Health: From little monster to little angel: it's kids' play: Psychologists are teaching parents how to reform problem children with games. Jerome Burne sits in

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Indy Lifestyle Online
THERE was a minor miracle in south London last month. Five-year-old Andrew went with his parents to the supermarket, had lunch at McDonald's and caught the train home without once hitting them, knocking things over, screaming or running off, deaf to all pleas to come back.

All parents have moments they would rather forget - battles over bedtimes, tantrums in the shops. But what happens when every day is a gruelling battle of wills that the parents seem constantly to lose? What happens if, in the jargon, you have a non-compliant child?

About 10 per cent of parents do and a further 25 per cent have children who are seriously out of control some of the time. These are children who are infuriating at five, but whose behaviour may be life-threatening at 15 and who later clog the courts. Until they run up against the law, these families are doomed to years of grinding, miserable conflict.

What is unusual and so hopeful about Andrew is that his behaviour has been changed. In six weeks he has gone from monster child to pleasant and affectionate infant. 'He used to be terrible,' says his father, Clive. 'He started school in September and by Christmas other parents were getting up a petition to have him thrown out. He'd spend all day sitting on a chair outside the headmistress's study. We couldn't take him anywhere because he'd fight with other children or smash things. It has been going on for two years.'

In March the family was referred to a special unit, at the Maudsley psychiatric hospital in London, set up to teach parents how to deal with non-

compliant children.

A few weeks later, Andrew and his mother, Amanda, find themselves in a shabby room filled with toys in the sprawling hospital. On one side of the room is a large two-way mirror. Behind it is the principal clinical psychologist of the Children's Department, Sue Jenner, with a microphone that lets her speak directly into the earpiece that Amanda is wearing. Mother and child are about to play together, while Sue talks Amanda through it.

'I want you to ignore the way he's banging on that box,' says Ms Jenner's voice in Amanda's ear. 'He's stopped that, so now you can pay attention to him. Try not to ask questions. 'Shall we' is a question. Also, without realising it, you are giving him a lot of instructions when you say 'wait a minute', 'hang on' and 'come over here'. Let him get the idea that he is giving the instructions.'

They are playing the Parent-Child Game, a technique developed in America that has proved successful in giving many parents a means of establishing discipline without tears. The method depends on doing the opposite of what parents and teachers have relied on for years. Faced with a naughty child, the natural reaction is to tell him (it is much more likely to be a boy) to stop it. Parents with 'non-compliant' children spend most of the day threatening, criticising and scolding. They become so exhausted that when the child is quiet or well behaved they ignore him.

'What children want most in the world is attention,' says Ms Jenner. 'These children get all the attention when they are naughty and are ignored when they calm down. Without realising it, the parents are training them to behave badly.'

To turn this around she drums into them, through the earpiece, a series of 'Dos' - telling the parent when to praise the child and to ignore minor bits of bad behaviour - and 'Don'ts' - not to ask questions (except for asking to join in), not to criticise and not to give instructions.

'Some of the parents when they start here are doing more than 100 of our 'Don'ts' in a 10-minute session. By the end they are often down to half a dozen,' she says.

Andrew is fiddling about on the floor in a nervy and distracted way. Suddenly he makes a break for the door to have another look at the room he has already been shown on the other side of the mirror. Amanda brings him, kicking and yelling, back into the playroom. Now she is faced with a decision that is drearily familiar. Only this time, instead of having to deal with it alone with a mixture of threats, slaps and pleading, she has Ms Jenner's voice in her ear giving her step-by-step instructions.

'I want you to ignore him. If he tries to get out just stand by the door. I want you not to look at him. Don't give him any attention.' Amanda picks up a magazine and flicks through it while Andrew rages and pushes at her legs. Then he switches off the playroom light. His mother switches it back on again.

'Just stand there so he can't get to the door or the light again,' Ms Jenner continues calmly. 'It is a question of waiting this one out. If he starts behaving in a way you can approve of, then say something nice.'

After about a minute Andrew begins playing with some building bricks. 'Say: 'I can see you are playing with building bricks',' she instructs. 'Well done. We've survived that outburst. Let's see if by giving him lots of positive attention you can keep him concentrating. Focus on what you are doing. Say: 'I'm passing you this car'. Good. Now I want you to say: 'I really love watching you play with that garage, Andrew'. That's lovely, well done'.'

Watching the game produces mixed emotions. There is sympathy for Andrew. You can see that he wants to look next door. And there is something forced and odd about Amanda being told to describe what her son is doing or to say how much she is enjoying it. But at the end of the session they are playing together naturally, and six weeks and six sessions later there is no need for Ms Jenner's voice in the ear.

The game was developed in the Seventies by separate teams of psychologists in Oregon and Georgia. There, studies have shown that 66 per cent of the children who have participated have near-normal behaviour when followed up after four to eight years. In this country, the game is still almost unknown. It was first used at the Maudsley about five years ago. Since then the unit has treated about 300 children. Two or three local authorities use the game on a small scale.

Most of the families seen at the Maudsley unit have been referred to it by the courts and the game has a heavy significance. For many parents, their ability to play it will decide whether or not they lose their child.

'Andrew was a bit unusual for us,' says Dr Stephen Wolkind, consultant child psychiatrist and head of the unit that runs the game. 'Most of the children we get are worse and have been referred by the courts for us to assess any possibility of improvement before the child is taken into care.

'But even with these end-of-the- line children we are helping about 30 per cent to improve significantly. When we get parents like Amanda and Clive who don't have learning difficulties, aren't alcoholic or drug addicts and haven't been abused themselves, the chances of improvement are high.

'Catching these children young can save so much money; treating one child costs about pounds 4,000 which, in a few years, is what will be spent in a single month keeping that kid in care,' Dr Wolkind adds. 'The game would also be valuable for anyone working with children. Most teachers could benefit from the principle of ignoring minor misbehaviour and concentrating on the good.'

'The central message is terribly simple,' says Ms Jenner. 'Show love in a way that is meaningful for the child. Do you know the one thing that parents find most difficult about the game? Having me praise them through the earpiece. No one has ever told them they are any good before.'

Clive and Amanda agreed to be filmed for the BBC 1's QED: 'The Family Game', due to be shown on Wednesday at 9.35pm.

(Photograph omitted)