Thursday, January 14, 2010
Behavior modification

By Dr. Anthony Policastro

I provide a lot of behavior modification advice in my practice. There are some things that parents do not readily realize about behavior modification in children. The first of those is that there is no such thing as a quick fix. Children develop behavior problems over a long period of time. Those behaviors are reinforced over and over again usually on a daily basis. For that reason, any type of change in behavior will take time as well. The best any one could hope for is to see a change after 7 - 10 days of consistently doing things differently. Nothing changes in less time than that. I see many parents who get frustrated after 3-4 days. That then reinforces to the child that what they are doing will continue to work. Some children respond poorly the first few days. If you think like a child, it is obvious why that is so. They know they were getting their way by doing what they were doing. Then they see that it doesn't work as well as it did. Their first reaction is to make it even worse. If screaming was working before, then they need to scream louder and longer now. However, once they realize even that does not work, they will begin to change. Overall, it takes a good week or so for them to get the message. Nothing works in less time than that. Another thing that is clear is that no two children are alike. What works for one will not work for another. For that reason, there is no one size fits all behavior program. Every child reacts to different rewards. Every child reacts to difference punishments. Some times, all we need to do is ask them what they see as a good reward or punishment. They often will tell you something that you would least expect. One thing is usually clear. Whatever way the parents are currently acting is exactly what the child wants. That is why the behavior is continuing. They are getting what they want from the behavior. That is why they continue doing it. I often will tell parents to do just the opposite of what they are now doing. Usually that means walking away from the situation. Often bad behavior is the way they get the parent's attention. That is true even if the attention is in the form of yelling at the child. Some parents will initially try to walk away. However, that is when the child decides that they need to be worse to get the attention they wanted. So they will become destructive. The parents will then stop walking away. The child gets what he/she wants. The behavior continues. Every child will learn how to push his/her parents' buttons. We should be smart enough to not let that happen. However, we often react emotionally rather than logically. When that happens, they are smarter than we are. The result is an unhappy situation. Behavior change in children is never easy. It takes too long to develop. Therefore, it also takes a long time to correct.

Family Caregiver Training offered The Alzheimer's Association Delaware Valley Chapter sponsors The Family Caregiver Education Series four times a year in each of Delaware's three counties. Methodist Manor House at 1001 Middleford Road in Seaford will host the free training session on Friday, Jan. 29, from 8:30 a.m. to 4:30 p.m. This program includes a medical overview, legal and financial issues, challenging symptoms, daily care issues and information on getting the help you need. Lunch will be provided by Methodist Manor House, therefore pre-registration is required by Friday, Jan. 22. For more information or to register, call Jamie Magee at 854-9788.

PRMC offers free screenings The Guerrieri Heart & Vascular Institute at Peninsula Regional Medical Center will be offering free blood pressure screenings during American Heart Month in February. The free blood pressure screenings will be held every Monday in February (1, 8, 15 and 22) from 10 a.m. to noon in both the Guerrieri Heart & Vascular Institute lobby and the Frank B. Hanna Outpatient Center lobby on the Peninsula Regional campus. There is no need to make an appointment. Free parking is available in the lot on East Carroll Street (for screenings in the Guerrieri Heart & Vascular Institute lobby) and in Garage B (for screenings in the Frank B. Hanna Outpatient Center lobby). For more information, call the Guerrieri Heart & Vascular Institute at 410-543-7123.

Camp Possibilities receives grant A $5,000 grant from the Frank E. Acierno Foundation Fund of the Delaware Community Foundation will make attendance at Camp Possibilities' one-week, overnight camp possible for a number of children who would otherwise be unable to afford to attend. Camp Possibilities is a camp for children with diabetes between the ages of 7 and 15 who, due to the complexity of their disease, often do not get the chance to go to a summer camp. The camp, which is held at Camp Ramblewood in Darlington, Md., will be held from July 25-30. More than 50 volunteer counselors and recreation staff comprised of high school and college students and professionals from the community collectively give over 5,000 hours of their time to make the camp possible each year. The camp's medical staff and others annually donate more than $100,000 in time, knowledge and service. For more information about Camp Possibilities, visit

Health Fair is Feb. 1 Bayhealth Medical Center - Milford Memorial Hospital will host a Milford Community Forum & Health Fair on Monday, Feb. 1, from 5 to 8 p.m., at the Carlisle Fire Company in Milford. The event is free and open to the public. This special event will include free health screenings, informational displays on Bayhealth programs and services, and the opportunity to interact with Bayhealth leaders, employees and physicians. Bayhealth's leaders will speak about Bayhealth's focus on Milford Memorial Hospital, including new physician recruitment, ongoing improvements and renovations, recent awards and recognition, new services and future plans. In the event of inclement weather, the event will be held on Wednesday, Feb. 10 at the same time and location. For more information, call 430-5978.

H1N1 vaccine now available to all Delaware Public Health has changed Delaware's influenza activity level from widespreadto sporadic.The reduction in flu activity designation does notdiminish the needfor caution and vaccination, nor does it diminish the potential severity of the illness for those who get the flu. Dr. Rattay, DPH director, reminds Delawareans thatall Delawareans above six months of age can now be vaccinated. This is possible due to an increase in 2009 H1N1 vaccine supply and because 75 percent of the vaccine that was requested by providers for high-risk populations has been shipped to them.Until this time, vaccine was not as readily available and high-risk groups had priority due to their susceptibility to complications caused by the flu or flu-like illness.

