Day 24: Behavior Modification

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This is Day 24 in the series: 31 days on Living with ADHD, Autism and Sensory Processing Disorder: What We Have Tried, What Has Worked, What Hasn’t Worked, and Never Giving Up.  Click here to see all the posts in this series.

Today’s topic is on Behavior Modification i.e.motivational rewards.  This is actually more controversial than I ever would have imagined before I had kids.  The first question to ask is should kids be rewarded at all?

Intrinsic vs Extrinsic Motivation

Just yesterday there was a post on 100daysofrealfood.com on “Why Kids Should Not Be Rewarded with Junk Food” besides pointing out rewarding children with food (especially junk food) is a bad idea the article went on to bring up the point of extrinsic vs intrinsic motivation.  I think we can all agree that we want our children to be intrinsically motivated in all areas of their lives.

One example of this would be eating healthy foods.  If we use a bribe to get them to eat their vegetables they might eat them today but it is highly unlikely they will still be eating them in 20 years.

Daniel Pink, author of A Whole New Mind: Why Right-Brainers Will Rule the Future and Drive: The Surprising Truth About What Motivates Us says:

“Rewards can deliver a short-term boost — just as a jolt of caffeine can keep you cranking for a few more hours.  But the effect wears off — and, worse, can reduce a person’s longer-term motivation to continue the project.” (p. 8) 
Pink calls this the carrot and stick effect and identifies seven ways in which external rewards do not work:
  1. They can extinguish intrinsic motivation.
  2. They can diminish performance.
  3. They can crush creativity.
  4. They can crowd out good behavior.
  5. They can encourage cheating, shortcuts, and unethical behavior.
  6. They can become addictive.
  7. They can foster short-term thinking. (p. 59)

100daysofrealfood.com said it this way: “In terms of school and sports, when we reward children, we are not allowing them to find their own self-satisfaction. That intrinsic emotion that should come naturally from just completing the job and doing a good job is fulfilled with an extrinsic item instead, such as the Tootsie Roll. But when those Tootsie Rolls stop coming, the behavior we were once reinforcing starts to peter out.”

How do I keep my child motivated without rewards?

When we are headed to school and Miss Tomboy says “I will do it myself” and succeeds she doesn’t need my praise or a reward.  Just the fact that she opened the gate all by herself without any direction is reward enough.  It is liberating and empowering to her that she has gained some independence.  Giving children independence (within reason) to make choices is a good first step.

Descriptive praise is another great way to motivate children.  Descriptive praise is NOT “Good job”.  Perhaps descriptive affirmation might be a better way of explaining this concept.  You want the child to realize you saw their action and approve of it.  For example, “Miss Tomboy you were so kind to open the gate for me.  You must be really strong to do that all by yourself.”  Read more about descriptive praise here.

The Montessori Method of education that Mr Rockstar has been in since he was 3 strongly emphasizes independence which naturally builds intrinsic motivation.  You can read more about it at followthechildmontessori.blogspot.com.  For more info on Montessori education read my post here.

So is a reward ever a good idea?

“The only case in which a reward or punishment is at all helpful is when the desired action is simply mechanical, requiring little or no cognitive ability or creativity (p. 62) ” says Daniel Pink in his book Drive: The Surprising Truth About What Motivates Us

I have been very torn about reward systems.  I find I have no need for reward systems with the twins.  Obviously they still have behavioral issues typical of 3 year olds and we have a couple ways to handle those (read the Top 9 Tips from Our Behavioral Counselor) but I don’t need to have any ongoing reward systems to help them grow or succeed in a particular aspect of their life.

Mr Rockstar on the other hand struggles.  We have used various reward systems since he was 3 or younger (it is hard to remember when they started).  I occasionally try to go without them and it is always a miserable failure.  When we started seeing the behavioral therapist she pointed out that reward systems aren’t intrinsically bad.  In reality the way we all work and get paid is at its most basic a reward system.  You agree to do X and for that I pay you $$.

