Interview Nancy Rappaport MD, Co-Author of The Behavior Code …Teaching the Most Challenging Students

Interview Nancy Rappaport MD, Co-Author of The Behavior Code …Teaching the Most Challenging Students

You know how there are some books you seem to connect with and appreciate more than others. Let me tell you as soon as I started reading The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students by Jessica Minahan and Nancy Rappaport, MD that is how I felt. I highly recommend The Behavior Code to all who work with or are raising children with problematic behaviors. Our review of The Behavior Code is here.

The Behavior Code is not only for teachers. Many of the solutions suggested can be applied to the home setting also. The book is very interesting, easy to read and to understand. Then it should be kept handy to use as a go-to resource book for years to come. The book concentrates on strategies for the K-6 grade levels but there is a lot of information for any parent or educator at every age level.

We are pleased to welcome Nancy Rappaport, MD, one of the co-authors of The Behavior Code, to our Author Interview Series.

Lorna: Congratulations on your wonderful book, The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students , that came out in April 2012! Please tell us about your studies and work experiences that led you to believe such a book was needed. 

Nancy Rappaport >> I am a child psychiatrist who has consulted to public schools for twenty years. I am often asked to help with students who are hard to reach or who have been aggressive – swearing in class, refusing to do work, having explosive episodes. These are the students whose teachers or principals confide in me that they feel that they are walking on egg shells and don’t know what to do next.

As I looked over these students’ records and talked to their teachers and specialists, I saw missed opportunities. In my 2006 article “From Zero to a Hundred in a Split Second: Understanding Aggression in an Eight-Year-Old Child , I asked experts around the country to weigh in to help me figure out how to support this aggressive child in school. They had a great discussion around diagnosis, but did not generate concrete strategies to support the child. Jessica Minahan, my coauthor of The Behavior Code and a behavioral analyst, had effective, user-friendly ways to turn around this student’s behavior.

I also realized that many teachers (and even special educators) can make mistakes because they follow their intuition. This works with most students, but they need additional tools to work with challenging students who may be struggling with anxiety, oppositional behavior, withdrawn behavior or sexualized behavior.

In writing The Behavior Code I wanted to provide teachers with critical support by giving them more information and tools to help them teach these students.

Lorna: You have a career, you are the mother of three, and you had already published another book, In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother’s Suicide (Basic Books, 2009). How does this accomplishment, your new book, compare with the other highlights in your life?

Nancy Rappaport >> In Her Wake is about the process of self-reflection and how deepening my understanding of my mother’s suicide as a mother, parent, and daughter informed my work as a child psychiatrist. Sharing my healing journey was an extremely hard and meaningful experience, and I still hear from many people who are deeply touched by my memoir. The Behavior Code, even though it is discussing the challenging topic of working with children who are suffering, is uplifting –it gives practical suggestions for educators and parents to help someone they care deeply about.

As a child psychiatrist it is deeply satisfying to work with my patients and my school community. As a mother and wife, I get great joy (most of the time!) from growing and loving my family.

Lorna: Dr. Rappaport, you have been an attending child and adolescent psychiatrist for the Cambridge, Massachusetts public schools for more than 18 years. In our society we have the saying, “happy childhood”. Unfortunately this is not true for some of our youths and yet many adults still have a problem understanding or being companionate with young children who have mental health problems. Do you agree and does this make it even more difficult for these children and their parents?

Nancy Rappaport >> If a child has cancer, the community mobilizes: the parents get sympathy cards, the child gets balloons in the hospital, etc. But when a child and family are struggling to cope because of the stresses of mental illness or traumatic events, it is much harder. There is often so much shame, and the expression of the stress (such as shouting, not following rules, or pushing people away) can cause the family’s support system to withdraw rather than rally around them.

In The Behavior Code, we talk about the importance of investing in the relationship with a child who is oppositional, even though it may be difficult. All the stars and stickers in the world are not as persuasive to a child as letting him know that you genuinely care about him.

Lorna: The Behavior Code focuses on the four most challenging students in our classrooms: students with anxiety-related, oppositional, withdrawn, and sexualized behaviors.  In a perfect world with unlimited budgets for student services, what should be in place in our schools to help these students?

Nancy Rappaport >> Most of the strategies in The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students  don’t cost money – just time to invest in understanding what drives the behavior, and then the personnel to implement some of the strategies. For example, having alternative lunch or recess requires the planning and support of caring adults who can help a child learn necessary social skills.

