps them to understand 

typical development and the issues 

surrounding challenging behavior. 

These challenging behaviors could 

include biting, hitting, crying or 

fussing in a difficult to soothe infant, 

constant moving in a toddler, and 

irregular or frustrated feeding and 

sleeping in an infant. Additional 

training should be done during the 

year to focus on supporting staff 

members in their work with various 

infants and toddlers and the 

subsequent issues that may surface. 

REFLECTIVE SUPERVISION 

Reflective supervision provides not 

only an avenue for learning from the 

work that has already been done but 

also a place to determine how the 

work can be focused in the future. 

Reflective supervision takes place 

between a supervisor and a 

supervisee and is characterized by 

active listening and thoughtful 

questioning by both parties; it 

happens on a regular schedule and 

can be done with individuals or 

groups, by supervisors or by peers 

(Parlakian, 2001). It provides an 

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E ARLY HEAD S TART NATIONAL RESOURCE C ENTER 

opportunity to explore (a) the events 

in the classroom or on a home visit 

and (b) the teacher’s or home 

visitor’s internal reactions to the 

events. 

Naomi is having a session with her 

supervisor around working with Carol in 

the classroom. Naomi bursts into tears 

and says, “I don’t know what to do with 

this child. She has turned my whole class 

upside down and the other children are 

afraid of her. Carol starts in as soon as 

she hits the door and goes nonstop until 

she leaves. There is rarely any “down 

time” with her, and I am finding it difficult to focus on the other children. A 

good day is when Carol does not have a 

tantrum and those days are rare. It’s like 

she knows just which of my ‘buttons’ to 

push to throw me off center.” 

The supervisor asks, “What specifically 

is Carol doing to push your buttons?” 

Naomi replies, “It makes me angry 

that she can’t just get along. She’s ready 

to fight when she sees another child with 

her little stuffed bear. Carol is able to 

get along as long as none of the other 

children have her favorite toy. If she 

doesn’t get the bear, Carol tantrums. 

She still makes noises during “quiet 

time,” but we’ve gotten her to stay on 

her cot with the stuffed bear if one of us 

sits near her. We always have to make 

sure that she has plenty to do from the 

time she arrives. She actually has better 

days when she has activities to occupy 

her time. It takes a lot of energy to have 

Carol in our classroom and I am 

exhausted by the time she leaves.” 

A Sample Protocol for Resolving

Challenging Behaviors 

1. Maintain ongoing observation and documentation of every child. 

2. In reflective supervision, review these questions 

(Wittmer and Petersen, 2006): 

a. What is the child experiencing? What is the child’s perspective on 

the situation? 

b. What, when, where, how, and with whom is the behavior occurring? 

c. What is the child communicating that he wants or needs? What is 

the purpose of the child’s behavior? What is the meaning of the child’s 

behavior? 

d. What do I want the child to do? 

3. Meet with the family to deepen and share understanding. 

4. Determine a consistent plan for intervention. 

5. Continue observation and documentation to provide data for evaluating 

improvement and ensuring the consistency of the intervention. 

6. Consult with a mental health professional if the child is not responding 

and the persistence, frequency, and duration of the behavior is not 

improving. 

7. Determine whether further referral to community resources is 

necessary through discussion with family, the supervisor, and the mental 

health consultant. 
TECHNICAL ASSISTANCE PAPER NO .10 

This vignette demonstrates one of 

the strengths of reflective 

supervision, helping the supervisee 

to recognize improvements in the 

situation with Carol even though it 

is challenging. It also clearly 

supports the importance of 

individualization of services and 

strategies for making this 

improvement happen in the young 

child’s classroom or playgroup. 