6 Steps For an Effective Behavior Modification Program

1. Contractual Agreement vs Bribe

You want a predetermined reward system not last minute bribes.  Bribes don’t work EVER.  Seriously they don’t.  From personal experience either one of two things happens:

  1. Your child is in the midst of a huge tantrum and is totally incapable of calming down (possibly a fight or flight episode).  In which case the bribe only makes the situation worse because they don’t calm down, they don’t get the bribe, and then they are double mad because they don’t get the carrot that was dangled in front of their face.  It is like throwing gasoline on a fire to put it out.
  2. Your child could actually calm down and do what is being asked of them but instead they are having a “brat” moment.  They need a parent not a bribe.  If you offer a bribe and they calm down then you are simply rewarding bad behavior.  Tantrum = Bribe.  Good things come to those who have meltdowns at the least opportune moments for mommy.  Right?  Hmmm probably not the best long term strategy.

The way to avoid reinforcing bad behavior is to make an agreement ahead of time on what your expectations are and what reward they might expect.  For many situations just talking with a child ahead of time about our expectations is enough.  I think too often we skip this step and then are surprised when they don’t act the way we want them to!  A huge part of parenting is education.

Once you have established expectations you can choose to also offer a reward.  We offer rewards to Mr Rockstar exclusively for proper behavior in stressful situations.  Once we see a recurring pattern that a certain weekly event is problematic we will create a reward to help motivate him to stay calm.  Role playing is great in situations like this.  Every week I role play with Mr Rockstar how to say “goodbye” to me at occupational therapy drop off.  We will practice 3-4 times with him saying “hi” to his therapist and then “bye” to me.  If we are running late and miss this role playing and reinforcement of the expectations and rewards he almost always has a bad drop-off.

2. What to Reward

Besides chores all the rewards we give Mr Rockstar are for appropriate behavior.  We aren’t handing out rewards for accomplishments or creativity….just behavior.

  • Follow Directions First Time the Fast Way (Compliance within 20 secs of command.  I will ask twice and only twice).
  • Keep Your Hand and Feet to Yourself (NO aggression of any kind.)
  • Use an Inside Voice (No screaming or roaring.)
  • Telling the Truth Quickly
  • Stay in Bed Quietly During Rest Time
  • Do Your Chores When Asked (some chores are rewarded and some he just has to do and would fall under compliance)

Chores are slightly different than the rest of the list.  Some chores the kids just have to do and some they earn a “commission” on.  They don’t get allowance money but if they want to buy something they can do chores to save up.

3. Cues and Reinforcement

Throughout the day I need to give Mr Rockstar positive cues.  For example, “You did that work so fast.  That was STAR work!  High five.”  This not only gives him descriptive praise but also serves to remind him of the goal he is working for.  Depending on if Mr Rockstar is having a good or bad day he will need more cues to stay on task.  On good days he needs hardly any cues to keep positive momentum.  On bad days it is critical to find a way to give him descriptive praise in combination with reminders of the reward system.  Sometimes this can turn a bad day around and help him regain some positive momentum.

There is a rating system our behavioral therapist gave us with four levels: Star, Smiley Face, So-So Face, and Sad Face.  This can be made into a nice visual for the kids so you can show them how they are doing in each area.  If they are being slow to comply you can cue them with “Mr Rockstar you are only listening So-So.  I need you to listen first time the fast way so you don’t get a sad face”.

In reality on his good days Mr Rockstar is intrinsically motivated.  On his bad days something is bothering him (whether it be a runny nose, his clothes, or something else) and he needs motivation to help him focus and maintain control.  The behavioral therapist is all about positive momentum… finding ways to get it and keep it.

4. Varied Rewards

If you don’t vary the reward over time the incentive value of the reward will go down.

