Only behavior placed in basket A results in a limit. Greene does believe there are some infractions, primarily physical attacks and destruction of property, that should be stopped. However, he gives parents little instruction or advice on how they might accomplish this. He believes that if most behaviors are tossed into baskets B and C, there should be far fewer episodes of rage that call for a firm unyielding limit and, for some reason, declines to be specific about how to set that firm unyielding limit.

Much of this sounds a lot like the old sensible parenting advice: "Pick your battles." But Greene's emphasis on baskets B and C is misplaced and potentially damaging. If in fact the parents are effectively setting limits for certain basket A behaviors, why not encourage them to expand their demands on their children's performance over time? If hitting Mommy in anger sends Johnny to timeout, parental immediacy and consistency should in time cause Johnny to think twice about such actions. Once parents see improvement in less hitting, why not begin to include swearing as another timeout offense?

This is not rocket science, but it is also not easy to achieve with difficult and persistent children. And no one approach works all the time for all children. Sometimes, the most useful thing parents can do with their wailing, whining 6-year-olds is hold them close and whisper sweet nothings into their ears. Parenting these children is like playing an antique violin. Bow too softly and you hear nothing. Bow too hard and it squeaks. Finding just the right amount of pressure to make the violin sing sweetly requires much skill, practice and often some instruction in mastering a difficult and beloved instrument.

Greene admits there is no published data supporting his approaches at this time. However, I suspect we will be seeing such studies in the future, if only because Greene works with the most prolific group of pediatric psychiatric researchers in the country. But no matter how his results are spun, I fear that Greene's approaches will be grabbed by the hungry hordes of desperate, uncertain parents struggling over setting limits and hoping to avoid the unpleasantness of dealing with their tantrummy preschool and school-age children. However, avoiding the unpleasantness of conflict with their kids will ironically lead to more and escalating conflict and more "explosive" bipolar children.

	The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children By Ross W. Greene Harper-Collins 326 pages Nonfiction Buy it Print story E-mail story

Keeping one's cool as a parent is quite important in child rearing. There's even a place for negotiating. Some negotiation with teens makes sense by virtue of their physical size, ostensible emotional maturity and "rights" afforded them by an ever more permissive society. Few angry teens can be safely hauled off to a timeout by their parents. If these kids haven't learned to go on their own by then, the cops might have to be called in to physically intervene. But how will these kids learn to self-control when their parents have been giving in to them since their toddler days?

That's my biggest worry about "The Explosive Child." Greene's approaches, as articulated in this book, are not approaches that I would recommend for the average family with a difficult or even very difficult 2- to 12-year-old child. Of course Greene would say these kids are beyond even very difficult. And that may well be true. On the other hand, I see many parents who feel as if they've already tried everything by the time they've gotten to my office. They feel as if they've tried to reward and punish without success. Yet so many of these families actually succeed once they've been given the permission and support to become more immediate and tangible with their discipline.

With less ambivalence interfering with their demands and follow-through, parents often wind up using the same approaches that previously failed but succeed when they are applied consistently and immediately. Rewards also have a role in shaping behavior, but they too should be immediate and tangible: stickers, stars and small toys for younger kids; money and extended privileges for older ones.

Rarely, though, are rewards alone an effective substitute for limits and discipline. Kids also need some time with their parents doing something together that is not merely shuttling from music lesson to soccer practice, a ritual that seems to pass for quality time among suburbanites and affluent city dwellers. And, of course, kids need affection and warmth from their parents too. However, I find in the families I see that showing love is not the parents' problem as long as their kids' difficult behaviors are under control.

Some children who are especially hyperactive and impulsive will be helped with drugs like Ritalin or Adderall. And some children will continue to rage and throw tantrums. No one approach solves all problems. Undoubtedly, a few children will never receive the degree of immediacy and consistency required to meet behavioral challenges within their own homes. That doesn't mean they are unresponsive to rewards and punishments. All animals (and probably some plants too) respond to these behavioral inducements. But for these kids, their current environment doesn't meet their needs.

I am not blaming parents. Some of these children have been extremely difficult from birth (which in itself doesn't fully exonerate their family and school from influence on their behavior). At some point, though, the choices for these families become very difficult. They may have to find another environment that can meet the kids' needs -- a relative's home, a different class or school.

If warring spouses aggravate the challenges, perhaps the parents should separate or the child should live with one parent exclusively for a while. Perhaps the next time the kid acts out the cops should be called. These types of painful decisions for parents make alternatives like more medication for the child or Greene's approaches to discipline attractive.

Somewhere in the mix for these very extreme cases, there might be a place for the strategies espoused by Greene in "The Explosive Child." I'm not sure whether Greene's approach works for the kids in his clinic or if the medications they are taking simply modify their behavior or sedate them. But for the many other families struggling with very difficult children, premature adoption of these techniques will have the paradoxical effect of creating more explosive children -- good perhaps for sales of books and medications, but tragic for a society that has lost its balance between the dual needs of children: loving nurturance and effective discipline.

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