MENTAL HEALTH 

PROFESSIONALS 

Every Head Start and Early Head 

Start program is required to use the 

services of a mental health 

professional. Sometimes working on 

the staff and sometimes a consultant 

to the program, the mental health 

professional “enables the timely and 

effective identification of and 

intervention in family and staff 

concerns about a child’s mental 

health” [1304.24(a)(2)]. This 

professional can offer a variety of 

services intended to enhance 

awareness and understanding of 

mental wellness. These services 

include (a) providing information 

and training to parents and staff and 

(b) supporting practices that 

promote mental health, for example, 

nurturing relationships, using an 

emotional vocabulary to name 

children’s feelings, and maintaining 

predictable routines. The mental 

health provider conducts on-site 

consultations that may include 

observing the child within the 

program. And perhaps most 

beneficial, the mental health 

professional helps the program 

develop and carry out protocols for 

problem solving when a child’s 

behavior is particularly confusing or 

disruptive. 

Carol’s Early Head Start program 

had a well-established relationship 

with Jerry, their mental health 

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E ARLY HEAD S TART NATIONAL RESOURCE C ENTER 

consultant from the community 

mental health center. He helped 

them to develop protocols for 

identifying concerns as well as to 

choose screening and assessment 

tools to track the children’s social 

and emotional development. In 

addition, he provided training and 

consultation to the staff members 

and the families. With Jerry present, 

the program conducted a “problemsolving meeting” that included the 

teacher, her supervisor, and Carol’s 

grandmother, Mrs. Jones. They 

worked through their problemsolving protocol, explored Carol’s 

history and the effect it may have on 

her actions, and developed a plan to 

improve the situation for everyone. 

PROTOCOLS FOR SOLVING 

PROBLEMS 

In Carol’s program, the protocol for 

responding to challenging behavior 

is based on observations of the child, 

using these questions: 

What is the child experiencing? 

What is the child’s perspective on 

the situation? 

What, when, where, how, 

and with whom is the behavior 

occurring? 

What is the child communicating 

that he wants or needs? What is 

the purpose of the child’s behavior? 

What is the meaning of the child’s 

behavior? 

What do I want the child to do? 

(Wittmer & Petersen, 2006) 

These questions can lead staff 

members and families to a deeper 

understanding of the child’s 

experience, which can point toward 

effective change in the teacher’s 

interactions or in the environment 

to support the child’s increasing 

control over her own actions. The 

following discussion shows how they 

applied in Carol’s situation. 

What is the child experiencing? What is 

the child’s perspective on the situation? 

Children use the best ideas they can 

devise to solve the problems in their 

lives. Toddlers struggle to learn the 

rules of their society and try very 

hard to “get it right” (Emde & 

Robinson, 2000 ). Those rules, 

however, can seem arbitrary and 
T ECHNICAL A S S I S T A N C E PAPER N O .10 

contradictory to a little child. Mrs. 

Jones provided some additional 

information about Carol’s first 

months of life. 

For 9 months, Carol watched her 

mother and her mother’s friends carrying on, laughing, teasing, and taking 

what they wanted from one another. 

They all appeared to get along and have 

a very good time. Most certainly, Carol 

has observed that Gramma doesn’t grab 

but she doesn’t mind when Carol does. 

To Carol, Naomi likely seems angry, 

but Carol isn’t sure what Naomi wants 

her to do. Carol probably sees that the 

other children have the toys they want. 

Surely, she assumes that she’s supposed 

to have toys, too. 

Jerry helped the adults realize how, 

for Carol, Early Head Start may feel 

very much like the endless parties at 

her mother’s apartment—lots of 

people, lots of activity and noise, 

and everyone taking what they want. 

Mrs. Jones described how Carol’s 

mother’s friends even took away 

Carol’s cookies just to see how they 

could make her cry. They were 

teasing and meant no harm. 

However, Jerry pointed out that the 

teasing was probably distressing for a 

young baby who had her treats taken 

from her. He emphasized, too, that 

she was learning some things from 

her mother’s friends about how 

people behave in groups. As Naomi 

came to understand how the 

experience might feel from Carol’s 

perspective, Naomi understood 

Carol to be misdirected rather than 

mean. 

What, when, where, how, and with 

whom is the behavior occurring? 