Major pharmacy chains in Delaware have begun to receive H1N1 vaccine under an agreement with the federal government. These vaccines will be available free to any adult who wishes to be vaccinated. Nationally, the pharmacies involved include Walgreens, CVS, Target, Costco, Kroger, Publix, SuperValu, Stop-and-Shop, Rite Aid, Wal-mart, ACME and Safeway.DPH is providing vaccine to pharmacies in Delaware that are not participating in this program.By law, pharmacists in Delaware cannot vaccinate persons younger than 18 years. The school vaccination program continues. Locally, Woodbridge Elementary in Bridgeville will offer vaccinations on Thursday, Jan. 14. For more information about both H1N1 and seasonal vaccines, visit

Cancer support group The Wellness Community-Delaware offers a free general cancer support group for people affected by cancer and their loved ones at Nanticoke Memorial Hospital in Seaford. The monthly support group meets in the second floor conference room of the Cancer Care Center on the third Monday of each month from 4:30 to 6 p.m. Due to the Martin Luther King Jr. holiday, the next meeting takes place on Monday, Jan. 25 at 4:30 p.m. The Wellness Community is dedicated to helping people affected by cancer enhance their health and well-being through participation in a professional program of emotional support and hope. All facilitators of these groups are trained mental health professionals. Call 645-9150 for information or to register. For more information about The Wellness Community, visit

Annual women's conference The fifth annual "Women Supporting Women Through Opportunity Conference" will begin Friday, March 26, and last through Sunday, March 28, with an array of activities including eight workshops, door prizes, food, fellowship and lots of fun and learning opportunities. The annual conference, planned by friends of the "GeeÉYou Will Project," a formal wear lending library and women and girls mentoring project serving those in need of these services throughout Delaware, will be held at Redden Lodge, near Georgetown. This celebratory fifth annual conference will begin with the "Eat Dessert First" reception and an evening of activities and dedications. As one of the special features of this year's conference, the Young Women's Drumming Empowerment Project (YWDEP), a Washington, D.C. area group lead by Kristin Arant will join the group on Friday evening. The YWDEP performance is sponsored by Lynne Betts of "MichaeLynne Peace Products" of Seaford. On Saturday a variety of workshop topics are planned including belly dancing; a woman's forum, homespun health; and meditation. On Sunday there will be a non-denominational "Celebration Ceremony" followed by a morning of crafting and other activities before a "Leftovers Buffet" and family reception in the afternoon. Cost of the conference is $50 which includes food, supplies, facilities and lodging (if desired) on a first come, first served basis. The conference is open to 55 women, ages 18-80 and beyond and workshop assignments are made based on registration dates. For more information, or if you or someone you know is interested in becoming a sponsor of the Conference or the "GeeÉYou Will Project," call Rosemary Joseph-Kappel at 302-242-0032 or e-mail

Sixth H1N1 death reported Officials with Delaware's Division of Public Health (DPH) say a 56-year old Kent County woman became Delaware's sixth H1N1-related death Jan. 2. She was hospitalized Dec. 18, 2009, tested positive for H1N1, and had several underlying health conditions. People with chronic underlying health conditions such as asthma, diabetes, heart disease, obesity and those who are immunosuppressed are at higher risk of complications from the H1N1 flu. There have been 1,697 laboratory-confirmed flu-related deaths in the United States, seasonal and H1N1 combined, reported to the Centers for Disease Control and Prevention (CDC) since Aug. 30, 2009, though the CDC stated the number of deaths is higher when estimating those not confirmed in labs. Signs of serious flu illness in children are: fast breathing or trouble breathing; bluish skin color; not drinking enough fluids; not waking up or interacting; being so irritable that the child does not want to be held; flu-like symptoms improve but then return with fever and worse cough; fever with a rash. In adults, signs of serious flu are: difficulty breathing or shortness of breath; pain or pressure in the chest or abdomen; sudden dizziness; confusion; severe or persistent vomiting. Stay informed about the latest developments on the H1N1 flu, by visiting

Man to Man support group Nanticoke Memorial Hospital offers a Man to Man support group meeting on the fourth Wednesday of each month. Man to Man helps men cope with prostate cancer by receiving information and peer support. Pre-registration is not required for this free support group. For more information, contact Larry Skala (337-3678) or Grafton Adams (628-8311).

Depression Support Group There is a free bimonthly Depression Support Group meeting in Laurel on the second and fourth Wednesday evenings from 7 to 8:30 p.m. Any person who has signs and symptoms of depression and is under the care of a professional counselor/MD is welcome to attend. To register, call Life Matters Counseling and Consulting at 302-465-6612.

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Monthly support group Compassionate Care Hospice, The Wellness Community-DE and Nanticoke Memorial Hospital will collaborate to present a monthly bereavement group, The Next Step. The group focuses on issues of loss that continue beyond the early stages of grief. Mary Van House, bereavement coordinator, will facilitate the group at 10 a.m. on the third Tuesday of each month, at the Nanticoke Cancer Care Center, second floor conference room. To register, call Lisa at 629-6611, ext. 2378.