Behavioral Concerns
Behavioral Concerns
Understanding What Behavior Is Communicating
When a child or adolescent is struggling behaviorally, the behavior itself is often only one part of the picture. Behaviors such as aggression, defiance, emotional outbursts, avoidance, or frequent conflict usually communicate something, even when the child may not be able to explain what is happening internally.
A behavior may be a response to feeling overwhelmed, frustrated, anxious, misunderstood, or unable to meet a demand. A child may avoid a task because it feels impossible rather than because they do not care. A teenager may react strongly to a situation because emotions are difficult to regulate in that moment. In some cases, behavior may be connected to sensory experiences, social challenges, attention differences, learning difficulties, or other factors that affect how a child experiences everyday expectations.
Understanding what is contributing to a behavior is an important first step. Effective support is not just about stopping a behavior that adults find challenging. It involves looking at when the behavior happens, what comes before it, what the child may be communicating, and what skills or supports may be missing.
At Coherence, behavioral support considers the function behind the behavior before determining what strategies are most appropriate. Jennifer Linton Reesman, PhD, ABPP and Dr. Korrie Allen, PsyD, ABSNP work with children and families to better understand the factors contributing to behavioral challenges and identify approaches that support meaningful change.
For many families, this means moving away from viewing behavior as simply a problem to fix and toward understanding it as information. When the underlying needs are identified and addressed, children can develop more effective ways to communicate, regulate emotions, solve problems, and navigate difficult situations.
Assessment Process
Assessment as the Foundation
Effective behavioral support begins with understanding the child and the situations in which challenges occur. Before deciding what strategies may help, it is important to look closely at the patterns behind the behavior: when it happens, what may contribute to it, what the child is experiencing in that moment, and what responses may be unintentionally maintaining the cycle.
Assessment may include conversations with parents and caregivers, review of developmental and school history, input from teachers when available, behavioral observations, and a careful review of the situations surrounding the concern. Understanding the context around a behavior helps clarify what the child may be communicating and what skills, supports, or changes in the environment may be needed.
For example, a child who refuses schoolwork may be avoiding because the task feels overwhelming due to an unrecognized learning difference. A child who becomes distressed in certain settings may be responding to sensory demands that are difficult to manage. A child who appears oppositional may be struggling with attention, flexibility, emotional regulation, or another developmental factor that has not yet been identified.
At Coherence, behavioral support considers these possibilities as part of the clinical picture. Jennifer Linton Reesman, PhD, ABPP and Dr. Korrie Allen, PsyD, ABSNP work with children and families to better understand the factors contributing to behavioral challenges and determine what types of support are most likely to help.
When behavioral concerns raise questions that a neuropsychological evaluation could clarify, clinicians at Coherence can collaborate with appropriate authorization. Evaluation may provide additional information about learning, attention, development, executive functioning, or other areas that influence behavior and daily functioning.
The goal is not simply to reduce a behavior. It is to understand why the behavior is occurring and help children develop more effective ways to communicate, regulate emotions, manage challenges, and participate successfully in their daily environments.
Please note that contacting this practice does not establish a patient provider relationship.
What Behavioral Support at Coherence Includes
- Functional assessment to understand the purpose and drivers of specific challenging behaviors
- Individualized behavioral support plans that are specific enough to be effective and simple enough to implement consistently
- School coordination and teacher consultation to ensure behavioral support in the home connects with what is happening at school
- Identification and addressing of underlying contributors including anxiety, learning difficulties, sensory needs, or unmet emotional needs
coherence and Evaluations
Behavioral Concerns and Neuropsychological Evaluation
Families preparing for a child’s first appointment at Coherence can make the process smoother by gathering any relevant information ahead of time. Records that may be helpful include previous neuropsychological or psychological evaluations, school documentation such as report cards, teacher feedback, IEPs or 504 Plans, medical records related to the concern being evaluated, and prior therapy records that provide useful background.
These materials help clinicians understand the child’s history, strengths, challenges, and the questions that led the family to seek support. Chelsea can provide the necessary authorization forms for families who would like Coherence to request records from schools, medical providers, or other professionals involved in the child’s care.
For a neuropsychological evaluation appointment, children generally do best when they arrive rested and having eaten. Families should bring any items the child uses regularly, such as glasses, hearing aids, or cochlear implants, so the evaluation reflects the child’s typical functioning. For younger children, snacks, a comfort item, or a familiar object may help with the transition.
Medications should be taken as prescribed unless the evaluating clinician has specifically discussed a different plan during the intake process. If there are questions about preparation before the appointment, families are encouraged to reach out so the evaluation can begin with the child feeling as comfortable and prepared as possible.