Behavior that bothers us can seem 

constant and endless. Careful 

observation can help teachers move 

beyond their own reactions and 

really analyze and understand the 

behavior. These familiar, simple 

questions can focus an observation 

and help illuminate the situations in 

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E ARLY HEAD S TART NATIONAL RESOURCE C ENTER 

which the challenging behavior 

occurs. What happens? Does she grab 

for a toy and bite when she is 

resisted, or does she bite as a first 

step and then take the toy from the 

crying child? When? Does she bite or 

hit once a day? Seven times? One 

hundred? Does she come in biting? 

Does she bite in the late morning 

when she is tired? Are the tantrums 

related to the biting? When do they 

happen? Where? Does she grab toys 

indoors and out? Does she grab a toy 

from a friend when there is a 

duplicate toy available? Does she 

behave the same way in open active 

spaces and in quiet protected spaces? 

Is the room arranged in a way that 

provides space for both active play 

and cozy cuddling? How? Does 

Carole issue a warning or is her 

behavior sudden and unpredictable? 

With whom? Who is she likely to 

bite, hit, or grab things from? Is one 

other child affected or are several or 

all of the children being treated this 

way? 

Naomi would have described Carol’s 

grabbing, biting, and hitting as constant, but by using the observation protocol provided by the mental health consultant, she discovered quite a lot about 

Carol. 

In the morning, Carol entered the 

room full of energy and went right to 

the climbing and rocking toys. She flitted from activity to activity after that, 

never settling long enough to explore. 

Outside, she was always on the move. 

Indoors, her attacks were more focused 

than Naomi had realized. Two younger, 

smaller children were the targets, usually when they had possession of her 

favorite doll or when they sat on the top 

of a little climbing structure near the 

window. 

Observation can clarify the actual 

behavior and the circumstances 

surrounding the behavior. Carol’s 

inability to calm and focus at any 

time during the day became as great 

a concern for the adults as the biting 

had been. 
TECHNICAL ASSISTANCE PAPER NO .10 

What is the child communicating that 

he wants or needs? What is the purpose of the child’s behavior? What is 

the meaning of the child’s behavior? 

Further observations of Carol 

revealed important clues to 

understanding her motivations: 

Although the biting and grabbing 

carry messages, Carol’s endless wandering and movement also speak to her 

understanding of the world. Carol’s 

early experiences were highly uncertain. 

She was surrounded by young, active 

friends of her mother, but her own 

needs for food, warmth, and comfort 

were rarely met in response to her cries. 

The music and activity around her provided more stimulation than she could 

manage. Her own energies were 

focused on getting by until someone fed 

her—or later, as she was able to crawl, 

finding ways to help herself. The mental 

health consultant helped Naomi and 

Gramma Jones become aware of 

Carol’s overriding sense of unpredictability in her life. 

Early Head Start in Action 

We begin by using the child’s name, looking at him or her at eye level (so the child knows you are speaking to him or her) 

and saying, 

“Jason, sit in the chair.” (Instead of, “Jason, if you stand in the chair 

you might fall and hurt yourself.”) 

“Maria, touch John’s back gently.” Then the caregiver or teacher can 

model a gentle touch. (Instead of, “Maria, if you hit John hard on his 

back, that might hurt him.”) 

“Michael, paint on the paper.” (Instead of, “Michael, why are you 

painting on the floor when there is paper right in front of you?”) 

Caregivers cannot assume that young children know what we want 

them to do, especially if we do not explain the situation to them. What 

is obvious to us is not obvious to a 2-year-old. By expressing the action 

you desire up front, you tell the child what you want him or her to do 

very simply. Use modeling as necessary to guide infants and toddlers. 

Consistency that is developmentally appropriate and offered lovingly is 

the key! 

Stanislaus County Office of Education 

Patterson, California 

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E ARLY HEAD S TART NATIONAL RESOURCE C ENTER 

Careful observation and analysis of 

the issue should be pivotal in 

creating strategies. The perspective 

of the mental health consultant can 

be extremely helpful at this stage in 

discovering underlying reasons for 

the behavior. Jerry recognized the 

combination of early experience and 

the wandering behavior as a 

potential sign that Carol just does 

not feel safe enough to focus her 

attention for very long on anything. 

