Behavior modification for kids with behavior issues is what I did for a living for 6 years. the one thing that you have going for you is that he is only 10. As kids get older it gets harder and harder to affect change in the behaviors. I would only let a doctor prescribe medication as a last resort. I do believe as working stiff does that diet has a huge relationship with behavior. I worked with a psychologist that specialized in ADHD and the first thing he had parents do before anything else was to give the kid double the dose of a childrens vitamin for a month and then come back and see him. In 60% of the cases this completely solved the issues that they were having. Also, like WS said, sugar has a dramatic effect on body chemistry creating dramatic fluctuations in a kids state, from high to low. I would limit sugar intake as well.
As far as behavior modification goes there are a couple of things that we always started with when we go a new client. A concrete and written behavior contract. Your son can be a part of creating this if he wants to participate and feel like he had a role in the expectations and consequences. Write a clear and concise list of behaviors that are expected and are acceptable, a list of unacceptable behaviors and then a clearly defined set of consequences for not following this contract. EVERY instance of violating the behavior contract needs to met with one of the consequences no matter what. Our kids know how to push their parents buttons and will always test when they think there is an opportunity to get away with something (parents are tired, stressed, sick, etc.). Post the contract on the wall poster size so there is no question what is expected, there is no saying I forgot by the child.
You can pair this with a visible chart on the wall that shows anything behaviors they did wrong that week but also behaviors they did well that week. This is a real concrete way for you and your son to chart his progress. The chart can have rewards that can be earned for not exceeding a certain number of behavior violations. This adds in an aspect of positive reinforcement that helps reinforce the desired behaviors.
You want all of this to be non confrontational, no yelling, getting mad, or anything like that. Refer to the contract, state that he knew what the expected behaviors were and what the consequences were and he did not live up to that. clearly tell him what the consequence of that violation are and start with it immediately. Consequences should have a defined period, that is to say what has to be done to have it lifted.
I am also a fan of if the behavior contract is not working that great you take EVERYTHING that child has away and they have to earn it back. When I say everything I mean strip their room bare to the walls and lock their stuff up where they cant get it. We as parents are required by law not to mentally or physically abuse our kids, provide food and shelter, and get them to school. Everything we do for them is because we love them and they deserve it. Sometimes kids with behavior issues need to be slapped with how good they have it and how much parents do for them that can be taken away.
These things usually have a solid effect at correcting behavior and can be re-instituted if their behavior starts to regress.
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