About Lois Black’s Approach to Children with Behavioral Problems

Lois’ work was based on the observation that neuropsychological disabilities – whether subtle or overt – surprisingly often play a key role in shaping a child’s psychological makeup. These disabilities include problems with movement, hand-eye coordination, attention, memory, planning, auditory processing, and other brain-related problems that may be present at birth. Her approach was to detect neuropsychological disabilities, to understand how they contributed to emotional and behavioral difficulties in the child and the family, and then to embark on an individualized therapy program based on this understanding. Using this approach, Lois dramatically bettered the lives of many of her patients, especially those with complex presenting problems or hidden neuropsychological issues. Take one little boy described in one of her lectures:

Frank repeatedly refused to join in on group activities, insisted on being off on his own rather than sharing or playing with other children, and moved around the room like a small bulldozer, knocking into toys and others. When Frank got out of a chair, you had to watch out. "Don't get in my way" seemed to be the message. Some days he came to class acting like this little bully powerhouse; other days he was sullen and somewhat withdrawn. He seemed to ignore requests made to him, with insistent demands having to be repeated time and again. Frank's mom appeared depressed. Frank's dad came from a family of ambitious, dominant men who ’liked their women at home.' He thought of many aspects of Frank's behavior as within the norm for little boys and as an expression of Frank's independence. The more negative out-of-hand features he seemed to hold Frank's mom accountable for. He thought she was weak on discipline and didn't know how to control him. Frank's mom said she never wanted to have any more children. She just didn't know how to handle Frank, she confessed. She wanted to hit and bite him back to teach him not to do it by showing him how it felt.

Lois’ neuropsychological evaluation revealed that Frank had several neuropsychological disabilities: attention deficit disorder, a mild language problem, and motor planning difficulties. These neuropsychological disabilities conspired with the family dynamics to create a very difficult situation. Lois worked with the family in a therapeutic process in which the child’s self-image and the parents’ ideas and feelings about their child were transformed to become more realistic, positive, and shared. Neuropsychological assessment was critical not only because it had revealed the disabilities but also because it had shown Frank’s strengths – a high non-verbal IQ and good imagination – that proved instrumental in making events take a turn for the better.

In cases such as Frank’s, the challenges for the professional are

Lois’ approach requires the professional to master and integrate the neuropsychological and the psychological pictures. This was what she knew was important to teach in pediatric neuropsychology, clinical child psychology, and developmental psychology programs.