Her endless movement and vigilant 

observation of the room become 

exhausting; still, she does not dare 

rest. Although it was clear that the 

biting had to stop, Jerry, Mrs. Jones, 

and Naomi decided that helping 

Carol feel safe and calm might be 

the most effective plan. 
TECHNICAL ASSISTANCE PAPER NO .10 

What do I want the child to do? 

Adults are more likely to tell little 

children not to do things than to tell 

them what we want them to do and 

then offer them support to do it. 

Carol’s grandmother simply let Carol 

run around the house. In past efforts 

to cooperate with one of the requests 

of the Early Head Start program, she 

would try to sit down and read a 

book with Carol, but as soon as 

Carol jumped up, Mrs. Jones would 

abandon the effort. Now, she 

decided to try saying, “Sit here with 

me Carol, while we look at this 

book.” Naomi, too, realized that she 

rarely actively tried to engage Carol 

in play or sustain her interest. She 

decided to try telling Carol, “I want 

you to stay here and try this.” 

The next morning, Naomi noticed 

Carol dropping a doll down the slide. 

As Carol began to bounce off to the 

next activity, Naomi called her back 

playfully and said, “That was really 

funny—your doll going down the slide. 

Have you ever dropped a ball down a 

slide? Come here. I’m going to try it.” 

Carol was surprised but interested. 

Laughing heartily when Naomi dropped 

the ball, she then retrieved it and 

repeated the action herself. Naomi 

invited her to find more things they 

could drop down the slide together, now 

guessing which would go quickly and 

which slowly. Carol sustained interest 

in this activity for several minutes and 

returned to it later, on her own. 

Naomi and Mrs. Jones began to fill 

Carol’s day with other little moments 

of supported interest. Their invitations 

to play included directions such as: 

“Now sit here with me for a moment 

...,” “Can you add two more 

blocks?,” “Can you stir this just a few 

more times?” Slowly, Carol began to 

become calm and participate in more 

exploratory play. 

Naomi was equally clear about the 

biting, telling Carol, “No biting, 

Carol, ask your friend for the doll ... 

Bring your friend a different doll to 

play with... Play with this while you 

are waiting for the doll.” Naomi was 

providing Carol with a variety of 

alternatives that the child had not 

even imagined. 

As adults approach challenging 

behaviors with effective strategies, 

the nature of the relationship begins 

to shift. The adults may feel more 

competent about, more interested in, 

and more empathic to the child’s 

experience. The child may begin to 

gain skills as a partner in a mutual 

relationship. 

REFERRALS 

Some behavioral issues that arise in 

the first years of life require a greater 

intervention than can be offered 

solely within an Early Head Start 

program. As program professionals 

plan and implement a response with 

a family, they may need to adjust the 

frequency or intensity of their 

interventions—or even rethink the 

strategy itself. However, if they have 

tried several ideas with consistent 

efforts and the behavior is not 

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improving—or may be worsening–– 

then the program protocol should 

include steps for further referral. 

These might include an infant 

mental health program, a 

community mental health clinic, 

early intervention services, or a 

department of social services. 

Focused therapeutic work with the 

family may be useful, and on rare 

occasions, behavioral or medical 

interventions may be required for 

the very young child. 

Early Head Start Programs in Action 

Members of community agencies are asked to discuss positive discipline at parent meetings. Families attend case management 

meetings to strategize with members of the teaching staff on ways to 

improve the child’s behavior. Sometimes a referral to an agency is made 

to assist the parent with the child’s behavior at home. Teachers and 

parents develope a plan to respond consistently to the child. 

Child Start, Inc. 

Napa, California 

Mental Health 

Support for 

Adults 

Early Head Start programs support the emotional and social 

development of their infants and 

toddlers just as they promote 

learning, health, and motor 

development. Supporting the babies, 

however, also requires supporting the 

adults who love and care for them. 

The mental health professional 

working with the program may offer 

many levels of support. Information 

on typical stages of development and 

ways to support children through 

challenging periods of behavior may 

be offered through regularly 

scheduled training opportunities for 

parents and staff members. 

