Four-Year-Old Sticks Her Tongue out

Get advice on how to handle a problem behavior in a four-year-old.
Our four-year-old daughter, who was diagnosed as being at "high risk" for ADHD, has recently started to stick her tongue out at us, her schoolmates, her teachers. Despite our disciplinary efforts, which involve taking away favorite playthings, she continues to exhibit this behavior. Any suggestions?
I think it is likely that your daughter is relishing the attention that she is getting, however negative, when she sticks her tongue out. She knows that it gets a reaction. I would suggest taking a different tack. I think that you and her teachers should totally ignore her when she sticks out her tongue, and actively remove your attention from her. When she sticks her tongue out you can calmly say something like: "I don't want to be with you when you stick your tongue out at me" and then calmly turn your back to her and go on with whatever activity you were doing. In school, they can use time out for this purpose.

The other thing that you will have to commit to, however, is making sure you are giving her "time-in" when she is behaving well and expressing herself appropriately with her words. Usually, children who try to get negative attention are feeling that they aren't getting enough attention of any kind, so they settle for the negative. You need to make a concerted effort to catch her being good, and reward her for this good behavior by giving her your undivided attention for a period of time.

Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.

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