Reward Ideas

As much as I hate it the most motivating rewards I have found are iPad time, Toys, and Food.  Here is a list those plus a few more that we use now or have used in the past:

    1. iPad: iPad time is limited to 1hr of earned time each day.
    2. Toys: For toys these can vary from really small (hot wheels cars or other toys I find at garage sales) or larger.  Sometimes if Mr Rockstar has a toy he wants we will agree on a certain number of stickers he needs to earn to get that toy.  He might be working towards a big goal for a week or two.  This can be a positive way for kids to learn delayed gratification and working towards a bigger goal.
    3. Food: This used to be one of our most used rewards until I read French Kids Eat Everything.  In that book it talks about why it is important not to reward your child’s behavior with food. Food should be reserved for meal times when we are hungry and not consumed for other reasons to make us feel good.  Since reading that book the only time we kinda use food as a reward is at dinner.  If the children try a bite of everything on their plate then they can have some juice with their dinner.  This is the only time they get juice ever.  If they refuse to even try dinner then they get water and crust of bread (just kidding) peanut butter and jelly.  In my mind this “reward” with juice is just communicating that when you are mature and try new things you can enjoy a more varied dinner experience.  Maybe I am just fooling myself and this is a horrible policy but we have have found this really helps to eliminate dinnertime battles plus if you can just get them to try new foods you have won 90% of the food battle.
    4. Money: Mr Rockstar is still a little young but sometimes he redeems his stickers for money and we go to the local charity shop and do some treasure hunting.
    5. Go Biking
    6. Have a Dance Party
    7. Go to the Lake/Go Swimming
    8. Bake Cookies with Mommy
    9. Go to the Playground

You can take pictures of each reward and then your child can choose one to be working towards.  Depending on the age of your child they could also have different sticker values.  I was always surprised how often Mr Rockstar would choose “Bake Cookies with Mommy” (I have a shortbread recipe with virtually no sugar that he LOVES making and cutting into shapes) or “Go Biking”.  Sometimes behavioral issues are simply attention seeking so having some activities to do with mommy or daddy as a reward can be great!

5. Immediate vs Delayed

The more difficult a situation is and the harder it is for your child to stay focused on controlling their behavior the shorter the time interval between rewards should be.  This is what is perfect about the sticker rewards system (though you could do the same thing with money).  If Mr Rockstar is having a bad day I can give him a sticker for every 15 minutes he stays in control of himself and doesn’t do something crazy.  If he is having a good day then I only need to check in with him a couple times for rewards.  At his age he still doesn’t have a very good concept of time so he doesn’t seem to notice this inconsistency from day to day.

One of our first reward systems which turned out to be an epic failure was a daily review.  If Mr Rockstar had a so-so day or better he earned one big surprise reward before bed.  The behavioral therapist had good results with some kids using it.  It turned out that a once a day incentive was too long a time interval for Mr Rockstar for now.  He just could’t keep focused on it.  I modified the reward system so he earns stickers throughout the day and once he earns enough stickers then he can cash them in for a big surprise or another pre-agreed to reward.  In reality the difference between these two systems is minor.  He is getting the same reward in both but the stickers act as mini-rewards throughout the day plus with the stickers it isn’t all or nothing.  If he has a rough day and only earns 10 stickers but he needed 25 stickers to get his reward then he still is closer to earning a reward than he was at the beginning of the day.  When we were doing the once a day review system if he had one major meltdown and the rest of the day was good he couldn’t understand why he didn’t get the reward.  Usually he would have a huge tantrum.  This system ended up causing more battles than it helped.

6. Have a Way Out

The reward systems the behavioral therapist sets up always have a way to wean off the reward system once the child has consistent appropriate behavior.  For example one reward system we put in place was to teach Mr Rockstar not to wake us up super early in the morning.  He might be awake but that doesn’t mean he needs to wake us up at 5AM.  In this system if he waited until his alarm clock changed color before waking us up then he could look in the mystery bag to see if there was a prize.  Before handing him the mystery bag we would say, “This is so exciting.  I HOPE there is something in it! but if there isn’t then we just say “Oh Pickles.  Maybe there will be something in it tomorrow.”  For the first few weeks there is ALWAYS something in the mystery bag but as the child’s behavior becomes consistent you can start having a few rare days that the bag is empty.  Slowly the bag is empty more often than having a prize in it and eventually the child just kinda forgets about it.  One nice thing about this method of weaning them off the rewards system is they are also learning disappointment management.  You are essentially role playing how to handle disappointment each day before giving them the mystery bag to inspect.  (This worked great and after a few weeks Mr Rockstar wasn’t waking us up anymore and started forgetting about the grab bag.  Then his sleep got all out of wack again this summer.  We have now added this to his sticker reward chart.)