If I had an unlimited budget, first I would increase the student to staff ratio. This would ensure that students who needed additional time devoted to learning these kinds of skills would not be detracting from other students’ learning time. Ideally, there would also be someone available to train a paraprofessional to provide some of the feedback and encouragement. Also, every classroom would have a tool box with strategies help that students learn to manage their emotions. So, for example, we would have the supplies to make a calming box for students who need one, and a computer for students who need it do writing activities.

We wrote this book, though, because the solutions to children’s behavioral struggles don’t require an investment of budget as much as they require taking an approach that manages the environment and events that lead to meltdowns.

Lorna: Most often for support services or for teacher implemented strategies, like the FAIR Plan, to work well it seems the parents should be involved in the process also. How should schools get in touch and keep in touch with parents and what role do schools want parents to play?

Nancy Rappaport >> Parents are critical to many successful endeavors and we strongly support outreach to parents. At the beginning of the year, it is useful at to identify what is the best way to contact parents (cell phone, email, etc.) and what kind of information they find most useful. It is also particularly important with a child who struggles in school to make sure that you “catch them being good” and make the extra effort to communicate this. Their parents often feel battle fatigued and have a sense of shame that they are only contacted by the school when their child is “acting up.”

We also have seen sometimes educators say that they can’t make a difference with the student because the parent is missing in action. We see this as an excuse, and we present plans that can be implemented in the classroom and alter teacher’s response regardless of the level of parent involvement.

Lorna: I found the many statistics in your book interesting. Two were, “Only 20% of students ages 14 to 21 with emotional and behavioral disturbances (E/BD) receive a high school diploma.After high school, only 30% of students with E/BD were employed and 58 % were arrested.” Is enough being done for these youth that these numbers will soon change for the better? What is the biggest obstacle that needs to be overcome so that we can see more changes?

Nancy Rappaport >> We need to start our interventions earlier, particularly for children who struggle with anxiety and oppositional behavior. We also need to have more comprehensive wrap-around services and outreach to support families. I hope these numbers change, but many of these students need intensive sustained support to alter their trajectories.

Lorna: We all remember fondly successes during our careers, while teaching it could be a child who has that Aha moment and puts everything together and starts to read independently.  Dr. Rappaport, can you share a story about a student who received the help he needed and you knew he was finally going to make it. 

Nancy Rappaport >> Wonderful question! It wasn’t that kind of dramatic moment, but I had a student who struggled with explosive behavior, and over time I could see that he was learning to identify what he was feeling (by using an emotional thermometer). Instead of getting into arguments with his teachers, he figured out how to ask for what he needed and to practice strategies that helped him feel more confident. These are small miracles, to watch children and teachers recognize that they can be successful.

Lorna: We often hear about the invisible disabilities, those that are not immediately apparent like diabetes, epilepsy, sleep disorders, ADHD, cancer, autism, etc. There are now awareness days, awareness months, web sites, support groups, etc. devoted to those disabilities.  Would you say the children you wrote most about in The Behavior Code, students with anxiety-related, oppositional, withdrawn, and sexualized behaviors, could be place in this group also? Do they fall under the term “disability” if it affects most aspects of their daily life? Would they receive more services and support? These children and their parents feel so alone, helpless, and hopeless.

Nancy Rappaport >> Families of children with behavioral outbursts and seemingly relentlessly demanding behavior are often embarrassed by the child’s performance and may feel marginalized. Others often see these children as distracting other students from learning because the teacher is consumed with managing their behavior, rather than realizing that they are  in desperate need of more support to help them learn better ways to manage their distress.

Our challenge is to increase awareness and empathy of these children’s needs. We become more empathic when we see the potential for change and recognize that students’ disruptive behavior is because they have not learned better ways of communicating their distress.  Teachers and school staff devote their time to providing the focused interventions that allow these students to gain momentum.

Lorna: What is still on Dr. Rappaport’s “Bucket List”? Do you have any interesting plans for 2012? Tell us how we can follow you, buy your books, hear you at conferences, etc. Thank you so much for making time for our Interview Series.

Nancy Rappaport >> Still on my bucket list are hiking in South America and writing a good short story! I am going to Ireland with my family this summer, and in the coming academic year I will be speaking about The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students and In Her Wake at several conferences.

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This post was written by Lorna
Lorna d’Entremont: Co-owner of SentioLife Solutions, Ltd. the company behind KidCompanions Chewelry (2007) and SentioCHEWS (2013), mother of three, grandma of 5 and wife. She is a retired teacher and special needs advocate. Throughout she has taught all levels from grade 2 to grade 9. Lorna loved teaching and enjoyed seeing the students progress in the school system. During her 30 year career she took a few years off to raise her three children.