Consultants might observe 

classrooms and have conversations 

with parents, teachers, and home 

visitors when a child’s behavior is 

confusing or of particular concern. 

Direct services might then be offered 

to children, parents, or staff 

members. When distressing events 

happen within a program (for 

example, the death of a staff 

member) or within a community (for 

example, the hurricanes along the 

Gulf Coast), the mental health 

consultant might need to provide 

counseling to an entire program 

[1304.40(f)(4)(i, ii, iii)]. 

Programs use a variety of models 

for mental health consultation. 

Some are able to have a full- or parttime position on staff. Some contract 

for consultation. Many programs 

report that having the consultant 

present at the program seems to 

remove some of the stigma 

associated with referrals to mental 

health clinics. 
TECHNICAL ASSISTANCE PAPER NO .10 

COMMUNITY PARTNERSHIPS 

Of course, Early Head Start may not 

be able to offer the intensive mental 

health or related services needed by 

a family. Partnerships with a variety 

of community agencies help 

programs provide the support needed 

by families and staff members. Some 

of these community agencies are 

described here. 

Community mental health clinics. 

Community clinics often serve the 

same economic groups as Early Head 

Start. Some offer special programs of 

consultation to child care, but most 

offer counseling services to adults, 

couples, or families. 

Respite programs. 

Sometimes parents of young 

children with challenging behavior 

need a break. Respite programs, 

offered through a department of 

social services or through various 

mental health associations, may 

provide the funding for regularly 

scheduled care to be provided by a 

familiar, comfortable, and welltrained caregiver who can share in 

the care of the child while the 

parents have a few hours to relax or 

run errands. 

Early intervention programs. Some 

states and territories include mental 

health issues in their eligibility for 

Part C services under the Individuals 

with Disabilities Education Act. 

Direct services may be available for 

children who have been assessed as 

having problems with social-emotional development. 

Conclusion 

Early Head Start promotes all areas of development in infants 

and toddlers. Using thier deep 

knowledge of child development, 

Early Head Start programs can 

provide adults with the information 

and support to help children 

maneuver through difficult points in 

development and to guide children 

as they learn how they are expected 

to behave. 

When life’s circumstances pose 

more serious challenges to emotional 

development, Early Head Start is 

prepared to use the services of 

mental health professionals to 

develop comprehensive strategies to 

provide treatment for the child and 

adults who may require it. 

Social-emotional development 

provides the foundation for later 

learning. Early Head Start is in a 

unique position to ensure that this 

foundation is sound. 

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References
 

Emde, R. N., & Robinson, J. L. (2000). 

Guiding principles for a theory of early 

intervention: A developmental-psychoanalytic perspective. In J. P. Shonkoff and S. J. 

Meisels (Eds.), Handbook of Early 

Intervention . New York: Cambridge 

University Press. 

Gilliam, W. (2005). 

Prekindergarteners Left Behind: 

Expulsion Rates in State Prekindergarten 

Systems. Retrieved November 22, 2005, 

from the Foundation for Child Development 

Web site: 

http://www.fcd-us.org/PDFs/NationalPreK 

ExpulsionPaper03.02_new.pdf. 

Parlakian, R. (2001). 

Look, listen, and learn: Reflective 

supervision and relationship-based work. 

Washington, DC: Zero To Three. 

Robinson, J. L. & Acevedo, M. C. (2001). 

Infant reactivity and reliance on mother 

during emotional challenges: Prediction 

of cognition and language skills in a 

low-income sample. Child Development, 

72(2), 402–426. 

Thomas, A., Chess, S., Birch, H. G., 

Hertzig, M. E., & Korn, S. (1963). 

Behavioral individuality in early 

childhood. New York: New York 

University Press. 

Wittmer, D. S., & Petersen, S. H. (2006). 

Infant and toddler development and 

responsive program planning: A 

relationship-based approach. Upper 

Saddle River, N.J.: Pearson Merrill 

Prentice-Hall. 
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