Reward Systems We Used

Train Stamps

For shorter specific tasks (~1hr or less) where Mr Rockstar needs to maintain focus and he struggles behaviorally we use Train Stamps.  These stamps get turned in for iPad time.  Roughly 1 stamp equals 10 minutes of iPad time.  Usually his behavior isn’t ALL bad or ALL good so using an all or nothing reward is hard.  We use this mostly for school (both when he went to Montessori preschool and now for homeschooling), therapy, and soccer.  It really is just s shorter version of our daily sticker chart.  Conceptually we award a sticker every 10 minutes or so he has appropriate behavior.  For this one reward system if he has a major tantrum/meltdown he can lose all his stickers.

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Mystery Motivator

Mystery motivator was first created by our behavioral therapist.  At the end of the day you sit down with your child and review the 3 or 4 (no more than 4) behaviors on the list.  You talk through whether the child was star, smiley face, so-so, or sad face.  Star would be they complied first time the fast way.  Smiley face they complied but you had to ask twice. So-so they maybe had to take a time out or two but they complied with the timeouts and turned their attitude around.  Sad face would be major non-compliance/aggression/tantrums.  Mr Rockstar really latched onto the rating system but ultimately this reward system wasn’t effective for us because waiting until the end of the day to review was too long a period of time to keep Mr Rockstar’s focus.  For older kids though I think it could be great.Screen Shot 2014-10-24 at 6.16.21 AM

Sticker Chart

I modified the Mystery Motivator reward system to be on a shorter time interval.  Now 2-4 times a day I sit down with Mr Rockstar and we review “Following Directions First Time the Fast Way” and “Keep Hands and Feet To Yourself”.  I dropped “Use an Inside Voice” because that hasn’t been as big an issue of late.  I added “Telling the Truth” because he was lying to me about hitting his sisters even when I could clearly see him hitting his sisters.  So now even if he hits his sister he can at least still earn one sticker if he tells me the truth.  Besides when we review these behavioral issues throughout the day he also gets a sticker for certain chores and anytime he has a stressful social interaction and remains calm.  In these situations he gets rewarded for the same good behaviors just on a more frequent basis.

 

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Nap

When Mr Rockstar was little he would fight taking his nap.  Having newborn twins I NEEDED him to at least rest.  When he was 4 I made him this behavioral reward chart.  He would pick one of the rewards at the bottom of the chart and put it on the chart.  If he would rest quietly for 10 minute he could have whatever reward he chose.  Usually if he could just be still and calm for 10 minutes he would fall asleep.

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Summary

  1. We want our children to be intrinsically motivated.  Some children seem to be more naturally intrinsically motivated.  Other children, perhaps because of internal battles due to sensory issues, ADHD, etc have a much harder time staying focused and in control of themselves.  For these kids rewards may help.
  2. Rewards should be contracts agreed to ahead of time not last minute bribes.
  3. Try to keep the list of what you reward simple.  Stay focused on the key behaviors that need modifying.  For Mr Rockstar it is aggression and compliance.
  4. Use positive cues throughout the day to reinforce the reward system
  5. Vary your rewards.  Keep it fresh and exciting!
  6. Determine what frequency you need to offer the reward to make it work for your child.  How often do they have a meltdown?  For Mr Rockstar we found every couple of hours is the maximum he can go on bad days without some reward to keep the positive behavioral momentum.
  7. Make a way out from the beginning so the reward system can naturally disappear and you aren’t stuck with it forever.

If you can get away without having to offer rewards to your child then great!  If however you are like us try not to feel like a failure.  Remember we all work for rewards each day….it is called money.  LOL.  Without money I don’t think many of us would continue going to work.  Think of these reward systems as teaching your child how the world works in a small way.

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