K7 · Behavior problems
Actual Child and teen
Definition
Ongoing tantrums, defiance, or aggression that disrupt care and family life.- Stress
- developmental disorders
- poor parenting skills
- illness
- Tantrums
- aggression
- defiance
- withdrawal
📋 Scenario
A hospitalized child hits staff.
Subjective (S): "No! I won't!"
Objective (O): Hitting staff; refuses care; tantrums; irritable.
Assessment tools for this scenario: CP-CHILD Child & Teen Check
Validated scales to consider: PEWS, FLACC
**CarePath diagnosis:** Behavior problems related to stress, as evidenced by tantrums and aggression.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Set limits. | Clear, consistent limits help a stressed child know what is expected and feel safe, and they protect staff and other patients from harm. |
| Praise good behavior. | Praise for good behavior rewards what the child does right, and children tend to repeat behavior that gets attention. |
| Distract. | Distraction shifts his attention from what is upsetting him and can stop a tantrum before it grows. |
| Involve parents. | Parents know the child best and can use the same approaches, so involving them keeps responses consistent and helps him feel secure. |
| Refer if it persists. | Persistent problems may have a cause such as illness or a developmental condition, so referral gets specialist assessment and support. |
**Expected outcomes**
- Within 48 hours: behavior improves, cooperates with care.
- Parent uses limit setting.
**Linking the data to the diagnosis**
The hospitalized child shouts, "No! I won't!" He hits staff, refuses care, has tantrums and is irritable. This fits behavior problems because the aggression and defiance are already disrupting care, so it is an actual diagnosis. The behavior seems to come from stress, but it is more than fear alone. The plan aims for behavior to improve within 48 hours, for him to cooperate with care and for the parent to use limit setting, through clear limits, praise, distraction, parent involvement and referral if the behavior continues.
CarePath diagnosis
Behavior problems related to stress, as evidenced by tantrums and aggression.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Set limits. | Clear, consistent limits help a stressed child know what is expected and feel safe, and they protect staff and other patients from harm. |
| 2. Praise good behavior. | Praise for good behavior rewards what the child does right, and children tend to repeat behavior that gets attention. |
| 3. Distract. | Distraction shifts his attention from what is upsetting him and can stop a tantrum before it grows. |
| 4. Involve parents. | Parents know the child best and can use the same approaches, so involving them keeps responses consistent and helps him feel secure. |
| 5. Refer if it persists. | Persistent problems may have a cause such as illness or a developmental condition, so referral gets specialist assessment and support. |
Expected outcomes
- Within 48 hours: behavior improves, cooperates with care.
- Parent uses limit setting.
Linking the data to the diagnosis
The hospitalized child shouts, "No! I won't!" He hits staff, refuses care, has tantrums and is irritable. This fits behavior problems because the aggression and defiance are already disrupting care, so it is an actual diagnosis. The behavior seems to come from stress, but it is more than fear alone. The plan aims for behavior to improve within 48 hours, for him to cooperate with care and for the parent to use limit setting, through clear limits, praise, distraction, parent involvement and referral if the behavior continues.