Answer: Based on the information you provided, I do not think your son needs to be placed back in the first grade. It sounds like he needs a behavioral intervention plan to address his disruptive behavior in school.

Your son's teacher or the school's social worker should be able to devise such a plan with your input. The plan should identify three to five target behaviors that you and his teacher would like to see increased in school, for example, raising his hand when he wants to speak in class, listening when the teacher asks him to be quiet, using an "inside voice" in the classroom, etc.

The target behaviors should be specific and positively stated. Once the behaviors have been identified, the next step is to make sure that the teacher reinforces your son every time he demonstrates the target behavior. For example, he could get a sticker each time he demonstrates a target behavior and if he earns a certain number of stickers, he gets a bigger reward at school (e.g. extra time on the class computer, extra recess time, getting to be a special helper to the teacher, etc.) and at home. It is important that your son is reinforced immediately after he demonstrates the target behavior to help him make the connection between his behavior and the reinforcement.

A thoughtful and consistently implemented behavior intervention plan should lead to some positive results after two weeks. If your son's school behavior does not show any signs of improvement after this time, you may want to have your son evaluated by a child psychologist to determine if there are any other factors that may be contributing to his behavior in school.

Dr. Lisa Hunter is an assistant professor in the department of child psychiatry at Columbia University and the director of school-based mental health programs at Columbia University's Center for the Advancement of Children's Mental Health. Her research focuses on the development, implementation, and evaluation of school-based mental health and prevention programs. In addition she is a licensed clinical psychologist in private practice in New York City. She specializes in cognitive behavioral treatment for children and adolescents.

Advice from our experts is not a substitute for medical or other professional advice and services from a qualified health-care provider familiar with your unique situation. We recommend consulting a qualified professional if you have concerns about your child's medical or emotional condition.

November 2006